Many years ago I found myself standing in the frozen food section flirting with the prospect of buying a mouth-watering strawberry cheesecake. I rationalized buying it by convincing myself I would eat only one small piece. So there I was later, being a couch potato and watching T.V. when I gave in to my craving and made a beeline to my dear friend the refrigerator. I plopped the frozen cheesecake on my lap in front of the TV and, without giving the dessert a chance to thaw out, I transformed in an instant from Dr. Jekyll to Mr. Hyde and devoured the entire thing. I unconsciously wolfed down the entire cheesecake within minutes! (It must have been a full moon.) That, my dear nurses, is a classic example of comfort binge eating.

Looking back, I realized I was looking for satisfaction; that is, I was eating that night to find comfort for four distinct reasons:

1. The first reason had nothing to do with food, but everything to do with trying to fill an emotional need. I was bored! What I’ve learned about myself since is that boredom is the number one reason I comfort eat.
2. Location: I had easy access to the cheesecake in the refrigerator.
3. The way I ate back then created a negative roller-coaster effect with my blood sugar level. When it dropped low, it triggered my craving for comfort food.
4. The fourth reason, let’s be honest. I love cheesecake!

I share my comfort food story with you because I know for many nurses comfort eating presents a difficult challenge to eating healthier, managing their weight, and maintaining their energy level.

You might comfort eat for a variety of emotional reasons; you might feel stress caused by your work environment, home life, relationships, finances, health, or you might feel exhausted, bored, lonely, anxious, frustrated, overwhelmed, or depressed. Comfort foods seem like they can be a quick fix to help manage your looping, but then you compound it with the guilt associated with unhealthy eating or overeating. Comfort eating has a lot to do with satisfaction and can translate into how you manage your life. If your needs aren’t being met successfully, sometimes food seems like an easy option to make you feel better. There are three easy reasons that contribute to why we comfort eat:

1. Location, location, location.
2. SCRUBS (Sugar Cravings Ruin Blood Sugar)
3. Skipping meals

Location, Location, Location

The proximity or availability of comfort food can raise your temptation level. Comfort foods tend to be very accessible to a nurse in the work environment. It’s like having an IV of snacks, sweets, and candy permanently attached to your arm. And of course, after being completely exhausted after work the last thing you feel like doing is making dinner. The location and accessibility of drive-in fast food restaurants represent a giant magnet, drawing you into them. Even if you make it past the gauntlet of burgers and fries, you arrive home after a long day of taking care of your patients’ needs to reward yourself with opening your Pandora refrigerator box only to find more comfort food. We haven’t even talked about when you have a family and you’re the only one that’s trying to eat healthy, but lying in wait are your kid’s favorite potato chips!

Empowering Nurses

Take Back the Station

Recruit patients’ families and others in helping keep you and your colleagues healthy. Here are a few ideas for keeping unhealthy foods out of sight and out of mind.

• Set an example by bringing in fresh fruits or vegetables for snacking once a week or every few shifts. If you need it, ask for donations from those who are snacking with you. Most people are happy to contribute, and your actions will be contagious. Before you know it, it will become a habit, and someone will be bringing in homemade hummus and rice crackers, trail mix, and couscous salad to go along with your vegetables.
• Post signs. Some families will read the signs posted around the units. Explain that in an effort to be healthy, the nurses ask that any thoughtful “thank you” gifts not include high calorie, low nutrient snacks or desserts. If it feels more comfortable, list diabetes as a reason to not bring in the bad stuff.
• Suggested donations could be vegetable trays, fresh or dried fruit, assorted raw nuts, and so on.
• Instead of tempting nurses with unhealthy snacks tempt them with a chair massage!

SCRUBS (Sugar Cravings Ruin Blood Sugar)

Secondly, roller-coaster fluctuations of your blood sugar levels trigger comfort food cravings for high-calorie, sweet, and unhealthy fatty foods—or SCRUBS (sugar cravings ruin blood sugar). One of the observations I made when I shadowed nurses is the inability for some nurses to maintain and manage healthy blood sugar levels throughout their shifts. Nurses have expressed their lack of energy and feelings of fatigue. I call this nurse glycemia—roller-coaster fluctuations in blood sugars occur when nurses skip meals because they believe they don’t have enough time to eat. Skipping a meal triggers low blood sugar and causes overeating at the next meal. Also eating highly refined foods can raise your blood sugar level quickly and then drop it like a rock, which can also lead to overeating at the next meal.

Foods that create satisfied, comfortable feelings—typically those high in refined carbohydrates and sugars—signal your pancreas to overreact, releasing too much insulin, first spiking the blood sugar level, then causing it to plummet. When your insulin returns to its lower level, the craving starts in again, repeating the cycle. This kind of blood sugar roller coaster can cause a dysfunctional metabolism, hormonal imbalances, and weight gain, headaches, migraines, and more severe PMS and menopause symptoms. You can have a more difficult time managing stress since lower blood sugar negatively effects how your brain can handle even the smallest irritations.

