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Studies examining sleep, nutrition, and/or physical activity to enhance cardiometabolic health parameters of airline pilots
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Background:
Airline pilots experience unique occupational demands that may contribute to adverse physical and psychological health outcomes. Epidemiological reports have shown a substantial prevalence of cardiometabolic health risk factors including excessive body weight, elevated blood pressure, poor lifestyle behaviors, and psychological fatigue...
Context in source publication
Context 1
... improvements in sleep, nutrition and exercise behaviors are associated with reduced fatigue [60] and improved physical and mental health in commercial pilots [50] ( Table 1). Preventive lifestyle interventions may promote work performance, flight safety, and positively impact pilot career longevity [134,135]. ...Citations
... While pharmacological treatments are commonly used, there is growing interest in non-drug therapies and lifestyle modifications. The current findings examine the effectiveness of these interventions, focusing on behavioral therapies, sleep hygiene, physical activity, dietary changes, and other complementary approaches (Briguglio et al. 2020;Wilson et al. 2022Wilson et al. , 2023. ...
Sleep is regarded as one of the most crucial factors in keeping a healthy lifestyle. To function normally, a person needs at least 6–8 h of sleep per day. Sleep influences not only our mood but also the efficiency with which we complete tasks. Sleep disorders exhibit diverse etiologies across different conditions and populations, with genetic and environmental factors playing a significant role in their development. Many issues emerge as a result of inadequate sleep. Unhealthy food and lifestyle choices have increased our susceptibility to sleep disorders. A well-balanced diet rich in essential vitamins and minerals can have a profound impact on sleep patterns, enhancing both the duration and quality of rest. The primary categories of sleep disorders include insomnia, sleep apnea (SA), narcolepsy, parasomnias, circadian rhythm disorders, and restless legs syndrome (RLS). The drugs used to treat sleep disorders are primarily habit-forming and have a history of withdrawal effects. This insufficiency in medication has prompted the hunt for newer, better options. Nutraceuticals are well-suited to the treatment of such illnesses. Its non-toxic, non-habit-forming properties, and practical efficiency have made it an outstanding choice. This review provides nutraceuticals used in sleep disorders. A comprehensive literature search was conducted utilizing several databases, including Google Scholar, Elsevier, Springer Nature, Wiley, PubMed, and EKB. Nutraceuticals are products that employ food or dietary components to treat or prevent disease. In the therapy of sleep disorders, nutraceuticals such as Artemisia annua, valerian, rosemary, jujube, Passionflower, lemon balm, ashwagandha, kava-kava, lavender, and chamomile have been shown to have remarkable benefits. These remedies exert their effects through multiple mechanisms, both directly by modulating neurotransmitter and hormonal pathways within sleep circuits, and indirectly by enhancing sleep quality through the alleviation of stress, inflammation, and oxidative stress. Clinical studies were piloted to validate the efficacy of natural sleep aids. Future research should focus on elucidating the precise mechanisms through which natural products influence sleep.
... Circadian disruption is an inherent risk for airline pilots due to occupational characteristics including shift work, changing work schedules, extended duty periods, and traveling across time zones [45]. Poor sleep is associated with impaired daytime functioning and increased mental health problems in the general population [4]. ...
... Poor sleep is associated with impaired daytime functioning and increased mental health problems in the general population [4]. Among pilots, poor sleep has been expressed as a primary form of work-related stress [15] and has been linked to elevated psychological stress and fatigue, dysregulation of other health behaviors, and poses risk to flight safety [9,45]. A recent study reported poor sleep quality among airline pilots was associated with an adverse profile of plasma biomarkers reflective of cardiometabolic risk [46]. ...
... Sedentary behavior and insufficient physical activity are associated with adverse effects on mental health [2,49]. Work demands of airline pilots are predominantly sedentary in nature [45], and a recent estimate of the prevalence of insufficient physical activity among airline pilots globally was 51.5% [9]. Correspondingly, 48% of our participants did not achieve MVPA guidelines. ...
Background
Lifestyle behaviors including physical activity, sleep, nutrition, smoking, and alcohol consumption are independently associated with health, yet the relationship between these behaviors and mental health has not been explored among airline pilots. The aim of this study was to measure the association between health behaviors and mental health.
