Policy

Special Diet Allowance (SDA) Conditions: Long Version in Plain Language
The description of the health conditions will follow the order in the SDA for:
  1. Cardiovascular Disease $10. "Cardio" refers to the heart and "vascular" refers to the blood vessels. There are many diseases in this vital system. The six conditions that are usually included are: (a) heart attacks and angina (chest pain) because of lack of blood flow to the heart muscles. (b) Stroke from lack of blood flow to the brain. There may be blood clots or bleeding into the brain. High blood pressure is the number one risk factor for stroke. (c) Peripheral vascular disease from lack of blood flow in the legs from clogged arteries . Walking becomes painful in the calves.(d) Heart failure results when the heart pump weakens from weak muscles . The disease may arise after heart attacks, leaky valves in the heart, too much alcohol and virus infection. The person may have swelling in the legs and shortness of breath.(e) Rheumatic heart disease is now uncommon in Canada but common in many poor countries. This disease begins with a bacterial infection in childhood, affecting joints and heart valves. The heart problems appear many years later. (f) Congenital heart disease arises from birth defect. There may be a "hole in the heart", valve problems or other complex mess in the heart.
    Reference: http://www.phac-aspc.gc.ca/cd-mc/cvd-mcv/index-eng.php

  2. Celiac Disease. Less than 2 yrs $58, 2 to 10 years $115,11 to 18 years $147 19+ yrs $131. ( a person with this condition automatically has a SDA condition called (malabsorption). Celiac disease results from damage of the absorptive surface of the small intestine by a substance called gluten. Gluten is a protein found in wheat, rye, barley flour that helps food to bind together. The bowel disease results in an inability of the body to absorb nutrients such as iron, folate, calcium, Vitamin D, protein, fat and carbohydrates. It is an inherited disease. They may have anemia, chronic diarrhea, weight loss, rash, fatigue, cramps, poor teeth, children who do not grow, mouth ulcers, osteoporosis and bloating. A biopsy is the definitive method to diagnose the condition. Blood test may be used to screen.
    Reference: http://www.hc-sc.gc.ca/fn-an/securit/allerg/cel-coe/index-eng.php
    Reference: http://www.celiac.ca/EnglishCCA/eceliac.html

  3. Chronic constipation $10. There are research definitions for constipation (Rome II criteria) consisting of 2 or more of the following conditions during more than 25% of bowel movements: straining, lumpy or hard stools, sensation of incomplete emptying of bowel, removal by hand and less than 3 bowel movement per week ( most doctors would not know the criteria!).
    Reference: Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA. Functional bowel disorders and functional abdominal pain. Gut 1999; 45 (Suppl. II): II43-7

  4. Chronic wounds requiring proteins $10. Wounds that do not heal may be from diabetes, veins in the legs that have ruptured and causes inflammation (stasis dermatitis), pressures sores and after some surgery. There may be pain, pus , swelling, darkened skin and oozing at the wounds.

  5. Congenital Abnormalities of adult type $10.
  6. Congenital Abnormalities of Infants and Children type $10.
    A congenital metabolic disease is also referred to as an inborn error of metabolism. These are rare inherited conditions. There are many conditions PKU or phenylketonuria, glycogen storage disease, porphyria and so on.

  7. Congestive heart failure $44. Results when the heart pump falls apart from weak muscles . The disease may arise after heart attacks, leaky valves in the heart, too much alcohol and virus infection. The person may have swelling in the legs and shortness of breath. Over 400,000 Canadians are living with congestive heart failure. Over five years, as many as 40-50 percent of people diagnosed with the condition may die.
    Reference: http://www.heartandstroke.on.ca/site/apps/nlnet/content2.aspx?c=pvI3IeNWJwE&b=3582279&ct=4632823

  8. Diabetes $42. A fasting plasma glucose (FPG) level of 7.0 mmol/L predicts the development of blood vessel disease such as clogged arteries in the brain that may result in stroke, heart causing heart attacks and clogged arteries in the eye causing blindness. One million Ontarians live with diabetes. The poor are among the at risk groups.

  9. Diverticulum/Diverticulitis $10. A diverticulum refers to an out pouching in the gastro-intestinal usually in the colon. Sometimes stool or indigested material collect in the diverticulum causing inflammation resulting the condition called diverticulitis. There appears to be an association with a low-fibber diet, constipation, and obesity. The incidence of diverticulitis increases with age, from less than 5% before age 40 years to greater than 65% by age 85 years.
    References: Emedicine "Diverticulitis: Minh Chau Nguyen et al. 2009

  10. Dysphagia /Swallowing or mastication difficulty $25 plus one time blender payment of $75. Dysphagia or swallowing disorder describe the inability to move food from the mouth to the stomach. Mastication refers to chewing and may be affected by having missing or decaying teeth

  11. Extreme Obesity Class III BMI more than 40 $20. The body mass index is calculated by dividing the mass of the person in kilograms by the square of the height in metres (see links below to calculate).
    Reference: http://www.hc-sc.gc.ca/fn-an/nutrition/weights-poids/guide-ld-adult/bmi_chart_java-graph_imc_java-eng.php
    Reference: http://www.nhlbisupport.com/bmi/

  12. Food Allergy-Eggs $10. Food allergies refers to reaction such as rash, shock, diarrhea, short of breath. Less symptoms if you avoid (eliminate) the food.

