Nutrition Tactics for Stressful Jobs with Megan Lautz

This podcast focuses on human performance optimization and training paradigms for medical professionals

Dr. Chris Myers: The views expressed by myself and the guests of this podcast do not reflect the official policy or position of the US Air Force, Department of Defense or the US government. Welcome to White coat Warriors. I’m your host, Doctor Chris Myers. And on this podcast, we talk about human performance optimization and training paradigms for you, the young medical professionals and how you can use it in your own professional practices to help yourselves and your clients. Hey, everyone, and welcome to another exciting episode of White Coat warriors here on WCW today, we have another great one for you. But before we get into it, if you like what we’re doing, feel free to give us a five star review or tickle that bell or give us a like, no matter what the platform you’re listening to us on. And today we have the great Megan Lautz with us. Who’s in it? Man, she’s just a rock star when it comes to being a dietician. So she. Megan. So she’s the head of rescue rd. She’s a summa cum laude graduate from Logan University and magna cum laude from James Madison and has over ten years of tactical and fire rescue, diet, dietetic experience. And on top of that, she’s a certified strength and conditioning specialist from the NSCA. Man, that is an amazing rosemary here, Megan, glad to have you.

Megan Lautz: Thank you. I’m happy to be here. You make me sound like I’m really good at stuff.

Dr. Chris Myers: You are. That’s why I’ve asked you on here. I’ve seen you talk God knows how many times I look back in 20, I was first time I saw you speak, talking about the caffeine, within firefighter, populations. And that was very, very well done. and ever since, I try to catch your talks whenever I can. Thank you. Yeah. And that I just hope you can impart some knowledge with us here.

I’m a registered dietitian and I specialize in first responders

So before we kind of get into all the fun stuff with it, I kind of gave you a little bit of a synopsis. So why don’t you kind of tell us a little bit more about yourself and your profession.

Megan Lautz: Sure. Yeah. So I am a registered dietitian, civilian, and I specialize in first responders. So fire and police specifically, of course, corrections and dispatch, they all sneak in there. I work full time for Fairfax county fire and police, which is a relatively large department just outside of DC in Virginia. and then I have my side business, rescue rd, where I do consulting to departments across the country because fire and police nutrition is a huge gap, in the market for dietitians who can adequately speak to shift work. and there’s a lot of carryover to med students for sure.

Dr. Chris Myers: Yeah. I think the key you said is shift work, and I think we will dig into that in a minute. that’s really, that’s kind of one of the crux, I think the intersection between, first responders, police and definitely young medical professionals. So. But you know, within that, it kind of, it’s going to be a question we have to ask right off the bat.

What is it like to work with firefighters? Oh, you’re never bored

What is it like to work with firefighters?

Megan Lautz: Oh, you’re never bored? It’s the dream. It’s my dream at least. Like, I wear leggings to work, I get to curse at work. you know, it’s, it’s always, you know, joking back and forth and it always surprises them when you have a little snippy comment right back at them like they never expected. And it’s just, I live to torture first responders.

Dr. Chris Myers: Oh, yeah. So, yeah. So let’s tell us a little bit. Do you got any good stories?

Megan Lautz: Oh, gosh, it depends on where you want to go with that. I’ve got all kinds of stories just in the caffeine component.

Dr. Chris Myers: Yeah. Do you have energy drink issues like we do in our populations?

Megan Lautz: Yeah, absolutely. I mean, you’re looking at 1224 hours shifts, for our area, you know, up to 96 and some other areas of the country. So lots of energy drinks and then also just like a general frustration with the shift work. Like they don’t have alternatives. On the general Internet, they’re getting nine to five information on sleep, nutrition, fitness, and it doesn’t really accommodate. So, so they just kind of get frustrated when things don’t really fit their lifestyle. So you really have to make those adjustments.

Dr. Chris Myers: Okay. Yeah.

What kind of nutritional challenges do shift work present to first responders

So within that, so you mentioned all that shift work and that the lack of knowledge from the nine to five, what kind of nutritional challenges does that cause with, you know, with your, with your population?

