Nutritional status and eating habits of bus drivers during the day and night

The effect of shift work on body mass index: A systematic review and meta-analysis of observational studies

CONTEXT

Shift work involves working outside the standard working hours of 9 am to 5 pm Monday to Friday and may include working evening, night, weekend, or rotating shift patterns. Since shift workers sleep less and their circadian rhythms are disrupted, they are reported to have higher body weight than day workers.

OBJECTIVE

This meta-analysis aims to determine whether shift workers (SW) are more prone to higher body mass index (BMI) than their day workers (DW) counterparts. It also addresses the question of whether the duration of shift work exposure, sex, or occupational type affect BMI value.

METHODS

Four databases that is PubMed, EBSCO Host, Scopus, and Web of Science were searched for reports published up to October 2023.

RESULTS

Sixty-three studies involving a total of 693 449 participants met our inclusion criteria. Meta-analyses showed a significant effect of shift work on BMI value (standard mean difference; SMD: 0.10 kg/m2 [95% confidence interval; 95% CI: 0.07; 0.13; p < .001]) as compared with non-shift counterparts. Subgroup analysis revealed that shift work significantly increased BMI for studies where male working on this job schedule (SMD: 0.10 kg/m2 [95% CI: 0.04; 0.17; p = .0018]) for studies where shift workers worked ≥13 years (calculated as the median of shift work experience; SMD: 0.14 kg/m2 [95% CI: 0.10; 0.18; p < .001]) as well as for studies where industrial (SMD: 0.12 kg/m2 [95% CI: 0.05; 0.19; p = .0012]) and other type of occupations were dominated (0.12 kg/m2 [95% CI: 0.07; 0.16; p < .001]).

CONCLUSIONS

We found that in general working on a shift schedule increases BMI as compared with day workers, especially in case of male employed in this job schedule, for shift workers working for long periods of time (≥13 years), and for shift workers employed in industry and other type of occupations(e.g., airline workers, firefighters, police officers, blue collar, security personnel, bus drivers, garbage collectors, railway workers, postal, oil and gas workers).

Rotating shift work time is directly associated with excess body adiposity

OBJECTIVE

To analyze the association between changes in body adiposity and length of service on a schedule of rotating shifts.

METHODS

The study was a cross-sectional investigation conducted during the years 2012, 2015, and 2018, involving individuals engaged in rotating shifts at a company involved in iron ore extraction situated within the Iron Quadrangle region of Minas Gerais and the southeastern region of Pará, Brazil. Sociodemographic and behavioral data were collected along with anthropometric parameters in order to calculate body mass index (BMI) and the waist-to-height ratio (WHtR). For data analysis, a multivariate logistic regression was employed to explore potential associations between indicators of body adiposity and the duration of shift work, employing a hierarchical determination model.

RESULTS

The findings showed that in the multivariate model, controlling for confounding factors, workers with 5 to 10, 10 to 15, and more than 15 years of shift work had 41 to 96% greater odds of being overweight (BMI > 25.0 kg/m2), 71 to 82% of having altered neck circumference (> 40 cm), 33 to 120% of altered WC (>102 cm), and 57 to 214% of having altered WHtR (> 0.5 cm).

CONCLUSION

The findings suggest that time spent in work has a significant effect on anthropometric indicators of body adiposity, especially if the worker has a previously established comorbidity such as dyslipidemia or hypertension and is frequently exposed to night work.

Temporal associations between nightly sleep with daytime eating and activity levels in free-living young adults

STUDY OBJECTIVES

This study aimed to quantify the temporal associations between nightly sleep quantity and timing with daytime eating behavior and activity levels in free-living (i.e. non-experimental) settings.

METHODS

Generally healthy young adults (N = 63; 28.9 ± 7.1 years) completed concurrent sleep (wrist actigraphy), eating (photo-assisted diet records), and activity (waist actigraphy) assessments over 14 days. Multilevel models quantified the associations between nightly sleep (total sleep time, timing of sleep and wake onset) with next-day eating behavior (diet quality, caloric intake, timing of eating onset/offset, eating window duration) and activity levels (total physical activity, sedentary time). Associations in the reverse direction (i.e. eating and activity predicting sleep) were explored. Models adjusted for demographic and behavioral confounders and accounted for multiple testing.

RESULTS

At within- and between-subject levels, nights with greater-than-average total sleep time predicted a shorter eating window the next day (all p ≤ 0.002). Later-than-average sleep and wake timing predicted within- and between-subject delays in next-day eating onset and offset, and between-subject reductions in diet quality and caloric intake (all p ≤ 0.008). At within- and between-subject levels, total sleep time was bidirectionally, inversely associated with sedentary time (all p < 0.001), while later-than-average sleep and wake timing predicted lower next-day physical activity (all p ≤ 0.008).

CONCLUSIONS

These data underscore the complex interrelatedness between sleep, eating behavior, and activity levels in free-living settings. Findings also suggest that sleep exerts a greater influence on next-day behavior, rather than vice versa. While testing in more diverse samples is needed, these data have potential to enhance health behavior interventions and maximize health outcomes.

Exploring Australian night shift workers' food experiences within and outside of the workplace: a qualitative photovoice study

OBJECTIVE

Night shift workers are at a 20 to 40 % increased risk of metabolic diseases, which may be associated with their disrupted eating patterns. This qualitative study explores factors that influence night shift workers' eating habits, within and outside of the workplace, to identify target areas for health promotion strategies.

PARTICIPANTS AND SETTING

Eligible participants resided in Australia, working at least three overnight shifts per month.

DESIGN

The photovoice method was used, whereby participants were asked to take photos that represent their typical eating habits. These photos were incorporated as prompts in a semi-structured interview, which explored factors influencing eating habits on night shifts and days-off and perceptions and enablers to healthy eating.

RESULTS

Ten participants completed the study. Thematic analysis generated four main themes, which were mapped onto the Social Ecological Model (SE Model). Aligned with the SE Model, our results show night shift workers' eating habits are influenced by intrapersonal, interpersonal and (work) organisational levels. Participants reported that at work, appropriate food preparation facilities are required to enable healthy food choices. Poor shift work rostering leads to prolonged fatigue on days-off, limiting their ability and motivation to engage in healthy eating. Consequently, night shift workers seem to require additional supports from their social networks and enhanced food literacy skills, in order to adopt/ maintain healthy eating behaviours.

CONCLUSIONS

Night shift work creates individual and environmental barriers to healthy eating, which are present during and outside of work. Health promotion strategies for this population should include multiple approaches to address these barriers.

Mobilizing adolescents and young women to promote healthy diets in urban settings of Colombia and Vietnam: Lessons from two action-research programs

Adolescent and young women face grave nutrition challenges, but limited evidence exists on solutions to improve their diets. Action-research was done over 3 years (2020-2022) in secondary cities of Colombia (Medellin) and Vietnam (Thai Nguyen) to identify nutrient deficits in adolescent and young women diets; elaborate food-based recommendations to improve their nutritional status using Optifood linear programming; and engage respondents in incorporating suggested recommendations to their diet using a Social Innovation Challenge approach. A total of 1001 respondents were interviewed in Vietnam, 793 in Colombia. The probability of nutrient inadequacy in both locations was highest for iron and calcium, followed by the risk of deficiency for several other vitamins and minerals. Social Innovation Challenge teams (11 in Vietnam, 9 in Colombia) were created and supported in developing solutions to improve diets and tackle those deficiencies. Awards and resources were transferred to the most promising solutions to enable their implementation. Pre/post measurements of the interventions' impact using the Global Diet Quality Score as outcome metric showed significant improvement in the diets of Challenge participants. After introducing a series of companion articles that offer detailed results on those various steps, this paper draws strategic lessons from an action-research perspective.

