What comes to mind when you hear the words, “Physical Activity”? For some, it might conjure up a negative connotation while for others, they may already be a go getter for an active lifestyle. Believe it or not, physical activity and exercise are two different terms although used interchangeably. Physical activity is any movement of the body done through skeletal muscle contraction that causes the energy expenditure to go beyond its baseline. Simply stated, physical activity is movement, in any form.
Sadly, less than 5% of adults participate in 30 minutes of physical activity, and 28-34% of adults aged 65-74 are physically active in the United States. It is important to gather some perspective on the impact of a sedentary lifestyle and how it is more common than physical activity. According to the Center for Disease Control, physical inactivity is even more common among ethnic and racial groups in most states. The CDC’s January report from 2020 showed overall, Hispanics had the highest prevalence of physical inactivity (31.7%), followed by non-Hispanic blacks (30.3%) and non-Hispanic whites (23.4%).
We all have heard of vital signs. Part of that assessment should also involve the type of physical activity one engages in. As nurses, we are the largest body of the health care workforce, and studies show that we are not following healthy practices when it comes to our self-care and well-being. The American Nurse Association even launched a Healthy Nurse, Healthy Nation initiative to address the core elements that address nurse’s self-care and well-being, Activity, being one of them which goes to show that this is a pressing concern.
Some of the challenges posed as to why people do not take part in physical activity is location. The neighborhood in which people live may not have access to outdoor parks, paved streets, or recreation centers. Depending on your home environment, you may not have the space to exercise in.
The good news is just doing any activity, especially one in which you enjoy doing is acceptable in burning calories. Anything is better than being sedentary. The risks of sedentary behavior are universal and it is important for nurses to adopt a more active lifestyle. Physical inactivity is closely related to premature death, preventable disease, and health care costs.
Exercise is a subset of physical activity and is defined as an activity that is organized, planned, and reoccurring which is done with the intent of improving or maintaining one or more components of one’s health. Having said this, physical activity can involve any movement and does not have to involve a schedule or with an “all or nothing” attitude. For those who are trying to lose weight, exercise is not as important as much as your food intake. There needs to be a calorie deficit in order to lose weight. Nutrition and physical activity work in tandem but about 80% is based on nutrition and 20% should be focused on physical activity.
Physical activity come with benefits such as: heart health and prevention of diabetes, improved strength and mobility, release of dopamine, endorphins and serotonin (the “feel good” hormones), increased lifespan, and increased insulin sensitivity. Carrying on extra weight can contribute to joint pain. For every additional pound that you are overweight, an extra 5 pounds of pressure is exerted on your joints.
It cannot be argued that the majority of nurses are female and women tend to hold onto more fat than men; that is how nature intended us to be designed. As we age, we are also at risk for bone loss. For that reason, we do not want to lose weight too quickly because we also want to protect our bones, which is why muscle resistant training is so important. Half a pound per week of weight loss is the ideal; it is all very specific to how much weight the person needs to lose. Even a 5-10% weight loss can reap positive effects on overall health.
Nurses, especially those of other ethnicities can become role models and advocates for system changes at the workplace as well as at home. Even if nurse leaders are not fully on board, it is important to heighten awareness on the benefits of physical activity which would improve morale as well as productivity. Identifying barriers is the first step and serving as a role model would also provide an impetus for behavior change.
Just like with patients, we need to assess our readiness and meet ourselves where we are at. We need to give ourselves permission to work on our fitness regimen so it can be more sustainable. The best exercise to lose weight is the exercise you will do. If you have to ask yourself, “Should I work out today?” hopefully, the answer is yes. If you choose “No”; well, yes you should.
The juicy fruits and plentiful veggies of summertime offer easy-to-grab, nutritious snacks, and the sheer bounty of seasonal summer vegetables makes meal prepping and planning especially easy. Fortunately, the fall harvest also offers seasonal fruit and vegetable choices that offer excellent nutrition and tasty meal options. Look for locally grown specialty crops that are specific to your region for the freshest products.
The sheer number of different squashes available can keep your diet packed with nutrients and variety. Squashes can form the basis of chunky stews, smooth soups, side dishes, and main courses. With a low-calorie profile and especially high levels of vitamins A and C and fiber, learning how to cook with squash in the fall can energize your typical menu.
Try butternut, acorn, spaghetti, and Hubbard to expand your squash go-tos. And you can even have these on hand all the time—you’ll find some squashes in the frozen food section of the grocery store.