Megan Lautz: Sure. I mean, the list goes on. yeah, we got time. Yeah, we’ve got lots of time. I hope you have time. yeah, from a nutrition standpoint. So I think one of the biggest challenges is the expectation that, a lot of health professionals have with first responders or even shift workers in general of them. And for medical professionals, you have that of yourself and then you have that of your clients. Right. Or your patients. And with that, you know, the general population, the nine to fivers. Right. Wellness is hard enough. Right. Like they feel stressed, they have a lot going on. but their level of expectation to perform is not that high, you know, mentally and physically. Right. Because first responders are running into burning buildings, they’re chasing, cops and robbers. Right? You know what? It. The expectation to perform is significantly higher, right. But then their baseline that the nine to fiverrs might be at is significantly lower because of sleep deprivation, exposure to trauma, overall stress load. So they have a significantly bigger gap than wellness professional or, excuse me, nine to fiverrs have, And they don’t have that information that’s tailored to them. When you don’t sleep even one night of bad sleep, research suggests that you, see a 24% increase in hunger due to an 18% increase in leptin, the hunger stimulating hormone, and a, 28% increase in ghrelin, the hunger stimulating hormone.

Dr. Chris Myers: Yep.

Megan Lautz: With that comes cravings for sugar, sodium, fatty or foods, that kind of stuff. So, you’re fighting those cravings. you’re just fighting overall exhaustion, exposure to trauma. You know, if you’re in a pediatric code, you’re not going to want to have a salad after that, right? Like, if anything, it’s going to be comfort food, right? and you’re seeing this. This is not one or two exposures. This is regular exposures or potential multiple exposures and a shift to trauma and that sleep deprivation. So the food choices are impacted. We see that at the stations. We m. See an increase in caffeine intake. and then the other challenge is flexibility. Right. So especially for fire. only about three. One to 3% of calls are actually fire related. So the chances of them running a fire related call, like a burning building, a dumpster fire, a car fire, are very, very unlikely for the structural side. But if it does happen, what do they need to do with their diet? They need to increase their carbs. They need to do more sodium. They might eat quicker sugars. So, you know, those adjustments are really challenging when you don’t have the education or the knowledge behind it.

Dr. Chris Myers: Okay, well, that’s definitely a lot to unpack. there. So let’s kind of break it down into kind of two areas. we’ll keep it simple first. one, we’ll talk shift work. The next is the flexibility, which I love that you brought that up.

38% of firefighters have a sleep disorder; 80% don’t know

So definitely, when it comes to shift work, I’m glad you brought up sleep. That has been a, we’re, you know, we’ve recorded several, different. Had several different conversations across leadership, strength and conditioning, and other medical. And sleep is, a common across all the episodes so far, sleep has come up at least once, and it’s really interesting that you bring that up from a nutritional standpoint. So what are some common strategies that you use with the population, especially on the shift work, to really kind of help yo, you know, kind of help with sleep? Yes. Effectiveness of the sleep or how they become more efficient with their sleep.

Megan Lautz: Yeah, there’s a couple different things that you can do from a shift work standpoint. Number one, depending on how long you’ve been doing shift work, we have to evaluate whether or not you need a sleep study or not to see if there’s some issues. and the reason I say this is, usually people come to my office. They’ve been with the department 57, 10, 15 years. And a lot of times, the big key indicator is their sugar cravings are, like, out of control. Like, they just feel like they have no control over their sugar cravings specifically. So that’s a little bit of a, you know, orange flag for me.

Megan Lautz: and then I’ll ask them, you know, if you’re getting less than 5 hours of sleep and you’re tossing and turning, to me, that’s an indicator that we need to get you a sleep study done.

Dr. Chris Myers: okay.

Megan Lautz: And the reason I am really diligent about that is, firefighters specifically, we see, I think it’s about 38% of firefighters have a sleep disorder, and 80% of them don’t know that they have it if they do. Interesting. And I think this starts to really kind of, and this is anecdotal, like, just from my coaching, about seven to 15 years in is where we’re really starting to see that. And seven to 15 years in is a 30 year old for some people, 30, 40, way earlier than people think they’re going to have sleep disorders. so getting them to a sleep study, while that might take a couple months to get it done, I had a 30 year old who ate well, worked out well, struggling to lose body fat with major obstructive sleep apnea. No other real warning signs. Got the sleep study done. Now he’s on the cpap, and he feels amazing. So it can happen younger, in, healthier, you know, quote unquote healthier people than you think. Number two is nap strategies. So, saying to a first responder or sleep deprived person, on shift work that you’re supposed to do seven to 9 hours a night is like, like, okay, cool, well, I guess screw me then, right? Like, you know, I’m not doing that. I can’t do that. That’s not how it works for me. so we really go with seven to 9 hours of sleep per day. And if you have to get it in chunks, and usually the chunks are 20 minutes or 90 minutes. 20 minutes is. Yes, exactly 90 minutes is the sleep cycles. You’re getting through all four phases of sleep, and waking up not less groggy, less angry than if you wake up in the middle of those sleep cycles. And then 20 minutes is a brain break. You’re just trying to breathe, chill out, hang out. and that’s one place that we’ll look at too.