Diurnal Variation of L-Arginine and the Cardiovascular Risk Markers Asymmetric and Symmetric Dimethylarginine and Homoarginine in Rotating Night Shift Workers and Controls

Asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) interfere with nitric oxide (NO) formation from L-arginine via different mechanisms. ADMA is a biomarker of cardiovascular disease and mortality, whilst SDMA is a biomarker of mortality after ischemic stroke. Homoarginine, another L-arginine-derived amino acid, is associated with stroke and congestive heart failure. Acute ischemic events like myocardial infarction show a time-of-day variation in the timing of their onset, as do NO-mediated vascular function and blood pressure. We studied whether the plasma concentrations of L-arginine-related amino acid metabolites show diurnal variation in a clinical study comparing 12 non-night shift workers with 60 rotating night shift workers. The plasma concentrations of L-arginine-related biomarkers, melatonin, and cortisol were measured every 3 h during a 24-h period. In addition, 24-h blood pressure recordings were performed. In non-night shift workers, L-arginine and homoarginine plasma concentrations showed diurnal variation with a 12-h period, which were both attenuated in night shift workers. ADMA and SDMA showed a 24-h rhythmicity with no significant differences in phase between night shift and non-night shift workers. The plasma profiles of melatonin and cortisol were not significantly different between both groups, suggesting that the rotating night shift work does not have a major influence on central suprachiasmatic nuclei clock timing. In addition, systolic and diastolic blood pressure patterns were similar between both groups. Our data show diurnal variation of dimethylarginines with the timing of their acrophases corresponding to the published timing of the peak incidence of cardiac ischemic events.

Impact of Nighttime Food Consumption and Feasibility of Fasting during Night Work: A Narrative Review

Shift work has been associated with an increased risk of developing chronic non-communicable diseases, such as obesity. The reduction in overnight fasting and its physiological consequences seem to affect the metabolic health of shift workers, but little has been discussed regarding the feasibility and implications of maintaining a night-long fast during work. This narrative review aims to discuss the impact of eating behavior on the reduction of overnight fasting in shift workers, as well as possible nutritional strategies involving fasting that have been tested for shift workers, to contribute to the establishment of nutritional guidelines for them. We used various databases and search engines to retrieve relevant articles, reviews, and investigations. Despite the potential benefits of overnight fasting for other groups, few studies have investigated this approach in the context of shift work. Generally, it seems to be a feasible and metabolically beneficial strategy for shift workers. However, it is essential to investigate the potential risks and benefits of reducing the fasting time for shift workers, considering social, hedonic, and stress-related factors. Furthermore, randomized clinical trials are necessary to establish safe and feasible strategies for shift workers to practice different fasting windows.

Influence of fasting during the night shift on next day eating behavior, hunger, and glucose and insulin levels: a randomized, three-condition, crossover trial

AIMS

To investigate the influence of fasting during the night shift on eating behavior, hunger, glucose and insulin levels the following day.

METHODS

Study with 10 male police officers who have been working at night. Participants were tested under three different conditions separated by at least 6 days of washout in a randomized, crossover design: "Night Shift Fasting" (NSF)-two nights of fasting during the night shift; "Night Shift Eating" (NSE)-two nights with the consumption of a standardized meal during the night shift (678 ± 42 kcal consumed at ~ 0200 h); and "Nighttime Sleep" (NS)-two nights of sleep. The morning after, blood glucose and insulin and hunger ratings were assessed, and food intake was assessed with an ad libitum test meal. Food intake was also assessed throughout the remainder of the day using a food record. Generalized Estimating Equations were used to analyze the effect of experimental condition.

RESULTS

Food intake during the test meal, especially of proteins and fats, was higher after fasting during the night shift compared to the other conditions (p < 0.05), whereas desire to eat scores were lower after the NSF compared to NSE condition (p = 0.043). Hunger levels were lower after the NSF compared to the NS condition (p = 0.012). Insulin and HOMA-IR were also lower in the morning after NSF (p < 0.001).

CONCLUSION

Fasting during the night shift leads to not only a higher intake of energy and macronutrients both in the early morning after work and throughout the next day, but also lower insulin levels and HOMA-IR in the morning.

REGISTRATION NUMBER OF CLINICAL TRIAL

NCT03800732. Initial release: 01/09/2019. Last release: 02/23/2022.

Meal timing variability of rotating shift workers throughout a complete shift cycle and its effect on daily energy and macronutrient intake: a field study

PURPOSE

To evaluate the meal timing variability of rotating shift workers throughout a complete shift schedule and its effect on daily energy and macronutrient intake.

METHODS

Thirty male shift-workers from a mining company were evaluated in a complete rotation shift cycle over 240 consecutive hours (10 days; two days of morning shifts, two days of evening shifts, 24 h free, two days of night shifts and three days off). Food intake related variables [meal timing, energy (kcal) and macronutrient intake (%)] were assessed by 24 h recall by a trained nutritionist. Mixed models were used to analyze the variation in meal timing and energy and macronutrient intake throughout the shift cycle, as well as the interaction between shift and time ranges (00:00-03:59, 04:00-07:59, 08:00-11:59, 12:00-15:59, 16:00-19:59, 20:00-23:59).

RESULTS

The first meal of the day was earlier on night shifts [D6 (3:44 ± 0:33) and D7 (5:52 ± 0:42)] compared to the other shifts (p < 0.001), except for D4 (evening shift; 5:51 ± 0:47) versus D7 (p = 0.999). Night shifts also showed a shorter night fasting (D5-D6, 9.3 h; D6-D7, 9.6 h) than most other nights (p < 0.05), except for the fasting between D1-D2 (11.3 h) and D3-D4 (11.2 h) (p > 0.05). There was no difference in 24 h energy intake throughout the shift cycle (p = 0.065). The analysis of interaction between shift and time ranges showed that night shift (D6) presented a higher intake of energy (441.5 ± 48.4 kcal), percentage of energy (D6: 17.8 ± 1.8%), fat (17.6 ± 2.0%), carbohydrate (17.0 ± 1.7%) and protein (16.4 ± 1.8%) between 00:00 and 03:59 compared with the other shift days (p < 0.05).

CONCLUSION

Night shifts seem to contribute to a longer eating window than other shifts. Moreover, there is a higher energy and macronutrients intake during night shifts, which reduces the night fast period and could have implications for metabolic dysregulation.

The role of insufficient sleep and circadian misalignment in obesity

Traditional risk factors for obesity and the metabolic syndrome, such as excess energy intake and lack of physical activity, cannot fully explain the high prevalence of these conditions. Insufficient sleep and circadian misalignment predispose individuals to poor metabolic health and promote weight gain and have received increased research attention in the past 10 years. Insufficient sleep is defined as sleeping less than recommended for health benefits, whereas circadian misalignment is defined as wakefulness and food intake occurring when the internal circadian system is promoting sleep. This Review discusses the impact of insufficient sleep and circadian misalignment in humans on appetite hormones (focusing on ghrelin, leptin and peptide-YY), energy expenditure, food intake and choice, and risk of obesity. Some potential strategies to reduce the adverse effects of sleep disruption on metabolic health are provided and future research priorities are highlighted. Millions of individuals worldwide do not obtain sufficient sleep for healthy metabolic functions. Furthermore, modern working patterns, lifestyles and technologies are often not conducive to adequate sleep at times when the internal physiological clock is promoting it (for example, late-night screen time, shift work and nocturnal social activities). Efforts are needed to highlight the importance of optimal sleep and circadian health in the maintenance of metabolic health and body weight regulation.

