An EMS Guide to Eating on the Go

"What do you want to eat?"

"What's for lunch?"

"Thinking about dinner yet?"

How often are we asked, or do we ask, these questions? A co-worker and I begin discussing lunch at 10 a.m. For those who work in an office or home environment, making nutritious meal choices is easy. However, when you're driving an ambulance and caring for patients, eating becomes a bit more challenging. You have no set lunch time, and even if you do find a spare moment to sit down for a meal, you could be dispatched to an emergency and there it goes!

I was interested to find out how our field staff nourished their bodies during their 12-hour shifts, so I asked. In an informal survey, I was shocked to learn how our employees ate. Menus ranged from two cups of coffee to an apple turnover to a bite here and there of cold spaghetti to nothing. One submission was nearly perfect in nutritional value, but the jury is still out as to whether this person was pulling my leg or not.

This country has a serious problem with nutrition, where 29% of American workers are considered obese, with only 14% categorized as eating right. It's no wonder when people eat on the run! They are more careful about the type of gas and oil they use in their cars, but will happily fuel their bodies with unhealthy, artery-clogging, processed "foods."

We all know the average worker isn't getting the daily recommendations of two to three servings of dairy and protein, three to five servings of fruit and vegetables and six to 11 servings of whole grains. Eating well on the road is really not that difficult, it just takes a moment of thought, some planning, a cooler and a couple of cold packs. I have put together a cheat sheet of portable, nutritious real foods and a lesson in easy label reading.

Start the Day Right

You don't have to plan, prepare and pack three meals plus snacks. The idea is to eat a "get you going" breakfast and then have some healthy snacks within easy reach so you're fueled and less likely to scarf down half the menu when you have five minutes to spare and are running through the drive-thru.

Breakfast is the most important meal of the day. In fact, skipping breakfast can slow down your metabolism. After what was hopefully a restful night's sleep, your body is running on empty and needs some fuel to start the day. If you don't replenish your protein stores first thing in the morning, your body may start using muscle tissue for energy.

A recent internal study, conducted by an EMS agency which examined the time of day ambulance collisions occured, showed a significant spike between 10 a.m. and noon, then again around 5 p.m. Why is this? These are times of the day when more cars tend to be on the road. But if you look at shift work, these are also times when fatigue sets in.

For example, you're working the morning shift. For a 6 a.m. start, you wake up at 4:30 to 5 a.m. Some EMS workers start their day with a cup of coffee and a bagel, donut or muffin in hand. They're easy to grab, portable, and you can eat them while driving into work. Yet the energy from this food is short-lived. By 10 a.m. the energy is long gone and you crash. If you're driving, sometimes you crash into something. You feel tired, distracted and a little irritated--not a good thing when you're interacting with patients or your partner.

What's a better idea? Try adding some protein and fat to your carbs. Getting at least 30 grams of protein at breakfast is recommended. Two hard boiled eggs; a piece of fruit and a small piece of cheese; a toasted whole-wheat English muffin with peanut butter or cream cheese; or a container of low-fat yogurt with some high-fiber cereal, even the old standby peanut butter and jelly on whole-grain bread are all good choices to start your day.

Choose Efficient Fuels

Let's talk about snacking.

ENRICHED FLOUR (WHEAT FLOUR, NIACINAMIDE, REDUCED IRON, THIAMIN MONONITRATE [VITAMIN B1], RIBOFLAVIN [VITAMIN B2], FOLIC ACID), SUGAR, DEXTROSE, VEGETABLE OIL (SOYBEAN, PALM, COTTONSEED AND/OR HYDROGENATED COTTONSEED OIL† WITH TBHQ AND CITRIC ACID FOR FRESHNESS), CORN SYRUP, WHEY, CRACKER MEAL, HIGH FRUCTOSE CORN SYRUP, COCOA, CONTAINS TWO PERCENT OR LESS OF CORNSTARCH, COCOA PROCESSED WITH ALKALI, SALT, LEAVENING (BAKING SODA, SODIUM ACID PYROPHOSPHATE, MONOCALCIUM PHOSPHATE), MODIFIED CORN STARCH, MONO- AND DIGLYCERIDES, SODIUM STEAROYL LACTYLATE, GELATIN, DRIED EGG WHITES, DATEM, PARTIALLY HYDROGENATED SOYBEAN OIL†, MODIFIED WHEAT STARCH, XANTHAN GUM, NATURAL VANILLA FLAVOR, CARAMEL COLOR, SOY LECITHIN, CALCIUM PHOSPHATE, COLOR ADDED, NIACINAMIDE, REDUCED IRON, VITAMIN A PALMITATE, PYRIDOXINE HYDROCHLORIDE (VITAMIN B6), RIBOFLAVIN (VITAMIN B2), THIAMIN HYDROCHLORIDE (VITAMIN B1), FOLIC ACID

Does this look familiar? If it doesn't, it should. This is the ingredient list of a popular toaster pastry. Let's look at just one of those ingredients: XANTHAN GUM. This is actually a natural fermented corn sugar polysaccharide (fancy name for a type of carbohydrate). Now the name XANTHAN comes from Xanthomonas Campestris which is the same type of bacteria that causes black rot to form on broccoli, cauliflower and other leafy vegetables. The bacteria forms a slimy substance which acts as a natural stabilizer or thickener. It is used to make medications, and it is also used as a laxative.