Tart cherry juice can help with two things, sleep and muscle soreness

And then the third thing from a nutrition perspective, one thing that I’ve been talking a lot more about is tart cherry juice. Are you familiar with that?

Dr. Chris Myers: Yeah. Oh yeah. Very familiar. Yeah. As a matter of fact, down in Florida state when I was there that there were, two of the professors were studying tart cherry juice. Doctor Arjmandi, he’s probably read a lot of his articles, as part of my doctoral, committee. Yeah.

Megan Lautz: Yeah. Well, what I’ve been kind of noticing is, so I started putting this into my slides specifically for like recruits, for fire or police because, even though they technically have a nine to five hour wise, they are very reliant on energy drinks. and there’s not a whole lot of education on improving sleep during the academy unless I take care of it. Right.

Dr. Chris Myers: Yeah.

Megan Lautz: And what I found is tart cherry juice can help with two things, sleep and muscle soreness. Recruits, that’s their two big problems. Right. and anybody over the age of like, I don’t know, 35, starting a new workout program, same problems. Right. so what tart cherry juice can do, I think. I believe the dose kind of varies. It can be as low as four to 12oz, maybe.

Dr. Chris Myers: Yeah.

Megan Lautz: I don’t know if you’ve seen something else. Yeah, four to 12oz for muscle soreness, it’s in the morning and in the evening, and then for sleep, it’s, it’s in the evening. but what I’ve found by telling recruits to do that, they’ve actually seen a decrease, a decrease in energy drink use. with recruits now, I also have energy drink tangents that I force them to sit through, but the tart chairs use gives them an out, you know what I mean? Here’s a thing that could maybe help improve sleep. And for some people, they, whether it’s placebo or not, I’ll take it. They’re like this. This is amazing. And my sleep is so much better. my muscle soreness is better. Other people are like, eh. So, yeah, that is one thing that I found that has given an alternative. Ah, okay. When people don’t have the. The luxury of quantity, they can work on the quality.

Dr. Chris Myers: Yep. Yeah. Same thing with, what we have with our, with the population that I work with is the same thing is they may only have, let’s say, 6 hours just due to work, family issues. Okay, fine. How can we optimize those that 6 hours? It’s, ah, usually we talk about nutrition, you know, eating. You know, how soon are you eating dinner or a, last meal of the day, you know, before going to sleep, because again, it’s glucose stability, which goes back to kind of what you were saying. You know, usually we find like 90 minutes to 2 hours before is when you should cut it off. But that also helps with weight management as well, where you’re getting to. Yeah. So. And then, ah, from there, it’s then talking about, sleep hygiene stuff, you know, how’s your room? Are you playing with your phone? Too late. we talked about the different strategies. I’ve mentioned it before is the, rule of 6321. so little things like that. but yeah, that’s really cool. It’s. I’m glad to hear that.

You have peaks on the ends when it comes to your population

Now, on the other side, so I know you probably have a nice little bell curve. Well, I would call it almost a inverted bell curve, where the. The median is actually dipped and you have peaks on the ends when it comes to your population, where you have those that are very hyper aware of their wellness and their optimization strategies, those who do not, or they’re just naturally gifted or whatever it is, then you have some in the middle, not as much, but some, I imagine at least that that’s what I’ve seen when I’ve worked with first responder populations. So let’s take this side out and kind of focus on this side. Those who don’t really know too much. And, you know, what are some of the, nutritional strategies that you give just in general for just basic wellness purposes with that, that section of the population?

Megan Lautz: Yeah, well, I actually kind of see it in a. In a slightly different way. Like there’s the, like, kind of green, yellow, red, almost.

