Nutrition for Shift Workers

When it comes to healthy eating, late night snacking has been shown to have negative health consequences [1]. But for some of us, what can we do with this information when our work schedule falls during the night? Let’s a look at how shift workers can make healthy nutritional choices and optimise their health while working through the night.

Health of Shift Workers

1 in 5 Australians is a shift worker and typically works between 6pm and 6am.  Research has shown that shift workers are at greater risk of cardiovascular disease, type 2 diabetes and obesity [2]. Shift workers are more likely to display unhealthy eating habits, including having a higher caloric intake and higher intake of discretionary foods like chocolate, ice cream or take-outs, and have a more irregular pattern of eating including snacking more.

There are many factors as to why this is the case! Typically, the night-time food environment can make it harder to make healthy choices. Oftentimes there is limited access to healthy food at night. Shift workers may also have high work demands and a lack of breaks that allow them to eat regular meals, which can lead to having quick discretionary items for bursts of energy. There can also be a greater supply of unhealthy foods, such as those gifted by patients or brought in for staff celebrations. Additionally, increased stress and poor mental health can lead to viewing unhealthy foods as a “reward” and relying on more palatable nutrient-poor foods [3].

While there’s clearly many factors that can make it difficult to choose healthy options for night shift workers, there’s also a different physiological response to eating foods at night compared to the day. Recent research has investigated the effects of eating in line with our circadian rhythms, which you may have guessed, is opposite to the typical eating patterns of shift workers. At night, there is a higher blood glucose response after eating in comparison to the day [4]. Not only is there more glucose in the bloodstream, but it remains there for longer. Interestingly, studies have also shown that nightshift workers burn ~60 kilocalories less than dayshift workers, even with the same amount of food and work, indicating that less calories are burned at night [5].

So, what can you do?

Maintain a regular eating pattern

Eat every 4-6 hours when you are awake to avoid “crashing” and reaching for energy-dense foods later. To do so, take your scheduled breaks. If it is difficult to do so, seek support from management to help you establish regular break times!

Have a greater share of your intake earlier in the day, including a small fasting window between 10p and -6am

 As mentioned, less calories are burned at night than during the day. Including a greater amount of nutrition earlier in the day can help you align your intake more with your circadian rhythm. For example, if you finish your shift in the morning, try having your biggest meal afterwards, rather than eating a large meal in the middle of the night.

 Choose snacks with protein

 Carbohydrate-rich snacks and/or meals leads to more glucose in the bloodstream, whereas choosing protein-rich options leads to less glucose in the bloodstream. Some protein-rich snack ideas are:

• Hard boiled eggs
• Baked beans
• Fruit with nut butter
• Tub of yoghurt
• Handful of unsalted nuts
• Tuna with cucumber

Bulk up your meal with veggies

 Choosing fibre-rich foods can help provide a sustained source of energy throughout your shift. Aim to have meals that contain plenty of vegetables, a lean source of protein, complex carbohydrates, and healthy fats. Ultra-processed foods and takeaways (like pizza, chips, or chocolate) are high in fat, refined sugars and/or calories.

 Stay hydrated and avoid sugar sweetened beverages

Sugar-sweetened beverages like coca cola and energy drinks can add a lot of hidden kilojoules to your daily intake. Try to make water your drink of choice and limit your caffeine intake so that it does not impair your quality of sleep. Shift workers can also go long periods without drinking water, so it’s important to keep hydrated!

Preparation is key

 Choosing healthy meals during your nightshift requires planning, planning, and more planning! Especially when food options are limited at night. Plan out your protein-rich snacks for the week so you have them on hand. For convenience, try bulk preparing your meals or utilising a meal or grocery delivery service so that you have reliable meal options on hand. You may also wish to have “Plan B” options handy, such as ready-made meals to avoid relying on takeout foods.

A Final Word

Working night shifts can make it difficult to make healthy choices. However, prioritising protein-rich foods, staying well hydrated, eating regularly and being well-prepared can help you set yourself up for success!

References

[1] Bouillon-Minois JB, Thivel D, Croizier C, Ajebo É, Cambier S, Boudet G, Adeyemi OJ, Ugbolue UC, Bagheri R, Vallet GT, Schmidt J, Trousselard M, Dutheil F. The Negative Impact of Night Shifts on Diet in Emergency Healthcare Workers. Nutrients. 2022 Feb 16;14(4):829. doi: 10.3390/nu14040829. PMID: 35215482; PMCID: PMC8876008.

[2] Vetter C, Dashti HS, Lane JM, Anderson SG, Schernhammer ES, Rutter MK, Saxena R, Scheer FAJL. Night Shift Work, Genetic Risk, and Type 2 Diabetes in the UK Biobank. Diabetes Care. 2018 Apr;41(4):762-769. doi: 10.2337/dc17-1933. Epub 2018 Feb 12. PMID: 29440150; PMCID: PMC5860836.

[3] Marko S, Wylie S, Utter J. Enablers and barriers to healthy eating among hospital nurses: A systematic review. Int J Nurs Stud. 2023 Feb;138:104412. doi: 10.1016/j.ijnurstu.2022.104412. Epub 2022 Dec 5. PMID: 36528912.

[4] Haldar S, Egli L, De Castro CA, Tay SL, Koh MXN, Darimont C, Mace K, Henry CJ. High or low glycemic index (GI) meals at dinner results in greater postprandial glycemia compared with breakfast: a randomized controlled trial. BMJ Open Diabetes Res Care. 2020 Apr;8(1):e001099. doi: 10.1136/bmjdrc-2019-001099. PMID: 32327444; PMCID: PMC7202752.

[5] McHill AW, Melanson EL, Higgins J, Connick E, Moehlman TM, Stothard ER, Wright KP Jr. Impact of circadian misalignment on energy metabolism during simulated nightshift work. Proc Natl Acad Sci U S A. 2014 Dec 2;111(48):17302-7. doi: 10.1073/pnas.1412021111. Epub 2014 Nov 17. PMID: 25404342; PMCID: PMC4260578.