Has your doctor prescribed your next flight?
That may be a reasonable question to ask as airlines showcase all variety of amenities and programs to assuage the physical and mental impact of air travel, a mode of transportation that literally can make you sick.
But while dozens of airlines include a veritable traveling medicine cabinet on board, only a small handful take a comprehensive scientific, evidence-based approach, commissioning physicians and other health professionals to develop their in-flight wellness programs.
Four Airlines that Want You to Stay Well
In the last two years, at least four airlines have retained medical professionals to look holistically at how to ward off the effects of air travel, especially on nonstop long-haul and the newer ultra-long-haul flights.
Air France involved its own medical aviation physician, Dr. Vincent Feuillie, and psychologist Philippe Goeury. Qantas has teamed with the University of Sydney’s Charles Perkins Centre, working closely with the center’s Stephen Simpson, a professor in the university’s School of Life and Environmental Sciences. Singapore Airlines turned to Dr. Richard Carmona, former U.S. Surgeon General and chief of health innovation at the resort spa Canyon Ranch, commissioning additional expertise from the resort’s staff. Turkish Airlines brought in cardiothoracic surgeon Mehmet Oz, host and producer of the Dr. Oz Show, who is of Turkish descent, to develop the airline’s “Fly Good, Feel Good” program.
While each doctor has used his own criteria and protocols to break down the critical contributors to the ills associated with air travel, they all say their research shows that “the biggest elephant in the cabin is the circadian clock,” as Dr. Simpson put it. An off-time body clock leads to what’s commonly known as jet lag. “The human body was not designed to cross several time zones in such a short time, so we are basically trying to trick it into believing it’s not.”
A Holistic Approach to Jet Lag & Stress
They also agree that there’s “still not enough scientifically rigorous evidence yet to submit to peer review for professional journals,” added Dr. Simpson. He said a 2,000-passenger Qantas study is underway, with results expected in six months.
Addressing both jet lag and stress, Dr. Oz explained that his holistic approach means “I considered the impact of air travel on all five senses, plus on one’s state of mind, and then applied my collected medical knowledge and experience to develop remedies and coping options.”
Among those remedies, he oversaw the development of various herbal teas that include, for example, rooibos (contains calcium and magnesium, helping to control stress), roselle (relieves bloating by contributing to the fluid and electrolyte balance), and green tea, cinnamon, ginger, corn silk, and garam masala (to aid excretion of excessive fluid due to edema, a condition that causes swelling as a result of long-term immobility).
In addition, Dr. Oz prescribed a series of head-to-toe exercises to offset the effects of gravity, of being sedentary for many hours in uncomfortable seating in small spaces—all made worse by being enclosed in a low-moisture compartment with limited ventilation.
“Singapore challenged us to do at 30,000 feet what we do on the ground at our two destination resort spas,” said Dr. Carmona, “namely, develop personalized integrative wellness programs that incorporate better food choices, exercise, and improved sleep.” Singapore is especially interested in this approach since in October 2018 it re-launched the world’s longest commercial airline route, a 10,400-mile flight of 18 hours and 45 minutes between Singapore and Newark International.
Flight of Fancy?
For Dr. Carmona, personalization of in-flight wellness raised a question: “How can we democratize air travel? Specifically, how can we make sure passengers in economy get the same wellness amenities as those in higher classes of seating?”
Leveraging new genetic findings, he said, “If we could identify genes that code for circadian dysrhythmia, we could make dietary and environmental recommendations on a passenger-by-passenger basis.
“Five to ten years from now, we may be able to use people’s genomic footprint—their DNA profile—to improve not only their flight but their lives,” said Dr. Carmona.
A Four-Pillared Approach
For Qantas, Dr. Simpson and his Perkins Centre team are taking a cross-disciplinary approach, building a wellness program on four pillars: cardio-metabolic health, sleep, immune functions, and cognition and mood. He said the team consists of circadian biologists, sleep physicians, biochemical engineers, immunologists, and researchers into cognitive behavior.
“Our philosophy is to gather evidence,” he said. “Our scientists give input to interior decorators designing our seating, for example.”
Among the pieces of evidence, the Perkins Center is examining data collected from Qantas travelers who attached medical-grade device monitors that recorded sleep, activity, and posture in flight. A second phase of that study is underway.
Mind-Soothers & Anti-Stress Programs
The medical team working for Air France has focused on offsetting the increasing mental anxieties of air travel. Philippe Goeury, Air France’s chief purser and psychologist, cited “drastic security rules and longer lines, air traffic congestion, more time in the airports before boarding, more and more people sharing less and less space in the economy seating environment.”
Add to those stressors reports of aircraft malfunction and crashes, such as the recent Boeing crash that has led to the grounding of those aircrafts.
“Stress exacerbates existing conditions and can lead to multiple comorbidities,” said Mr. Goeury.
Drawing on a survey Mr. Goeury conducted with more than 1,500 people, Air France passengers following its fear-of-flying course, “Taming the Plane,” Air France offers a meditation program in partnership with Mind, an application on the airline’s entertainment on-screens programming.
“The classical in-flight programs are supposed to entertain you during the flight,” Dr. Goeury. “The relaxation and/or meditation channels have another purpose: to literally distract you from the noises, the moves of the plane, the never-ending duration of your flight.”
Is It Really Worth It?
No matter how well intentioned, are airlines’ investment in these various methods worth it? Not necessarily, says Sean Mullen, associate professor and director of the Exercise, Technology and Cognition Laboratory at the University of Illinois at Urbana-Champaign.
Dr. Mullen, an expert in brain training who takes about six domestic business trips a year, said he has tried various airline on-screen programs to improve one’s mental and physical wellbeing in flight. He was not overly impressed.
“You’d get just as much bang for your buck by standing in the aisle and walking to the restroom even if you didn’t have to go,” Dr. Mullen said. “Physical activity and reducing sedentary time are likely the best ways to improve your mental state in such a confined space. Alternatively, buy some noise cancellation speakers and/or use an app to facilitate rhythmic breathing and mindfulness.”