Dr. Chris Myers: Oh, okay. Yep.

Megan Lautz: Yeah. Like there’s the green who, if they come to me, like they’re just coming for a gold star for the most part. They’re like, please just like, reduce my anxiety and tell me I’m doing everything. And I’m like, yes, here I am. and then there’s the red. And the red is. They are. They are in the trenches. Like, they. There’s a mental health thing going on. Maybe. there’s a lot of stress that they. They have either no interest or life has beaten them down so much that they have no motivation. There’s like, kind of. It’s usually a mental health thing. So a lot of times the red flags for those are like, divorces, significant weight gains, just general low energy or, like, a flat affect, like the eeyores, kind of. Yeah. And they do not want to come to me. Like, it doesn’t matter who tells them to go to me. They have no interest in me whatsoever. And then there’s some people in that yellow area, that kind of gray area in the middle where it could be an education thing or it could just be a tart, like less of an education. Like, they know what to eat. It’s targeted education. So I. Maybe. I guess that’s kind of the same thing, but that’s how I kind of see it is, the green doesn’t really need me, the reds not ready for me, but the people who I can adjust in the middle is going to be in the yellow. So, in terms of, like, basically, at the end of the day, working with first responders or working with busy people who do shift work is better bad decisions. Right. and this is from our strength coach, Jake Patton. He says it all the time, and I steal it from him and I want it. Want it to be mine, but it’s not excellent, but better bad decisions. And I think that’s a great explanation because you are dealing with populations who are very type a, who want to do things by the textbook. Right. But the textbook isn’t real life. and that is where a lot of newer medical, health professionals struggle, is why are they not doing what the textbook says? Well, the textbook isn’t accounting for the pack that these people don’t have. They don’t have time, they don’t have money, they don’t have energy to do these things. So you have to take it down several notches.

Dr. Chris Myers: Okay.

Megan Lautz: It’s gonna feel like it’s not enough. So, for example, energy drinks, right. I’ve gotten to the sad point in my career where I’m recommending monsters and Red Bull because they’re the half the caffeine to the bang celsius heat and. Right.

Dr. Chris Myers: That is true.

Megan Lautz: Right. and I’ll still give the education on why energy drinks are bad, why we don’t want to have a regular use of them, but there’s always going to be that alternative. It’s not healthy, but it’s meeting them where they’re at, and it’s actually cutting their caffeine in half. So that’s kind of where I’m getting at with the better bad decisions. It’s not textbook, but it’s broken down into more of a stepwise manner so that they achieve something rather than just be like, damn, I suck, screw this. I’m not doing it because change is hard.

When you work shift work, especially firefighters, whole foods go bad

Dr. Chris Myers: So what about actual foodstuffs? What are, what’s some of the advice that you kind of give those personnel when it comes to foodstuffs? Because, yeah, we could talk caffeine all day long. I. I have my own personal war against energy drinks with, with my, with my clientele, and I’ve got it in the same. After a couple of years, I’m like, okay, like you said, it’s, well, there’s no viable alternatives, and so it’s the lesser of two evils, right. And kind of go there. At least with the lesser, you can get more hydration in there, so you get more water. So, okay, it’s a minor win. but, yeah, when it comes to food stuff, what’s some of the, tactics and techniques and procedures that you use with personal shift work?

Megan Lautz: Yeah. So, the other big thing for that, for breaking stuff down is the nine to five nutrition information is my plate, and we’ll just eat whole foods. Well, when you work shift work, especially super long shifts or overtime or you get held over or you have to study after your shifts, whole foods go bad. You know, you buy them, they sit in your fridge. You get too tired to do the meal prep, so they rot in your fridge, and you just wasted all that money and you get frustrated. So the, eat whole foods. The. My plate doesn’t work for people who do need off of plates and who don’t have time to make the whole foods. So then it becomes, what are better options for fast food? Frozen, non perishable options for a lot of health nuts. That gives them the anxiety they are. They, they think I’m nuts. you know what? I’ve been to California for the California firefighters, and they said, get a more knowledgeable nutritionist. And I’m like, guys, come on. Like, you know, it’s. You have to meet people where they’re at and where they’re at is convenience. So.

Dr. Chris Myers: Convenience.

