Mental health in chefs: are we at boiling point?
During my time at my undergraduate university, I had a lot of friends working in the hospitality industry as waitresses or bar managers, but also many of whom were chefs. My partner has also worked as a chef for over 10 years, so I’ve seen first-hand the impact the occupation can have on nutrition, lifestyle and mental health time and time again - and it’s not pretty.
Many films and TV programmes glamourise the life of chefs, but it couldn’t be further from the truth. It is an incredibly challenging career – long hours, late nights, hot and cramped working spaces, not enough staff and tight budget margins all create extremely high-pressure environments, which are often fuelled by alcohol and drugs – quite frankly, it can be a catalyst for poor mental health to thrive. The research (albeit limited) backs this up too; a UK survey of 1273 hospitality staff conducted by The Burnt Chef Project revealed chefs felt their occupation resulted in poor diet (74%), anxiety (59%), low mood (52%), depression (42%) and reliance on alcohol (27%). Furthermore, industry reports from The Royal Society for Public Health RSPH and Nestle Professional both suggest the lifestyles of chefs are negatively affected by their work, with many reporting eating less, taking insufficient breaks, increased alcohol consumption and reduced physical activity.
Nutritional Psychiatry, more colloquially known as ‘Food and Mood’, is an emerging topic in the field of nutrition. Epidemiological studies suggest that a healthful diet, containing a variety of fruits, vegetables, nuts, vegetable oils, legumes and fish may be protective against anxiety and depression. Similarly, diets high in fat, sugar and processed foods have been found as an independent risk factor for development of depression and anxiety. Pioneering interventions such as the SMILES and HELIFIMED trials also provide strong evidence that manipulating the diet towards a Mediterranean-style pattern of eating (already touted as the gold standard in nutrition) can improve mental health outcomes.
Despite the growing body of literature around food and mood and the glaringly obvious mental health crisis present in our restaurant kitchens, I found there was not a single study looking at the links between nutrition and mental health in chefs – which seems crazy when you start reading some of the stark statistics. Seeing as the hospitality sector is the 3rd largest industry in the UK, directly contributing £72 billion into the economy in 2018, and with employment in restaurants making up the largest part of the industry, this isn’t just a matter of personal interest - this is a real public health concern.
Back in 2020, I conducted a cross-sectional study to try and fill this gap in the research. 68 chefs took part in my online survey measuring demographic information, habitual food intake (via a food frequency questionnaire (FFQ)) and current mood status (using a validated scale called DASS-21). Most participants were aged 18-34 (60.3%), though we had participants right up to the 55-64 age bracket. Approximately two thirds of participants were male and one third were female. Mean BMI score of all participants was 31.52±21.60. The FFQ data was used to calculate diet scores using the Alternate Healthy Eating Index 2010 (AHEI-2010), which allowed us to score participants’ dietary intake based on 11 different categories (including red meat, sugar sweetened beverages, fruits, vegetables and alcohol). The highest available score is 110, indicating perfect adherence to dietary guidelines.
The Results
The most poignant (although pretty bleak) finding was that mood disorders were prevalent across the industry, with 77.84% of participants scoring high enough to qualify for the ‘extremely severe’ category for anxiety, 55.5% for stress and 36.76% depression. We also found that men had higher scores for the ‘severe’ and ‘extremely severe’ categories across all mood disorders, which makes sense when you consider that men in the UK are at three-fold risk of suicide compared to women. Mean AHEI-2010 score across both sexes was 54.46±12.99, indicating an average quality diet. Surprisingly and in contrast to the literature, alcohol consumption in chefs was only found to be moderate, although it is likely that some social desirability bias was at play here. Overall, we did not find significant associations between diet quality and mood disorders in this cohort. However, this could be down to a number of factors, including the methods chosen for dietary assessment (FFQ’s are notorious for inaccuracy and lack of detail), not using biomarkers (which would have increased validity of the FFQ findings) and potentially one of the biggest factors – data collection was completed during the peak of the coronavirus outbreak. The hospitality industry were arguably the hardest hit by the crisis and many chefs were left either unemployed or (for the lucky ones) on furlough – this could have impacted both their perceived mood states and dietary intake.
As the first study of its kind, we recommend these preliminary findings are used to strengthen the methodology for future research to build upon the currently limited evidence base, in order to further explore influencing factors, treatment and prevention strategies for mental health outcomes in this population group.
I’d like to take this opportunity to say thank you to all the chefs that gave up time from their busy schedules to take part. Although this was a pilot study, I hope that my work highlights the need for more research in this population group. If this has piqued your interest, I encourage you to share this blog to help raise awareness to support the people that work so tirelessly everyday to keep us fed!