title: Dietary patterns, metabolic markers and subjective sleep measures in resident physicians.
abstract: Shiftwork is common in medical training and is necessary for 24-h hospital coverage. Shiftwork poses difficulties not only because of the loss of actual sleep hours but also because it can affect other factors related to lifestyle, such as food intake, physical activity level, and, therefore, metabolic patterns. However, few studies have investigated the nutritional and metabolic profiles of medical personnel receiving training who are participating in shiftwork. The aim of the present study was to identify the possible negative effects of food intake, anthropometric variables, and metabolic and sleep patterns of resident physicians and establish the differences between genders. 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 (height, weight, body mass index, and waist circumference), fasting metabolism (lipids, cortisol, high-sensitivity C-reactive protein [hs-CRP], glucose, and insulin), physical activity level (Baecke questionnaire), sleep quality (Pittsburgh Sleep Quality Index; PSQI), and sleepiness (Epworth Sleepiness Scale; ESS). We observed a high frequency of residents who were overweight or obese (65% for men and 21% for women; p = 0.004). Men displayed significantly greater body mass index (BMI) values (p = 0.002) and self-reported weight gain after the beginning of residency (p = 0.008) than women. Poor diet was observed for both genders, including the low intake of vegetables and fruits and the high intake of sweets, saturated fat, cholesterol, and caffeine. The PSQI global scores indicated significant differences between genders (5.9 vs. 7.5 for women and men, respectively; p = 0.01). Women had significantly higher mean high-density lipoprotein cholesterol (HDL-C; p < 0.005), hs-CRP (p = 0.04), and cortisol (p = 0.009) values than men. The elevated prevalence of hypertriglyceridemia and abnormal values of low-density lipoprotein cholesterol (LDL-C; >100 mg/dL) were observed in most individuals. Higher than recommended hs-CRP levels were observed in 66% of the examined resident physicians. Based on current recommendations, a high prevalence of low sleep quality and excessive daytime sleepiness was identified. These observations indicate the need to monitor health status and develop actions to reassess the workload of medical residency and the need for permission to perform extra night shifts for medical residents to avoid worsening health problems in these individuals.
authors: Post Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil.
authors: Maria Carliana
authors: MC
authors: Mota
authors: Daurea Abadia
authors: DA
authors: De-Souza
authors: Luana Thomazetto
authors: LT
authors: Rossato
authors: Catarina Mendes
authors: CM
authors: Silva
authors: Maria Bernadete Jeha
authors: MB
authors: Araújo
authors: Sérgio
authors: S
authors: Tufik
authors: Marco Túlio
authors: MT
authors: de Mello
authors: Cibele Aparecida
authors: CA
authors: Crispim
mesh_terms: D000328:Adult; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D015228:Hypertriglyceridemia / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D007396:Internship and Residency; D008019:Life Style; D008297:Male; D008505:Medical Staff, Hospital; D015596:Nutrition Assessment; D009752:Nutritional Status; D009765:Obesity / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D016272:Occupational Health; D010561:Personnel Staffing and Scheduling; D015995:Prevalence; D012737:Sex Factors; D012890:Sleep; D020178:Sleep Disorders, Circadian Rhythm / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014940:Work Schedule Tolerance; D016526:Workload
chemical_list: D015415:Biomarkers