Dietary Risk Factors and Eating Behaviors in Peripheral Arterial Disease (PAD)

Dietary risk factors play a fundamental role in the prevention and progression of atherosclerosis and PAD (Peripheral Arterial Disease). The impact of nutrition, however, defined as the process of taking in food and using it for growth, metabolism and repair, remains undefined with regard to PAD. This article describes the interplay between nutrition and the development/progression of PAD. We reviewed 688 articles, including key articles, narrative and systematic reviews, meta-analyses and clinical studies. We analyzed the interaction between nutrition and PAD predictors, and subsequently created four descriptive tables to summarize the relationship between PAD, dietary risk factors and outcomes. We comprehensively reviewed the role of well-studied diets (Mediterranean, vegetarian/vegan, low-carbohydrate ketogenic and intermittent fasting diet) and prevalent eating behaviors (emotional and binge eating, night eating and sleeping disorders, anorexia, bulimia, skipping meals, home cooking and fast/ultra-processed food consumption) on the traditional risk factors of PAD. Moreover, we analyzed the interplay between PAD and nutritional status, nutrients, dietary patterns and eating habits. Dietary patterns and eating disorders affect the development and progression of PAD, as well as its disabling complications including major adverse cardiovascular events (MACE) and major adverse limb events (MALE). Nutrition and dietary risk factor modification are important targets to reduce the risk of PAD as well as the subsequent development of MACE and MALE.

Time-Related Eating Patterns Are Associated with the Total Daily Intake of Calories and Macronutrients in Day and Night Shift Workers

The aim of the study was to investigate whether time-related eating patterns are associated with the daily intake of calories and macronutrients in Brazilian male military police officers (n = 81; 29-day and 52-night workers; mean age: 36.4 ± 0.9 and 38.5 ± 0.7 years, respectively). Energy and macronutrient intake were determined by a non-consecutive 3-day food recall. Time-related eating patterns, such as the time of the first and the last meals, eating duration, and caloric midpoint, were evaluated. Individuals were classified as “early” or “late” eaters according to the median caloric midpoint. Night shift workers showed a later eating time for the last meal (p < 0.001), longer eating duration (p < 0.001), and later caloric midpoint (p = 0.037) than day workers. Late eaters from both workgroups consumed more 24 h energy (p = 0.028), fat in calories (p = 0.006) and protein (calories: p < 0.001; percentage of total calories: p = 0.042), and less carbohydrates in calories (p = 0.010) intake than early eaters. The time of the first meal was negatively correlated with 24 h energy (p = 0.024) and carbohydrate (p = 0.031) intake only in day workers. The time of the last meal was positively correlated with 24 h energy (day workers: β = 0.352; p = 0.044; night workers: β = 0.424; p = 0.002) and protein (day workers: β = 0.451; p = 0.013; night workers: β = 0.536; p < 0.001) intake for both shift workers, and with carbohydrate (β = 0.346; p = 0.016) and fat (β = 0.286; p = 0.042) intake only in night workers. Eating duration was positively correlated with energy (day workers: β = 0.473; p = 0.004; night workers: β = 0.320; p = 0.023) and carbohydrate (day workers: β = 0.418; p = 0.011; night workers: β = 0.364; p = 0.010) intake in both groups. Thus, time-related eating patterns indicative of intake later at night are associated with increased daily energy and macronutrient intake.

Cardiovascular risk behavior among industrial workers in the Northeast of Brazil: a cluster analysis

This research aimed to investigate the occurrence of clusters of cardiovascular risk behaviors and their association with social demographic and occupational characteristics in a population of industrial workers in the metropolitan area of Recife, Brazil. It was a transversal study with 727 workers of both genders. We identified cluster distribution from the variables: smoking, alcohol consumption, physical activity and waist circumference, by a combination of hierarchical and non-hierarchical analysis. We later tested the association with the social demographic and occupational variables with a multi-varied analysis. We have identified a protection cluster (sufficient physical activity, moderate alcohol consumption) and a risk cluster (high waist circumference, sedentarism, smoking, excessive alcohol consumption). The protection cluster was positively associated with night shift or variable shift work (RP: 1.66, IC95%: 1.26-2.17), and the risk cluster was associated with women (RP: 1.15, IC95%: 1.01-1.31). Cluster analysis allowed to identify that, for day shift workers and women, the shortest daytime outside the work environment can influence the adoption of cardiovascular risk behaviors.

Cardiorenal Metabolic Consequences of Nighttime Snacking: Is it an Innocent Eating Behavior?

PURPOSE OF REVIEW

Health consequences of nighttime eating, as a publicly discussed eating behavior type, have been speculated lately. Nighttime eating has been linked to various metabolic outcomes including hyperlipidemia, hypertriglyceridemia, hyperglycemia, weight gain, elevated blood pressure, obesity, and metabolic syndrome, and cardiorenal outcomes such as atherosclerosis, a decline in eGFR, and proteinuria.

RECENT FINDINGS

Although the exact underlying pathophysiological mechanism is not yet clear, multiple hypotheses including disrupted circadian rhythm, altered hormonal levels, and decline in cellular regeneration have been proposed. In this review, we aim to evaluate the growing literature on nighttime eating behavior in terms of metabolic and cardiorenal outcomes, pathophysiological basis, and potential therapeutic alternatives.

Relationships Between Food Groups and Eating Time Slots According to Diabetes Status in Adults From the UK National Diet and Nutrition Survey (2008-2017)

Time of eating is associated with diabetes and obesity but little is known about less healthy foods and specific time of their intake over the 24 h of the day. In this study, we aimed to identify potential relationships between foods and their eating time and to see whether these associations may vary by diabetes status. The National Diet and Nutrition Survey (NDNS) including 6,802 adults (age ≥ 19 years old) collected 749,026 food recordings by a 4-day-diary. The contingency table cross-classifying 60 food groups with 7 pre-defined eating time slots (6-9 a.m., 9 a.m.-12 p.m., 12-2 p.m., 2-5 p.m., 8-10 p.m., 10 p.m.-6 a.m.) was analyzed by Correspondence Analysis (CA). CA biplots were generated for all adults and separately by diabetes status (self-reported, pre-diabetes, undiagnosed-diabetes, and non-diabetics) to visually explore the associations between food groups and time of eating across diabetes strata. For selected food groups, odds ratios (OR, 99% CI) were derived of consuming unhealthy foods at evening/night (8 p.m.-6 a.m.) vs. earlier time in the day, by logistic regression models with generalized estimating equations. The biplots suggested positive associations between evening/night and consumption of puddings, regular soft drinks, sugar confectioneries, chocolates, beers, ice cream, biscuits, and crisps for all adults in the UK. The OR (99% CIs) of consuming these foods at evening/night were, respectively, 1.43 (1.06, 1.94), 1.72 (1.44, 2.05), 1.84 (1.31, 2.59), 3.08 (2.62, 3.62), 7.26 (5.91, 8.92), 2.45 (1.84, 3.25), 1.90 (1.68, 2.16), and 1.49 (1.22, 1.82) vs. earlier time in the day adjusted for age, sex, body mass index (BMI), and social-economic levels. Stratified biplots found that sweetened beverages, sugar-confectioneries appeared more strongly associated with evening/night among undiagnosed diabetics. Foods consumed in the evening/night time tend to be highly processed, easily accessible, and rich in added sugar or saturated fat. Individuals with undiagnosed diabetes are more likely to consume unhealthy foods at night. Further longitudinal studies are required to ascertain the causal direction of the association between late-eating and diabetes status.

