Food Consistency?

[Jiddo]

Hi All.

I wanted to get some practical advice from you regarding food consistency and coumadin. I understand the concept of "dose the diet," but I'm wondering what you guys routinely eat. For example, do you have a weekly/monthly calendar of what you normally eat for breakfast, lunch and dinner (written or not)? When you are at restauraunts, how do you maintain consistency? For example, what if you ordered chicken but it's cooked in olive oik (high k food item) when you normally cook your chicken in a different type of oil?

My dad usually eats cereal for breakfast but once a while he will pick something up from Starbucks or IHOP. Does he have to go there once/week or once/month to maintain consistency? Or, sometimes he will snack on fruit but he doesn't keep track how mant pieces he has per day or week. Do you guys keep track?

Whenever I go out to eat w/ my parents, I end up bringing the vitamin k list with me to determine what my dad can eat. Is this normal? I can tell that my dad hates being "babysat" with his food.

I hope you don't get mad at me for asking these questions....I would just like to understand how you all maintain consistency.

Thanks.
Jennie

 

[Ross]

Jennie I do not keep track of anything and eat what I always eat. What you want to watch out for more or less is SUDDEN binging on High Vit K things. In other words, don't let him sit and eat a bag of spinich unless he normal does this. Other then this, food plays a very small role in INR overall. Don't worry about cooking oil either. It's not worth fretting over and unless he's drinking a gallon of Olive Oil, your not going to see a change in INR.

Throw the vit k list away! It will only frustrate all of you and really, it's useless. It's alright to use to see how much K there is in something, but do not use it as a dietary schedule, it just doesn't work.

Let him eat what he normally does in the amounts he normally eats. Matters not if he goes to IHOP or whereever. We are creatures of habit, which means we will fall back to our normal eating habits no matter what, just watch out for sudden binging on high k items.

This is taken from another site. My Doctor doesn't even believe in a Coumadin restricted diet for the simple reason cited. You always return to your old eating habits anyway:

Some physicians place Coumadin® patients on strict Low-Vitamin-K diets. Foods that are high in Vitamin K are discouraged.

However, dietary restrictions rarely succeed over a long period of time. Most patients return to eating their favorite foods, gradually at first. Thus the more prudent approach for Coumadin® maintenance is to adjust the medication, not the diet. That is one of the very reasons for repeating the Pro-Time until a steady dose is found that provides the right anticoagulation regardless of the dietary intake of the patient.

For your information, the following lists presents foods known to be Medium to high in Vitamin K. If you eat them it shoud be consistant and you should check with your doctor. This list will just give you an idea of which types of food contain Vitamin K.


Kale Spinach Broccoli Cauliflower Turnip Greens Chick Peas Brussels sprouts Green tea Soybean oil beef, pork, or chicken livers soy protein products (including Tofu) OH Yea, No Tofu ! vitamins A & E (large doses) lettuce, dandelion greens, cabbage, mustard greens, endive. Sauerkraut and coleslaw come from cabbage, Egg yolks, Mayonaise, Braunsweiger or liver sausage, Asparagus, avocado and those new "Fat Free" chips.

My long story shortened: Let him be himself, eat what he wants and adjust his dose to match his normal everyday diet, whatever it is.

 

[Karlynn]

A Coumadin-restricted diet will fail for the reason all diets fail - people return to their old patterns.

The reality is that people are very consistent in their diets. No one really goes all over the board eating different things every day. They don't eat all meat one week and all greens the next. A safe diet for Coumadin users is the same safe/recommended diet for anyone.

I have never paid any attention to what I eat as far as my warfarin goes. I love spinach salad (with that sweet dressing - yum!), but I'm too lazy to make it. However, I'll have it at a party if someone else brings it, and not worry about it. If I then decided I wanted to have it every day and stopped being lazy about it, yes, I'd need to worry about my INR and my dose - but that ain't gonna happen!

My MIL was on warfarin following hip replacement. Her doctor had her so restricted on what she could and couldn't eat she didn't know where to turn and her INR was all over the place. Had she just followed her normal eating habits I'm pretty sure she would have been fine.

You do need to watch out for hidden soy. Packaged meals that are "low carb" tend to get their protein from soy. Someone here started on some prepackaged diet plan that was low-carb friendly and their INR dropped way down. I told them to look at the protein source on the package - sure enough it was soy. Soy isn't a bad thing, you can adjust your dose to reflect the increased need. But stopping it will make your INR go way too high if you don't take that into consideration.

