Nutrition is another arm of a behavioral health plan. It is considered a behavioral health issue because diet and nutrition effect how we look, feel, think and act. What we give our bodies for fuel predicts how well our body can perform emotionally, physically and cognitively. Individuals interested in nutrition, including special recommendations for the specific nutritional needs of firefighters, is referred to pages 76-79 of the Wellness-Fitness manual (insert web link.)
In addition, every fire fighter knows that calories-in need to balance with calories-out, or a change in weight, and a change in function, will result. Overeating results in weight gain, which can result in decreased fitness for duty.
Under eating results in weight loss, which can also decrease fitness for duty.
Specific guidelines for amount of foods eaten types of foods eaten and methods of maintaining a healthy diet have been established by organizations such as the:
American Dietetic Association
American Heart Association
Center for Disease Control, Healthy Eating Tips
Food and Nutrition Information Center
The consequences of poor nutrition are considerable. Surprisingly, some studies suggest that the majority of Americans are malnourished. Indeed, Americans (more than Canadians and Europeans) tend to be overweight and undernourished. Poor nutrition results in poor behavior, lower core strength, increased body fat, slower mental problem solving, less alertness, and slower muscle response time.
The National Institute of Health highlights the impact of poor nutrition on health:
An estimated 65.2 percent of U.S. adults are overweight or obese, defined by having a body mass index of 25 or more (National Center for Health Statistics, 2003).
30.1% of US adults have hypertension (NCHS, 2002)
Hypertension is called a silent killer, because it often goes undetected and untreated.
High Cholesterol is a leading contributor to heart disease. A high blood level of low-density lipoprotein cholesterol (LDL) can lead to atherosclerosis. High cholesterol diets are common in US and Canadian citizens.
Diabetes is estimated to effect 8% of the adult US population.
Each year, more than 500,000 Americans die of heart disease. The single greatest cause of line-of-duty death in fire service is heart attack.
Stroke occurs when a blockage or weakness in the circulatory system results in a bleeding event. The most common strokes occur in the brain, usually resulting in some degree of brain damage.
Gallstones are deposits of minerals in the gall bladder that can result in significant pain when moving through the system. Some gallstones may require surgical interventions.
Gout is a painful condition of the joints caused by an accumulation of uric acid, which results in crystals forming in the joints. Associated swelling can result in permanent joint damage. Poor diet is a leading contributor to the development of gout.
Sleep apnea is the condition in which a sleeping person stops breathing for periods exceeding 20 seconds. The resulting lack of oxygen can trip off rhythm problems with the heart. People with sleep apnea are frequently not well rested, as the lack of oxygen results in frequent waking.
Osteoarthritis is an inflammation of the joints, resulting in calcifications and breakdown of joint flexibility.
Several types of cancer, particularly colon cancer, bladder cancer and breast cancer, may be affected by diet.
Depression, eating disorders, distorted body image are often associated with poor nutritional status.
What can someone do to alter his or her unhealthy eating patterns?
Nutritional Counseling is available and often covered by insurance. The local EAP representative should have a list of licensed counselors that understand the physical and mental demands placed on firefighters. Nutritional counselors can provide a complete analysis of your current diet; make suggestions for a healthier diet, and problem solve methods of achieving a healthy diet.
Exercise will aid in appetite management, and will maximize the number of calories you can consume while remaining healthy. Links between a healthy diet and exercise are discussed on www.acefitness.org.
There are also a number of non-profit and for-profit weight management programs available. For example, a non-profit is the 12-step group Overeaters Anonymous (OA). Information on local branches of OA is found on www.oa.org.
Weight Watchers (www.weightwatchers.com) is a for-profit weight management program that has the longest history in the United States of helping adults modify their diets. Relative to other, less long-standing weight management programs, Weight Watchers is reasonably priced and seems more focused on learning behavioral changes that will translate into longer term success and modification.
Finally, there is a growing industry in medical interventions to manage eating habits. Stomach stapling procedures are expensive and controversial, with preliminary data indicating that although the weight loss can be significant, unless the person is morbidly obese, the procedure’s risks outweigh the benefits. Furthermore, unless a person learns healthier eating patterns and better food choices, the weight loss will not be permanent.