Dietary Behaviour Is Associated with Cardiometabolic and Psychological Risk Indicators in Female Hospital Nurses-A Post-Hoc, Cross-Sectional Study

Associations between Variability in Between- and Within-Day Dietary Intake with Adiposity and Glucose Homeostasis in Adults: A Systematic Review

This systematic review aims to comprehensively evaluate the literature regarding the impact of variations in dietary intake, both between- and within-day, on adiposity and glucose metabolism. We included observational and experimental articles obtained from PubMed, Scopus, Cochrane Library, and gray literature until 9 October, 2023, evaluating the impact of between- or within-day variations in meal, energy, or macronutrient intake on these outcomes. Our focus was on adults aged ≥18 y, spanning both healthy individuals and those with type 2 diabetes mellitus (T2DM). Given the diverse range of exposures, treatments, and outcomes among the selected articles, we chose a qualitative synthesis approach to effectively analyze the data. Eighty articles from 43 observational and 37 experimental studies were included, involving 89,178 participants. Patterns of dietary intake variation were identified and systematically organized into distinct categories based on similarities. Between-day variations in dietary intake consisted of between-day variations in both the quantity consumed and meal timing. Meanwhile, within-day variations encompassed factors such as eating window, meal omission, within-day meal timing, within-day variation in dietary intake quantity, and temporal distribution. Despite mixed results, time-restricted eating was generally associated with lower adiposity. However, limited control for total daily energy intake (TDEI) suggests that the contribution of lower energy intake cannot be conclusively excluded. Conversely, the adverse effect of meal omission on glucose parameters was consistently supported by randomized trials. Interestingly, the results showed that consuming a substantial portion of TDEI in the morning may increase the likelihood of observing improvements in adiposity. Furthermore, inconsistencies in outcomes across articles examining the effects in healthy compared with T2DM populations, or in energy-sufficient compared with deficient individuals, indicate potential condition-specific effects. These findings support the need for further investigation into the effects of between- and within-day variations in dietary intake to better understand their impact on adiposity and glucose homeostasis. This review was registered in PROSPERO as CRD42020214307.

The Impact of Night Work on the Sleep and Health of Medical Staff-A Review of the Latest Scientific Reports

Introduction: Employees working in shifts are exposed to many threats affecting their health, quality of life and safety at work. Those who perform their work only at night are particularly vulnerable. The purpose of the review is to identify risks to the health, quality of life and sleep of shift health workers. Method: A systematic review (SR) was used in the analysis. Electronic databases were searched. The search was limited to the latest studies published in the last five years: 2019-2023. Results: Finally, 36 articles were included in the review. Most authors have shown a link between sleep disturbance or its quality and shift work/night work. Moreover, a three-shift schedule was the most significant factor for poorer subjective sleep quality when compared to other work schedules. Furthermore, many authors have shown a link between shift/night work and health problems, which include cardiometabolic risk, glucose intolerance, breast cancer and immune vulnerability. Conclusions: The research results clearly show a significant impact of night work on the increased risk of sleep disorders and health disturbance. Healthcare workers should be aware of the risks associated with night work in order to take measures preventing sleep/health problems. Shift/night workers should have the opportunity to be screened for disorders linked with their work.

The association between dietary meal intake habits and coronary artery stenosis and cardio-metabolic risk factors

BACKGROUND AND OBJECTIVE

We are not aware of studies examining the association between dietary meal intake habits (DMIH) and severity of coronary artery stenosis (CAS). This study was conducted to investigate the relationship between DMIH and the severity of CAS as well as cardiometabolic risk factors in adults undergoing coronary angiography.

METHODS

This cross-sectional study was done on 720 patients undergoing coronary angiography (aged 35-75 years) who were admitted to Afshar Hospital, a referral hospital for cardiovascular diseases in Yazd, Iran. Data on DMIH were gathered by interview. Blood samples were taken for biochemical analysis. Blood pressure, anthropometric indices, and body composition were also evaluated. The relationship between DMIH and the severity of CAS [examined by angiography based on Gensini Score (GS) and Syntax Score (SS)] and cardiometabolic risk factors were assessed using logistic regression and the analysis of covariance (ANCOVA), respectively, in crude and multivariable adjusted models.