Global overview of dietary outcomes and dietary intake assessment methods in maritime settings: a systematic review

BACKGROUND

Seafaring is a risky occupation with high prevalence of risk factors for non-communicable diseases. Food intake and eating habits are important cornerstones regarding health and health promotion. The aim of this study was to provide an overview of dietary intake and dietary intake assessment methods of seafarers and suggestions for applicable assessment tools.

METHODS

We systematically searched PubMed and NLM Gateway (for MEDLINE), Web of Science, and SCOPUS up to February 2020 using standard keywords including nutrition OR diet OR meal AND maritime settings. Two independent reviewers extracted the data. The quality of included studies was assessed using the Joanna Briggs Institute Critical Appraisal checklist.

RESULTS

From 4449 studies initially identified, 26 articles were included in the final review. Qualitative data (e.g. on unhealthy eating) had been gathered using in-depth individual or group interviews, participant observations, and phone-based chats. Composition of menu analysis, 24 h dietary recall, food diaries/ diet records, dietary habits questionnaire, food stores and food waste of the ship were used to assess the quantitative outcomes (e.g. dietary intakes). Access to meat, processed meat and egg, frozen and canned food items, sugary drinks, alcohol, greasy and salty food was high. In contrast, consumption of fruit, vegetables, dairy products, and cereals was lower than recommended.

CONCLUSIONS

Eating habits and dietary intakes in maritime settings are unhealthy. Subjective dietary assessment methods combining menu analysis with new technologies (e.g. mobile-based) might be an applicable method in this hard to reach setting which is the vessels.

A Nutritional Counseling Program Prevents an Increase in Workers' Dietary Intake and Body Weight During the COVID-19 Pandemic

The COVID-19 pandemic caused thousands of deaths and changed lives all over the world. Daily life has also altered people's eating habits, mainly among those who stayed working at home. However, changes in the eating habits of workers who remained working during the pandemic are still unknown. The aim of this study was to evaluate the impact of the COVID-19 pandemic on the dietary habits of day and shift workers from a condominium management company, as well as to measure adherence to a nutritional counseling program and its effect on workers' food intake and body weight. One hundred and fifty-one workers (77.5% of day workers and 22.5% of shift workers) were followed up in the pre-pandemic period and during the pandemic. Data on anthropometry, food consumption, and adherence to nutritional counseling were collected during nutritional meetings, which focused on qualitative modification of food intake and control of energy consumption. The rate of adherence to the program did not differ between shifts. The pandemic significantly increased the intake of calories, macronutrients, and several micronutrients in workers of both shifts. Adherence to the nutritional counseling program had an impact on the consumption of proteins and some micronutrients, and also promoted a reduction in body weight and body mass index of workers of both shifts. Evening/night shift workers overall ate their meals later than day workers and also presented an earlier afternoon snack during the pandemic when compared with the pre-pandemic period. In conclusion, the pandemic seems to contribute to the increase in food intake of workers, regardless of the work shift. Those who joined a nutritional counseling program managed their food intake and lost weight.

The Impact of Different Types of Shift Work on Blood Pressure and Hypertension: A Systematic Review and Meta-Analysis

Shift work (SW) encompasses 20% of the European workforce. Moreover, high blood pressure (BP) remains a leading cause of death globally. This review aimed to synthesize the magnitude of the potential impact of SW on systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension (HTN). MEDLINE, EMBASE and CENTRAL databases were searched for epidemiological studies evaluating BP and/or HTN diagnosis among shift workers, compared with day workers. Random-effects meta-analyses were performed and the results were expressed as pooled mean differences or odds ratios and 95% confidence intervals (95% CI). The Newcastle-Ottawa Scale was used to assess the risk of bias. Forty-five studies were included, involving 117,252 workers. We found a significant increase in both SBD and DBP among permanent night workers (2.52 mmHg, 95% CI 0.75-4.29 and 1.76 mmHg, 95% CI 0.41-3.12, respectively). For rotational shift workers, both with and without night work, we found a significant increase but only for SBP (0.65 mmHg, 95% CI 0.07-1.22 and 1.28 mmHg, 95% CI 0.18-2.39, respectively). No differences were found for HTN. Our findings suggest that SW is associated with an increase of BP, mainly for permanent night workers and for SBP. This is of special interest given the large number of susceptible workers exposed over time.

Differences in Clinical Indicators of Diabetes, Hypertension, and Dyslipidemia Among Workers Who Worked Long Hours and Shift Work

BACKGROUND

Many studies have reported an association between overwork, shift work, and chronic disease. However, there is little research on the influence of working hours and shift work and management of chronic diseases. The objective of this retrospective study was to examine the association between working hours, shift work type in workers with hypertension, diabetes, and dyslipidemia.

METHODS

Among 18,513 hourly wageworkers from the Korea National Health and Nutrition Examination Survey, 4,313 with hypertension, diabetes, and hyperlipidemia were selected. An analysis of covariance with general linear modeling was used to estimate group differences in clinical indices of chronic diseases according to weekly working hours and types of shift work, both unadjusted and adjusted for gender, age, education, marital status, household income, and medication usage.

FINDINGS

Clinical indicators were worse in workers with diabetes (differences in HbA1c = 0.15%; fasting blood glucose = 4.84 mg/dL), hypertension (differences in diastolic blood pressure = 1.2 mmHg), or dyslipidemia (differences in total cholesterol = 3.3 mg/dL) who worked for more than 40 hours/week compared with workers who worked less than 40 hours per week. Clinical indicators in workers with diabetes and hypertension were worse in shift workers, including evening and night shifts, relative to those who did not work shiftwork.

CONCLUSIONS/APPLICATION TO PRACTICE

Working more than 40 hours per week and shift work were negatively associated with adverse clinical indicators among workers with chronic diseases. To improve the health of workers with chronic diseases, these findings suggest that adjustment of working hours and shift work may be warranted.

Definition and Multiple Factors of Recurrent Spontaneous Abortion

Recurrent spontaneous abortion (RSA) is usually defined as three or more spontaneous abortions prior to 20-28 weeks gestation. RSA affects approximately 2-5% of all women of childbearing age, and it brings tremendous psychological and psychiatric trauma to the women and also results in economic burden. The causes could be female age, anatomical and chromosomal abnormalities, genetic, endocrinological, placental anomalies, infection, smoking and alcohol consumption, psychological factor, exposure to environmental factors such as heavy metal, environment pollution, and radiation.

Differences in the Prevalence of Fruit and Vegetable Consumption in Spanish Workers

The present study aims to examine the differences in daily fruit and vegetable consumption in the working population in Spain. A cross-sectional study was conducted, using data from the 2017 National Health Survey (n = 10,700 workers aged between 18 and 65 years). The daily consumption of fruit and vegetables was evaluated using two items included in a food frequency questionnaire. Occupations were classified into the 17 main groups of the National Classification of Occupations of 2011 (CNO-11). The prevalence (P) of daily fruit and vegetable consumption was calculated in relation to sociodemographic characteristics, health behaviors, work-related characteristics and occupations. Logistic regression analysis was performed to examine the association, with simple and adjusted Odds Ratio (aOR). The P of daily consumption of fruit and vegetables in workers was 60% for fruit and 40% for vegetables. After adjusting for sociodemographic characteristics and health behaviors, workers working night or rotating shifts had a lower consumption of fruits (aOR:0.9; p < 0.05), and those working on temporary contracts had a lower consumption of vegetables (aOR:0.8; p < 0.05). Engineers, scientists, health care workers and teachers had the highest fruit consumption (74.5%) and the highest vegetable consumption (55.1%). The lowest consumption of fruits was presented by the military (42.3%) and unskilled workers in the service sector (45.8%), and the lowest consumption of vegetables was presented by skilled construction workers (25.5%). These findings could aid in workplace health promotion and could be used in future studies to evaluate the impact of the activities adopted.