Methods
A cross‐sectional study was conducted among 502 airline pilots. The primary outcome measure was the mental component score (MCS), derived from the Short Form Health Survey 12v2. We collected information regarding age, sex, ethnicity, height, body mass, alcohol consumption, tobacco smoking status, moderate‐to‐vigorous physical activity (MVPA), fruit and vegetable intake, and sleep duration.
Results
After controlling for demographic and anthropometric parameters, MVPA, fruit and vegetable intake, and sleep duration were positively correlated with MCS (p ≤ 0.001), and alcohol consumption and tobacco smoking were negatively correlated with MCS (p ≤ 0.001). Multiple linear regression analyses revealed alcohol consumption was the strongest predictor of MCS (β = −0.308, p ≤ 0.001), followed by smoking (β = −0.236, p ≤ 0.001), MVPA (β = 0.233, p ≤ 0.001), sleep (β = 0.148, p ≤ 0.001), and fruit and vegetable intake (β = 0.097, p = 0.003).
Conclusion
The results suggest that greater physical activity, sleep duration, and fruit and vegetable intake are associated with better mental health. Meanwhile, excessive alcohol consumption and tobacco smoking undermine mental health status.
... In the context of airline pilots, who face unique occupational stresses and irregular schedules [18], maintaining regular oral hygiene routines might be particularly challenging, potentially exacerbating this issue. However, considering the cross-sectional design of our study, which is unable to measure causes and effects, we acknowledge that the observed relationship is not necessarily causal. ...
Introduction
Airline pilots are susceptible to mental health issues, with depression prevalence ranging from 1.9% to 12.6%. Recent research in the general population indicates a potential link between depression and oral health. In this cross-sectional study, we sought to investigate the association between self-reported oral hygiene practices and depressive symptoms among airline pilots.
Methods
One hundred actively working male airline pilots of Caucasian descent voluntarily enrolled in the study during routine occupational health visits. Depressive symptoms were assessed using the Beck Depression Inventory II (BDI-II). Self-reported oral hygiene practices, including toothbrushing frequency and mouthwash usage, were examined. Univariable and multivariable logistic regression analyses were performed to investigate associations between depressive symptoms and oral hygiene practices.
Results
Twelve pilots (12%) demonstrated mild depressive symptomatology (BDI-II scores 14-19). Pilots with mild depression reported significantly lower rates of brushing teeth twice or more per day (33.3% vs. 80.7%) and higher rates of rarely brushing (16.7% vs. 1.1%) compared to those with minimal depressive symptoms (p < 0.001). Nonuse of mouthwash was more prevalent among pilots with mild depression (66.6% vs. 23.9%, p = 0.008). Multivariable logistic regression analysis revealed that pilots who rarely brushed their teeth (adjusted odds ratio (OR) = 14.6; 95% confidence interval (CI) = 1.3−197.9; p < 0.05) or did not use mouthwash (adjusted OR = 5.7; 95% CI = 1.4−25.2; p < 0.05) had significantly higher odds of mild depressive symptoms.
Conclusions
Self-reported oral hygiene habits may serve as a proxy indicator for mild depressive symptoms among airline pilots. Incorporating oral health assessments into routine aeromedical examinations could provide a practical method of identifying pilots at risk for depression, supporting timely interventions and enhancing flight safety.
... Kebisingan di kokpit pesawat terbang dapat mencapai 120 desibel dan dapat menyebabkan gangguan pendengaran, terutama pada pilot jet yang baru memulai karirnya. Tekanan udara di kokpit pesawat terbang dapat mencapai 0,8 kali tekanan udara normal dan dapat menyebabkan penyakit kardiovaskular, seperti penyakit jantung dan stroke (Hardy & Parasuraman, 1997) (Wilson et al., 2023). Keamanan kesehatan pilot jet menjadi isu yang penting untuk dipertimbangkan. ...
