Sandwich Generation – an interview with Ken Milne and nutritional advice

Today, we’re fortunate enough to be joined by Dr. Ken Milne, also known as BATDOC, from the Skeptics Guide to Emergency Medicine

Ken has an impressive social media reach, and has managed to become a successful emergency medicine clinician, researcher, an internationally known podcaster and champion of evidence based medicine, all the while having a busy, fulfilling personal life.

As he is interviewed by Dr. Lisa Fischer, Ken opens up about navigating a difficult time in his personal life, while still juggling his regular day jobs (notice this is plural). He describes the challenges of living the “sandwich” generation and how he was able to discover a new normal after not “being ok”. Given the discussion around the sandwich generation, today’s post also includes some tips on nutrition and eating well for shift work.

Interview

To further the talk on nutrition, as I am clearly no expert (see my description of a baguette sandwich covered in oozy-gooey cheese stuffed with fries as a food recommendation), I reached out to Jill Bondy and Colleen Golka, both Registered Dietitian’s at the Ottawa Hospital, for some tips about eating healthy as a shift worker.

First off, prioritize nutrition the same way you would sleep, exercise, and (gasp) maybe even work. A Canadian study in 2011 led by Dr. Jane Lemaire compared the cognitive abilities of physicians at baseline and during an intervention day (where they were fed healthy snacks and drinks… where can I sign up?). Not surprisingly, participants performed significantly better the days they were fed regular nutritious items. So plan ahead! Keep healthy snacks available at work to avoid the pastries at the coffee shop. Make sure you don’t come home to an empty fridge after a long work day. Meal planning and scheduling a once-a-week grocery stop will actually save you time, money and fuel your energy levels! Ps- have you heard of click and collect or even delivery of groceries in some parts of Canada? Get creative!

Second, adopt the KISS method (Keep It Simple Stupid). Avoid processed foods and beverages that are high in sodium, sugar and saturated fat. Reduce sugar and artificial chemicals in foods and eat more unrefined plant foods. You don’t need to cook complicated intricate meals to eat healthy. Eggs, raw veggies and hummus, fresh fruit and nut butter, smoothies, are all examples of quick things to eat on shift.

Third, think about your drink. I make a concerted effort to begin my shift with a huge glass of water (and coffee), knowing I will often forget to drink for the next 8 hours. Avoid making a habit of drinking specialty coffees at work (your waistline and your wallet will thank you). Although many of us like to unwind with an alcoholic beverage here and there, be careful of this becoming the norm. According to recent news articles, the fastest rising demographic of “problem drinkers” in Canada are women, and many are young working professional mothers.

Forth, with respect to night shifts, remember that from a circadian point of view, the body is NOT designed to eat at night. Avoid eating, or at least restrict energy intake, between midnight and 6h00. This means try to eat at the beginning and at the end of the night shift. If you need some “pick me ups” to stay awake, protein-rich foods such as eggs, nut butters, lean meats , legumes, cheese, yogurt can help. Try not to go to bed hungry (for fear of waking up hangry!) and some good snacks before you sleep are light carbohydrate-rich/lower fat foods such as whole wheat breads, pita, tortillas, crackers, melba toast, veggies or fruits.

Fifth, eat away from your work area, and if possible, with someone else. Pro tip: it’s gross to be eating near patient care areas (and it’s also heavily frowned upon by our Occupational Health and Infection Prevention colleagues). Who wants to dig into their pho with the fresh aroma of C.diff wafting by? Also, eating with others helps us enjoy our food and be mindful of what and how much we are eating. Mealtimes, across cultures, are ways to connect and socialize with others, and too often we find ourselves scarfing down semi reheated meals in a dingy physician room while furiously completing patient charts (no… just me?)

Lastly, from a system’s point of view, take the lead in building a work environment that supports healthy eating. Advocate for healthy options if food is being served at educational events or meetings. Ensure water jugs are available (with reusable cups to cut down on waste) instead of canned sugary drinks. If there are vending machines in your patient care areas, lobby for healthier options as has been done in many Canadian schools. Promote healthy eating habits by scheduling in time for one another to take breaks to eat and refuel (imagine that! A doctor taking a paid lunch break! I will believe it when I see it…)

In conclusion, remember the childhood adage of “you are what you eat”. Eating Well is a necessary step to Staying Well. Ironically, as doctors, while we have no qualms about educating our patients on nutrition, we often fail to practice what we preach.