Calidad de la dieta del personal de salud de un hospital chileno según el índice de alimentación saludable

Introducción. Se ha reportado que los trabajadores hospitalarios tienen una alta probabilidad de presentar factores de riesgo modificables asociados al desarrollo de enfermedades crónicas no transmisibles, tales como mala alimentación, altos niveles de estrés y cambios de los patrones del sueño.Objetivo. Determinar la calidad de la dieta del personal de salud que usa los servicios del Casino de Funcionarios del Hospital Regional de Temuco de acuerdo a sistemas de turno, sexo y edad. Para la medición de la calidad de la dieta se utilizó el índice de alimentación saludable (IAS).Materiales y métodos. Estudio transversal realizado en 201 trabajadores (156 mujeres y 45 hombres), a quienes se les solicitó completar una encuesta sobre consumo de alimentos para evaluar sus IAS; el instrumento estuvo dividido por grupos de alimentos.Resultados. La edad promedio fue 34.8±10.7 años y el puntaje promedio de IAS fue 67.5±14.5. El 12.9% de los participantes tenía hábitos alimenticios poco saludables, el 65.2% requería cambios dietarios y el 21.9% presentaba una alimentación saludable. Se observaron diferencias estadísticamente significativas respecto al IAS según sexo (p=0.033) y edad (p=0.009), pero no entre puntaje IAS y el sistema de turnos (p=0.334). Conclusiones. La mayoría de participantes necesita modificar sus hábitos alimenticios, por lo que es necesario que en los hospitales, como lugar de trabajo, se implementen acciones que promuevan la adopción de hábitos alimenticios saludables por parte del personal de salud, en particular en el caso de los hombres, quienes tuvieron puntajes de IAS significativamente bajos en varios grupos de alimentos en comparación con las mujeres.

Eating Duration throughout a Rotating Shift Schedule: A Case Study

OBJECTIVE

The impact of the rotation between different shifts and free days within a short period of time on the food consumption is poorly addressed in the literature. Our objective was to characterize the eating duration (ED) over 10 d of clockwise rotating and to associate it with the intake of energy and macronutrients.

METHODS

Thirty male shift-workers from a mining company were evaluated over a complete rotation shift schedule of 10 consecutive days (2 d of morning shifts, 2 d of afternoon shifts, 24 h free-day, 2 d of night shifts, and three free days). ED was defined as the interval between the first meal after awaking and last meal before sleep onset. Sleep/wake periods and food intake were evaluated by actigraphy and 24 h recalls, respectively. Generalized models were used to analyze the variation in ED and its association with nutrient intake over the shift schedule.

RESULTS

ED periods showed significant variations throughout shift rotation and were associated with energy intake. The highest energy intake (3410 ± 235 kcal) and longest ED (20.7 ± 1.2 h) were found on Day 5, the day between afternoon and night shifts, and a part of Day 6 (night shift), i.e., in the longest period of wakefulness and the shortest sleep duration (4.7 ± 0.3 h) (p < 0.05 for all). The lowest energy intake (1284 ± 125 kcal) and shortest ED (4.96 ± 0.7 h) (p < 0.05) occurred after the last night shift (Day 7). The balance between the percentage of macronutrients did not differ statistically between the ED periods.

CONCLUSIONS

In general, longer periods of wakefulness showed greater energy intake, demonstrating the tendency of workers to eat around the clock during their shift. Even with the energy intake variation, the balance of macronutrients remained the same over the ED periods. Despite the need of confirmation in future studies, these results suggest that the management of ED period could be considered in the nutritional approach of shift workers.

Adherence to dietary and physical activity guidelines among shift workers: associations with individual and work-related factors

Objectives

Shift work is associated with adverse effects on the health and lifestyle behaviours of employees. This study aimed to examine factors associated with adherence among shift workers to selected indicators of dietary and physical activity guidelines.

Methods

A cross-sectional study was conducted on 1300 shift workers. Data were collected using a 15 minute telephone-administered questionnaire. Logistic regression methods were used for data analysis.

Results

Male shift workers (p<0.001, OR=0.55, 95% CI 0.40 to 0.74) and those of lower socioeconomic status (p=0.046, OR=0.75, 95% CI 0.57 to 0.99) were significantly less likely to consume five or more daily servings of fruits and vegetables. Shift workers with access to workplace vending machines were significantly more likely to consume soft drinks at least weekly (p=0.003, OR=1.64, 95% CI 1.18 to 2.27). Middle-aged shift workers (p=0.012, OR=0.65, 95% CI 0.46 to 0.91) and those reporting insufficient break times at work (p=0.026, OR=0.69, 95% CI 0.49 to 0.96) were significantly less likely to be sufficiently active.

Conclusions

Individual, work schedule and workplace environment related factors were independently associated with selected indicators of adherence to dietary and physical activity guidelines in this cohort of shift workers.

Effect of consuming a late-night high-protein/moderate-carbohydrate vs. low-protein/high-carbohydrate meal by night workers on their food perceptions later during the day: a randomized crossover study

It is typical of night workers to consume a large dinner meal before their work shift, even though this practice may increase the risk for metabolic disorders. Night workers usually eat at night to socialize with colleagues as well as to stay alert and to avoid upset stomach during the night shift. However, little is known if and how the composition of the nighttime meal by night shift workers influences their food perceptions and eating behavior later during the day. The aim of this study was to analyze the effect of a high-protein/moderate-carbohydrate (HP/MCHO) meal vs. low-protein/high-carbohydrate (LP/HCHO) meal eaten at night by night-shift workers on their food consumption and perceptions later during the day. Fourteen male night shift workers were followed-up for 7 days for their eating and sleep habits. Then, participants underwent two isocaloric dietary events - one event a HP/MCHO meal containing 45% carbohydrate, 35% protein, and 20% fat and the other event a LP/HCHO meal containing 65% carbohydrate, 15% protein, and 20% fat, with a 6-day washout period between them - at 01:00 h during their night shift. Thereafter throughout the day, participants filled a food register of all the food consumed and perceptions, including hunger before meals, enjoyment of meals, and satiety. Generalized estimating equation analyses were used to examine the effect of both conditions on food consumption and food perceptions. Appetite for salty food snacks was greater after the HP/MCHO condition than after the LP/HCHO condition (p = .041). During the day following consumption of the nighttime HP/MCHO vs. LP/HCHO meal, there was higher percentage of carbohydrate consumption during lunch and a lower percentage of fat consumption during dinner (48.14% vs. 36.98% and 27.34% vs. 40.39%, respectively). These findings suggest the composition in terms of carbohydrates, protein, and fats of the meal consumed for the night shift by night workers may affect later during the day both food consumption and perceptions.

