Continued from Page 1

Although people in all professions have challenges that make it difficult to control eating and find time to exercise, nurses face some particular difficulties.

Stress, irregular work schedules, long hours, no real break or meal times, vending machines full of junk food, tables of cookies and candy brought in as thank-you's from patients and families all contribute to cycles of hunger followed by gorging on high-calorie foods.

"I hate food at work," said Penny Weismuller, DrPH, RN, a recently retired division manager for epidemiology and disease control for the County of Orange Health Care Agency. "People bring in junk. They don't bring in a beautiful basket of fruit. They bring in doughnuts and cookies and junk food. That's deadly when you're tired and busy and you don't get a break."

Nurses and teachers also are prone to overeating when get they home from work around 4 p.m., said Meredith Medeiros, RN, a certified diabetes outpatient educator and educator and research nurse at the Miriam Hospital weight management program in Providence, R.I. Many nurses go home after a stressful day and immediately want to eat, she said.

Nurses also may put off exercising or eating well-something most people say takes planning and scheduling-because they are too busy taking care of others. "Physically and emotionally, nursing is a hard job," said Kathleen Jones, MSN, CNP, a nurse practitioner with the nutrition, fitness and weight management programs at Northwestern Memorial Hospital Wellness Institute in Chicago. Nurses need to make taking care of themselves a priority, she said.

Less is best

The sure way to lose weight is deceptively simple in concept and has been around for thousands of years. "You can lose weight on any diet that restricts your calorie intake," said Jodee Dorsey, Ph.D., RD, LD/N, associate professor of nutrition in the Nutrition, Food, and Exercise Sciences Department at Florida State University in Tallahassee. For instance, she said, Atkins-style high-protein, low-carbohydrate diets work for short-term weight loss partly because they cut out calorie-dense foods like desserts and muffins.

Calorie restriction accounts for why most diets work for a while and why new diet books come out every year with some variation on the theme, say nutritionists and dietitians. Unrestricted single-food diets may work for a week or so because people get so tired of the allowed food that they don't want to eat it any more, even if the food is ice cream or jelly beans.

How much people should eat and what kinds of foods they should eat is individualized and still somewhat controversial, even among experts.

"One of the real challenges that's going to be in the health profession is that we're finally going to grow out of the idea of one diet fits all," said Donald Layman, Ph.D., professor of nutrition in the Department of Food Science and Human Nutrition at the University of Illinois, Urbana-Champaign. Health professionals need to realize that there are a range of foods people can eat and that the key is trying to decide what diet fits what person, he said.

For example, he said, a high-carbohydrate, low-fat diet might work well for some people, but for those with high triglycerides and low HDL cholesterol, "that's exactly the wrong diet." Many adult women near menopause are not satisfied with the high-carbohydrate diet and always feel hungry, he said. They may need more protein.

A recent study showed that people lost weight equally and reaped nearly equal health benefits on four different types of diets-Atkins (low carbohydrate), Ornish (high carbohydrate, low fat, vegetarian), Weight Watchers (restricted calories) and Zone (moderate carbohydrate).

"The good news about this study is that we have demonstrated that all these diets work," said the study's author, Michael Dansinger, MD, assistant professor of medicine at Tufts-New England Medical Center, in Boston, at an American Heart Association press conference. "That means that physicians can work with patients to select the diet that is best suited to the patient."

If you can eat only 1,200 calories in a day-the amount an inactive woman needs to lose weight-you have to choose calories that will leave you the most satisfied, Layman said. He recommended starting with protein, then adding fruits and vegetables and using whatever is leftover for carbohydrates and fats. Other nutritionists favored diets with higher amounts of carbohydrates, mostly from fruits, vegetables and whole grains.

Layman and other nutritionists did not recommend any diet that eliminated entire categories of foods, including fat, carbohydrates and fruits and vegetables.