COVID-19 has exacerbated burnout in physicians and essential health care workers who are already at high risk of burnout. The demanding pace, emotional intensity, and time-sensitive work that results in burnout negatively affect the personal well-being of health care providers and reduce the quality of patient care. Physician burnout is correlated with significant medical errors and, among nurses, is associated with elevated patient mortality rates and the spread of hospital transmitted infection. These high rates of burnout can eventually lead to health care providers leaving the field and contribute to the shortage of these professionals.
Diet is a modifiable factor regarding burnout risk. Chronic stress, like thestress experienced by individuals suffering from burnout, has been shown to influence the amount and type of food individuals eat, contributing to excessive eating and undereating, and stress hormones have been linked with abdominal obesity. Burnout is also associated with chronic conditions, attributed to poor diet and lifestyle habits, such as type 2 diabetes and cardiovascular disease. Burnout in women has been linked with emotional and uncontrolled eating behaviors correlated with higher body mass index.
Dietary strategies to reduce burnout for physicians and health care professionals are needed to minimize shortage within health care professions, maximize investment in healthcare professionals' training, and improve quality of life for these frontline workers. Strategies could focus on applying existing evidence on nutrition interventions for mental health conditions, strategies to promote behavior change, and system-level changes to promote healthy eating among these groups.
Evidence on the Mediterranean dietary pattern and the supportive role that specific nutrients have in cardiovascular benefits, optimal brain function, and mental health have been provided. The traditional Mediterranean diet includes a high intake of vegetables, fruits, legumes, nuts, seeds, whole grains, and olive oil. It contains moderate amounts of fish and low intake of highly processed food and red meat. Efforts to support adherence to this eating pattern may be applied to physicians and health care professionals to reduce the risk of burnout by imparting mental and physical health benefits.
Effective strategies for improving nutrition behaviors include nutrition education and counseling and mindful eating interventions. Registered dietitians utilize counseling techniques based on various behavior change theories to support nutrition-related behavior changes. Cognitive-behavioral theory, which uses strategies such as self-monitoring, problem-solving, goal setting, stress management, stimulus control, and cognitive restructuring, has the most substantial evidence for eliciting behavioral change.
Finally, policy and institutional-level support include worksite wellness, healthy food policy, and incorporation of nutrition competencies into the medical training curriculum.
Multilevel strategies for improving nutritional status may reduce burnout risk among physicians and essential health care workers.
References:
Esquivel MK. Nutrition Strategies for Reducing Risk of Burnout Among Physicians and Health Care Professionals. American Journal of Lifestyle Medicine. 2020; 20:10. https://doi.org/10.1177/1559827620976538
Dima El-Halabi, MSc, RDN
College of Health Sciences
Abu Dhabi University