A High-Protein Meal during a Night Shift Does Not Improve Postprandial Metabolic Response the Following Breakfast: A Randomized Crossover Study with Night Workers

The aim of this study was to compare the acute effect of a high-protein/moderate carbohydrate (HP-MCHO) versus low-protein/high-carbohydrate (LP-HCHO) meal served at night on the postprandial metabolic response of male night workers the following breakfast. A randomized crossover study was performed with 14 male night workers (40.9 ± 8.9 years old; 29.1 ± 5.3 kg/m²). Participants underwent two different isocaloric dietary conditions at 1:00 h of the night shift: HP-MCHO (45 en% carbohydrate, 35 en% protein and 20 en% fat) and LP-HCHO (65 en% carbohydrate, 15 en% protein and 20 en% fat). Postprandial capillary glucose levels were determined immediately before the intake of the test meal and 30, 60, 90 and 120 min after the end of the meal. At the end of the work shift (6:30 h), participants received a standard breakfast and postprandial levels of glucose, insulin and triglycerides were determined immediately before and then every 30 min for 2 h (30, 60, 90 and 120 min). Higher values of capillary glucose were found after the LP-HCHO condition compared to the HP-MCHO condition (area under the curve (AUC) = 119.46 ± 1.49 mg/dL × min and 102.95 ± 1.28 mg/dL × min, respectively; p < 0.001). For the metabolic response to standard breakfast as the following meal, no significant differences in glucose, insulin, triglyceride, and HOMA-IR levels were found between interventions. A night meal with a higher percentage of protein and a lower percentage of carbohydrate led to minor postprandial glucose levels during the night shift but exerted no effect on the metabolic response of the following meal. This trial was registered at ClinicalTrials.gov as NCT03456219.

Metabolic implications of circadian disruption

Circadian rhythms are generated by the circadian clock, a self-sustained internal timing system that exhibits 24-h rhythms in the body. In mammals, circadian rhythms are driven by a central clock located in suprachiasmatic nucleus and various peripheral clocks located in different tissues and organs of the body. Many cellular, behavioral, and physiological processes are regulated by the circadian clock in coordination with environmental cues. The process of metabolism is also under circadian regulation. Loss of synchronization between the internal clock and environmental zeitgebers results in disruption of the circadian rhythms that seriously impacts metabolic homeostasis leading to changed eating behavior, altered glucose and lipid metabolism, and weight gain. This in turn augments the risk of having various cardio-metabolic disorders such as obesity, diabetes, metabolic syndrome, and cardiovascular disease. This review sheds light on circadian rhythms and their role in metabolism with the identification of gaps in the current knowledge that remain to be explored in these fields. In this review, the molecular mechanisms underlying circadian rhythms have been elaborated first. Then, the focus has been kept on explaining the physiological significance of circadian rhythms in regulating metabolism. Finally, the implications for metabolism when these rhythms are disrupted due to genetic mutations or social and occupational needs enforced by modern lifestyle have been discussed.

Consequences of Circadian Disruption in Shift Workers on Chrononutrition and their Psychosocial Well-Being

The workers and employees in various institutions are subjected to different shifts and work schedules. The employees work not only at daytime but also during odd hours at night. The biological clock of an individual is often altered during night shifts. This affects the psychosocial well-being and circadian nutritional intake of the worker. Disturbance in circadian rhythm results in the development of metabolic disorders such as hypertension, dyslipidemia, dysglycemia, and abdominal obesity. In the present review, we discuss the nature of shift work, sleep/wake cycle of an individual, chrononutrition, dietary habits, and meal changes with regard to timing and frequency, related to shift work. We also discuss the relationship between nutritional intake and psychosocial well-being among shift workers. The review may be beneficial for prevention of metabolic disorders and maintaining sound psychological condition in shift workers.

[Unhealthy eating habits and associated risk factors among truck drivers]

The scope of this article is to identify risk factors associated with unhealthy eating habits among truck drivers. It involved a cross-sectional study carried out with truck drivers individually interviewed at the Port of Paranaguá in the State of Paraná, Brazil. Information was obtained on the consumption of fruit, vegetables, fried salted food, sweetened beverages, and the removal of visible fat from red meat and of skin from chicken meat. Hierarchical Poisson regression models were applied to identify factors associated with unhealthy eating habits. Of those interviewed (n = 670), 53.1% had four or more unhealthy eating habits. This condition was associated with age less than 40 years (prevalence ratio, PR = 1.49; 95% confidence interval, CI = 1.28-1.73), moderate, low or very low ability to exercise the profession (PR 1.28; 95% CI 1.08-1.52), not taking physical exercise in free time (PR = 1.66; 95%CI = 1.38- 2.00), overall self-reported eating habits as poor or very poor (RP = 1.25; IC95% = 1.05-1.49) and body mass index < 25 Kg/m2 (PR = 1.22; 95% CI = 1.05-1.43). More than half of the truck drivers revealed unhealthy eating habits, highlighting the need for strategies to rectify these habits.

Eating Behavior (Duration, Content, and Timing) Among Workers Living under Different Levels of Urbanization

Urbanization has contributed to extended wakefulness, which may in turn be associated with eating over a longer period. Here, we present a field study conducted in four groups with different work hours and places of living in order to investigate eating behavior (duration, content, and timing). Anthropometric measures were taken from the participants (rural (n = 22); town (n = 19); city-day workers (n = 11); city-night workers (n = 14)). In addition, a sociodemographic questionnaire was self-answered and 24-h food recalls were applied for three days. The 24-h food recalls revealed that fat intake varied according to the groups, with the highest consumption by the city-day workers. By contrast, city-day workers had the lowest intake of carbohydrate, whereas the rural group had the highest. In general, all groups had some degree of inadequacy in food consumption. Eating duration was negatively correlated with total energy intake, fat, and protein consumption in the rural and town groups. There was a positive correlation between body mass index and eating duration in both city groups. The rural group had the earliest start time of eating, and this was associated with a lower body mass index. This study suggested that food content and timing, as well as eating duration, differed according to place of living, which in turn may be linked to lifestyle.

Prevalence and lifestyle-related risk factors of obesity and unrecognized hypertension among bus drivers in Ghana

Obesity and hypertension are public health problems associated with cardiovascular events worldwide. Bus drivers, whose lifestyle is primarily sedentary and characterized by poor eating habits are at increased risk. This study determined the prevalence and lifestyle-related risk factors of obesity and hypertension among Inter-Regional Metromass Bus Drivers (IRMBDs) in Ghana. This cross-sectional study recruited 527 professional drivers from Metromass Bus stations in Accra and Kumasi Metropolis, Ghana. Structured questionnaires were administered to obtain socio-demographic and lifestyle characteristics from all participants. Anthropometric measurements including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and blood pressure (BP) were determined. The prevalence of unrecognized hypertension was 38.7%. The prevalence of obesity using BMI, WC, and WHR as obesity indices were 19.0%, 19.9%, and 19.4%, respectively. Use of sleep inhibitors, long-duration sitting and eating late at night were independent risk factors for obesity, regardless of the obesity index used (p < 0.05). Physical inactivity, high caloric intake and eating at stressful periods were independent risk factors for obesity based on WC and WHR measurements (p < 0.05). Ageing, smoking history, alcoholic beverage intake, sleep inhibitor drug use, high calorie intake, long-duration sitting, eating late and under stressful conditions were independent risk factors for hypertension (p < 0.05). There is a high prevalence of unrecognized hypertension and obesity among IRMBDs which were associated with individual lifestyle and behaviours. Increased awareness through educational and screening programs will trigger lifestyle modifications that will reduce cardio-metabolic disease onset and offer clues for better disease predictive, preventive and personalized medicine.