  13. Food Allergy-Milk/Diary or Lactose Intolerance. Less than 2 yrs $95, 2 to 10 years $97, 11 to 18 years $55 19+ yrs $35. Allergy to milk refers to rejection of milk by the immune system in the body even in very small amounts. Milk intolerance refers to the lack of enzyme, lactase, to digest milk . The majority of Asians and Africans have milk intolerance. "Mal-absorption", a SDA condition is present with allergies and intolerance and celiac disease (SDA condition). A safe, inexpensive and accurate way to identify food intolerance is by doing an "Elimination Diet". All questionable foods are removed from the person's diet and are then re-introduced to check for food reaction. The test may be repeated a few times to check to see if it is valid.

  14. Food Allergy-Soya $83. The reaction may be from allergy or intolerance. Soya reaction is common.

  15. Food Allergy-Wheat. Less than 2 yrs $38, 2 to 10 years $77,11 to 18 years $98 19+ yrs $57. Most reaction to wheat is from gluten intolerance rather from an immune response. The intolerance reaction may be delayed by days and may affect the gut with bloating and diarrhea, skin rashes, mouth sores and headaches. Wheat allergy is usually immediate and severe reactions will result in a shock state with tissue swelling in the throat and mouth and breathing difficulty.

  16. Gestational diabetes (Diet is available during pregnancy and for 3 months post partum) $44.

  17. Gout $32. refers to swollen joints that are involved in repetitive activity such as the foot (big toes, top of foot and heel), knees and hands. The condition arises because excess uric acid is not removed by the kidney and is deposited in joints and spaces between bone and soft tissue. The condition may be inherited.

  18. Hyperlipidemia $10. Lipid refers to any or all cholesterol and triglyceride. Elevation of any lipids will qualify for this condition.

  19. Hypertension $10. Refers to high blood pressure. Blood pressure is measure by two numbers. The first number given is the systolic pressure when the heart contracts and the second number is the diastolic pressure measured when the heart relaxes. For those with diabetes, high blood pressure is present when the systolic is 130 or higher and diastolic pressure is 80 or higher (130/80)

  20. Hypertension and Congestive heart Failure and grade 1 or 2 left ventricular function $44. Refers to a combination of two conditions of high blood pressure and heart failure. If you have this condition you will also qualify for "cardiovascular disease" as well as "hypertension" and "congestive heart failure"

  21. Hypercholesterolemia $22. Refers to too much cholesterol in the blood. the higher the cholesterol level, the more likelihood of clogged arteries. Whenever the doctor says high cholesterol and watch your diet, you have the condition.

  22. Inadequate lactation to sustain breast feeding or breast feeding is contraindicated during the first 12 months of infant's life. Refers to the child's inadequate access to breast milk and whether the child can tolerate milk or not.
    • Lactose tolerant $75
    • Lactose intolerant $83

  23. Liver Failure/ Hepatic disorders $10. Includes any liver disease such as hepatitis B or C, alcohol hepatitis and cirrhosis

  24. Macrocyctic anemia $10. The red blood cells are insufficient in amount but large in size. Refers to a person with anemia because of a lack of Vitamin B !2 and folates. The condition may also be present among those with excessive alcohol consumption, chronic obstructive lung disease and hypothyroid condition.

  25. Malabsorption $20. Results when the gastro-intestinal system absorbs nutrients poorly such as when they have allergy to food or intolerance to food.

  26. Microcyctic anemia $30. Refers to a person with low red blood cells or anemia because of low iron. This is the commonest form of anemia and occurs primarily in women of reproductive age, adolescent girls, young children and those with inadequate food. This condition may also be seen in those with thalassemia and lead poisoning.

  27. Osteoporosis/ Osteomalacia/ Osteopenia $10. Osteopenia is a certain degree of lack of mineralization of bone, and osteoporosis is a greater degree of lack of bone. A bone density that was one standard deviation (34.1%) below that of an average 30-year-old woman. The group also defined osteoporosis as bone density 2.5 standard deviations (49.8%) or more below that 30-year-old. using that definition from the World health Organization many people have osteopenia. Osteomalacia refers to softening of bones because of inadequate deposition of minerals. Lack of Vitamin D results in rickets in children and osteomalacia in adults. Adult osteomalacia may be associated with chronic kidney disease, malabsorption-related disease (Crohn's disease, cystic fibrosis, and celiac) and malnutrition.

