Healthy Nutrition, Physical Activity, and Sleep Hygiene to Promote Cardiometabolic Health of Airline Pilots: A Narrative Review

Abstract

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. Achieving health guidelines for lifestyle behavior nutrition, physical activity, and sleep are protective factors against the development of noncommunicable diseases and may mitigate the unfavorable occupational demands of airline pilots. This narrative review examines occupational characteristics for sleep, nutrition, and physical activity and outlines evidence-based strategies to inform health behavior interventions to mitigate cardiometabolic health risk factors among airline pilots. Methods Literature sources published between 1990 and 2022 were identified through electronic searches in PubMed, MEDLINE (via OvidSP), PsychINFO, Web of Science, and Google Scholar databases, and a review of official reports and documents from regulatory authorities pertaining to aviation medicine and public health was conducted. The literature search strategy comprised key search terms relating to airline pilots, health behaviors, and cardiometabolic health. The inclusion criteria for literature sources were peer-reviewed human studies, meta-analyses, systematic reviews, and reports or documents published by regulatory bodies. Results The results of the review show occupational factors influencing nutrition, sleep, and physical activity behaviors and delineate evident occupational disruptions to these lifestyle behaviors. Evidence from clinical trials demonstrates the efficacy of nutrition, sleep, and physical activity interventions for enhancing the cardiometabolic health of airline pilots. Conclusion This narrative review suggests that implementing evidence-based interventions focused on nutrition, physical activity, and sleep could help mitigate cardiometabolic health risk factors among airline pilots, who are particularly susceptible to adverse health outcomes due to unique occupational demands.

A Comparative Study of Seroprevalence of 17 Common Pathogens Among Airline Pilots and Office Workers

“…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.…”

“…Intriguingly, studies have demonstrated a potential association between the seroprevalence of anti-HSV-1 antibodies and CVD [ 17 - 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.…”

“…The nature of their work, which involves irregular flight schedules, shift work, and travel 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.…”

Prevalence of hepatic steatosis and fibrosis in apparently healthy airline pilots: a transient elastography study

“…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.…”

Evaluating the Serum Levels of Beclin-1 and Mammalian/Mechanistic Target of Rapamycin (mTOR) in Three Different Professional Categories

“…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].…”