Growing tired of hard work

In the first of this two-part series on stress and fatigue, Sqn-Ldr Belinda Ball looks at identifying and dealing with workplace stress.

Some causes of fatigue

Poor food choices: Active people lead busy lifestyles and often leave little time for shopping and food preparation. Insufficient carbohydrates and too few fruits and vegetables, along with a heavy reliance on fatty take-away foods, can quickly lead to fatigue, decreased immunity and general ill health. Hoping a quick-fix diet will boost energy and lose weight will only have a bandaid effect and not address long term nutritional problems.

An athlete might use foods containing caffeine to increase energy levels, for example coffee, chocolate and cola drinks. This, in itself, can set up a cycle of chronic tiredness. Caffeine can interfere with sleep patterns, making it difficult for the athlete to get to sleep. Come morning, they are so exhausted that they need more caffeine to start the day. A sports dietician can help athletes develop a nutritious eating plan that will provide the right balance of carbohydrates, protein and fat, and sufficient vitamins and minerals.

Chronic dehydration: Many athletes and the general norm of people are dehydrated without being aware they are. Although you may drink during the day and during exercise, we often forget that we’re usually working and exercising in air conditioned buildings, which deplete our fluid intake.

In winter, tea and coffee can be drunk at the expense of water and other fluids, and may lead to less effective hydration during the day. High protein intakes may also contribute to dehydration. Signs to watch for are general lethargy – which is worse in hot weather – headaches, nausea and an inability to concentrate. Dry skin, pimples, cramping during exercise and strongly coloured urine can also be the result of dehydration.

Drink during training but also for the rest of the day. Remember that fluid requirements will be higher during hot weather, if there is an increase in training, or after long aircraft flights

Iron deficiency: Athletes are prone to iron deficiency due to blood loss in sweat, urine and faeces. Females also have increased losses due to menstruation, while those involved in contact sports can have regular injuries that result in bleeding. Drugs such as anti-inflammatories can cause gastro-intestinal bleeding, which also increases iron loss. Some vegetarians can also be iron deficient if they do not modify their diet to replace iron rich foods. The current recommended daily intake is 12-16mg for women and 5-7mg for men. A female athlete may need up to 22mg per day.

Iron deficiency anaemia is less common than low iron stores. Full blown anaemia results in extreme symptoms such as shortness of breath, to the point that the person simply cannot function or exercise. Decreased iron stores can result in a more general form of tiredness with an increase in recovery time, decrease in immunity, cold-like symptoms and depression.
A blood test is used to determine iron status. As readings such as haemoglobin (Hb) and ferritin can be affected by heavy training, it is often difficult to assess from a single blood test whether iron stores are low. Monitoring changes to iron levels with consideration of symptoms and risk factors will give a better picture of whether insufficient iron is the cause of fatigue. A sports dietitian can alter an athlete’s food intake to optimise iron intake.

Symptoms of fatigue

• Elevated heart rate.
  
• Drop in performance.
  
• Increased feeling of effort.
  
• Muscle soreness and pain.
  
• Sudden weight loss.
  
• Loss of appetite
  
• Low resistance to infection.
  
• Loss of enjoyment in training.
  
• Sleep disturbances.
  
• Depression.

Reduce the risk

• Eat for health. Avoid crash diets and poorly balanced diets.
  
• Take time to eat enough food. Enjoy your meals.
  
• Avoid fad diets and those that eliminate carbohydrate foods or whole food groups (for example, no dairy products).
  
• Eat a wide variety of foods.
  
• Choose wisely when eating on the run. Sandwiches, rolls, flavoured milks, fruit and low fat muesli bars are some of the better choices.
  
• Don’t be obsessed with eating “good” foods, avoiding anything containing fat, or limiting fat intake to 20g or less per day.
  
• If you are vegetarian, include meat substitutes like nuts and legumes.
  
• If you think you are iron deficient, get a blood test. Take steps to increase your iron intake.
  
• Ensure you are well hydrated.
  
• Eat plenty of fruit and vegetables on a daily basis.
  

Vitamin supplements

There is a widely held belief that our food supply is deficient in most nutrients due to poor soil and processing techniques. Many supplement companies claim this is the reason why everyone should take supplements. But nutritional analysis of all foods within Australia shows this is not the case. Fatigue and ill health is more commonly caused by an imbalance of carbohydrates, protein and fat. Taking a supplement will do little to rectify this problem beyond giving a psychological boost.

Of course, if a vitamin or mineral deficiency is present, taking a supplement may be necessary to restore levels back to normal. A multivitamin may also act to protect those who are travelling and cannot get their normal meals or have to limit their food intake to reduce their weight. Elite athletes, who have a heavy competition schedule resulting in disrupted meals, may also benefit from a multivitamin.

Causes of tiredness at work

• Poorly fitting equipment.
  
• Inadequate ventilation.
  
• Boredom.
  
• Emotional stress.
  
• Visual stress.

Burnout, a disabling exhaustion similar to battle fatigue, is associated with prolonged working hours under stressful conditions.

Pick up a guide based on a previous OHS booklet published in 1998 – Stress and Fatigue: Their implications for health and safety in the workplace. This publication remains current as a scientific summary of stress and fatigue.

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