Trending Topics

6 ways paramedics can improve their wellness

Understand the importance of balancing clean eating with stress to achieve your wellness, fitness and health goals

Injury, disibility and even death are a risk that every first responder accepts when entering the profession. Yet I am pretty sure that not a single responder has willingly decided to destroy their future by slowly poisoning their bodies to the point of metabolic syndrome, diabetes, obesity, PTSD and heart disease.

Here are a few truths of the EMS profession. Chronic stress activation, both good stress and bad stress, will slowly affect your allostatic balance.

Allostatic load is wear and tear on the body, which worsens over time when an individual is exposed to repeated or chronic stress. It represents the physiological consequences of chronic exposure to fluctuating or heightened neural or neuroendocrine response that results from repeated or chronic stress [1].

The issue we must deal with as first responders is the complete inability to manage the allostatic load. It is often a blend of stress from the job, stress at home, work-life imbalance, chronic fatigue, environmental stress and physical stress.

As you lose the ability to maintain balance and the scales tip out of your favor, a predictable but deadly syndrome begins to occur. It goes like this.

You can no longer sleep. When you do sleep it’s broken and of poor quality so your body never has he chance to heal. The chronic activation of stress hormones causes you to crave high-fat and high-sugar foods.


First responders often struggle to balance their allostatic load

The constant fatigue and poor food choices make it impossible to exercise because of the inflammation in your body causing pain, which is the number one barrier to fitness. No one wants to exercise when they are so weighed and worn down physically, emotionally and cognitively.

This begs the question of exactly how does a paramedic or EMT invest in wellness when the job stacks the deck against them?

Eat clean
Food must heal the body, not harm it. Yet we are exposed to more processed and chemical-laden foods than ever before.

The first step in investing in your wellness is to get clean, which means that you must learn to avoid and then replace the five evil foods with foods that will help to restore the allostatic balance. The five evil foods to remove from your diet immediately are:

  1. White bread
  2. White rice
  3. White pasta
  4. White potatoes
  5. Cow’s milk

These white refined foods are essentially nutrient-free and high-sugar products. They are pushed on us because they are cheap and easy to produce.

Food is color coded. The darker the color of non-processed, non-refined food the better it is for you. Instead of white rice eat brown, black or multi-grain rice.

Better yet cut out the rice completely. Eat quinoa or amaranth, which is very high in protein, vitamins and minerals.

Instead of the white bread eat an ezekiel, multigrain or oatmeal-based bread. Even better is to cut the bread completely out of your diet.

Instead of white pasta try a quinoa, spinach or whole-wheat pasta. Instead of a white potato eat a sweet potato.

Also on this spectrum are the other whites, like cream sauces, ranch dressing and mayonnaise. These are the hidden white evils.

There are a lot of great natural and healthy substitutes, like soy mayo, Braggs amino acid soy sauce substitute and even salsa in place of ketchup, which is loaded with sugar. These healthy foods are almost always found on the top shelf in most stores.

The final facet of clean eating is the hardest one. Avoid red meat and eat a lot more dark leafy greens and dark colored fruits. Red meat is a known carcinogen so simply swap it out with chicken or fish.

Cold-water fish like salmon and tuna also boost your intake of good fatty acids, omega-3 and 6, so they pack quite a punch on the healthy side. Just make sure that they wild and not farm-raised.

Fill the tank
I recently taught at the National Strength and Conditioning Associations’ tactical strength and conditioning conference. I was amazed by how much research was presented on what shift work, allostatic imbalance, dehydration and poor diet was really doing to your wellness. Below are some of the biggest takeaways from the conference.

1. Increase DHA intake
We need more docosahexaenoic acid, also known as DHA or fish oil, as well as its plant-based cousin flax or chia seeds. One study showed that risk of suicide increased significantly when our brains are deficient of DHA.

Plus, the study also showed DHA reduced the risk of heart disease. DHA also lowers the catabolic effect on the body from physical stress, part of the allostatic load. Recommendations for DHA range from 1,000 mg to 3,000 mg daily.

2. Vitamin D is our next culprit
Low levels of vitamin D are well known to contribute to heart disease, diabetes and depression. During the 2015 tactical strength and conditioning conference, a study showed that soldiers who died by suicide had up to 30 percent lower vitamin D levels than other soldiers.

Another study documented that people with higher vitamin D levels in the blood also had higher levels of testosterone, which is known to be drastically low due to chronic allostatic imbalance.

3. The elephant in the room is testosterone.
Lack of sleep plus high abdominal fat plus lack of exercise can cause low testosterone. Low T is known to cause an increased risk of heart disease, diabetes and atherosclerosis. I strongly recommend that all men get their testosterone levels checked during their annual physical.

4. More deep, uninterrupted sleep
We all need more sleep, especially sleep that is deep and uninterrupted. Broken sleep is currently an accepted occupational hazard and one that definitely needs to change. To promote better sleep off duty, research shows that magnesium, tryptophan, melatonin and 5-HTP supplements taken around bedtime are helpful.

5. Meet daily magnesium requirements
Magnesium, especially for firefighters and responders working in hot environments, is lost through sweating. It’s estimated that 68 percent of the population is not meeting it’s USDA magnesium requirements. When magnesium is low, cardiovascular risks and systemic markers of inflammation increase.

6. Consider zinc replenishment
Zinc, another essential mineral, is found to be low in up to 42 percent of the population. Zinc can lower systemic inflammation and improve sleep patterns. Low zinc levels are also associated with lower testosterone levels. Supplements, like ZMA which has zinc and magnesium, can help replenish those levels as well as promote better sleep.

The bottom line is simple. First, eat a lot more whole and natural foods. Every meal should have a green leafy vegetable.

Nuts are a great source of good fats and have an added benefit of being high in all the minerals discussed in this article. Plus nuts are high in protein.

Second, avoid processed and fast foods. If you must eat them make good choices. Third, learn what foods make your body feel good versus just satisfying hunger and master the art of food substitution to avoid the white foods.

Finally, get an annual physical and have your blood analyzed before running to the store to stock up on supplements.

Work referenced
1. Dr. Mark Abel, TSAC 2016 presentation

Bryan Fass, ATC, LAT, CSCS, EMT-P (ret.), dedicated over a decade to changing the culture of EMS from one of pain, injury and disease, to one of ergonomic excellence and provider wellness. He leveraged his 15-year career in sports medicine, athletic training, spine rehabilitation, strength and conditioning and as a paramedic to become an expert on prehospital patient handling/equipment handling and fire-EMS fitness. His company, Fit Responder, works nationally with departments to reduce injuries and improve fitness for first responders.

Bryan passed away in September, 2019, leaving a legacy of contributions to EMS health and fitness, safety and readiness.