Megan Lautz: like, one of the big things with the non perishables is always having a go bag, for police, for fire, for medical, for the dietician, quite frankly, because, what happens is when you get held over, stuck on a call, stuck with a client, stuck in rounds, whatever, your meals get delayed. And what happens when your meals get delayed? You lose your freaking mind, right? No one goes to chick fil a and gets a salad after lunch has been delayed three to 4 hours. Okay. Not even the dietitian. Okay.

Dr. Chris Myers: It’s convenience.

Megan Lautz: Yeah, like you said. And. And it’s food choices, too. So if I get someone to, have an applesauce pouch or a protein bar or a fig bar or something, you know, and they get that down really quickly between whatever they’re doing, it’s going to prevent them from eating everything that’s not tied down when they do get to get to that meal. plus also some of these calls, you know, like, you could be stuck on a gas leak for 3 hours just standing there, you know? same thing for, ah, police. I mean, some of their, they could be on scene 24 hours or more.

Dr. Chris Myers: Yeah.

Megan Lautz: So, which is crazy. you know, you’ve got to have these non perishable options. Some of my favorites are applesauce pouches, fig bars, cliff bars, protein bars, nuts and seeds, dried fruit, and not just craisins and raisins. We’re talking like, mango, banana, apple. Most people only know the craisins and raisins, tuna packets, jerky, those kinds of things. dried cereal, even. and you want to have, like, a gazillion options because you don’t know what you’re going to be in the mood for. and having those non perishable options is huge. other things, things in the freezer. So, you know, actually, Costco has this, cauliflower crust pizza, which.

Dr. Chris Myers: Oh, that’s. It’s amazing.

Megan Lautz: Okay? I swear. And I swear by it, too, but it never comes well from, like, the dietitian and the doctor, right? Think the cauliflower crust pizza is good? I swear I was not on board until the firefighters told me it was good.

Dr. Chris Myers: Oh, yeah. You don’t taste the difference. It’s.

Megan Lautz: Yeah, well, I mean, if you’re like, a doughy pizza person, like, if you’re a Chicago pizza, it’s not like it’s a thin crust. So you have to understand. But it’s a good day to day pizza. That was convenient. and it gets, you know, a decent. It’s not super high protein, but it has enough and you get a veggie. And it is what it is.

Dr. Chris Myers: Yep.

Megan Lautz: so having stuff like that. And then the last thing, too, when we’re talking about convenience, is meal prep companies are actually not as expensive as a lot of people think. Think they are.

Dr. Chris Myers: Interesting.

Megan Lautz: okay, well, and you have to think about this. If you are spending $18 at Chipotle for a double meatball, first of all, you must be rich. Second of all, like, you’re only getting one. Well, for the firefighters. For me, maybe one meal, not two.

Dr. Chris Myers: Yeah.

Megan Lautz: so there are companies like factor, a local one for us is mighty meals territory. cook unity. These are all meal prep programs that will deliver this fresh to your house or frozen. And, they’re usually about nine to $12 a meal.

Dr. Chris Myers: Yeah.

Megan Lautz: So when you think about it, you’re not. If you’re spending that money in fast food, you know, it’s. It’s worth, you know, the convenience. it also automatically regulates people’s portions. So, and they get a protein, a carb and a veggie. It’s usually pretty balanced.

Dr. Chris Myers: Okay.

Megan Lautz: And there’s variety, so they don’t get too bored. So now I understand nine to $10 a meal is probably expensive for some people, but you have to look at what you’re spending in your budget otherwise.

If you don’t have your nutrition, you’re not going to advance

Right. you know, and also, I have also, we called mighty meals in Fairfax, and we said, hey, would you give us a discount to our first responders? And they said, yes, and they gave us a 25% off discount for our first responders. good. So it’s also strategy that way, like seeing if you can get that for your population.

Dr. Chris Myers: Yeah, that’s really good. Especially having you’re talking those helpful, options for, you know, for those on shift work. and, yeah, it’s just also looking at the budget, you know, maybe not buy the, seven dollar coffee from Starbucks, even though I’m a starbucks guy, going through withdrawals living here in Germany. But, yeah, it’s. You guys got, you got to look at the balance things, what the goals are, what you’re capable of doing, because nutrition, you could be doing everything else right. And I love the saying is you can do your physical right, you could do your cognitive drills right, do your mental tools. Right. But if you don’t have your nutrition, you’re not going to make any advances.

