You Are What You Eat
There are a range of health factors that impact paramedics across their career with paramedic wellbeing can be linked to mental, emotional and physical health. The Paramedic Wellbeing series will contain some simple strategies to enhance eating, sleeping, mindset and exercise to assist paramedics not just survive but to hopefully thrive.
Paramedics work long and often extended shifts that can involve unpredictable meal opportunities. This type of shift work influences the obtainability of food, as well as the type of food available for on-the-go paramedics to consume.
The human body operates on a 24-hour sleep/ wake cycle that regulates hormones and digestion. It is no secret that shift work alters and disrupts this cycle, and there are multiple studies outlining how this disruption can lead to short- and long-term health problems. However, it is not all doom and gloom, these problems can be reduced by managing oral intake and choosing to consume healthy foods and liquids during shifts. This approach can help alleviate some of the effects of these disruptions, to provide you with energy when you need it (on shift) and reduce it when you don’t (during sleep). This article will discuss the issues of eating well and shift work.
Shift work can put you at a greater risk of developing chronic diseases including depression, heart disease, type 2 diabetes and some cancers. Research has shown that that male shift workers are at an even greater risk of developing type 2 diabetes, while female shift workers are at a greater risk of developing breast cancer.
The Vice Chair of the Trainee Committee of the Association of Anaesthetists and member of the association’s Joint Fatigue Working Group, Roopa McCrossan highlights that “cake, crisps, and chocolate are what people want to eat on night shift but what you should eat couldn’t be more different”. McCrossan discussed how the circadian clock and sleep/ wake cycle misalignment caused by night shift can cause sleep deprivation and increase cravings for calorie-dense, sugary and salty food. However, studies have shown that consuming this food on the night shift may limit our ability to process food causing the cycle of low energy and craving to continue. To avoid this pitfall McCrossan advises eating a healthy and filling meal prior to your shift consisting of low GI foods (foods that release energy slowly). Liquids are often not forgotten (everyone loves a goodnight shift coffee), but more emphasis on keeping hydrated throughout the shift with water is ideal.
Martin Kohlmeier, Director of the Human Research Core at the University of North Carolina’s Nutrition Research Institute, explains that “the effect of a disrupted sleep cycle on energy metabolism is real but of modest size.” He discussed that planning ahead to ensure convenient access to nutritional food, snacks and liquids during a potentially time-demanding shift is best. Maintaining hydration with water and low to no-calorie drinks is of utmost importance, as is understanding that too much caffeine can in fact cause dehydration and fatigue. Similar to McCrossan, Kohlmeier advised eating a meal consisting of complex starches and whole grains prior to a shift, as this solid foundation will assist to curb cravings and minimize hunger. He also recommended taking your own food and snacks on shifts to avoid falling into ordering delivery, picking up fast food or succumbing to vending machine snacks.
What can shift workers do?
Planning prevents poor performance. Based on the aforementioned, if you are a paramedic working rotating night shifts, plan your meals in advance. You should treat the start of a night shift as the start of your day, so start with a good hearty breakfast (at night). When you finish the shift, you should be winding down in preparation to sleep, so plan a small, but wholesome meal similar to a dinner (in the morning). We get it, its odd, but so is night shift. Night shift is a reversal of what we as humans are biologically programmed to see as normal, so we must adapt.
Meal preparation is a handy strategy that can be managed on your days off. Preparing meals in advance of a shift rotation gives the opportunity to control what is available to you whilst on-the-go. Investing in a lunch box or a cool bag makes taking meals to work and storing them in an ambulance much easier. With this system in place, your nutrition improves as your access to healthy meals improves.
Whilst many shift workers have the luxury of a microwave to reheat meals, often paramedics do not. However, most hospitals will have a lunchroom for staff, so get creative and curious. Find where it is and seek permission. This will enable you to bulk produce some nutritional and tasty meals and freeze them each week. Try making meals with wholegrain breads and pastas, as these are high in fibre and can release their energy slower which will keep you full and more energised during your shift. Also, carrying a frozen meal in a cool bag is a good option. When at hospital or station, after a quick re-heat wallah! Access to a good hearty and healthy meal.
Listen very carefully, we will say this only once – reduce the temptation to turn to a vending machine. The fact that the poor-quality nature of snacks and beverages offered by vending machines is globally recognised should be your first indicator to avoid. The high calorie, salt, sugar and fat saturation and deficiency of essential vitamins, proteins and fibre in vending machine snacks makes them more of a gateway drug to obesity and health complications. Don’t get us wrong, we love an occasional Snickers as much as the next person, however, not every shift. To avoid loading your body with fat and sugar bring your own snacks. Foods including fruit, vegetable sticks or crackers with hummus, nuts, air-popped popcorn and dry roasted edamame are filling and full of healthy nutrients. If you do have a sweet tooth, a small amount of dark chocolate or a low sugar high fibre treat bar should do the trick.
Lastly, keep hydrated. Water is involved in almost all human body functions and is essential for life. Without adequate hydration, thermoregulation, biochemical reactions, vascular volume, nutrient delivery and waste removal are all compromised – but as paramedics we all knew that, right? As body mass reductions by greater than 2% due to dehydration are associated with increased levels of fatigue and reductions in alertness, hydration is even more essential for both the paramedic and the welfare of their patients. Buy a water bottle you like, with a method of liquid administration that is convenient to you (screw top, sipper, flip and flow etc.) and aim to drink between 2.5 – 3.5L of liquid per day, majority of it being water. If water alone is too boring at times, you can infuse it with fruit for more flavour without the added calories of other drinks. Hot or cold herbal or fruit flavoured tea (low or no caffeine/ calories) is another way to work towards a daily fluid intake goal.
The human body is not designed to work shift work and this disruption can cause short – and long-term health problems, particularly when associated with poor eating and drinking habits. Providing your body with healthy and filling food and maintaining adequate water hydration during a shift can maintain your energy and have long term benefits. As paramedics generally attend the sick, injured, unwell and unhealthy the importance of maintaining your own health through good nutritional choices should be a no brainer. Taking these steps to look after your body will keep you in the game longer and healthier.
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