Sleep pattern is associated with adipokine levels and nutritional markers in resident physicians

Abstract

Shift work and long hours of work are common in medical training and have been associated with a higher propensity for developing nutritional problems and obesity. Changes in leptin and ghrelin concentrations - two hormones that contribute importantly to the central regulation of food intake - are poorly described in this population. The aim of this study was to identify possible negative associations between sleep patterns, nutritional status and serum levels of adipokines. The study included 72 resident physicians (52 women and 20 men) who underwent the following assessments: nutritional assessment (3-day dietary recall evaluated by the Adapted Healthy Eating Index), anthropometric variables, fasting metabolism, physical activity level, sleep quality and sleepiness. Resident physicians with poor sleep quality reported greater weight gain after the beginning of residency (5.1 and 3.0 kg, respectively; p = 0.01) and higher frequency of abnormal waist circumference (44.2 and 17.6%, respectively; p = 0.04) than those with better sleep quality. Mean ghrelin concentration was greater in volunteers with poor sleep quality (64.6 ± 67.8 and 26.2 ± 25.0 pg/mL, respectively; p = 0.04). Women identified as having excessive daytime sleepiness had lower levels of leptin (9.57 ± 10.4 ng/mL versus 16.49 ± 11.4 ng/mL, respectively; p = 0.03) than those without excessive sleepiness. Furthermore, correlations were found between hours of additional work per week and: intake of cereals, bread and pasta (r = 0.22, p = 0.01); intake of servings of fruits (r = -0.20; p = 0.02) and beans (r = -0.21; p = 0.01); and global score for Adapted Healthy Eating Index (r = -0.23; p = 0.008; Table 3). The sleep quality total score correlated with servings of beans (r = -0.22; p = 0.01) and servings of oils (r = 0.23; p = 0.008). Significant correlations were found between mean of time of sleep and servings of cereals, bread and pasta (r = 0.20; p = 0.02), servings of meat (r = -0.29; p = 0.02) and cholesterol levels (r = 0.27; p = 0.03). These observations indicate that sleep patterns and long working hours of resident physicians are negatively associated with biological markers related to central food control, the lipid profile, cholesterol levels and eating healthy foods. These factors may predispose these shift workers to become overweight and develop metabolic disorders.

Impact of a Residency-Integrated Wellness Program on Resident Mental Health, Sleepiness, and Quality of Life

“…Previously validated psychological instruments were administered to participants in private and collected in a confidential manner during the first month of program implementation (July 2015). To assess baseline depression, anxiety, and quality of life, the 8-item Personal Health Questionnaire Depression Scale, 20 Generalized Anxiety Disorder 7-Item Scale, 21 and Quality of Life Scale 22,23 were administered. The Epworth Sleepiness Scale 24 was administered to assess baseline sleep deprivation.…”

Co-Morbidity, Mortality, Quality of Life and the Healthcare/Welfare/Social Costs of Disordered Sleep: A Rapid Review

“…Disrupted circadian mechanisms play an unequivocal role in abnormal adipogenesis, low glucose tolerance, impaired insulin responsiveness, and genetic susceptibility, which, in turn, are aggravated by excessive (high caloric) food intake and sedentary lifestyles [44,45]. Poor sleep has been associated with changes in appetite-regulating hormones (including lower levels of leptin and increased levels of ghrelin), increased subjective appetite and caloric intake, obesity or high BMI, or increased blood pressure [46,47]. …”

Calidad de la dieta del personal de salud de un hospital chileno según el índice de alimentación saludable

“…Experiencias internacionales demuestran que el personal que trabaja en servicios hospitalarios tiene mayor probabilidad de presentar factores de riesgos asociados a las ECNT, entre ellos, pocas horas de sueño, bajos niveles de consumo de frutas y verduras, alto consumo de azucares, sobrepeso, tabaquismo y altos niveles de estrés (6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Es así como el trabajar a través de sistemas de turnos nocturnos también tiene repercusiones en el metabolismo, generando un impacto negativo en salud de las personas.…”