Have you heard enough? Wouldn't you rather eat something made from the following ingredients?

DATES, PEANUTS, CHOCOLATE CHIPS, SALT (70mg sodium)

These are the ingredients in a popular snack bar. And while the pastry with all the big words has much less fat and fewer calories, I can guarantee your body will know how to use the above four ingredients much more efficiently as fuel.

Learn to Read Labels

Label reading is an area of much confusion for some. While I was studying for my personal trainer certification, my instructor gave me a quick, easy lesson. There are really only two areas you need to look at to make a decision about whether or not to eat a particular item.

Area #1: Take notice of the serving size, but also note the total calories and calories from fat. A good choice is when the calories from fat doesn't exceed one-third of the total calories.

Area #2: Take notice of dietary fiber, sugar and protein. For fiber, look for at least 3 grams per serving. For sugar, less is better. Try not to exceed 10 grams per serving. Protein levels depend on your activity level. Recommendations are roughly 1.1 grams per 1 lb. of body weight, which is 112 to 154 grams for a 140-lb. woman.

But sometimes this theory doesn't fit. Remember that popular toaster pastry? It has 200 calories and only 45 calories from fat. But it has no fiber, 20 grams of sugar, 210 mg sodium and 3 grams of protein. The snack bar has 230 calories with 110 from fat, but it has 4 grams of fiber, 5 grams of protein, 70 mg sodium and the 19 grams of sugar is forgivable given the purity of the other ingredients.

Stock your Lunch Box

Getting back to snacking, what are some good items to stock your Judy Jetson lunch box with?

• Fruit: Fresh or dried, packed with vitamins, fiber and good carbs; combine any of them with peanut butter or cheese for some added protein.
• Vegetables: Carrots, celery, green beans, cucumber slices, cherry or grape tomatoes, endive leaves, sugar snap peas…the list goes on and on. A small container of hummus or peanut butter will add protein.
• Nuts and seeds: Walnuts, almonds, pistachios, sunflower or pumpkin seeds to name a few; preferably raw and/or unsalted. Blend your own trail mix with the above nuts, seeds, some dried fruit and chocolate chips (use dark chocolate and get the benefits of the antioxidants).
• Dehydrated fruit and vegetables: Different from dried fruit, these are crunchy, much like chips.
• Low-fat dairy: Toss a couple of cold packs into your bag-o-snacks and you can carry some low-fat yogurt, skim milk (also available in handy no-refrigeration-needed single-serve cartons; it comes in chocolate, too!), low-fat cheese, string cheeses, Baby Bell® cheese, which are good sources of protein and calcium and are great with fruit.
• Whole grains: Fill a baggie with whole-grain cereal with raisins or other dried fruit bits, whole grain crackers, whole-wheat flat breads or sandwich thins. Fiber Gourmet® makes cheese crackers that are delicious and good for you.
• Beverages: The obvious choice is water. Keeping yourself hydrated is KEY! Recent studies show that any liquids count towards your daily fluid intake. However, water is the best choice. Drink caffeinated beverages, sports and energy drinks and soda (regular and diet) in moderation.
• Extras: Rice cakes (mini or regular sized) spread with peanut butter, hummus or low-fat cheese. Many brands of peanut butter are packaged in single-serving sizes. Some snack/meal replacement bars are good choices, but remember our label-reading lesson and watch the sugar content. Look for snacks with protein, good carbs and good fat.

Everyone Benefits

By following a healthy diet, you not only make the best choices for your body, but all those around you will benefit. Once you clean your diet of over-processed junk, you'll feel better, sleep better, even look better. Your mood will improve, which will make your patients and partners feel better, too, and perhaps learn by your example.

The above examples are just some suggestions that show how easy it is to stock up on healthy, satisfying snacks. Read up on nutrition. The more you know, the more you'll want to implement better choices in your diet. There are so many resources on the market today, books on what to eat and what not to eat. Every chain restaurant and convenience store has a website listing nutritional information. So the next time you do get to sit down and actually order a meal, your choice will be a much better one. I guarantee you.

Jackie Mac Allister is a W.I.T.T.S Certified Personal Trainer and A.A.A.I. Certified Weight Management Consultant.