INTRODUCTION

The current pandemic due to Sars-Cov-2, exposes the vulnerability of patients with previously hidden chronic non-transmissible diseases, through the increase of risks of complications and mortality in case of infection by COVID-19¹. This phenomenon was identified early, strong evidence was published demonstrating that patients with hypertension, diabetes, cardiovascular diseases and chronic respiratory diseases have 3 times the risk of suffering from hospital complications secondary to COVID-19².

It is known that these chronic non-transmissible diseases have a direct relationship with habits and lifestyle³. The concept of lifestyle was described for the first time in 1979 by Alvin Toffler, writer and futurist, who predicted the explosion of different lifestyle forms of a postindustrial society. In modern times, lifestyle is considered a conscious or unconscious election of behavioral type which has a direct effect over the biological mechanisms that lead towards health or disease. These include changes in genetic expression, inflammation, oxidative stress, and metabolic dysfunction⁴.

In a lifestyle evaluation of health professionals, it was reported that only 11.5% of physicians practice a healthy lifestyle⁵. Taking into consideration these numbers we can deduce that approximately 9 out of 10 doctors practice habits unaligned with healthy lifestyle. Physicians and health professionals usually represent the the maximum authority in health matters and unconsciously communicate these poor habits to the general population. For this reason, it is of crucial importance to find effective and reproductive methods to improve the lifestyle of health professionals. The objective of this work is to provide information about the effects of educational intervention based on the promotion of a healthy lifestyle from the real working world.

METHODOLOGY

RESULTS

A total of 18 participants were included, the frequency of sex, ethnicity, smoking, alcoholism, schooling, and job shift were described in table 1. An age range between 28 and 45 years was reported, with an average and standard deviation of 38± 5,4 and 32± 6,2 years in women and men, respectively. The general average height was 168,2 ± 8,4 centimeters. (Table 1)

Positive changes and improvement are reported in all measured variables, these are exposed inFigure 1. The exercise sessions increased the average from 2 to 3 (33%) per week, the duration of each exercise session increased from 19 to 43 minutes (100%+), the daily portions of fruits, vegetables, legumes, and seeds increased from 4 to 6 (50%), the night sleep hours increased from 6 to 7 (16%), and there was improvement in the perceived stress scale score from 20 to 19 (5%0, furthermore a decrease in percentage of poor quality nutrition reported in the last 2 weeks was reported from 42% to 33% (22%). The most important change was shown in the duration of each exercise session.

Figure 1: Description of pre and post intervention changes 

DISCUSSION

The differences characteristic of lifestyle by geographic location have been described. The western countries tend to lean towards behaviors unaligned with healthy habits such as smoking, alcoholism, fat-rich diets, processed and ultra-processed foods, inactivity, and inadequate stress-management⁸. When everyday habits are not healthy, a substantial negative effect on health is added. The WHO has reported that people with an insufficient physical activity level have a death risk between 20% and 30% greater compared to people who reach a sufficient level of physical activity. Furthermore, the deficit in consumption of fruits, vegetables, seeds, and legumes is found in sixth place between risk factors of human mortality⁹.

On the other hand, the improvement and practice of healthy habits have a promising beneficial effect. The consumption of a balanced diet, rich in fruits and vegetables and enjoying physical activity on a regular basis is related to better competition of our immune and metabolic system. This results in less risk of chronic non-transmissible diseases and infectious diseases, a highly relevant benefit in our present^10-12. It is estimated that 80% of cardiovascular diseases could be prevented by improving risk factors related to lifestyles¹³.

The lifestyle intervention and its metabolic benefits have been taken advantage in different parts of the world including developing countries due its low cost and feasibility¹⁴. In Nepal improvement on blood pressure has been reported in people with systemic arterial hypertension (SAH) and in adults without SAH¹⁵. Furthermore, significant benefits have been reported in all age ranges including preschool, elementary, high school students college students and housewives^16-19.

Very little evidence exists in relation to educational interventions of lifestyle promotions directed to health professionals²⁰. This population has a high predisposition to create a poor-quality lifestyle since the work environment in which the physician engages exposes them to adverse situations such as rotating schedule, long working days with sleep deprivation, emotional toll and high levels of stress²¹. It is necessary to consider health professionals as an important population for health promotion and chronic disease prevention programs. This, with the aim at improving health and establish them as model examples for their community, since physicians practice a healthy lifestyle have greater probability of recommending and inducing habits that are just as healthy in their patients²².

The educational intervention carried out in this study reached positive changes in the lifestyle of participants. An increase in the consumption of fruits and vegetables, increase in reported hours of sleep, a decrease in consumption of food of low nutritional quality, and increase in frequency of exercise sessions and duration of these were evidenced, being the latter the one which reported the most significant change. Regarding perceived stress, there was little improvement, we considered that diverse variables influence in the level in which the individual evaluates life situations such as stressors⁷. The data here presented orients a theory which, as the populations previously studied, general practitioners in the work environment are also sensitive to lifestyle educational interventions. The result in this case is a significant improvement in lifestyle. Additional studies are required in this population specifically with more intensive interventions, controlled and long term with the aim to identify more effective interventions for this population.

A weakness of this study was the short participant follow-up time, for this reason we propose a follow-up of 6 months and one year. We recommend carrying out similar interventions in the population of physicians and therefore reach positive changes in their health.

With a simple and low-cost educational intervention we were able to reach favorable changes in lifestyle of physicians.

CONCLUSION

This practical and low cost educational internvention achieved improvements in the lifestyle of physicians. For this reason we recommend the replication of similar interventions and their documentation.