Megan Lautz: Absolutely. Well, and the other thing is, that for these populations, there’s a tendency to skip meals, and a tendency to skip carbs, and that impacts their mental performance, and that impacts their energy levels. So sometimes just getting more regular meals and snacks and adding a carb with each of those meals and snacks, they see a significant improvement in energy levels.

Dr. Chris Myers: Yeah. I love the fact that you’re just focusing on the basics. I love that you have to do. Yeah, you do the basics well, everything else will fall in line. And that’s really amazing.

Megan Lautz: It’s, lifestyle targeted is kind of what I really call it. Like, if you call it the basics, they’re like, this is lame. but when you really hyper focus, and I think this is important for med students when they’re talking about their professional side, is there’s a tendency for us, again, to just go with the textbook and be like, perfect all the time. But if you overlook that person’s lifestyle, they’re never going to change because you never met them where they’re at. So the lifestyle includes career, kids, you know, side jobs, overtime, all of those things.

Dr. Chris Myers: Okay, great. Yeah, so, man, this is just some amazing content and some knowledge that you’re giving here. I’m even learning stuff. I’ve been doing this for about 20 years. but, yeah, the one thing that. So we always think, you know, with nutrition, we’re always thinking food, food and vitamins. but the other thing that usually doesn’t get discussed is hydration.

There’s a difference between drinking water and hydration

Now we’re talking. Now, for those who are fairly new to this, especially when we start talking about human performance and wellness principles, there’s a difference between drinking water and hydration. So I could go into that. But you know what? I don’t want to take any more of your thunder. Megan, why don’t you. Can you explain layman’s terms, what hydration is?

Megan Lautz: Yeah. Well, hydration includes, well, it depends on your losses. Right.

Megan Lautz: and then also your intake. So, a lot of times people overlook the electrolyte piece. And if they are truly already pretty dehydrated, they’re already compromised the sugar piece, because there’s a lot of sugar free products out there now.

Megan Lautz: and to start with, that, like, one of the biggest problems I see with shift work, other than sleep, is, holding their urine. Right? Like, you don’t have access to bathrooms. And whether that’s like, the bathroom is 5ft away and you’re just stuck in rounds or you are truly in a patrol car and there is nowhere safe for you to go. so people purposely dehydrate themselves so they don’t have to go to the bathroom.

Dr. Chris Myers: Right on.

Megan Lautz: now, of course, with fire, police, Swat, like, some of those higher m intensity units are going to have significant losses. With fire, it’s up to 40oz. So, like a Stanley cup, in 30 minutes. Okay, so their losses are insane. Like your med student in an air conditioned place, probably fine, surgeons, I’d imagine, would have another issue. Right. But a lot of times, these more health conscious individuals are going for sugar free electrolyte products. And the concern that I have with that is not that they don’t work. They work. Right. Sodium pulls water across the cell membrane from the intestine into the cell to rehydrate the cell. But what a lot of people don’t realize is there’s a power up option, and that is called the sodium glucose co transporter. And in order for that transporter to work, you have to have glucose available. Right. And then you have to. Then it’ll pull sodium across, which then water will follow. Right. So you rehydrate the cell two to three times faster. so when you have a product that contains sugar, this is how oral rehydration, solutions work, is they rely not only on the electrolyte, but they also rely on the sugar or the glucose.

Dr. Chris Myers: Interesting.

Megan Lautz: Okay, so when I have someone who’s asking me, hey, Megan, how do I optimally rehydrate? Well, I’m going to tell you to choose the product with the sugar and the sodium. Right. With the oral rehydration solutions, based on the who standards.

Megan Lautz: so that is drip drop, I believe liquid iv and pedialyte sport are some of the most popular ones. but a lot of people are going for element or, fire salt or some of these other products that are sugar free, which I. I’m not going to say they don’t work. They do work, but they’re not going to work as fast. And if I’ve got a dehydrated firefighter or even a dehydrated surgeon, I need to fix that fast.

Dr. Chris Myers: Yeah.

Megan Lautz: Right. So that’s one of the biggest considerations with hydration, Evan.

Dr. Chris Myers: Interesting.

Megan Lautz: Okay.

