In so many ways, medical school is unlike any other type of training. The hours are long and the schedule is inconsistent. The lack of structure can prove to be a significant barrier to eating right.
AMA Wire® spoke with Kathy Kolasa, PhD, a registered dietitian, nutritionist and master educator in East Carolina University’s departments of family medicine and pediatrics. She has studied nutrition among physicians and medical students extensively. Kolasa offered these tips for medical students looking to keep their diets on track.
It is not uncommon for medical students, or students in general, to skip breakfast. “Most people do better if they have breakfast. They think better, they have more energy and they don’t overeat throughout the day,” Kolasa said.
Kolasa recommends that students plan for breakfast before they leave home. One on-the-go-option is a package of plain oatmeal, which offers a good source of grain and far less sugar than the flavored options.
For many medical students, missing meals is the effect of a busy schedule, but that can backfire.
“One of the [areas] where I see medical students really get off track, even if they are doing well, is during rotations. Let’s say rounds go long and they are used to eating their lunch at 12, but they didn’t bring lunch. They do one of two things. They stop by a vending machine and get junk, or they starve and then when they get something to eat they chow down like crazy.”
In an effort to plan for the unexpected, Kolasa recommends that medical students keep a surplus of “white coat snacks.” Healthy options that can fit within a coat pocket include nuts and seeds; dried fruit; granola bars with nuts and less than 12 grams of sugar; salmon and tuna packets; dry cereal; and Babybel cheese.
If you do have to make one of those dreaded trips to the vending machines, it is best to focus on the more sensible options such as baked chips, small portions of nuts and low-fat cookies or crackers.
“If you want to eat healthy and your hospital or medical school isn’t offering those options, one of the things you need to do is to get active and advocate for healthier items in the vending machines and hospital cafeteria,” Kolasa said. “If the medical students and doctors don’t advocate for it, it doesn’t really happen.”
Water will always be your best beverage choice, and not drinking enough of it can leave students feeling fatigued and weak. Beyond that, when students are going to drink coffee or tea for their caffeine fix, Kolasa cautions students to monitor the sugars in those beverages.
It is also worth noting that beverages do little for your appetite.
“There’s no satiety in drinks,” Dr. Kolasa said. “You won’t feel full if you have 400 calories of a latte or of a soda, so that’s 400 calories of empty calories.”
At East Carolina, Kolasa takes part in a program that offers third-year medical students the opportunity to plan their diet and physical activity for a four-week period. That type of advanced planning, particularly as students transition from the pre-clinical to clinical stages of their learning, can help students maintain or improve their eating habits.
“When you eat food you have prepared yourself, you have control over the ingredients,” she said. “You are likely to do a better job of managing sodium, managing sugar and managing fat that has been added.”
Kolasa touts the dietary approaches to stop hypertension (DASH) diet as the best option for anyone looking to eat healthy. The diet has proven to be among the most effective at preventing heart disease and properly managing blood pressure and weight.
The DASH diet is heavy on fruits, low-fat dairy, vegetables, whole grains and lean protein and light on high-fat meats. Those restrictions do not have to make the diet expensive.
“We’re hoping that everybody is going to eat one more fruit and one more vegetable every day,” Dr. Kolasa said. “Getting those in canned or frozen packages is easier than getting them fresh. Typically, there’s less waste. You can get some of those things ready to eat, but it’s expensive.
“For the past six months in our grocery stores, really nice pineapples have been $3. It takes only a couple minutes to fix the pineapple fresh. That same amount of pineapple, if you buy it already cut and cored in a plastic container, is $5. Students on a budget may consider that,” she said.