WEIGHT, A DICEY AFFAIR

NB: This is work I had published previously on a different platform in 2021.

“Self-care is never a selfish act - it is simply good stewardship of the only gift I have, the gift I was put on earth to offer others. Anytime we can listen to true self and give the care it requires, we do it not only for ourselves but for the many others whose lives we touch.” Parker Palmer

 

Can you perform two minutes of effective CPR without feeling like you may need to be resuscitated too? Most of us dread it. We are so unfit that often it is the main indicator of our fitness level. We spend many hours taking care of others that we forget to care for ourselves. Two minutes of CPR have us breathless and on the verge of collapsing. If you don't believe me just steal a glance at your colleagues after they complete one cycle of CPR during a mega code.

Better still glance at your colleagues as you read this how many of them look fit? To correctly determine one's level of fitness we need to use quantitative measures and merely not visual inspection. After all, are we not the propagators of evidence-based practice? At this time, however,  just humour me and think about your colleagues. How many colleagues are complaining of fatigue yet it is just the start of the shift? How many are undergoing treatment for lifestyle-related conditions? Are you one of them? 

In a study done by Kyle et al. (2017) a quarter of nurses in England hospitals were considered obese. Comparatively, this was a lower figure than for nurses in Australia (28.5%), New Zealand (28.2%),15 the USA (27.0%), South Africa (51.6%) and Scotland (29.4%). What about Kenya? I think it is time we explore the figures.  

Often, the general population expects health workers to have lesser rates of obesity due to enhanced health awareness. However, from different studies such as the aforementioned one we realize that there isn't much statistical weight difference between the two cohorts.

The World Health Organization (2021) article on obesity states that most of the world's population lives in countries where overweight and obesity kill more people than being underweight. The article further details how the deaths related to being overweight and obese are a result of cardiovascular conditions, malignancies, and musculoskeletal disorders. This is quite concerning. So, what makes us be at risk?

Most studies link it to our uptake of longer shifts, notably nightshifts. However, it is not a clear-cut cause and effect due to the association of other confounding factors. Nonetheless, it would be a great area for further exploration. Below are links to some studies on this topic.

Shift work and abdominal obesity

Prevalence of overweight and obesity among nurses in Scotland

Obesity among the general population in South Africa

Prevalence of overweight and obesity among healthcare workers in Nigeria

 Some proposed reasons for the increased prevalence of overweight and obesity among health workers include.

1. Adopting poor dietary habits is linked to frequent snacking and disproportionate caloric intake.
2. Low recreational physical activity.
3. Sleep deprivation- This leads to a decrease in leptin levels which is crucial in appetite suppression. When this occurs it leads to elevated ghrelin levels which enhances appetite causing weight gain. Often this is due to the need for increased caloric intake without adequate caloric expenditure.
4. Night shifts lead to disruption of the circadian rhythm yet it is needed in controlling the sleep-wake cycle and this results in unplanned weight gain.

Due to the nature of our work, we cannot do without shift work but we can try to make some modifications to try to curb this problem. Some recommended solutions by Kelly and Wills (2018) include.

1. Organizational level changes

• Provision of staff meals. There should be an option for healthier food/snack.
• Release staff for exercise sessions within the working days.
• Generate in-house programs that encourage physical activity.
• Conduct yearly staff wellness checks that include nutritional assessments and services.

    2. Personal behaviour changes

• Seek to practise more self-care.
• Be intentional about adopting healthier food options.
• Due to the possibility of decreased physical activity, try increasing the number of steps taken each day.  For instance, take the stairs more instead of the workplace lifts. 

In summary, as we try changing the health patterns among our patients, we should remember that we can only create a permanent positive impact in their lives when we adopt the same because  "The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires." William Arthur Ward

                                                     References

Kelly, M., & Wills, J. (2018). Systematic review: What works to address obesity in nurses? Occupational Medicine, 68(4), 228-238. https://doi.org/10.1093/occmed/kqy038 

Kyle, R. G., Wills, J., Mahoney, C., Hoyle, L., Kelly, M., & Atherton, I. M. (2017). Obesity prevalence among healthcare professionals in England: a cross-sectional study using the Health Survey for England. BMJ Open, 7(12), e018498. https://doi.org/10.1136/bmjopen-2017-018498 

World Health Organization. (2021). Obesity and overweight.