RESULTS

After adjustment for all possible confounding variables, the study revealed that people who ate 3 meals/day had a lower risk of severe CAS compared to people who ate 2 or fewer meals (OR = 0.48, 95% CI: 0.26, 0.88, P-trend = 0.02). There was an inverse association between the number of snacks /day and the severity of CAS (OR = 0.43, 95% CI: 0.22, 0.87, P-trend = 0.02). There was also an inverse relationship between breakfast frequency/week and the severity of CAS based on both GS and SS (P < 0.05). Breakfast consumption, meal frequency, lunch consumption, snack frequency, and more food consumption on holidays were also associated with different cardiometabolic markers and anthropometric measures (P < 0.05).

CONCLUSION

According to the results of the present study, meal frequency and breakfast consumption might be inversely associated with CAS and cardiometabolic risk factors.

Construct validity and test-retest reliability of a chrononutrition questionnaire for shift work and non-shift work populations

The irregular eating patterns of both shift workers and evening chronotypes adversely affect cardiometabolic health. A tool that conveniently captures temporal patterns of eating alongside an indicator of circadian rhythm such as chronotype will enable researchers to explore relationships with diverse health outcome measures. We aimed to investigate the test-retest reliability and convergent validity of a Chrononutrition Questionnaire (CNQ) that captures temporal patterns of eating and chronotype in the general population (non-shift workers, university students, retirees, unemployed individuals) and shift work population. Participants attended two face-to-face/virtual sessions and completed the CNQ and food/sleep/work diaries. Outcomes included subjective chronotype, wake/sleep/mid-sleep time, sleep duration, meal/snack regularity, meal/snack/total frequency, times of first/last/largest eating occasions (EO), main meal (MM) 1/2/3, and duration of eating window (DEW). 116 participants enrolled (44.5 ± 16.5 years, BMI: 27.3 ± 5.8 kg/m2, 73% female, 52% general population); 105 completed the study. Reliability was acceptable for chronotype, sleep, and all temporal eating patterns except on night shifts. Convergent validity was good for chronotype and sleep except for certain shift/shift-free days. Generally, meal/snack regularity and frequency, and times of first/last EO showed good validity for the general population but not shift workers. Validity was good for DEW (except work-free days and afternoon shifts) and times of MM 1/2/3 (except afternoon and night shifts), while time of largest EO had poor validity. The CNQ has good test-retest reliability and acceptable convergent validity for the general and shift work population, although it will benefit from further validation, especially regarding regularity, frequency, and times of first and last eating occasions across more days amongst a larger sample size of shift workers. Use of the CNQ by researchers will expand our current understanding of chrononutrition as relationships between timing of food intake and the multitude of health outcomes are examined.

Assessing the relationship between nutrition literacy and eating behaviors among nursing students: a cross-sectional study

BACKGROUND

Eating behavior is an essential aspect of life that can have long-term effects on health outcomes. Nutrition literacy is crucial for better health and well-being. It empowers individuals to make informed decisions about their nutrition and take control of their eating habits.

OBJECTIVES

This study aimed to assess the relationship between nutritional literacy and eating behavior among nursing students at the nursing faculties of Ardabil University of medical sciences.

METHODS

A cross-sectional correlational study was conducted in Ardabil province, northwest Iran. The study collected data through simple random sampling at nursing schools in Ardabil province, with 224 nursing students participating. The study collected data from a demographic information form, the nutritional literacy self-assessment questionnaire for students (NL-SF12), and the adult eating behavior questionnaire (AEBQ). The data were analyzed using SPSS version 14.0 software.

RESULTS

Based on the results, nutritional literacy explains 44% of the variance in eating behavior and shows significant explanatory power in two sub-scales of eating behavior. The adjusted R2 values for food approach and food avoidance scales were 0.33 and 0.27, respectively.