Obesidade abdominal e padrões alimentares em mulheres trabalhadoras de turnos

Resumo Objetivou-se identificar os padrões alimentares e a associação destes com a obesidade abdominal em mulheres trabalhadoras de turnos no sul do Brasil. Para isso, realizou-se um estudo de caso-controle não pareado, incluindo um total de 541 mulheres de 18 a 53 anos de idade (215 casos; 326 controles). A presença de obesidade abdominal foi verificada pela aferição da circunferência da cintura ≥ 88 centímetros e os padrões alimentares foram obtidos por meio da análise de componentes principais de 53 itens. Os padrões foram classificados com base nos alimentos de maior carga fatorial e características nutricionais. A associação entre obesidade abdominal e os padrões foi verificada por meio de regressão logística não condicional. Três padrões alimentares foram identificados: “gordura animal/calorias”, “lanches/fast-food” e “frutas/verduras”. Após análise ajustada, os casos apresentaram uma maior chance de adesão ao padrão “frutas/verduras” (OR = 2,26; IC95%:1,30-3,93) e uma menor chance de adesão ao padrão “lanches/fast-food” (OR = 0,60; IC95%:0,36-1,01). Assim, identificou-se três padrões alimentares entre as trabalhadoras de turnos e verificou-se uma melhora na alimentação naquelas com obesidade abdominal, representando uma possível alteração de hábitos alimentares após sua ocorrência.

The factors influencing the eating behaviour of shiftworkers: what, when, where and why

Shiftwork leads to altered eating patterns, with workers often eating foods at all times across the 24 h period. Strategies to reduce the burden of shiftwork on the workers should be prioritised and altering these eating patterns is an important area for change. This narrative review examines the current evidence on the individual and environmental factors influencing the eating behaviours of shiftworkers. A systematic search was conducted and yielded 62 articles. These were split into four themes that influence eating patterns; When shiftworkers eat, What type of foods shiftworkers eat, Where the food is sourced from, and Why shiftworkers choose to eat on shift. Irregular working hours was the biggest influence on when workers ate on shift, shift-type was the biggest influence on what workers ate, the majority of food was sourced from canteens and cafeterias, and socialising with colleagues was the biggest reason why workers chose to eat. While more research is needed to explore multiple industries and shift-types, and to investigate the ideal size, type and timing of food on shift, this review has highlighted that future research into shiftworker eating needs to adopt an integrative approach and consider the different individual and social contexts that influence eating patterns.

Is shift work associated with a higher risk of overweight or obesity? A systematic review of observational studies with meta-analysis

Background

An increasing number of original studies suggest that exposure to shift work could be associated with the risk of overweight and obesity, but the results remain conflicted and inconclusive. This study aimed to quantitatively synthesize available epidemiological evidence on the association between shift work and the risk of overweight and obesity by a meta-analysis.

Methods

The authors searched PubMed, Embase and the reference lists of all included studies up to April 2017, with a verification search in December 2017. Inclusion criteria were original studies that reported odds ratios, relative risks or hazard ratios (ORs, RRs or HRs, respectively) of at least one outcome of overweight or obesity. Summary risk estimates were calculated by random-effect models.

Results

Twenty-six studies (7 cohort studies, 18 cross-sectional studies and 1 case-control study) involving 311 334 participants were identified. Among these studies, the cut-off points of overweight and obesity varied greatly, so the heterogeneity was substantial; however, the results were stable. Shift work was found to be positively associated with the risk of overweight [RR: 1.25; 95% confidence interval (95% CI): 1.08-1.44] and obesity (RR: 1.17; 95% CI: 1.12-1.22).

Conclusions

Individuals involved in shift work are more likely to become overweight or obese. Appropriate preventive interventions in the organization of shift schedules according to ergonomic criteria would allow shift workers to avoid potential health impairment.

Association between DNA damage, dietary patterns, nutritional status, and non-communicable diseases in coal miners

Several negative health effects have been associated with environmental pollution. Coal mining activities are related to DNA damage. However, the impact of lifestyle as well as environmental exposure must be considered when evaluating the extent of DNA damage. The aim of this cross-sectional study was to analyze nutritional status, dietary patterns, and the prevalence of non-communicable diseases (CNCDs) among coal miners as well as to investigate the correlation of these variables with DNA damage. We used a questionnaire to assess demographics, health, and dietary habits. The nutritional status was measured in terms of BMI (body mass index) and DNA damage was assessed by the comet assay. The sample population was composed of 158 coal miners from the largest coal mining company in South of Brazil, and majority of them were classified as overweight (51.3%) or obese (28.5%). Hypertension was the most common CNCD (50.6%) and a majority of these workers consumed all groups of foods three or more times a week. There was a significant positive correlation between BMI and DNA damage (r = 0.1646, p = 0.04) and this association was stronger (r = 0.2556, p = 0.04) in coal miners with some CNCD. There was no significant correlation between dietary patterns and DNA damage in coal miners. These results suggest that the nutritional status and CNCD increase the extent of DNA damage in coal miners. Since this population is at high occupational risk, specific strategies should be designed to improve the health of these workers, aiming to achieve health equity.

Association of night eating habits with metabolic syndrome and its components: a longitudinal study

Background

Night time eating is a risk factor for metabolic syndrome and obesity. The aim of this study was to investigate whether dinner immediately before bed, snacks after dinner, or combinations of both were associated with metabolic syndrome and its components in a large Japanese cohort.

Methods

We enrolled 8153 adults aged 40–54 years who participated in specific medical checkups in an Okayama facility from 2009 to 2010 and from 2013 to 2014. Age-adjusted and multivariable-adjusted odds ratios of metabolic syndrome and its components in participants with both night eating habits for an average of 3.9 years were evaluated. The relative excess risk due to interaction (RERI) was utilized to determine the supra-additive interaction of both eating habits on metabolic syndrome and its components.

Results

The multivariable-adjusted odds ratio for obesity for those with both eating habits compared to those with neither habit was 2.11 (95% confidence interval [CI], 1.42–3.15) for men and 3.02 (95%CI, 1.72–5.29) for women. Both habits had a supra-additive interaction effect on obesity development in women (RERI, 1.67; RERI%, 85.0; p = 0.058), although this result was not significant. In women, there was an association between eating habits at night and metabolic syndrome, but in men it was unrelated. Both night eating habits were associated with dyslipidemia in men and women.

Conclusions

These findings suggest the need for intervention and awareness among individuals with night eating habits to mitigate further complications.

Prudent diet is associated with low sleepiness among short-haul truck drivers

OBJECTIVES

The lifestyle of postindustrial society has undergone major shifts characterized by changes in demographic and epidemiologic profiles, eating habits, and job structures, with irregular working hours, particularly night shifts. The investigation of dietary patterns is of great importance for the discussion and devising of effective dietary strategies for shift and night workers in general, particularly in view of the increased sleepiness reported during night work.

OBJECTIVE

We aimed to determine the association between dietary patterns of Brazilian truck drivers and sleepiness levels, according to work shift.

METHODS

A cross-sectional study of 52 drivers (25 long haul and 27 short haul) at a freight company was carried out. This study entailed application of a structured questionnaire collecting sociodemographic, lifestyle, and nutritional status data. Assessment of dietary intake using a 24-h dietary recall and an evaluation of sleepiness by the Karolinska Sleepiness Scale were performed. The principal components of the diet were analyzed by factor analysis to derive dietary patterns. A linear mixed model was then applied to determine a model for sleepiness levels of the drivers as a function of dietary pattern, time of day, and work shift.

RESULTS

Three intake patterns were derived: traditional, prudent, and Western. Associations of time of day (F = 23.629, P < 0.01) and shift type (F = 42.218, P < 0.01) on sleepiness were found. An association between diet and sleepiness was also evident, where the prudent pattern was associated with low sleepiness among short-haul truck drivers (F = 3.865, P = 0.02).

CONCLUSIONS

The results of the present study revealed an association between dietary patterns and short-haul driving, in which the healthy pattern produced low sleepiness during the day. The sleepiness curve of long-haul drivers appears to have a flattening pattern, probably because of irregular working times.

