Even doctors and nurses don’t always follow the healthy lifestyle choices they recommend for patients to reduce the risk of medical problems like obesity, heart disease and diabetes, a US study suggests.

Although rates of these conditions appeared lower among health care workers than among other people, the diseases were still common. They also rose over time at rates similar to increases in the general population, researchers reported in Mayo Clinic Proceedings.

The findings suggest that the same societal and environmental factors that can influence the development of chronic diseases for ordinary people also impact clinicians and medical experts, said lead study author Dr Anupam Jena, a health policy researcher at Harvard Medical School and physician at Massachusetts General Hospital in Boston.

“This highlights the notion that nobody is fully immune to the factors that promote unhealthy lifestyle behaviours,” Jena said.

Jena and co-author Dr Elias Dayoub of the University of Pennsylvania in Philadelphia analysed data from nationwide surveys conducted from 2002 to 2013, in which respondents were asked about their occupation, health behaviours and chronic health problems.

About three per cent of the roughly-150,000 survey participants were health professionals, including doctors, dentists, chiropractors, pharmacists, physician assistants, therapists and nurses.

Overall, average rates of obesity, diabetes and hypertension were lower among the health workers than the rest of the survey participants, but the growth in these problems from 2002 to 2013 was similar between the groups.

Health professionals were less likely to smoke and more likely to exercise than the people in other fields, but they were more likely to report moderate to heavy alcohol consumption.

Nobody is fully immune to the factors that promote unhealthy lifestyle behaviours

The fact that growth in disease burden for health professionals often mirrored the general population suggests there may be limits to how effective public education can be in reversing growth in unhealthy behaviours or chronic disease, the authors conclude.

“The take-home message for patients is that healthy lifestyle choices and good health are important but aren’t easy to come by,” Jena said. “Both take work and even healthcare professionals find it difficult.”

Shortcomings of the study include its reliance on self-reported survey data as well as the potential for health professionals to be diagnosed with diseases more often than other people because they generally have better access to care, the researchers acknowledge. It’s also possible that by lumping all health professionals into a single category, the survey data didn’t capture nuances of particular jobs that might influence health behaviours and disease prevalence, Dr Gal Dubnov-Raz, a sports and exercise medicine specialist at Sheba Medical Centre in Tel Hashomer, Israel, said by e-mail.

Shift work and activity levels, for example, might differ by occup-ation within the health field and influence lifestyle behaviours, noted Dubnov-Raz, who wasn’t involved in the study.

Even so, doctors, nurses and other health professionals will set an example that patients may follow, making their lifestyle behaviours important in a public-health context, said Dr Erica Frank, a researcher at the University of British Columbia who wasn’t involved in the study.

“We aren’t just docs, we are still also women and men, and are subject to the same environmental and social influences as are others,” Frank said by e-mail. “We tend to preach to patients what we practise ourselves – so we should be thoughtful about that and not compromise patient care because we can’t square it with our behaviour.”

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