Nutritional status, dietary intake and factors influencing the eating behavior of seafarers working on merchant vessels: Results from the “e-healthy ship” cross-sectional study

Abstract

Background: The prevalence of risk factors for lifestyle-related diseases, such as cancers and cardiovascular disease, was found to be high among seafarers. However, studies on lifestylefactors often lack detailed information about health behavior changes at sea. Regarding nutrition aboard ships, a few studies have reported unfavorable eating habits. As previous research failed to include workers from the largest seafarer nations of South-East Asia, the aim of this study was the assessment of the nutritional status and the dietary intake, as well as to understand the individual and environmental factors influencing the seafarers’ eating behavior among Burmese, Filipinos, and Europeans. Methods: In the course of the “e-healthy ship” project, Burmese (n=20), Philippine (n=27) and European (n=22) seafarers were investigated aboard three merchant vessels of two German shipping companies. Data was gathered by multiple assessments, such as weighing, blood collection, questionnaires, smartwatches, and the 24-hour dietary recall interview. Nutritional intake was compared to the DACH dietary reference values. Results: Overweight was prevalent, and measured blood markers deviant from their reference range. Seafarers stated to have gained weight since they started seafaring, however, if weight gain took place at home or sea remained open. The average nutrient intake was above the dietary reference values for sodium, protein, and fats, such as saturated fatty acids and cholesterol, while below for carbohydrate, fiber, vitamin A, folate, vitamin C, vitamin D, vitamin E, potassium, calcium, and iodine. Moreover, seafarers stated to consume more vegetables, fruits, and fish at home but less sausage, noodles, chips, salted nuts, cola, coffee, sweetened tea, and spirits compared with their time at sea. Queries regarding innovative intervention methods, such as an “e-learning” app, received high agreements. Conclusions: The nutritional status and the recorded dietary intake turned out to be unfavorable, and eating behavior negatively influenced at sea. An intervention promoting healthy nutrition onboard vessels is necessary in order to address all levels related to nutrition within maritime shipping, to improve the nutritional status as well as the diet of seafarers, and therefore to reduce seafarers’ risk for lifestyle-related diseases.