Perkembangan teknologi kesehatan telah membawa solusi inovatif untuk meningkatkan pemantauan kesehatan pilot, aspek yang krusial dalam keamanan penerbangan. Penelitian ini membandingkan pendekatan aplikasi konvensional dengan integrasi teknologi blockchain dalam platform One Gate Analyst, dengan fokus pada pengembangan instrumen, validasi data, dan keamanan data secara keseluruhan. Pada One Gate Analyst, pengembangan instrumen mengambil jalur yang lebih rumit, menggabungkan fitur keamanan canggih dan validitas berbasis blockchain untuk memastikan keandalan data kesehatan pilot. Meskipun kedua aplikasi mengikuti metode konvensional dalam uji validitas dan reliabilitas, One Gate Analyst memperkuat keamanan data melalui pemanfaatan teknologi blockchain. Fase implementasi pada One Gate Analyst melibatkan integrasi teknologi blockchain, secara signifikan meningkatkan keamanan data dan pengendalian akses melalui smart contracts dan user access guards. Sebaliknya, aplikasi konvensional tidak melibatkan integrasi blockchain, yang berpotensi membuka risiko keamanan yang lebih rendah. Proses pengumpulan data pada One Gate Analyst memanfaatkan teknologi blockchain untuk pengumpulan data yang terdistribusi, memperkuat keamanan data, menjamin ketahanan data, dan memastikan keandalan informasi kesehatan pilot. Analisis data pada One Gate Analyst mempertimbangkan keamanan dan integritas data yang diberikan oleh teknologi blockchain, memberikan informasi yang lebih terpercaya bagi profesional medis dalam membuat keputusan medis yang krusial. Sebagai kesimpulan, integrasi teknologi blockchain dalam One Gate Analyst menunjukkan peningkatan yang signifikan dalam keamanan data, keandalan, dan distribusi dibandingkan dengan aplikasi konvensional. Pendekatan pengembangan instrumen yang canggih dan integrasi blockchain meningkatkan keseluruhan keamanan dan efektivitas pemantauan kesehatan pilot, membentuk dasar yang kokoh untuk kemajuan dalam keamanan penerbangan.
... across different time zones, often disrupts their natural body rhythms. In addition, pilots may suffer from fatigue, exposure to cosmic radiation, irregular meal times, disrupted sleep patterns, and even symptoms of depression [6][7][8][9][10]. The sedentary nature of their job and the cabin environment, characterized by noise and vibrations [11], further compound these challenges. ...
... Intriguingly, studies have demonstrated a potential association between the seroprevalence of anti-HSV-1 antibodies and CVD [17][18][19]. Remarkably, the burden of cardiovascular risk factors appears to be significantly elevated among APs [7,8,20]. In a cohort study conducted by Siscovick et al. [17] in the United States, it was discovered that older individuals with IgG antibodies against HSV-1 were twice as likely to experience myocardial infarction and cardiovascular mortality. ...
... Furthermore, H. pylori infection has been linked to various extraintestinal manifestations, such as CVD, obstructive sleep apnea syndrome, and metabolic syndrome [29]. These are conditions that have been previously reported in the pilot population [6][7][8], adding to the significance of this association. Another intriguing observation is the connection between H. pylori and motion sickness. ...
Background
The variation in infection risk among individuals is thought to be partially influenced by occupational factors. This study aims to investigate the seropositivity rates of 17 common infectious agents in male airline pilots (APs), a professional group known to experience a high prevalence of cardiovascular and gastrointestinal diseases.
Methodology
In our study, we employed a case-control design with 100 male APs as cases, matched by age, sex, and tenure (i.e., at least five years of service) to 100 male office workers (OWs) who served as controls. We measured the IgG antibody levels to 17 pathogens using specific enzyme-linked immunosorbent assays, including herpes simplex virus 1, herpes simplex virus 2, varicella-zoster virus, Epstein-Barr virus, cytomegalovirus, human herpesvirus 6, human herpesvirus 7, Kaposi’s sarcoma-associated herpesvirus, Toxoplasma gondii, human T-lymphotropic virus 1, BK virus, John Cunningham virus, Merkel cell polyomavirus, human papillomavirus 16, human papillomavirus 18, Chlamydia trachomatis, and Helicobacter pylori. The determination of seropositivity cutoffs for each pathogen was made in accordance with the guidelines provided by the respective kit manufacturers.
Results
The seropositivity rates for the 17 pathogens ranged from 1% for human T-lymphotropic virus 1 to 94% for varicella-zoster virus and were similar in both professions, except for herpes simplex virus 1 and Helicobacter pylori, which were more prevalent in APs.