Turnips, parsnips, carrots, beets—all these vegetables add flavor and substantial texture to a dish. To add sweetness to your menu without any added sugar, roast root vegetables to create a whole new flavor. As they roast on high heat, the natural sugars in these veggies are drawn out. For an easy and hearty side dish, cut up beets, carrots, and potatoes and roast them in a hot oven (about 450 degrees) for 20 to 30 minutes with a little olive oil. When they are done sprinkle with salt and pepper if you want.
Cauliflower, broccoli, cabbage, and Brussels sprouts are all part of the cruciferous vegetable family and contain potent cancer-fighting ingredients. Working these vegetables into your fall diet is as simple as using them as a base for warm and comforting soups and gratins. A blended cauliflower and potato soup or a broccoli cheese soup is easy to make and even easier to eat as a quick lunch or dinner at work.
Everyone thinks of apples during fall and with good reason. The fall apple harvest brings out apples that aren’t typically found in grocery stores because they are heritage or brand-new varieties that don’t have large crops. And apples pair well with meats like pork or chicken as easily as they shine in desserts like apple pie or apple crisp. Peel, core, cut, and cook apples for a homemade applesauce that can be added to oatmeal.
The round red pomegranate is an antioxidant powerhouse. Filled with juicy seeds (called arils), these ruby fruits have a beautiful fall color. Like a watermelon makes you think of summer, pomegranate’s sweet-tart taste is a distinctly fall flavor. You can seed your own whole pomegranates or buy the seeds already prepared in the grocery store. Eat the seeds alone, add them to a yogurt and granola parfait, use them to top a salad, or brighten a cooked dish with the extra flavor.
Try a new dish or a new seasonable fruit or vegetable and you’ll probably find a new flavor you love.
A recent merger of several nutrition-focused organizations is highlighting the need for a new attitude about what people eat and drink. The opportunity for nurses to bring this into their daily practices is huge as they can help patients with the food choices that will have the greatest health impact.
The newly formed nonprofit American Nutrition Association is a merger of the American College of Nutrition; the Board for Certification of Nutrition Specialists; the Center for Nutrition Advocacy; the Accreditation Council for Nutrition Professional Education; and the American Nutrition Association Foundation. The new group sees better nutrition as a broad-sweeping problem that requires a broad scope of experts to help fix it. From the people who grow and distribute food to the policy proponents who can bring change into schools and neighborhoods to the funders who can support new initiatives, the group aims for an ecosystem approach to change.
The driving factor behind the new association is the enormous health risk poor nutrition brings to human health including those that are greater than known health-wreckers like smoking or a sedentary lifestyle. Food, in essence, is a nonpharmaceutical medicine people can use to improve their health.
Nurses are proponents of good nutrition because they know the direct result it can have on all ages—from children’s development to chronic illness in adults. A lack of proper nutrition has far-reaching impacts where it can create problems in both physical and emotional health. Nurses also know some of the barriers patients face in having access to or preparing healthy meals. Personalized nutrition is one of the new group’s pillars, and nurses can use this as a way to talk with and help patients choose food that nourishes their bodies and is affordable and attainable. They can help them explore alternatives for their usual diet.
In addition to access, education is an essential part of a proper diet. For nurses, who are well-informed and educated about the benefits of kale over crackers, helping patients understand their choices and how that can fit into their lives provides an important foundation to build on. Showing patients what good nutrition looks like is a starting step.
Nutrition is also important because it is something people can change when they think about a healthier lifestyle. People can’t choose their genetics, but they can change what they eat for dinner or what they snack on. And it’s simple to make small changes. Patients don’t want to hear they have to make an entire overhaul of their diets (unless their illness forces that kind of top-to-bottom change). In fact, many people who think they have to cut out everything they love will find that kind of plan too overwhelming to even begin.
Hearing that you can still have a big impact on health with small modifications is often motivating. Patients can swap out a serving of pasta for a salad or a serving of vegetables. They can bring a lunch instead of relying on a takeout lunch that’s generally higher in fat, salt, and calories and lower in essential nutrients.
What kind of changes can you help your patient population with?
A recent study linking diets heavy in junk food and cancer likely gave nurses everywhere pause. Although nurses see the health problems brought on by poor diet choices every day, educating patients and changing their habits is tough.
The study, published in the peer-reviewed PLOS journal found that a diet heavy in junk food was linked with increased cancer rates. Using Nutri-Score, a food labeling system used in parts of Britain and Europe, researchers were able to identify that diets with an overall lower score for nutritional value was associated with increased cancer and other health problems.
Nutri-Score uses different scores and color labels depending on the nutritional quality of foods. At a glance, consumers can identify how nutritious a food is. According to the study, those who consumed the most junk food had “higher risks of cancers of the colon-rectum, upper aerodigestive tract and stomach, lung for men, and liver and postmenopausal breast for women.”