Variation in Men's Dietary Intake Between Occupations, Based on Data From the Japan Environment and Children's Study

There has been increasing interest in dietary health promotion in the workplace. Although many previous studies have focused on dietary habits in specific occupations, variation between occupational groups requires clarification. The present study aimed to examine differences in food and nutrient intake between occupational groups, using detailed classification. A cross-sectional study was conducted using data from the Japan Environment and Children’s Study. The study included 38,721 employed Japanese expectant fathers aged between 20 and 65 years. Dietary intake was assessed using a food frequency questionnaire. Occupations were categorized into 11 categories according to the Japan Standard Occupational Classification. Analysis of variance and analysis of covariance were performed to compare dietary intake of occupational groups. Logistic regression analysis was performed to examine the differences in adherence to dietary recommendations across occupations. Dietary intake differed significantly between occupations. Specific dietary intake was observed in security and agricultural workers, who tended to exhibit higher consumption levels for numerous foods and nutrients. In addition, relative to other workers, security workers showed higher intake of dairy products and calcium, and agricultural workers consumed larger amounts of pickles and salt. The study categorized occupations into detailed categories using the Japan Standard Occupational Classification, which facilitated the clarification of overall dietary trends across occupations and identification of specific dietary characteristics in individual occupations. The findings could aid in workplace health promotion.

Meta-analysis on shift work and risks of specific obesity types

AIMS

This systematic review and meta-analysis evaluated the associations between shift work patterns and risks of specific types of obesity.

METHODS

PubMed was searched until March 2017 for observational studies that examined the relationships between shift work patterns and obesity. Odds ratio for obesity was extracted using a fixed-effects or random-effects model. Subgroup meta-analyses were carried out for study design, specific obesity types and characteristics of shift work pattern.

RESULTS

A total of 28 studies were included in this meta-analysis. The overall odds ratio of night shift work was 1.23 (95% confidence interval = 1.17-1.29) for risk of obesity/overweight. Cross-sectional studies showed a higher risk of 1.26 than those with the cohort design (risk ratio = 1.10). Shift workers had a higher frequency of developing abdominal obesity (odds ratio = 1.35) than other obesity types. Permanent night workers demonstrated a 29% higher risk than rotating shift workers (odds ratio 1.43 vs. 1.14).

CONCLUSION

This meta-analysis confirmed the risks of night shift work for the development of overweight and obesity with a potential gradient association suggested, especially for abdominal obesity. Modification of working schedules is recommended, particularly for prolonged permanent night work. More accurate and detailed measurements on shift work patterns should be conducted in future research.

Alteration in eating habits among shift workers of a poultry processing plant in southern Brazil

The relationship between shift work and the eatinghabits of workers was investigated in a slaughterhouse in southern Brazil. It involved a cross-sectional study with 1,206 workers of both sexes between 18 and 50 years of age. A standardized questionnaire was used to gather demographic, socioeconomic, work shift and eating habit information. The shift of work was categorized into daytime and nighttime, based on the starting and ending times of the shift. The eating habits of workers were evaluated as follows: number and type of meals eaten during the 24 hours of a normal day, the inappropriateness of the hoursof these meals and the dietaryrisk score. This was built on the risk score of the weekly consumption of 13 food items. After adjusting for potential confounders, non-Caucasian and younger male workers were more likely to manifest eating risk habits. Nighttimeshift workers consumed ahigher number of meals/day with greater inappropriateness of meal times than daytimeshift workers. The night shift can negatively influence the eating habits of workers of that shift.

Metabolic disturbances due to a high-fat diet in a non-insulin-resistant animal model

Objective:

Shift workers have metabolic changes more often than day workers. It is also known that night workers prefer foods high in saturated fat. Such data suggest that shift workers are prone to cardiovascular disease. Therefore, the objective of this study was to propose an animal model to test the effect of high-fat diet (HFD) based on shift workers' diet.

Methods:

This is an experimental study with 20 Wistar rats. Ten rats were allocated to the control group (CG) and were fed standard diet. Ten rats were allocated to the experimental group (EG) and were fed HFD (45% fat). Serum triglycerides (TG), glucose and high-density lipoprotein-cholesterol (HDL-cho) were measured 5, 10 and 15 weeks after the beginning of the study. The amount of visceral adipose tissue (VAT) was determined. Body weight was assessed weekly, and food and water intake were measured daily. Student's t-test was used for independent samples, and P<0.05 was considered significant.

Results:

After 15 weeks of intervention, the EG showed increased serum levels of TG (P=0.001) and glucose (P<0.001) and decreased HDL-cho (P<0.001) when compared with the CG. The EG showed increased VAT (P=0.005) and liver weight (P=0.01). Food intake and water intake were higher in the CG (P<0.001 and P<0.001, respectively), whereas energy intake showed no difference (P=0.48). No difference was found in the weight of adrenal glands (P=0.07) and body weight (P=0.63).

Conclusions:

The experimental diet was effective to show changes in the serum levels of glucose, TG and HDL-cho and visceral fat in spite of no change in body weight in 15 weeks.

Social Jetlag Among Night Workers is Negatively Associated with the Frequency of Moderate or Vigorous Physical Activity and with Energy Expenditure Related to Physical Activity

This cross-sectional study analyzed the association between physical activity (PA) and social jetlag (SJL) among shift workers. We evaluated 423 employees, aged between 18 and 60 years, who worked in a poultry-processing company in Brazil. Physical activity levels (PAL) were determined by the short form of the International Physical Activity Questionnaire (IPAQ-SF). SJL was calculated as the absolute difference between the time of mid-sleep on work and free days. The percentage of workers insufficiently active was high on all shifts, with no significant differences between the 3 shifts. The amount of time spent in sedentary behavior on workdays did not differ between shifts. Among night-shift workers, negative associations were observed between SJL and 1) the duration and weekly energy expenditure while walking; 2) the frequency of moderate and vigorous PA; and 3) the total energy expenditure related to PA. Even though PAL did not differ among workers on different shifts, we found a high prevalence of subjects who were insufficiently active or too sedentary among all groups. Also, SJL was negatively associated with PA in night-shift workers. These results suggest that PA should be encouraged among shift workers and that SJL may be an important factor in reducing PA in this cohort.

Sleep Duration and Chronic Fatigue Are Differently Associated with the Dietary Profile of Shift Workers

Shift work has been associated with dietary changes. This study examined factors associated with the dietary profiles of shift workers from several industries (n = 118, 57 male; age = 43.4 ± 9.9 years) employed on permanent mornings, nights, or rotating 8-h or 12-h shifts. The dietary profile was assessed using a Food Frequency Questionnaire. Shift-related (e.g., sleep duration and fatigue), work-related (e.g., industry), and demographic factors (e.g., BMI) were measured using a modified version of the Standard Shift work Index. Mean daily energy intake was 8628 ± 3161 kJ. As a percentage of daily energy intake, all workers reported lower than recommended levels of carbohydrate (CHO, 45%–65%). Protein was within recommended levels (15%–25%). Permanent night workers were the only group to report higher than recommended fat intake (20%–35%). However, all workers reported higher than recommended levels of saturated fat (>10%) with those on permanent nights reporting significantly higher levels than other groups (Mean = 15.5% ± 3.1%, p < 0.05). Shorter sleep durations and decreased fatigue were associated with higher CHO intake (p ≤ 0.05) whereas increased fatigue and longer sleep durations were associated with higher intake of fat (p ≤ 0.05). Findings demonstrate sleep duration, fatigue, and shift schedule are associated with the dietary profile of shift workers.