Conclusions
Our findings suggest a higher prevalence of previous infections with herpes simplex virus 1 and Helicobacter pylori in APs compared to OWs. These infections may be associated with the prevalence of specific non-communicable diseases in this professional group. However, additional longitudinal studies are needed to substantiate this hypothesis.
... Airline pilots face distinctive occupational circumstances that are marked by irregular schedules, prolonged periods of wakefulness, and extended exposure to ultraviolet and cosmic radiation [11,12] Such conditions are recognized contributors to an increased risk of cardiometabolic disorders and malignant melanoma [11,12], all conditions that could be closely linked to compromised autophagy flux [13][14][15]. Additionally, construction workers who are regularly exposed to environmental contaminants like particulate matter and toxic metals may also experience an increase in autophagic flux as a protective response [16]. ...
... Airline pilots face distinctive occupational circumstances that are marked by irregular schedules, prolonged periods of wakefulness, and extended exposure to ultraviolet and cosmic radiation [11,12] Such conditions are recognized contributors to an increased risk of cardiometabolic disorders and malignant melanoma [11,12], all conditions that could be closely linked to compromised autophagy flux [13][14][15]. Additionally, construction workers who are regularly exposed to environmental contaminants like particulate matter and toxic metals may also experience an increase in autophagic flux as a protective response [16]. ...
Background: The possible associations between occupational factors and autophagy - a catabolic process that is evolutionarily conserved and serves as a vital cornerstone in maintaining cellular balance - remain largely unexplored.
Objectives: We assessed serum levels of beclin-1, a principal effector of autophagy, and the mammalian/mechanistic target of rapamycin (mTOR), a protein recognized for its part in suppressing autophagy, within a group of healthy individuals hailing from three different professional fields, each characterized by its unique working conditions.
Methods: A total of 60 men were recruited from three distinct occupational categories: airline pilots, construction laborers, and fitness trainers. Each group consisted of 20 subjects who were selected during routine occupational health appointments. Serum levels of beclin-1 and mTOR were measured using commercially available immunoassays and compared among the three categories.
Results: Fitness instructors had the highest concentration of beclin-1 (3.1 ± 0.9 ng/mL). Construction workers followed with a mean of 2.4 ± 0.4 ng/mL, while airline pilots had the lowest levels at 1.9 ± 0.5 ng/mL (one-way analysis of variance, P < 0.001). In terms of mTOR levels, construction workers had the highest concentration (5.9 ± 1.9 ng/mL), followed by airline pilots (4.4 ± 1.7 ng/mL). Fitness instructors, on the other hand, had the lowest mTOR levels (3.5 ± 1.2 ng/mL; one-way analysis of variance, P < 0.001).
Conclusions: Serum levels of autophagy biomarkers can vary among healthy individuals based on their professional roles. Considering the crucial function autophagy serves in both health and disease, further investigations are crucial to deepen our comprehension of the potential implications of autophagy in the field of occupational medicine.
... This is especially significant as it allows for the early detection of NAFLD in seemingly healthy pilots, enabling timely intervention through evidence-based interventions targeting nutrition, physical activity, and sleep hygiene. [28] Considering the critical role APs play in ensuring the safety of millions of travelers globally, [4] it is imperative to prioritize providing guidance and support to overweight pilots. Furthermore, prospective studies are needed to further evaluate the usefulness of LSM and CAP as imaging biomarkers for predicting clinical cardiometabolic outcomes in this occupational group. ...
Background and Aim
Airline pilots (APs) are often characterized by a sedentary lifestyle, predisposing them to adverse cardiometabolic consequences. In this cross-sectional study, we used transient elastography (TE) to investigate the prevalence of hepatic steatosis and fibrosis among apparently healthy APs.
Materials and Methods
The study cohort consisted of 137 male APs of Caucasian descent who voluntarily underwent TE. To evaluate the extent and severity of hepatic steatosis and fibrosis, we employed established cutoff values for the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM).