CONCLUSION

Given the significant relationship between nutritional literacy and eating behaviors among nursing students, nursing faculty managers and health policymakers should develop new public health strategies to increase nutritional literacy among nursing students.

Consequences of Shift Work and Night Work: A Literature Review

Nonstandard work schedules such as shift work and night work tend to trigger problems for workers in different areas. To illustrate the diversity of areas affected and the relative interest of the scientific community, we conducted a literature review of the effects of shift work and night work on workers. In particular, we intended to identify the main variables addressed in the field of health, the family sphere, and the organizational context. The literature review was carried out using the Web of Science with the following terms: "shift work", "rotating shifts", and "night work". Inclusion criteria incorporated empirical studies and articles written in Portuguese or English published in 2019. We selected 129 of the 619 articles identified. Regarding the impacts of shift work and night work, there existed a high discrepancy of focus between the three defined areas: health, family life, and organizational context. Specifically, health-related variables were the most studied (83.4%), followed by organizational variables (9.2%), and, lastly, family variables (7.4%). Based on these results, it is essential to extend the study of the two underrepresented impacts to other crucial areas, not only for the worker but also for organizations.

The Relationship Between Depression, Anxiety, and Stress Levels and Eating Behavior in Emergency Service Workers

Introduction It is seen that shift work causes various biological, psychological, and behavioral problems in individuals. This study aimed to determine the eating attitudes and behaviors of health workers working in shifts in a stressful environment such as the emergency service and to examine the relationship between depression, anxiety, and stress levels and eating behaviors (emotional eating, restrictive eating, and external eating) in terms of sociodemographic and clinical characteristics. Material and Methods Sociodemographic data form; Depression, Anxiety, and Stress Scale (DASS); and Dutch Eating Behavior Questionnaire (DEBQ) were used. The study sample consisted of 92 employees (doctor, nurse, emergency medical technician (EMT), medical secretary, and security, staff) who were actively on duty in the emergency department of Alanya Alaaddin Keykubat University Medical Faculty Training and Research Hospital. Results In our study, when the eating behavior of emergency service workers was evaluated in terms of "emotional, external, and restricted eating" sub-dimensions, depression (p=0.043), anxiety (p=0.017), increased stress levels (p=0.002), being female (p=0.022), nurse-emergency medical technician profession (p=0.001), working in 24-hour shifts (p=0.001), and diet history (p=0.013) were associated with "emotional eating." In addition, an increase in depression levels (p=0.048), being single (p=0.015), working in 24-hour shifts (p=0.005), a decrease in age (p<0.001) with "extrinsic eating," an increase in body mass index (BMI) (p=0.020) and waist circumference (p=0.049), and diet history (p<0.001) were associated with "restricted eating." Conclusions In our study, among the sociodemographic factors, being female, being single, working in 24-hour shifts, diet history, nurse-EMT profession, and undergraduate education level were found to increase the tendency to develop eating behavior problems. An increase in depression levels, being single, working in 24-hour shifts, and a decrease in age were associated with "extrinsic eating." There is a correlation between depression, anxiety, and stress scores and emotional eating scores. Additionally, we found significant correlations between body mass index, waist circumference, diet history, and restricted eating scores. In the approach to eating behavior problems, it is important to determine the individual eating behavior disorder. Due to the increased risk of eating behavior disorder in those who work in long shifts such as 24 hours, it will be possible to organize work programs and increase the quality of service.

The Effects of Shift Work on Cardio-Metabolic Diseases and Eating Patterns

Energy metabolism is tightly linked with circadian rhythms, exposure to ambient light, sleep/wake, fasting/eating, and rest/activity cycles. External factors, such as shift work, lead to a disruption of these rhythms, often called circadian misalignment. Circadian misalignment has an impact on some physiological markers. However, these proxy measurements do not immediately translate into major clinical health outcomes, as shown by later detrimental health effects of shift work and cardio-metabolic disorders. This review focuses on the effects of shift work on circadian rhythms and its implications in cardio-metabolic disorders and eating patterns. Shift work appears to be a risk factor of overweight, obesity, type 2 diabetes, elevated blood pressure, and the metabolic syndrome. However, past studies showed discordant findings regarding the changes of lipid profile and eating patterns. Most studies were either small and short lab studies, or bigger and longer cohort studies, which could not measure health outcomes in a detailed manner. These two designs explain the heterogeneity of shift schedules, occupations, sample size, and methods across studies. Given the burden of non-communicable diseases and the growing concerns about shift workers' health, novel approaches to study shift work in real contexts are needed and would allow a better understanding of the interlocked risk factors and potential mechanisms involved in the onset of metabolic disorders.