Dr. Chris Myers: I’m glad you brought that up. Yeah, it’s. It’s really interesting, to really see what all the different products out there and we don’t really consider. Yeah, yeah. This may be a healthier option, but doesn’t meet my needs and, well, performance.

Megan Lautz: Because performance and healthy are two different things, in my opinion. Yeah. because I get a lot of, like, canteens or rehab units. So these are the units that show up to really big alarms, big fires, like, lots of firefighters in there, lots of cops are there, like, big incidents. and they show up and they bring snacks. It’s like a food truck. And they’re like, how do we make this healthier? And I’m like, well, healthier is not what you want at these major alarms. Right. You need sugar and sodium. yeah, it needs to be quick fuel and need the sodium to replace for rehydration purposes. But that’s not the stuff I want you to be, you know, taken down when you’re just sitting watching tv in the day room. It comes down to context. So sugar and sodium are performance enhancing in high intensity scenarios. But high sugar, high sodium diets, when you don’t really do a whole lot of those high intensity scenarios, can be long term, lead to long term health consequences.

Dr. Chris Myers: Exactly. Yeah. So it’s a similar, so it’s a similar approach, whereas with the, Ironman athletes that I work with. Right. And so it’s during those long, really long exercises. Okay, we’re, we’re switching out the fuels. We’re actually using a mix of slow burning carbs, you know, and start hitting the higher carb counts, roughly about 60 to 90 /hour plus, a sugar free, electrolyte mix, you know, like noon or something like that. That works out well. Or we break it up in half for the water bottles, depending on how much they’re drinking hour, or if they can also eat simultaneously. Same thing with, with the tactical populations.

Hydration for shift workers varies significantly based on how active they are

Now, the thing we need to consider is, you know, let’s take shift work aside, so let’s kind of flip it on its paradigm a little bit. so sometimes, you know, with our, young medical personnel, but they’re, they’re not working shift. They may just be working long hours, but they’re getting, let’s say they are getting, you know, three squares, you know, balanced, or even four if they’re breaking it up smaller per day. how would you change that, that strategy? Or if you would, for hydration, when.

Megan Lautz: You said three small, did you say meals? Or did you say meals?

Dr. Chris Myers: Sorry, meals. Yeah. If they’re eating three meals a day or if they’re breaking up to smaller four, five, six meals a day, how would you, how would you advise the hydration strategy based on that type of scenario?

Megan Lautz: Yeah, well, so, it kind of. It depends. It depends on how active you are. and, and the challenge with active is it varies significantly for shift workers. Right.

Megan Lautz: so I go based off kind of their step count. And this is all anecdotal. I’m just kind of making this stuff up. And the reason I use step count is if you’re getting 10,000 steps per shift without even trying, that’s a medium, that’s a medium busy. If you are getting 1520, 5000 steps in a shift without trying, then that’s a pretty active shift. You’re at a busier station, you’re physically moving. You’re not just mentally moving. you’re physically moving. So if you’re on that higher end, you’re going to need at least. I go by the Institute of Medicine Standards, 90 to 125oz of fluid. 90 for women, 125 for men. Those are the minimums. But also keep in mind that that includes juice, that includes coffee, that includes tea. So, from my understanding, research suggests that, especially in habitual coffee drinkers, people’s total body hydration over the course of the day stays the same. They lose more fluid in the first hour, but they replaced it with the liquid from the coffee so it just evens out. now of course, if you’re doing jet fuel or like death wish and the super high caffeine stuff, there’s other issues there.

Dr. Chris Myers: Yes.

Megan Lautz: which I always have to mention because they are doing that. so those all count towards that. So that’s the minimum. So we’re talking, if you do the Stanley’s like, we’re talking about two to three of these a day, 40oz. So, And how you spread that out is kind of up to you. I mean, I would suggest evenly throughout the day. you know, or if you know, you’re doing hot stuff later in the day, really kind of front loading that maybe adding a liquid iv, Or a drip drop. I do tell people if you sweat, this is anecdotal as well. If you sweat through one uniform, which many of my first responders will set sweat through several uniforms throughout the course of the day. You need probably one liquid iv or one drip drop so that you don’t feel hungover at the end of your shift. So it’s a little place, but I don’t know if that helps.

