Sunday December 17th 2017

To eat or not to eat?

Nurses offer healthy advice to colleagues and their patients

Proposed federal dietary guidelines are calling for Americans to limit their consumption of added sugars, like those found in cookies, soft drinks and pastries, to 10 percent of their total daily caloric intake. The guidelines also lift, for most Americans, a restriction on their intake of dietary cholesterol in foods like eggs and shrimp.

Given changing recommendations and often conflicting research, it’s not surprising that some nurses and patients might be confused about what to eat and what not to eat. That said, most nurses know that heavy helpings of certain foods are a recipe for chronic conditions: obesity, metabolic syndrome and cardiovascular disease, for example.

So what can nurses do to ensure that they remain or get healthy themselves, and be healthy role models and trusted advisers to their patients?

Nurses are people too

In general, one-third of people in the United States are overweight, and another one-third are obese, said Deborah Greenwood, PhD, RN, BC-ADM, CDE, FAADE, president of the American Association of Diabetes Educators, an organizational affiliate of the American Nurses Association. About 86 million have prediabetes.

Looking at the nurse population, the percentage of RNs who are obese or overweight is at least on par with the general public, which also puts them at greater risk for prediabetes or diabetes, she said.

RNs’ work environment is one major factor that contributes to their less than ideal health status.

“Shiftwork is the greatest culprit,” said Jane Nelson Worel, MS, ANP-BC, APNP, FPCNA, FAHA, a board member of the Preventive Cardiovascular Nurses Association, an ANA organizational affiliate, and practitioner at Phases Primary Health Care for Women in Madison, WI. “It’s also hard to follow a healthy diet when you’re rotating shifts. Your eating patterns get in disarray, and you tend to grab high-sugar, high-fat snacks to stay awake and alert. And when your sleep is disturbed, you feel tired and not up for exercising.”

Then there is the stress of the job. Research has shown that stress hormones provoke people to want to eat – and often overeat – foods that have more sugar, fat or both. Research also has shown that working night shifts and rotating shifts can lead to cardiovascular disease, diabetes, gastrointestinal problems and metabolic syndrome, among other ill effects.

On the road to better health

Nelson Worel sees the proposed federal guidelines that call for limiting the intake of added sugars as a way to help everyone, including nurses, eat more wisely and become healthier.

“Fruit juices and fruit drinks are loaded with sugar and [are] high in calories, and some coffee drinks can have the equivalent of 10 [or more] teaspoons of sugar in one serving,” said Nelson Worel, whose primary care patients include nurses. Also, many people might think that choosing a low-fat snack is a good choice, but manufacturers replaced fat with sugar to survive the low-fat movement of the 1980s and 1990s.

As the program coordinator for Sutter Health Integrated Diabetes Education Network in Sacramento, CA, Greenwood knows that reducing added sugars is important. But it’s only one component of good nutrition.

“In our diabetes prevention programs, we encourage people to focus on foods that are low in calories, low in refined sugars and low in saturated fat,” Greenwood said. “But really aiming for these goals is something everybody can benefit from.

“We also encourage people who are overweight or obese who are in these programs to reduce their weight by 5 to 7 percent and engage in 150 minutes a week of physical activity,” she said. “And because we individualize our plans, we can help people identify realistic goals that are attainable so they will be successful.”

Many hospitals have educational programs that can help nurses and other employees get healthier and reduce their risk for diabetes, and many of them are covered to varying degrees by insurance, Greenwood added.

Greenwood and Nelson Worel also offer other effective strategies to eat healthy and get healthy:

  • Partner with someone who can help you stay accountable — either a diabetes educator, a family member, a co-worker or a friend.
  • Track daily food intake by either writing it down or by using a mobile app, which also can calculate total calories consumed and burned through physical activity.
  • Bring your own meals and snacks to work.
  • Advocate for 24/7 access to healthier choices in employee cafeterias and in vending machines.

Additionally, Nelson Worel said, “Nurses need adequate break times, so they can go for a walk and get away from the stress.”

She also recommends that nurses seek out only reputable websites, such as the U.S. Department of Agriculture, for information on healthy eating, disease prevention and weight management — for their own use or to guide their patients.

“As for all the confusing messages, I’d encourage nurses to look at research critically,” she said. “Food studies often are population-based, not double-blind control studies.”

Finally, Greenwood believes it’s critical for nurses to be good role models for their patients and colleagues by eating right. Said Greenwood, “If you are eating right and engaging in other healthy behaviors, you can bring people along with you [and everyone will be healthier].”

— Susan Trossman is the senior reporter for The American Nurse.

Resources

ANA’s HealthyNurse™ and Health Risk Assessment:
www.nursingworld.org/healthynurse

Preventive Cardiovascular Nurses Association’s heart healthy toolbox:
www.pcna.net

American Association of Diabetes Educators:
www.diabeteseducator.org

U.S. Department of Agriculture dietary guidelines and MyPlate (replaced food pyramid):
www.cnpp.usda.gov/dietaryguidelines

Centers for Disease Control and Prevention:
www.cdc.gov/healthyweight

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