Association between Dietary Habits, Shift Work, and the Metabolic Syndrome: The Korea Nurses' Health Study

Metabolic syndrome (MetS) is an important public health problem, and unhealthy dietary habits and shift work are considered major factors that increase the prevalence of MetS. The purpose of this study was to examine whether dietary habits, alcohol drinking, and shift-working were associated with development of MetS in shift-working female nurses. This study analyzed cross-sectional survey data from the Korea Nurses’ Health Study (KNHS). Of the 1638 nurses, 403 participants were selected based on the propensity score matching method (PSM). These participants had either no or more than three MetS determinant factors. Analysis was conducted by using multivariable logistic regression to confirm the factors influencing MetS. The prevalence of MetS in this group (1638 participants) was 5.6% (92 participants). Consumption of over 50% of daily calorie intake after 7 p.m., consumption of carbonated drinks, family history of diabetes, and non-shift work were significant factors influencing MetS. Nurses are one of the at-risk groups for unhealthy dietary habits due to the nature of their work. Therefore, nurse managers should include regular dietary education for nurses and continue their policy efforts to resolve health problems that may arise in connection with nurses’ work.

Effectiveness of Lifestyle Health Promotion Interventions for Nurses: A Systematic Review

BACKGROUND

Prior research has investigated various strategies to improve health, wellbeing and the job-related outcomes of nurses. However, the scope of this evidence is not clear and the types of intervention most likely to have positive outcomes are unknown.

OBJECTIVE

To provide an overview and synthesis of the effectiveness of interventions conducted with the goal of improving health, wellbeing and the job-related outcomes of nurses.

METHODS

A systematic database search was conducted from January 2000 to December 2018, with pre-defined criteria (Cochrane Central Register of Controlled Trials; MEDLINE and PubMed; EMBASE; CINAHL; PsycINFO; and BioMed Central). In total, 136 intervention studies with a total sample of 16,129 participants (range 9-3381) were included and evaluated. Data extraction, quality assessment and risk of bias analyses were performed.

RESULTS

Studies included randomised controlled trials (RCTs; n = 52, 38%), randomised crossover design studies (n = 2, 1.5%) and non-randomised pre-post studies with a control group (n = 31, 23%) and without a control group (n = 51, 37.5%). The majority of interventions focused on education, physical activity, mindfulness, or relaxation. Thirty-seven (27%) studies had a multimodal intervention approach. On average, studies had relatively small samples (median = 61; mode = 30) and were conducted predominantly in North America (USA/Canada, n = 53). The findings were mixed overall, with some studies reporting benefits and others finding no effects. Dietary habits was the most successfully improved outcome (8/9), followed by indices of body composition (20/24), physical activity (PA) (11/14), and stress (49/66), with >70% of relevant studies in each of these categories reporting improvements. The lowest success rate was for work-related outcomes (16/32). Separate analysis of RCTs indicated that interventions that focus solely on education might be less likely to result in positive outcomes than interventions targeting behavioural change.

CONCLUSIONS

Interventions targeting diet, body composition, PA, or stress are most likely to have positive outcomes for nurses' health and/or wellbeing. The methodologically strongest evidence (RCTs) is available for body composition and stress. Interventions relying solely on educational approaches are least likely to be effective. Organisational outcomes appear to be more challenging to change with lifestyle intervention, likely requiring more complex solutions including changes to the work environment. There is a need for more high-quality evidence since many studies had moderate or high risk of bias and low reporting quality.