According to the UK-based team behind the report, very little has been published on the use of nutritional supplements by medical professionals who work in physically and mentally challenging job roles.
Led by Daniel Parry at King’s College London, the team noted that dietary supplements have been shown to improve the performance athletes, military personnel, and airline pilots – adding that the optimisation of vitamins and nutrients in the diet “is thought to be essential to ensure the best performance in people who are exposed to greater levels of stress and pressure than most.”
“The work of doctors and surgeons is both mentally and physically challenging, but to our knowledge, little has been published about the potential benefits of supplements on clinical performance,” they said – adding that in many ways the pressure, concentration, physical and mental resilience, and endurance that are required for long operating days or other clinical activities is very similar to professions that have been studied and shown to benefit from supplementation.
“Studies on nutrition and supplementation in athletes and military personnel have clearly shown that several compounds improve cognition, mental well-being, and physical performance,” said the team writing in British Journal of Oral and Maxillofacial Surgery. “Based on this evidence, and with the many pressures faced by healthcare workers, as well as the need for concentration and endurance, some dietary supplements might be beneficial.”
Evidence of benefit
The UK-based team searched published reports for evidence of improvements in physical or mental performance, or both, as a result of the use of supplements – noting that most studies came from fields outside medicine and surgery, but it is likely that the mental and physical challenges experienced by doctors are similar to those reported.
They noted that omega-3 highly unsaturated fatty acids such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) have been demonstrated to have positive effects on mental health and well-being and also have a crucial role in cognition, emotion, and mental well-being.
“Studies have found that a low concentration of serum DHA is a strong predictor of the risk of suicide in the future, as it correlates with an increased risk of depression,” said the team – adding that other reports have shown that up to 20% of doctors have had some mental health issues during their careers, and both female and male doctors have a higher risk of suicide than the general population.
Furthermore, the team noted recent research that showed the importance of omega-3 to maintain a healthy state of mind, and has been recommended for US military personnel to improve their mental health and ability to concentrate.
Meanwhile, the UK authors suggested that vitamin B3 (niacin) may provide benefits against ionising radiation for surgeons who are regularly exposed.
“Ionising radiation (IR) is carcinogenic,” said the authors. “While a recent study found that surgeons are within safe limits for exposure to radiation, trauma and orthopaedic specialists are exposed to more than five times as much as those in other surgical disciplines, with the dose being up to 85% of the recommended threshold for safety.”
They noted that animal studies have shown vitamins B3 and B12 protect DNA against damage from ionising radiation – adding that supplements of B vitamins have been used to protect airline pilots who regularly fly at high altitudes by reducing the rate of chromosomal translocations - an established biomarker of exposure to this form of radiation.
Vitamin C (ascorbic acid) has been shown to help reverse the symptoms of fatigue, which is experienced by surgeons and medical professionals, noted Parry and colleagues.
Further, the vitamin has also been shown to have a positive effect on mood, “can potentiate the effects of antidepressants, improve academic performance in students (possibly because it reduces anxiety) and in those with a low dietary intake, and improve levels of physical activity, particularly in young men,” they said.
“While we cannot recommend supplements for every situation, omega −3 may benefit our mental well-being,” the team concluded. “Low concentrations of vitamins and fatty acids can be detrimental to our physical and mental health, and we should ensure that we should optimise our diets not only for our health but also to enable us to provide the best care for our patients.”
Source: British Journal of Oral and Maxillofacial Surgery
Volume 56, Issue 2, February 2018, Pages 85-89, doi: 10.1016/j.bjoms.2017.12.002
“Can dietary supplements improve a clinician’s well-being and health?”
Authors: D.A.Parry, et al