Performance Nutrition for the Intensive Care Unit

We think of elite athletes when we hear recommendations regarding sports nutrition, recovery strategies and race fueling , but there are others who also benefit from these guidelines and protocols. Firefighters , for example, or musicians. Or hospital staff. They all go through intense shifts, whether it's a fire, a concert/rehearsal, or an emergency. We often see many intensive care unitstaff members working hard. It is good to keep the cornerstones of nutrition in mind for this, because it will make a difference for the staff. How they start a shift matters. They need to reduce fatigue and delay it, and they need to recover between their deployments. And - like athletes - they don't have much time to cook, meaning recipes should be quick and easy, yet nutrient-dense.

Prepare - Fuel - Recover - Hydrate

Good preparation means a good meal before the shift. It should contain a generous amount of carbohydrates, preferably whole grains, along with lean protein and fruits/vegetables. The fat content should be low. Remember, it should be preparation similar to a race (easily digestible).

‍Examples:

Oatmeal with raisins, walnuts, cinnamon, and yogurt.
Quinoa with zucchini, beetroot, olive oil, and ricotta.
Chicken breast with potatoes and a serving of cooked vegetables, finished with olive oil.
Whole wheat pasta with tofu, peas, and walnuts.

During intense physical exertion, we need quick energy. Walking back and forth between rooms, running up and down stairs, pushing a bed down the hallway - all of this involves muscle work, and muscles work best with an adequate supply of carbohydrates. And to keep the brain sharp, a regular intake of carbohydrates is even more important.

‍Example

Banana,
Diluted fruit juice,
Banana bread,
Fruit bar,
Sports drink,
Water with syrup.

OUR BRAIN NEEDS SUGAR
Sugar is the preferred energy source for our brain. Don't underestimate the brain's energy consumption. On a normal day, it requires up to 10 g of sugar. However, when our brain has to perform strenuous work, think complexly, or handle multitasking, the energy demand is significantly higher.

After the effort, it is important to keep the three R's in mind: rehydrate, rebuild, refuel. It is not always possible to drink enough while working, so rehydrating is important to get back to being well-hydrated. Some protein for the muscles is important. Even though you are resting, your muscles remain active; they are recovering and need the right building blocks to do so. Furthermore, it is not always easy to eat and drink. It is not unusual to miss a meal because there is so much to do. Eating carbohydrates after the effort helps to replenish empty stores.

‍

‍Examples:

Chocolate milk/cocoa,
Risotto with tuna and kiwi; tea or diluted fruit juice,
Bread with cottage cheese and an apple; tea or diluted fruit juice,
Oatmeal with raisins, walnuts, cinnamon, and yogurt; tea or diluted fruit juice,
Smoothie with fresh fruit, rolled oats, a few nuts, and milk,
Recovery shake.

STAY AWAY FROM KETO
Low-carb on high-intensity days leads to depleted glycogen stores and won't provide enough fuel for your brain either. A ketogenic diet will ultimately lead to a faster drop in performance, even in the ICU. Low-carb diets are still popular. A recently published study showed that just a few days of a ketogenic diet leads to an increased perception of effort and faster onset of fatigue during exertion. So, if you work in the ICU, remember that a keto diet is a bad idea, especially now during COVID times.

And finally, a word on quality. Now more than ever, it is important that your diet is of high quality to ensure you get all the nutrients you need for a strong immune system. Whole grains and legumes (for carbohydrates), lean meat and fatty fish or plant-based protein, small amounts of healthy fats (fish, olive oil, rapeseed oil, seeds, nuts), and plenty of color with vegetables and salads. And if you need snack ideas, here are a few examples: