A prospective observational study of lifestyle behaviors and biomarkers to promote cardiometabolic health in healthcare workers during the COVID-19 pandemic

Introduction Nutrition, physical activity, and sleep deficits contribute to diminished health status in healthcare workers (HCWs). The purpose of this study was to focus attention on HCWs by incorporating precision health approaches to address lifestyle behaviors believed to influence immune health, cardiometabolic status, and wellbeing. Methods In this 1-year prospective observational study, a digital dashboard was created to post a health promotion video, targeted health messages, and personal health data accessible to each participant. Activity-sleep trackers were provided to capture actual step and sleep activity. Lifestyle questionnaires, serum biomarkers, body composition by bioelectrical impedance analysis, and blood pressure were obtained at four timepoints; gene expression was measured at three timepoints. Genes linking host immune response to key nutrients were isolated for correlational analyses with lifestyle behaviors. Participants received a comprehensive summary of their personal results at 12 months. Primary outcome was participant engagement. Results 104 HCWs enrolled between July and October 2021. At 12 months, 60% of participants were high adopters for device-wear time and daily step threshold. Daily steps declined by 831 (±3,441) steps per day, t statistic −1.742, p = 0.09 after 1 year. Insomnia Severity Index results suggested persistent subclinical insomnia with a mean score of 8.1 (±6.1) at 12 months. Thirteen genes had a moderate correlation with steps, r (49) = 0.29–37, sleep, r (56) = 0.27–0.37, distance, r (61) = 0.28, and Insomnia Severity Index, r (56) = 0.30–0.38, p = NS, after Benjamini–Hochberg adjustment. Conclusion Participant engagement may have contributed to favorable behavior change in the first 6 months, but this was not sustained at 12 months. Novel strategies are needed to boost engagement for longer studies, promote HCW wellness to optimize immune and cardiometabolic health, and abate chronic disease progression.