ABSTRACT
Glucose is the fuel of the brain. When blood glucose levels drop, so does cognition. Interestingly, it's the higher cognitive functions, such as decision making and the ability to perceive risk, that go out first. Motor skills go last, and so the pilots’ hands may go to the right switches and levers, but his mind will be lagging behind. Data also shows that cognitive performance degrades long before people are aware of any symptoms such as a sense of hunger or having a headache. Thus, low blood glucose levels represent a serious safety risk in complex operations, and especially in aviation where pilots may have to go for many hours with little or no food. Part of the reason for this lack of food is the elimination of crew meals in many domestic operations. We review data showing the effects of low blood glucose on pilot performance, and discuss the ethical and practical issues surrounding the problem.
