Welcome to Focus on Fatigue,

One of the main challenges shift workers face is keeping their energy levels high through those long shifts, especially at night. Maintaining a healthy diet is a great way to assist in this area. However, with another year drawing to a close and all those silly season celebrations close at hand, it can be difficult to eat a good variety of healthy foods. In this month’s Focus on Fatigue, we’ll look at the impact of shift work on our nutrition, and ways in which shift workers can stay healthy and alert at work.

Here at InterDynamics, we would also like to take this opportunity to wish you and your family a very happy Christmas and New Year period.

The FRMS Team

InterDynamics Pty Ltd
320 Adelaide Street Brisbane Qld 4000
Tel +61 2 8404 0400 Ext 23
www.interdynamics.com

Views expressed in articles and links provided are those of the individual authors, and do not necessarily represent the views of InterDynamics (except where directly attributed).

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Eating on the Job

Maintaining a healthy diet is one of the many challenges faced by shift workers around the globe. A number of the negative health consequences associated with shift work – such as obesity (especially abdominal obesity), type 2 diabetes and cardiovascular disease – also have poor diet as a risk factor.

There are many reasons why a healthy diet can be difficult to maintain when working shifts, including:

Lack of access to healthy food (in the middle of the night the only food available may come from a vending machine);
Lack of time/motivation for preparing food to bring in from home;
The need to eat quickly or while on the move;
Lack of time to eat at all due to work demands; and/or
Lack of appropriate food storage/preparation areas at work.

Nutrition and the Circadian Rhythm

The human circadian rhythm (our internal body clock) has a major influence on when we feel alert and when we feel sleepy. It turns out the circadian rhythm also play a part in when we feel hungry. This can be problematic for shift workers who finds themselves trying to eat ‘lunch’ at midnight. Indeed, shift-workers have been found to be more likely to develop gastric problems.

In one study, participants were asked to rate their appetite and food preferences during a 13-day period. It was found that appetite tended to be lowest at around 8am and peaked at 8pm, leading to the desire to eat a larger meal at night. It was suggested that this greater appetite before sleeping helps us to make it through the night without waking due to hunger, while the lack of hunger in the morning prevents us from being overly ravenous when we wake up. Another study looked at the appetite of shift workers who worked either day shifts, early morning shifts, or night shifts. It was found that those who worked the early morning shift tended to have the lowest appetites and were more likely to eat fatty foods.

In keeping with this idea that the body’s need for food decreases through the night to a low-point in the morning, shift workers have been found to use ‘nibbling behaviour’ during night-shifts, rather than eating full meals. Assuming they are nibbling on healthful foods, this may assist workers in consuming their daily requirement of calories in a more comfortable manner than if they attempted to eat a heavy meal in the middle of the night.

Food Choices

Shift workers have been found to have a tendency to eat more inflammatory diets than non-shift workers. This includes an increased consumption of calories, fats, proteins, carbohydrates, and sweets. They can also be less likely to consume vegetable and fruits, but more saturated fats, than their day-working counterparts.

Another study found that the food intake of night workers was more likely to be influenced by habit and time availability, than by hunger. They were more dependent on snacks than day workers, looked forward to their meals less and felt more bloated after eating. These effects were still present, to a lesser degree, on their rest days.

What can shift workers do to stay healthy?

Diabetes Australia has published a short guide to nutrition for shift workers. You can download the guide here. Below are some of the tips given for making sure your shift working nutrition plan is good for you:

Eat every 3-4 hours, including 3 main meals and 2-3 snacks in each 24-hour period
Eat according to the time of day: breakfast in the morning, lunch in the middle of the day and dinner in the evening
If you’re eating late at night, when you would normally be sleeping, aim for a snack that’s high in protein instead of a full meal
Eat a small meal after your shift so you don’t go to bed hungry
Keep an eye on your portion sizes
Drink more water than any other drink
Limit sugary drinks, alcohol and caffeine
Avoid caffeine within the six hours before going to sleep

The Shifting Nutrition guide also includes meal ideas and more information on the different types of food shift workers should aim to consume and in what quantities.

Research

Crispim, C. A., Waterhouse, J., Damaso, A. R., Zimberg, I. Z., Padilha, H. G., Oyama, L. M., Tufik, S. and de Mello, M. T. 2011) Hormonal appetite control is altered by shift work: A preliminary study. Metabolism Clinical and Experimental, 60, 1726-1735.
Diabetes Australia (2015) Shifting Nutrition: A Shift Workers Guide to Nutrition. Queensland Government.
Hemio, K., Puttonen, S., Viitasalo, K., Harma, M., Peltonen, M. and Linstrom, J. (2015) Food and nutrient intake among workers with different shift systems. Ocuppational and Environmental Medicine, 72(7), 513-520.
Reinberg, A., Migraine, C., Apfelbaum, M., Brigant, L., Ghata, J., Vieux, N., Laporte, A. (1979) Circadian and ultradian rhythms in the feeding behaviour and nutrient intakes of oil refinery operators with shift-work every 3-4 days. Diabete & Metabolisme, 5(1), 33-41.
Scheer, F. A. J. L., Morris, C. J. and Shea, S. A. (2013) The internal circadian clock increases hunger and appetite in the evening independent of food intake and other behaviors. Obesity, 21, 421-423.
Sun, M., Feng, W., Wang, F., Li, P., Li, Z., Li, M., Tse, G., Vlaanderen, J., Vermeulen, R., and Tse, L. A. (2017) Meta-analysis on shift work and risks of specific obesity types. Obesity Reviews, doi: 10.1111/obr.12621.
Waterhouse, J., Buckley, P., Edwards, B. and Reilly, T. (2003) Measurement of, and some reasons for, differences in eating habits between night and day workers. The Journal of Biological and Medical Rhythm Research, 20(6), 1075-1092.
Wirth, M. D., Burch, J., Shivappa, N., Steck, S. E., Hurley, T. G., Vena, J. E. and Hebert, J. R. (2014) Dietary inflammatory index scores differ by shift work status: NHANES 2005 to 2010. Journal of Occupational and Environmental Medicine, 56(2), 145-148.

In the News

Provided below are a selection of articles from around the web on the issues associated with fatigue. We hope you find them useful and interesting.

Article: Shift work: How to stay healthy while working round the clock

The Guardian, 22 June 2017

Shift work: it’s complicated. Are you “working” when you’re asleep but at work? Should you be paid for being on call when you’re at home? Recent legal cases have looked at whether a sleepover shift is “working time” (and therefore, the worker should be entitled to the national minimum wage) and there’s new research on shift workers and their health too. A recent study found that delaying meals because of working shifts can mess with your internal body clock. But what if you can’t avoid shift work? What if your job kicks off in the evening and ends at dawn, and that’s just the way it is? Try these six ways to survive the slog.

Focus on Fatigue, Issue 50: Eating on the job