How can nurses use this study to help their patients? While many patients know the risks of a poor diet, they don’t often identify certain foods as less nutritious as others. What’s the difference between stopping for a fast-food burger than making one at home? The difference can be significant based on the choices, but sometimes it has to be explained.
Nurses are in an excellent position to help patients understand that even small tweaks to their food choices and preparation can make a significant difference in their health. Just on the most basic level, meals made at home tend to have less fat and sodium. A burger at home can be made with a leaner ground beef and accompanied by a salad (bagged salads are easy), a piece of fruit, and oven baked fries. It takes some preparation and planning, but even if the swap is made a couple of times a month, the health benefits will add up.
The study was able to adjust for other factors such as family history, lower physical activity, and higher BMI that can also influence cancer rates. Food choices are such an important part of health and one that can be adapted in small doses. Nurses can help patients assess their food intake and show them where small swaps like popcorn for chips, flavored seltzer and juice for soda, or salsa for onion dip can add up.
Patients might also benefit from hearing about fitting more nutritional foods into their diets. Junk food and cancer might be associated, but intake of junk food is controllable. No one has to give up pizza night, but adding vegetables (either on the pizza or as a side salad) will boost the overall nutrition for the meal. A breakfast of cereal gets a boost from a handful of berries. Even using a store-bought prepared chicken as the basis for an at-home meal will give you more control over the total portion, calories, and flavors.
And as a busy nurse, it can help to take some of the ideas to heart. Consider your eating habits and how you might be able to add and subtract to get more bang for your buck. Bring foods to work that are easy and fast to eat, but offer as much nutrition as possible. You’ll find doing so gives you more energy, keeps you feeling full longer, and might even help regulate your fatigue levels, weight, blood pressure, blood sugar, or stress.
If you’re able to notice a few positive changes, you’ll be the best champion of making nutritional changes for your patients. And if they are trying to eat better to gain control over their health now and in the future, each small boost in nutritional food is worthwhile.
Nurses are especially prone to falling into an eating-on-the-run trap. With long shifts that barely offer time to sit, nurses rarely have the luxury of taking the time to eat a relaxing meal when they are on the job. No one recommends eating quickly, but, let’s face it, most nurses have to eat quickly or they won’t eat at all.
During National Nutrition Month, the Academy of Nutrition and Dietetics helps people focus on making nutritious choices. Knowing that nurses have short bursts of time in which to get the most nutrition possible, they have to plan ahead to map out what is the best eating plan for them. Leaving it all to chance means fast food that might be higher in fat and salt and lower in things like fiber.
What makes sense for nurses? Figure out what and how you eat throughout the day and try to find foods that can fit that pattern but that offer a nutrition boost. Do you make a coffee run and add in a danish or a roll? Is lunch whatever is left in the vending machine and that you can eat in the few minutes you have?
Packing your food at home and bringing it with you is an easy option. Once you get into the habit of prepping your food at home (beware – it can feel like a chore until you get into a groove) you’ll have an instant fallback of food you like to eat, that gives you energy, and that provides you with the most nutrition possible.
Salads are an excellent way to pack in vegetables, fruits, and some great protein, but they take a lot of time to eat. You can keep the focus on the nutrition a salad provides and bring other foods that are healthy but take less time to eat. One of the easiest ways to pack in all those veggies and fruits is with a smoothie. Throw all the ingredients into a blender, add some protein powder or high-protein Greek yogurt, and you have an easy-to-digest and quick-to-eat option.
Lots of granola bars in the supermarket offer wholesome ingredients without extra sugar or added binders. With pure ingredients like nuts, seeds, and dried fruit, these bars are easy to tuck into a bag, don’t take a lot of time to eat, and offer energy-boosting nutrition. You can also make your own trail mix to bring. Customize it to include the ingredients you like and you’ll get an even more pure (and less sugary) small meal. Pair it with a yogurt drink, a hard boiled egg, or a few slices of rolled deli meat and you’ll feel more energized for a longer time.
If you think it will fit into your day, pack smaller portions, but eat more frequently. A small bowl of brown rice or quinoa, lentils, beans, or chicken, and some finely chopped veggies takes less time to eat than a bagel with cream cheese and offers a powerhouse of hunger-fighting fiber, protein, and nutrients.
And one of the best ways to keep yourself energized is to stay hydrated. Instead of fueling with caffeine all day, add in some other beverages. Try to swap out soda with flavored seltzers (add in some juice if you need more flavor) or throw a couple of fruit-flavored herbal tea bags into your water bottle with a little lemon. Being even slightly dehydrated quickly saps your energy and makes your body work harder at everything.
With a few small changes, you can give your body the energy and nutrition to have a more productive day and better overall health.