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Performance Nutrition for Physician Trainees Working Overnight Shifts: A Randomized Controlled Trial
Maryam S Makowski1, Mickey T Trockel2, Nikitha K Menon3
1M.S. Makowski is clinical assistant professor, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0003-0823-5376 .
Summary
Dietary interventions improved physician trainees' alertness and reduced sleepiness during overnight shifts. Both low and high carbohydrate-to-protein ratio diets showed benefits compared to usual eating habits.
Area of Science:
- Medical Education
- Nutrition Science
- Sleep Medicine
Background:
- Physician trainees experience significant sleep deprivation during overnight shifts.
- This can negatively impact alertness, cognitive function, and patient safety.
- Nutritional strategies may offer a way to mitigate these effects.
Purpose of the Study:
- To compare the acute effects of two dietary interventions against usual dietary habits on physician trainees' alertness during overnight shifts.
- To assess the impact of low carbohydrate-to-protein ratio and high carbohydrate-to-protein ratio diets on neurobehavioral outcomes.
- To evaluate changes in self-reported sleepiness and work exhaustion.
Main Methods:
- A registered, controlled, block randomized crossover trial involving 61 physician trainees.
- Participants followed usual dietary habits for one night, followed by two intervention nights (low or high carbohydrate-to-protein ratio).
- Interventions included provided healthy meals, snacks, and beverages, with a 10 pm meal cutoff. Neurobehavioral tests and self-report measures were administered overnight.
Main Results:
- The low carbohydrate-to-protein ratio intervention significantly improved psychomotor vigilance scores and reduced sleepiness compared to usual habits.
- The high carbohydrate-to-protein ratio intervention also significantly reduced sleepiness compared to usual habits.
- Neither intervention demonstrated benefits for sensory-motor speed, working memory, risk decision making, or work exhaustion. No significant differences were found between the two intervention types.
Conclusions:
- Dietary interventions, specifically those manipulating carbohydrate-to-protein ratios, show potential in mitigating the negative effects of sleep deprivation on physician trainees.
- Further research is needed to explore the efficacy of various nutritional strategies for enhancing physician alertness during demanding work schedules.
- Nutritional support may be a valuable component in managing resident well-being and performance during overnight shifts.
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