Stay away from Boost, Slim-fast, Carnation Instant Breakfast - all those have lots of K. Unless your Dad has always had a Slim-fast shake for breakfast - then it has been part of his eating habit.

The darker the green gets - the more K you'll find. If your Dad loves brocolli and likes to have it quite a bit - that's fine. Just remember that his dose will probably be higher.

 

[Magic8Ball]

Someone, somewhere once told me that over any given two week period you will naturally eat roughly the same amount of stuff overall.

I don't watch anything i eat, some days i have 4 weetbix for breaky, other days i have a coffee and run, other days i'll have a breakfast bar and a tea.

Lunch is usually a sandwich but can be chips, a cooked meal, fruit & muffin.

I have late night snacks, chocolate etc etc.

I do avoid large amounts of green veggies but do eat them in pasta's and meals, just not loads of them (but i never did before surgery anyway)

My INR has been pretty much 2.5 to 3.0 for months with only an occasional 3.2 or 2.3.

I had no idea before reading the above post that cauliflower and mayo had high vit K.....my sandwiches usually have mayo on, i also love cauliflower cheese...i guess i'll carry on with doing it as it works.

Eating out is a none issue.

I guess as ross says, diet usually has little to do with your INR unless you generally have other issues with INR metabolism for diet to have a bigger % affect.

 

[Ross]

Jen don't know if this helps or not, but here is this weeks menu for me thus far.
Mon-Steak, Fries, Spinich, Milk
Tue-Tilapia, Cauliflower with Cheese, Salad, Milk
Wed-Center Loin Pork Chops, Kashi Rice Pilaf, Brussels sprouts, Milk
Thur-Veal Parmesan, Spaghetti, Salad, Garlic Toast, Milk
Fri-Sausage Sandwiches, Corn, and whatever else I can think of
Sat-Eat Out Night
Sun-Unknown at this point.

 

[Karlynn]

I'm moving in with Ross. But then I'd be as big as a house!

 

[Cooker]

I'm moving in with Ross. But then I'd be as big as a house!

Sorry Karlynn......I got first dibs

 

[Bina]

I'm sure I could survive quite nicely on Ross's leftovers.

 

[Cooker]

I'm sure I could survive quite nicely on Ross's leftovers.

LOL I don't think that the term leftovers and Ross go together ......sorry Rossman

 

[catwoman]

Sun-Unknown at this point.

Hmmmmmmmmmmmmmmmm.

Is that like Manager's Choice on school lunch menus?

 

[Ross]

LOL I don't think that the term leftovers and Ross go together ......sorry Rossman

I buy only enough for the meal. No extras. Chris is learning the hardway too. I told him if he plans to eat with us, he has to be here or else. Couple times he's come home whining because there wasn't any left for him. I simply didn't buy it or make it because of his lack of planning.

 

[Ross]

Hmmmmmmmmmmmmmmmm.

Is that like Manager's Choice on school lunch menus?

Kind of, probably Chicken, mashed potatoes, asparagus, and some sort of fruit.

 

[Karlynn]

Kind of, probably Chicken, mashed potatoes, asparagus, and some sort of fruit.

Oh now you're just showing off!! Not to mention being intentionally cruel.

 

[Jiddo]

Hi All.

Thanks for your clarity on food consistency. I just came back from lunch with my parents and it's actually kind of humerous how my mom manages my dad's food intake. We went to Indian food and there were very tiny green particles (probably parsley) in my dad's naan bread and my mom tried to shake them all off. Then we went to Starbucks and had some coffee/cake. I ordered the low fat blueberry coffee cake for us to share and my mom would only let him have part of the cake without the blueberry. I am trying to educate her on the food intake but she is still so nervous. I think it's gonna take some time.

Ross, I would love to come over your house for dinner (and so would my husband)!

BTW, my dad had 2 soft boiled eggs the other day so I looked up the vitamin k content on the nutrition site I think Cooker just sent out. The site didn't indicate a high content of vitamin k on egg yolks. I noticed that some sites contradict each other when reporting on vitamin k, which also creates some confusion.

Anyways, thanks again for your input.

Jennie

 

[catwoman]

I just came back from lunch with my parents and it's actually kind of humerous how my mom manages my dad's food intake. We went to Indian food and there were very tiny green particles (probably parsley) in my dad's naan bread and my mom tried to shake them all off. Then we went to Starbucks and had some coffee/cake. I ordered the low fat blueberry coffee cake for us to share and my mom would only let him have part of the cake without the blueberry. I am trying to educate her on the food intake but she is still so nervous. I think it's gonna take some time.