Results
Of the APs, 34 (24.8%) were diagnosed with TE-defined steatosis. Specifically, 25 APs (18.2%) exhibited mild steatosis, 6 (4.4%) moderate steatosis, and 3 (2.2%) severe steatosis. The majority of participants (80 APs or 58.4%) showed no signs of liver fibrosis based on LSM values. However, 49 APs (35.8%) were diagnosed with mild fibrosis (F1), 7 (5.1%) with significant fibrosis (F2), and one (0.7%) with advanced fibrosis (F3). None of the pilots had F4 (cirrhosis). In multivariable linear regression analysis, BMI was the sole independent predictor of both CAP (β=0.34, p<0.001) and LSM (β=0.41, p<0.001) values in our sample of male APs.
Conclusion
TE is a straightforward and convenient non-invasive method for detecting hepatic steatosis and fibrosis in high-risk occupational groups such as APs.
Introduction and Aim: Sleep quality is an important determinant of general health and daily functionality and is affected by many factors, including sleep hygiene. Sleep hygiene, on the other hand, is the collection of environmental factors, habits, and practices conductive to the person’s sleep for the right amount of time and quality. This study aimed to evaluate sleep quality and its determinants in medical students. Methods: The data of this descriptive study were collected at Marmara University Faculty of Medicine in January-February 2020. Medical students from Term 2 and Term 5 were included in the study. The data collection form consisted of 37 questions about individual characteristics, behaviors affecting sleep hygiene and sleep quality. The sleep quality level of the participants was evaluated with the Pittsburgh Sleep Quality Index (PSQI). The chi-square test, Fisher’s exact test, and Spearman’s rank correlation coefficient were used in data analysis. Results: Of the participants, 66.9% (n=107) had poor sleep quality. Among the behaviors that negatively affect sleep hygiene, the most common ones were ‘using a mobile phone/tablet computer in bed’ (‘always’ 26.3%, ‘often’ 46.3%), ‘thinking about daily problems and anxious situations in bed’ (‘always’ 13.1%, ‘often’ %30.0%), and ‘sleeping and waking up at different times during the week’ (‘always’ 8.1%, ‘often’ 31.9%). Statistically significant correlations were found between PSQI total score and ‘thinking about daily problems and anxious situations in bed’, ‘sleeping and waking up at different times during the week’, ‘consuming caffeine within four hours before going to bed’, and ‘using a mobile phone/tablet computer in bed’ (rho=0.404, rho=0.334, rho=0.180, and rho=0.169 respectively; p<0.05 for all). Conclusion: It was observed that the frequency of poor sleep quality is high among students, and behaviors that negatively affected sleep hygiene decreased the level of sleep quality. Effective guidance practices that will create lifestyle changes to increase sleep quality and improve sleep hygiene in university students are required.
BACKGROUND
Flight cadets need to have good physical fitness to cope with the challenges of flying missions. The continuous development of science and technology has led to the constant upgrading of fighter jets and the improvement of their performance, which has resulted in new and higher requirements for the physical fitness of flight personnel. The traditional physical training mode, method, and assessment have been used for many years and do not meet current fitness needs.
AIM
To investigate the impact of a 12-wk comprehensive anti-G fitness training program on the aerobic capacity of aviation cadets and to evaluate its effectiveness.
METHODS
Fifty-five cadets were randomly assigned to control and experimental groups using a randomized, single-blind design. The control group maintained their existing training regimen, while the experimental group participated in a 12-wk comprehensive training intervention. The training program comprised strength training twice per week, high-intensity interval training three times per week, and supplemental nutritional and psychological support. Maximal oxygen uptake (VO2max), lower limb strength, and hemoglobin levels were measured at baseline, at 6 wk and 12 wk post-intervention.
RESULTS
Repeated measures analysis of variance revealed significant differences of both VO2max and relative VO2 in both groups across time points (P < 0.05). However, no significant time-group interaction was observed (P > 0.05). Paired t-tests comparing baseline and 12-wk results showed that VO2max and relative VO2 were significantly higher in the experimental group than the control group (P < 0.05). This suggests that the training program effectively enhanced the aerobic capacity of the experimental group. Key indicators of aerobic capacity, bilateral lower limb strength and hemoglobin levels, were also significantly different over time and between groups (P < 0.05). No significant differences were noted in heart-rate metrics (P > 0.05).
CONCLUSION
A 12-wk comprehensive anti-G fitness training program significantly improved the aerobic capacity of aviation cadets, thereby enhancing their overall capacity and laying a physiological foundation for enduring high-G flights.