  28. Post-Gastric Surgery $10. Weight loss after surgery of the gut.

  29. Prediabetes impaired glucose tolerance (GT) or impaired fasting glucose (IFG) $42. Six million Canadians with pre-diabetes or at high risk of type 2 diabetes. Their glucose level taken after fasting may be between 6.0 to 6.9 mmol/l. Their long term index of glucose load given by the test called hemoglobin A1C may be at 0.06 or higher.

  30. Renal failure- dialysis $44. Very severe chronic kidney disease.

  31. Renal failure- pre-dialysis $44. Severe chronic kidney disease before dialysis.

  32. Wasting/ weight loss due to one or more of the following medical conditions. (as per current policy note that the identification of the medical condition for which the applicant is eligible is not required- some social service workers may not be aware of the policy)
    • Amyotrophic Lateral Sclerosis. Known as Lou Gehrig's disease in North America, is a form of motor neuron disease that develops gradually and is a fatal degeneration of motor nerve cells in the central nervous system that control voluntary muscle movement.
    • Crohn's Disease. It is an inflammatory disease of the gut and may affect the person from the mouth to the anus. There is abdominal pain, diarrhea (may be bloody), arthritis, weight loss.
    • HIV/ AIDS is caused by a virus that weakens the immune system and allow other infection and disease to develop.
    • Lupus. It is a chronic inflammatory disease of the connective tissue. Lupus can affect many different body systems, including joints, skin, kidneys, blood cells, heart, and lungs
    • Malignancy. Cancer as commonly called. The condition includes blood , bone marrow and lymph node cancers such as leukemia and lymphomas.
    • Multiple Sclerosis. It is a disease of the central nervous system which is composed of the brain and spinal cord. The disease attacks the myelin which is a protective covering wrapped around the nerves of the central nervous system.
    • Ostomies. An ostomy refers to the surgically created opening in the body for the discharge of body wastes (stool and urine) from the gut such as the intestines or bladder.
    • Pancreatic insufficiency. Pancreatic insufficiency is the inability of the pancreas to produce and/or transport enough digestive enzymes to break down food in the intestine and to allow its absorption. There may be recurrent acute and chronic pancreatitis (for example from alcohol) . Cystic fibrosis and Scwachman-Diamond Syndrome are inherited causes of pancreatic insufficiency. There are symptoms of malabsorption, vitamin deficiencies, and weight and is often associated with loose, fatty, foul-smelling stools.
    • Short bowel Syndrome. There is a lost of segments of the small bowel following surgery and results in malabsorption. It is sometimes an inherited condition.
    • Ulcerative Colitis. Inflammation of the bowels with diarrhea and loss of blood.
    Check one of the following:
    • Wasting/ weight loss less than or equal to 2 % of usual body weight $75.
    • Wasting/ weight loss more than 2% less than or equal to 5% of usual body weight $150.
    • Wasting/ weight loss more than 5% or less than or equal to 10% of usual body weight $180.
    • Wasting/ weight loss of more than 10% of usual body weight $240.

  33. Wasting/ weight loss due to one or more of the following medical conditions:
    • Anorexia Nervosa. It is an eating disorder with extremely low body weight. There is distorted body image and an obsessive fear of gaining weight. The person refuse to maintain body weight at or above a minimally normal weight for age and height (e.g. weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected). (DSM IV-TR.)
    • Cystic Fibrosis. It is an inherited disease with defective production of sweat, mucous and digestive juices. There is resulting poor lung functions and malabsorption with associated weight loss.
    • Kwashiorkor. It results from lack of proteins. There is swelling (edema), irritability, anorexia, ulcerating skin disease, and large liver. The presence of edema caused by poor nutrition defines kwashiorkor. Occurs at 18 months or later when the mother breast milk is no longer available.
    • Marasmus. It is a form of severe protein malnutrition. The child has an emaciated look (skin and bones). The condition is found at one years or earlier.
    Check on of the following:
    • Wasting/ weight loss of less than or equal to 2% of usual body weight (includes wasting/ weight loss of 0%) $75.
    • Wasting/ weight loss of more than 2% of usual body weight $150.

  34. Pregnancy/Breast-feeding Nutritional Allowance.
    A monthly pregnancy/ breast feeding nutritional allowance is payable beginning the month an approved health practioner confirms the pregnancy (i.e. completes, signs, and dates this application) and continuing until the month the pregnancy ends, up to the and including the month the infant is 12 months of age. Please indicate whether the applicant is:
    • lactose tolerant $40.
    • lactose intolerant $50.

Please click here for a short version of the Special Diet Allowance conditions