Associations Between Dietary Patterns and Sleep-Related Impairment in a Cohort of Community Physicians: A Cross-sectional Study

Abstract

There is increasing evidence that diet can mitigate fatigue. The objective of this study was to assess the associations between dietary habits and sleep-related impairment (SRI) in a cohort of community physicians. In this cross-sectional study, we analyzed data from 245 physicians who had completed a wellness survey in March 2016 (98% response rate). Three dietary patterns were derived using principal component analysis: plant based, high protein, and high saturated fat and sugar. In the adjusted analysis, every SD increase in the plant-based dietary pattern score was associated with a 0.71-point decrease ( β = −0.72; SE = 0.32; P = .027; 95% CI = −1.35 to −0.08) in the SRI score, and every SD increase in the high saturated fat and sugar dietary pattern score was associated with a 0.77-point increase ( β = 0.77; SE = 0.32; P = .015; 95% CI = 0.15 to 1.39) in the SRI score. There were no associations between high protein diets and SRI scores. Physicians adhering to diets that are high in plant-based foods and low in saturated fat and added sugars had less SRI. Physicians currently face significant barriers to maintaining a healthy diet. This study highlights the potential role of workplace nutrition on SRI and work performance of physicians.

Systematic review of the factors and the key indicators that identify doctors at risk of complaints, malpractice claims or impaired performance

“…In general, community doctors have a slightly higher sleep-related impairment score compared with reference populations (ie, the 2000 General US Census). 20 Surgeons' performance post-on-call shift (ie, when a clinician is able to be contacted to provide care if necessary, but not formally on duty) was similar to, or worse than, the performance of intoxicated surgeons to a degree where dose-dependent ethanol-induced performance closely resembled the decrease of performance over a 14-hour night shift. 46 Similarly, a study from the USA 47 reported that doctors remained impaired (eg, attentional failures) even after over 4 hours of sleep.…”

“…18 The extent to which age is confounded with patient volumes is unclear and potentially important, as detailed examination has shown that the number of claims per 1000 patient encounters is higher for clinicians with lower numbers of patient encounters. 19 Impairment Younger doctors at risk of impaired performance were more likely to be affected by environmental factors (eg, work induced fatigue), 20 while older doctors (eg, 59-90 years of age) were at greater risk of impaired performance due to cognitive disorders. 21 22 According to two studies, age was not a good predictor of impaired performance 23 or burn-out.…”

“…37 Doctors with diets that were high in plant-based foods and low in saturated fat and added sugars had less sleep-related impaired performance. 20…”

The Effect of Nutrients on Subjective Accomplishment at Work: Results from a Health Survey and a Single-Arm Dietary Intervention Study

“…DS and fatigue caused by elevated blood glucose levels and parasympathetic hyperactivity after eating are physiological phenomena that many people have experienced [15]. Intake of foods high in melatonin, tryptophan, trans fatty acids, and saturated fatty acids tend to make people feel tired after eating [16,17]. There are also reports that avoiding highcarbohydrate diets can suppress postprandial rises in blood glucose levels, and avoiding high-protein diets can maintain adenosine levels in the brain, which may reduce postprandial sleepiness [18,19].…”

Designing and Building a Portfolio of Individual Support Resources for Physicians

“…12 In the authors’ experiences, broad educational health promotion is often a first step in providing individual support measures for professional well-being. For example, organizations may provide training seminars or workshops to teach or encourage mindfulness or meditation, 16,17 breathing techniques, 18 time in nature, 19 gratitude and positive psychology, 20,21 psychological first aid in disaster management, 22 nutrition, 23 sleep, 24 and exercise. 25 Meetings that focus on the human aspect of medicine, such as the interprofessional Schwartz rounds, 26 can be inspiring and encourage important discussions about the meaning of health care work; they also can be helpful for the emotional support of health professional teams.…”