The best way to hop off the roller coaster and select a gentler carousel ride is to eat every 3 or 4 hours, even if it’s just a healthy snack. The snacks should consist of healthy protein and complex carbs. If you find yourself in a situation at work were you don’t have time to snack, make sure you are hydrated with plenty of water to keep your energy level up. Also make it a priority that when you do eat your regular meal it is made up of healthy protein, whole grains, and fruit or vegetables to help keep your blood sugar level from plummeting over the course of the time that you are not eating.

Another contributing factor to the blood sugar roller coaster is eating low-fat desserts that are often loaded with added sugar to increase the flavor. So make sure you read your food label and try to have only 6 grams or less per serving of sugar. You can also dress up your own desserts with healthy fruits and nuts. This isn’t the only reason to watch out for unhealthy low-fat desserts. Your body responds to them by failing to turn off the signal that you have had enough.

Empowering Nurses

PMS Sabotage

Are you one of the women nurses who experience uncontrollable cravings for chocolate, sweets, ice cream, or salty foods the week (or two) before your period? This can play havoc with your weight management, healthy eating, and blood sugar level maintenance.
There’s a whole host of research and studies out that point to diet, nutrition (including supplements), and exercise as the answer to mild to moderate cases of PMS. (Extreme dysmenorrhea should be investigated with your health care provider.) In addition, the Nurse’s Study II has revealed that women with higher intake of calcium and vitamin D have fewer and less severe PMS symptoms (Querna, 2005). Here’s a list of commonly accepted nutrition and lifestyle changes that may help PMS sufferers from Womenshealth.gov (U.S. Department of Health and Human Services, n.d.):

• Exercise regularly.
• Eat healthy foods, including healthy proteins, fruits, vegetables, and whole grains.
• Avoid salt, sugary foods, caffeine, and alcohol, especially when you are having PMS symptoms.
• Get enough sleep. Try to get 8 hours of sleep each night.
• Find healthy ways to cope with stress. Use your assertiveness training to make sure your needs are being met. Talk to your friends, exercise, or write in a journal.
• Don’t smoke.

I would also include:

• Drink plenty of filtered water.
• Reduce salt intake to minimize swelling.
• Avoid coffee, soft drinks, and alcohol.
• Eat smaller meals throughout the day.
• Engage in physical activity—raises serotonin and lowers cortisol levels. (WebMD, n.d.)

<font=color”#893BFF”>A Word About Soft Drinks

The Nurses’ Health Study Annual Newsletter, 2005, reported that soft drinks are the main source of added sugar in the nurse’s diet that can contribute to weight gain. It found that over an 8-year period nurses gained an average of 17 pounds if they started drinking at least one sugar sweetened soft drink per day. In addition daily consumption of these beverages nearly doubled the risk of diabetes.

So what do you do if you want to change your lifestyle and eat healthier, besides giving up your job and staying at a secluded health spa for the rest of your life?

“Discharge” Comfort Food Intake

To eat healthier you first need to identify your top five comfort foods:

1. ____________________________
2. ____________________________
3. ____________________________
4. ____________________________
5. ____________________________

Identify your top two emotional comfort food triggers (relationship, boredom, and so on):

1. ____________________________
2. ____________________________

Identify three of the most accessible locations of your comfort foods that can sabotage your efforts to eat healthier (nurses station, break room, home, and so on):

1. ____________________________
2. ____________________________
3. ____________________________

You can help discharge your comfort foods by assertively taking the following proactive steps. You can implement assertiveness by making a paradigm shift in how you get your needs met. The following are some examples.

• If I’m bored, I structure my time. I read instead of watching so much TV. I knit, crochet, paint, or host a card game with my friends. I schedule time for tennis, biking, or take a nature walk with the kids.
• I spend quality time with my significant other.
• I schedule an honest talk with my spouse about making a commitment at any time to place needs on the table without the other person escalating or feeling defensive.
• I meet a like-minded potential love interest by being involved with a community service.
• I schedule a meeting with my supervisor to explain that I need to play more to my strengths when it comes to my job. This would not only benefit myself but benefit the entire staff.
• I request to work a different shift or floor that better suits my needs.

Gary Scholar, MEd, is a nationally recognized health and wellness expert who spent 10 years as a consultant to the employees of the American Hospital Association. This is an excerpt from his new book: Fit Nurse: Your Total Plan for Getting Fit and Living Well courtesy of Sigma Theta Tau International. All rights reserved. Visit www.nursingknowledge.org/STTIbooks to purchase or learn more about the book.