Dr. Chris Myers: Yeah, you know, that’s actually really good advice. I mean, it’s the same thing. You know, if you’re in a high, if you’re in a high, intensity hot or. Yeah, yep. You’re going on the same thing.

Megan Lautz: Yeah, yep.

Dr. Chris Myers: So.

Megan Lautz: Or stress sweats, same thing.

Dr. Chris Myers: You’re still losing water, you’re still losing the iron, still losing the calcium. So your ph is, you know, is dropping. You’re so, I mean, you might as.

Megan Lautz: Well front load then, you know, if you’re going to be in an or scenario, whether you’re a resident or a surgeon or whoever, you are. And you know, you’re not going to be able to get anywhere. Try and get that liquid iv in an hour before, That way you can still kind of go to the bathroom right before you have to start the surgery or whatever. And then you kind of front loaded it. What most people do is they forget. They do it on the back end and then they still feel like garbage. So you kind of want to front.

Dr. Chris Myers: Very interesting. Again, always learn something from, you know.

Megan Lautz: You don’t learn this from a textbook. You learn this by slamming things around and hoping for the best and seeing what happens.

Dr. Chris Myers: I love it. Just the trial and error. Yeah, it’s really good, but that, but that’s where it goes. I think you really hit it on the point where the textbook does not meet reality all the time. The, the, textbook teaches you the box. Now you have to start thinking outside the box when the environment changes.

Megan Lautz: Yeah. And it depends. The textbook doesn’t teach. It depends. Right.

Dr. Chris Myers: Yeah. So, you know, yeah, it’s what keeps us all, keeps us all employed. I love it. So, yeah, I mean, so this has been great. I mean, gotta have you back. I mean, there’s more to kind of unpackage here, but we are starting to run short on time.

I mean, so with all that, if you had one piece of advice to kind of give to, you know, our young medical professionals, and even some of our seniors, some of the senior medical professionals that listen to this, what are some of the advice you give them personally to kind of help with, you know, professional, professional performance, but also with some of the advice they might be able to give to their, their clients as well.

Megan Lautz: Yeah. I think it just comes down to like, it’s okay to make better bad decisions. Right. or healthy ish decisions. So, you know, if you have, all you have the option for, for lunch is pizza and a side salad. You did the side salad and said two pieces of pizza. That’s a better bad decision. Right. And a lot of people will just spend a lot of time beating themselves up because it wasn’t the perfect option. So in these scenarios, you, you’ve just, you’ve got to pick the better op, the better bad decision. Right. so, you know, it’s okay. And just so you know, like a lot of people don’t realize there’s room for, in our diets for discretionary calories. So if you need some ice cream at the end of the day to take the edge off, have a little bit of it, keep it controlled. but try not to have a bunch of sweets throughout the day. So again, it comes down to you kind of have to negotiate with yourself. you know, it’s, you know, trying to make those slightly better decisions with your food, with your hydration. and try and figure out strategies that work with your lifestyle instead of how can I make my nutrition and everything super perfect? Because that can actually lead to a disorder. yeah, so, and I used to do bodybuilding, and that’s exactly what happened to me. So, you know, the gray area is okay.

Dr. Chris Myers: Yeah. Excellent. I love it.

Well, Megan, it’s been a pleasure. I mean, I hope, I know I learned something. I definitely hope our audience did, and I hope they enjoyed it. So, I mean, if they, if they ever, if there’s any questions or anything, is there a way that they can get in contact with you or reach out to you?

Megan Lautz: Yep. so rescuerd.com is my website. Megan, at rescuerd’s email, I’m also pretty active on LinkedIn, TikTok, Facebook, and Instagram. While it’s firefighter focused, it’s really just for people who don’t have time, money, and energy. Right. So that’scu rd.

Dr. Chris Myers: Excellent. Yeah. So reach out, you know, follow Megan on LinkedIn and the amazing website. Just the tidbits she puts out on a daily basis is amazing. So, a lot of my, a lot of my, colleagues follow you as well, kind of turn them on to you. So you’ll see some, some air force people following you too. So. All right, well, thanks for your time, and I hope to talk to you again in the near future.

Megan Lautz: Absolutely. Thank you.

Dr. Chris Myers: All right, I, hope you all enjoyed, enjoyed this podcast. See you next time on WCW.

Megan Lautz: It, ahoda media production.