Eating Well

Nutrition and exercise are important aspects of self care that can easily be neglected when you are busy working as a doctor. Many of us tend to focus more on looking after other people than ourselves, and we have an ingrained institutional attitude that service provision trumps everything else.

Sometimes lunch is just a fix to stop you becoming hypoglycaemic in the afternoon clinic or operating list!

It is important to remember through all this that what we eat affects the way we function, and that skipping meals or making poor food choices can affect not only our clinical decision making but make us feel bad. Worse still, for many of us during a hard day, eating can be the only recourse to get a glimmer of happiness before running back to ED.

So how do you eat healthy? The following are the Ministry of Health’s Food and Nutrition guideline statements on healthy eating.

1. Maintain healthy body weight by eating well and regular exercise (at least 30 minutes most days)

2. Eat well by including nutritious food from each of the four major food groups each day

• Eat plenty of vegetables and fruit

• Eat plenty of breads and cereals, particularly wholegrain

• Have milk and milk products in your diet, preferably those low in fat

• Include lean meat, poultry, seafood and eggs or alternatives

3. Prepare foods or chose pre-prepared foods, drinks or snacks:

• with minimal added fat, especially saturated fat
• that are low in salt, if possible using iodised salt only
• with little added sugar, limiting your overall sugar intake

4. Drink plenty of fluids, especially water

5. If choosing to drink alcohol, limit your intake

6. Purchase, prepare, cook and store food to ensure food safety.

As we all know, being an RMO means you are entitled to a meal for each meal break you work through; this is compensation for not having protected meal break time. Unfortunately in some hospitals the variety of food you can access is often restricted and can be of variable quality. Catering in New Zealand hospital cafeterias is contracted out to companies (with approximately 1/3 of hospitals using in-house catering in their cafeterias). While the MoH provides guidelines for the types of food that should be provided, there are no regulations—and the only restrictions are financial, to reduce budget expenditure on catering.

In this situation often you have to try and make the best of a bad situation. Here are some helpful tips provided by the local dieticians in my hospital:

• Avoid hot meals if possible, these are often higher in fat and sodium than other options like sandwiches etc

• Try to eat fruit with every meal, often it’s seasonal—but is free at work and expensive in the supermarket!

• Higher protein options like legumes, meat and dairy will fill you up better than carbohydrates like bread and chips.

• If nuts and seeds are available these are good alternatives which make your feel full—just watch out for sodium in salted products.

• Drink water with meals; hospitals are dry places (with all the frusemide floating about) and going to the toilet is a good excuse to take a quick break which nobody can begrudge you. It is also an alternative to caffeinated beverages and sugary drinks.

• It is okay to have chips and pies occasionally, but not routinely. You shouldn’t feel guilty about treating yourself every now and then.

And finally, if you are struggling to eat well at work, preparing lunch is always an option. Even making a sandwich or bringing leftovers and supplementing them with cafeteria food are alternatives to help you avoid bad options at work.

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