NurseWeek: Food for thought

Food for thought
Nurses dish up advice for healthy eating

By Ed Frauenheim
January 8, 2001
Photo: Photodisc

Nurses keen on improving their diet are finding encouraging trends. New nutrition research provides a clearer picture of what foods are healthy, and hospital cafeterias are wising up to the importance of nutritional meals.


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Nurses more than most people know that an apple a day keeps the doctor away. But working alongside doctors in today’s often hectic health care industry can make good nutrition a challenge for nurses.

"There’s always something to do," said Nancy Whitehead, a nursing instructor at the Milwaukee Area Technical College who has lectured on nutrition. "We’re eating rushed, probably choosing [foods] that are easily prepared."

But nurses keen on improving their diet are finding encouraging trends. New nutrition research provides a clearer picture of what foods are healthy. Hospital cafeterias are wising up to the importance of nutritional meals, and role models are showing that even busy nurses can eat right.

Leading by example
Take Donna Davidson, MSHP, RN. Davidson, 63, supervises nurses at three hospitals in the Salt Lake City area but manages to eat five servings of fruit or vegetables a day, keep her carbohydrate intake low and down soy milk shakes with protein powder.

She always has a bottle of water at her desk and keeps one in the car for trips between her job sites. This strategy keeps her hydrated without the calories that sodas carry.

"I was once told, ‘If you drink soft drinks, water will never taste good. If you stick to water, it’ll taste good to you,’ " Davidson said.

But being smart about what she eats and drinks is only half of Davidson’s story. The other is exercise: She usually manages to squeeze in a 45-minute workout on her treadmill or with weights six days a week.

"That means I’m often up at 4:30 in the morning," she said. "If I’m not up by then, I don’t have time for my exercise, and it’s that important to me."

Davidson’s company, Intermountain Health Care, encourages employees to follow her example. Intermountain’s "Healthy Balance" program asks workers to set goals in the fields of nutrition, exercise and preventive medicine—for example, getting screened for cholesterol or glucose levels. Savings the company realizes from healthier employers are returned to the workers.

Davidson’s motivation to monitor her diet and activity level stems in part from observing too many colleagues ignore theirs.

The numbers don’t lie
"I see so many unhealthy nurses," she said. "The statistics we see around the country about the increase in obesity, we see in our staff."

In fact, nurses are more likely to be obese than Americans in general. The U.S. adult rate was 17.9 percent in 1998 according to a study by the CDC. The rate for female nurses in a Harvard Medical School study is roughly 22 percent—although the women in that study are aged 54 to 79.

The Harvard study also shows that about 56 percent of nurses could be classified as overweight.

The study, a collaborative effort with Brigham and Women’s Hospital known as the Nurses’ Health Study, has been tracking the health of 121,700 female nurses since 1976, so plenty is known about nurses when it comes to diet and exercise. For example, the average nurse consumes about 1,700 calories a day, a typical amount for adult women, according to Nurses’ Health Study researcher Diane Feskanich, Sc.D. Nurses appear to eat more fruits and vegetables than most Americans, she said.

Working in a workout
But they don’t excel when it comes to getting off their duffs for a workout.

"Physical activity is very low," Feskanich said. "About 25 percent report no leisure time [exercise] activity."

Thirty minutes a day of moderate to vigorous activity is widely recommended.

Most nurses don’t have to get up at 4:30 a.m. to start sweating off those pounds. Nurses willing to pay attention to their diet can benefit from the latest findings in nutrition research.

Eating green
The American Heart Association recently revised its dietary recommendations to stress eating a larger proportion of plant-based foods. Five servings of fruits and vegetables each day and six servings of grains still are recommended. The association also still promotes whole grains, low-fat dairy products, fish, lean meats and poultry. But in the wake of new research on the importance of oils known as omega-3 oils, the association now calls for two weekly servings of "fatty fish" such as tuna or salmon. Other sources of omega-3 fatty acids are flaxseed oil, canola oil and nuts.

The association also warns people to cut down on saturated fats—typically found in animal products and tropical oils—and "substantially reduce" intake of trans fatty acids—the hydrogenated oil found in many commercially prepared foods and some hard margarines.

Of course, hospital cafeterias and vending machines provide plenty of not-so-healthy offerings, including junk foods oozing with trans fatty acids. That’s one of many factors working against good nutrition choices for nurses. Nurses who feel pressured to fill out paperwork, care for patients and comply with doctors’ requests may not have the time or energy to focus on finding the whole-grain bread. The strains of raising a family also can mean skimpy breakfasts or no breakfast at all.

The payoff
Even doing a good job can backfire when it comes to eating right: Grateful patients are more likely to bring in a box of doughnuts than a platter of fruit.

Still, Whitehead, a nurse for 22 years, is hopeful. She notices hospital cafeterias serving healthier meals, and nurses taking the cue.

"I see nurses eating a lot of salads or foods that are good for them," she said.

Monitoring what goes in your mouth pays off: The Nurses’ Health Study found that subjects who most closely followed the "food pyramid" guidelines (similar to the heart association’s recommendations) had a 14 percent reduced risk of cardiovascular disease.

To Davidson, nurses’ nutrition is critical to the profession’s mission.

"We just don’t do a good job of taking care of ourselves, and we need to [because] the work is demanding," she said.

Of course, a sound diet also goes to the heart of nurses’ own quality of life.

"If you lose your health," Davidson said, "you lose everything."