What's Your Care Plan?

A Q & A with Julia Buss, RN, MS, on how to develop a healthy eating plan that works for you

According to the World Health Organization, an estimated 80% of heart disease, stroke and type 2 diabetes, and 40% of cancer could be avoided if common lifestyle risk factors were eliminated. When Julia Buss, RN, MS, found a 2008 study in the Journal of the American Academy of Nurse Practitioners that showed 54% of nurses are overweight or obese, she knew she had to take action.

Armed with that information, Buss set out to send an active message to the 3 million registered nurses in the United States, as well as anyone else who wants to prevent chronic health issues. She offers Your Care Plan: A Nurse's Guide to Healthy Living as a guidebook for healthy living.

Is this your first experience writing a book?

This is actually the second book I have written. My first book was a travel memoir about a trip my husband and I took where we flew a single-engine plane around the edge of the lower 48 states of the U.S. It was the trip of a lifetime and I realized how much I liked writing.

At the time, I was also working for the American Heart Association and was visiting a lot of hospitals. Subjectively I started thinking about how nurses and healthcare professionals have information about eating and living healthy, yet many of them still have some of the same issues as the rest of the general population when it comes to weight gain and health behaviors.

It prompted me to write this book for nurses--although anyone can benefit from reading it--to make them think, to make changes and to encourage them to look after themselves as well as they look after everyone else.

You indicate you wrote the book for nurses. Are there special issues they face that make it more difficult for them to eat healthy? Can other professionals, such as EMS workers, benefit from reading the book?

The book contains general advice that is useful for anyone. The No. 1 problem in a nurse's environment is shift work, which is also relatable to EMS. In some jobs it's easier to take an hour lunch break, to know when to start and finish a shift. Oftentimes, nurses work long hours and stay late. They may not take a proper break. Shift work can also correlate to sleep deprivation and stress. And in the case of nurses and EMS workers, they're coping with life and death issues, which can be emotional.

The hospital environment may not provide healthy food options either so nurses may rely on vending machines. There's also often a culture of using food as a reward. Many of these same issues relate to EMS professionals. They have the same work schedules and job-related issues such a lack of sleep, long hours and limited access to healthy food options.

How did you determine what information to include in the book?

I didn't want to include any information that science couldn't back up. However, I didn't want it to turn into a science book. It wanted to make it a reference book, something that is useful to have and to look at. I wanted readers to be able to browse through it to find things that would encourage them to make a change.

Many of my sources include organizations such as the American Heart Association, the Center for Disease Control, the USDA, the National Institutes of Health, the Mayo Clinic, the Stroke Association and the American Diabetes Association.

One of the most interesting things I found while researching the book was that not all calories are the same. It's isn't necessarily how much you eat, but also what kinds of foods you eat.

I became interested in the research of Dr. Robert Lustig, a pediatric endocrinologist at the University of California, San Francisco. He's seen a lot of obese children, even babies, and he wanted to figure out why so he studied how our bodies metabolize sugar. He theorizes how too much sugar, in the form of fructose, and too little fiber increases insulin and leads to weight gain. When you eat a carbohydrate that comes with fiber, such as an apple, it has lots of vitamins and some sugar. But if you eat a processed food with table sugar or high fructose corn syrup, it has a different kind of carbohydrate, one that is metabolized differently in your body.

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