Jennie, Jennie, Jennie:
I got a big chuckle out of your post. Sounds just like me right after my MVR!

I boned up on what's extremely high, high, etc., in vitamin K and committed that to memory, or carried a little chart with me to restaurants & grocery stores.
I'd beg a server to peel the cucumber slices in my salad -- because the green peel has vitamin K. I'd forgo sushi because nori (seaweed) is very high in vitamin K. I'd limit myself to only 1 dark green thing a day, and would NOT eat broccoli-cheese soup or make cream of asparagus soup. I avoided pickles (same rationale as insisting on peeling cucumbers). I stopped eating cole slaw & spinach salads. I picked out the broccoli in stir-fry dishes. I swore off guacamole.

Then I discovered this website and got a life. I realized I was doing myself a disservice -- avoiding foods I had enjoyed for years and that were, for the most part, healthful for me (broccoli-cheese soup is too salty, so I still don't eat it).

I now eat what I enjoy and what's healthy, regardless if it has vitamin K or not. I just don't pig out on spinach salads every day. If I switched to a spinach salad every day, I know it would lower my INR and would be testing to see how much the INR dropped, then work at adjusting my warfarin dosage to handle the extra vitamin K intake. It ain't worth it to me; besides, volume for volume, a romaine lettuce salad is cheaper and my dosage is already adjusted to accommodate that.

 

[Ross]

Just as a side note, I don't always eat that healthy. This has been an unusual week where I could actually do it. Usually a diet around here is anything you can get your hands on! Mostly Pasta and Hamburger diet, but I do try to include a high Vit k GREEN veggie of some sort daily. Remember my philosophy about Brussels Sprouts or baby cabbage heads, we're technically only allowed about 5 as a serving, well I CAN'T DO THAT, I gotta have at least 12. My dose is adjusted to accommodate this diet.

Jennie tell mom to keep her hands off of dads food!

 

[Blanche]

Jennie:

Tear up, shred, and burn all of your vitamin K charts immediately!!! What you and your mom are doing is, as another poster said, is trying to separate the fly ship from the black pepper!!! Why would you want to do that?

Now that I have your attention.....Seriously, fussing about vitamin K to the point that one changes one's eating pattern is misguided and totally unnecessary. What your family needs most now is to celebrate and get on with living. Fussing about food and vitamin counts (a speck of green, an egg, blueberrys...) is counterproductive. It just causes more stress.

Tell your mom, apartments are for letting, not husbands!

Relax!
Blanche

 

[Jiddo]

LOL.....You got my attn, Blanche.

I think my mom (and especially dad) would love to throw out the rules on vitamin k. My mom is just trying to watch out for my dad's best interest. However, by doing that she is jus stressing everyone out. Yesterday was especially stressful for her as the coumadin lady called my mom to confirm my dad's dosage. Because I pushed to increase his dosage this past week, the lady told my mom there was an increased chance of bleeding. My mom just about flipped out and told the lady off (my mom is one of a kind, she says what's on her mind no matter what). I told my mom to calm down (which we all need to do) because my dad is going to be on this medication the rest of his life and we just have to all learn to live with it.....and understand it.

Jennie

 

[Ross]

LOL.....You got my attn, Blanche.

I think my mom (and especially dad) would love to throw out the rules on vitamin k. My mom is just trying to watch out for my dad's best interest. However, by doing that she is jus stressing everyone out. Yesterday was especially stressful for her as the coumadin lady called my mom to confirm my dad's dosage. Because I pushed to increase his dosage this past week, the lady told my mom there was an increased chance of bleeding. My mom just about flipped out and told the lady off (my mom is one of a kind, she says what's on her mind no matter what). I told my mom to calm down (which we all need to do) because my dad is going to be on this medication the rest of his life and we just have to all learn to live with it.....and understand it.

Jennie

Hon she's not only stressing you all out, she's making it harder for him to find his actual dose. She needs to understand this and stop fiddling with his food. I realize mom is torn between listening to a manager that is not on Coumadin and a bunch of self dosing self monitoring managers telling her things to the contrary, but who should you believe? The person NOT on Coumadin or those that take it everyday of their lives? No, we are not Doctors, but we live with this medicine and do have a great respect for it. Were not going to tell you to do something dangerous. Were telling you tried, tested, and true information.

Increased risk of bleeding.......oh please.

That tiny bit you had him bump isn't going to increase anything but his chances of being in range.

 

[Jiddo]

You summed it up so well, Ross! ....and thanks for the reassurance.

Jennie