Airlines Turn to Doctors With Goal of Limiting Long Flights’ Negative Effects

https://www.nytimes.com/2019/04/29/business/airlines-long-haul-flights-wellness.html

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Turkish Airlines brought in Dr. Mehmet Oz, host and producer of “The Dr. Oz Show.” Singapore Airlines turned to Dr. Richard Carmona, a former United States surgeon general who is now chief of health innovation at the resort spa Canyon Ranch. Air France works with its own medical aviation doctor and psychologist.

Airlines have long vied to offer the most front-of-plane amenities. More recently, the competition has moved to a new area: in-flight wellness programs meant to help passengers ward off the effects of air travel, especially on nonstop long-haul and the newer ultra-long-haul flights, with meditation apps, exercises, better blankets and bedding, herbal teas and healthier meals.

Some carriers have gone further, hiring doctors and other health professionals to prescribe what they say are programs based in science.

But are these programs helping? Or are they public relations campaigns that sound good without being particularly effective?

The answer to both questions is a qualified yes.

“These are positive gestures toward healthier cabin environments and experiences, though somewhat behind the times,” said Charles Platkin, the executive director of the Hunter College New York Food Policy Center and the editor of DietDetective.com, a website that rates and ranks the healthiness of in-flight snacks and meals. “But I wonder if the airlines are just jumping on the P.R. bandwagon to earn bragging rights and stay competitive.”

As for successful outcomes and results, Stephen Simpson, the academic director of the University of Sydney’s Charles Perkins Center, who oversees Qantas Airways’ wellness efforts, echoes other doctors involved with airlines.

“We don’t have enough scientifically rigorous evidence yet to submit to peer review for professional journals,” Professor Simpson said. He expects the results of a 2,000-passenger Qantas study, currently underway, in less than six months.

Although several websites rate airline meals, seats and on-time records, none rate in-flight health and wellness programs. Nor are there studies or published reports that correlate the availability of such programs to increases in bookings. Airlines do not release their own passenger satisfaction surveys to the public.

Geoffrey Thomas, the editor in chief of AirlineRatings.com, said, “We have been looking to add a separate rating for wellness offerings, as it’s an important and emerging issue” that will affect travelers’ choices.

Each of the doctors who consult for airlines uses his own criteria to deal with the ills associated with air travel, but they all say their research shows that, as Professor Simpson put it, “the biggest elephant in the cabin still is the circadian clock.” An off-time body clock leads to what is 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,” Professor Simpson added.

Dr. Oz, a cardiothoracic surgeon of Turkish descent, said he approached the task of working with Turkish Airlines as a scientist. “I considered the impact of air travel on all five senses, plus on one’s state of mind,” he said, “and then applied my collected medical knowledge and experience to develop remedies and coping options.”

Some airlines promote a selection of herbal teas, but Dr. Oz sought out herbs with specific potential health benefits for people sitting in airplanes. Teas on Turkish Airlines now include rooibos (an African shrub that contains calcium and magnesium, which can help reduce stress), roselle (a species of hibiscus that reportedly relieves bloating by contributing to the fluid and electrolyte balance) and a blend of green tea, cinnamon, ginger, corn silk and garam masala (to aid the excretion of excessive fluid).

He said he also drew on his own experience growing up in Turkey. “Naturally, I introduced more food items from the Mediterranean diet, which has proved to be among the world’s healthiest.”

In addition, Dr. Oz said he prescribed a series of head-to-toe exercises to offset the effects 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.

Dr. Carmona said Singapore Airlines had asked him and his Canyon Ranch colleagues to develop personalized wellness programs that incorporated exercise, better food choices and improved sleep strategies “to replicate at 30,000 feet what we do on the ground” at Canyon Ranch’s two resort spas. The airline now flies the world’s longest commercial route, a 10,400-mile flight of nearly 19 hours from Singapore to Newark Liberty International Airport.

Dr. Carmona said the personalization of in-flight wellness raised a question. “How can we democratize air travel?” he asked. “How can we make sure passengers in economy get the same wellness amenities as those in higher classes of seating?”

One answer, he said, might involve exploring how to make use of new genetic findings.

“If we could identify genes that code for circadian dysrhythmia, we could make dietary and environmental recommendations on a passenger-by-passenger basis,” he said, adding, “Five to 10 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.”

Professor Simpson said his team at the Perkins Center was taking a cross-disciplinary approach for Qantas, building a wellness program on four pillars: cardio-metabolic health, sleep, immune functions, and cognition and mood. He is working with circadian biologists, sleep physicians, biochemical engineers, immunologists and researchers who study cognitive behavior.

The Perkins Center is examining data collected from medical-grade monitors that Qantas attached to travelers that recorded their sleep, activity and posture in flight. A second phase of that study is underway.

The medical team working for Air France, directed by the airline’s medical aviation physician, Dr. Vincent Feuillie, has focused on offsetting the anxieties associated with air travel. Philippe Goeury, a psychologist for Air France, cited a long list of stress-inducing conditions, including “drastic security rules and longer lines, air traffic congestion, more waiting time in the airports before boarding, more and more people sharing less and less space in the economy seating environment.”

“Stress exacerbates existing conditions and can lead to multiple comorbidities,” so that one condition aggravates another, Dr. Goeury said.

Drawing on a survey that Dr. Goeury conducted involving more than 1,500 Air France passengers who took its fear of flying course, “Taming the Plane,” the airline now offers a meditation program in partnership with Mind, an app on the airline’s entertainment screens.

“The classical in-flight programs are supposed to entertain you during the flight,” Dr. Goeury said. “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.”

Still, no matter how well intentioned these programs, are airlines’ investments worth it? Not necessarily, said Sean Mullen, associate professor and director of the Exercise, Technology and Cognition Laboratory at the University of Illinois at Urbana-Champaign.

Professor Mullen, an expert in brain training who takes about six domestic business trips a year, said he had tried various airline onscreen programs that were supposed to improve mental and physical well-being in flight. He was not 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,” he 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 or use an app to facilitate rhythmic breathing and mindfulness.”