1
|
Crowther ME, Ferguson SA, Gupta CC, Reynolds AC. The Development and Validation of the Health Belief Model for Shift Workers (HBM-SW) Scale. Behav Sleep Med 2024; 22:353-377. [PMID: 37807653 DOI: 10.1080/15402002.2023.2265520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Shift work is associated with circadian misalignment, sleep loss, and suboptimal health behaviors, which may contribute to longer term negative health outcomes. To inform future interventions for shift workers, the present study aimed to develop and evaluate the Health Belief Model for Shift Workers (HBM-SW) scale. METHODS The HBM-SW development involved a seven-step process, including a literature review, expert panel analysis, cognitive interviews with shift workers, and a trial with a pilot sample of shift workers (n = 153). Utilizing exploratory factor analysis for factor identification and item reduction, the developed scale loaded on seven factors in line with the theoretical framework of the Health Belief Model: Perceived Threat, Perceived Severity, Perceived Benefits, Perceived Barriers, Cues to Action, Self-efficacy, and Health Motivation. Validation of the scale was conducted utilizing Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire, and Food Frequency Questionnaire. RESULTS The pilot sample had an average age of 34.0 (18.0) years, was majority female (54.2%), with an average of 8.0 (11.0) years shift work experience. The HBM-SW showed good - excellent (α = 0.74-0.93) internal consistency and moderate - good (ICC = 0.64-0.89) test re-test reliability. Using health behavior outcome measures, the HBM-SW scale showed meaningful correlations with sleep quality, sleep duration, diet quality and leisure time physical activity, and acceptable validity and reliability. Further testing should be conducted in a larger sample to facilitate confirmatory factor analysis. CONCLUSIONS The developed Health Belief Model for Shift Workers scale is likely beneficial for use in future studies of interventions for shift workers.
Collapse
Affiliation(s)
- Meagan E Crowther
- Appleton Institute, CQUniversity Australia, Adelaide, South Australia, Australia
| | - Sally A Ferguson
- Appleton Institute, CQUniversity Australia, Adelaide, South Australia, Australia
| | - Charlotte C Gupta
- Appleton Institute, CQUniversity Australia, Adelaide, South Australia, Australia
| | - Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
2
|
Davis C, Huggins CE, Kleve S, Leung GKW, Bonham MP. Conceptualizing weight management for night shift workers: A mixed-methods systematic review. Obes Rev 2024; 25:e13659. [PMID: 37985937 DOI: 10.1111/obr.13659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/24/2023] [Accepted: 10/01/2023] [Indexed: 11/22/2023]
Abstract
Shift workers have an increased risk of obesity and metabolic conditions. This mixed-methods systematic literature review on night shift workers aimed to: (1) identify barriers/enablers of weight management; (2) examine effectiveness of weight management interventions; and (3) determine whether interventions addressed enablers/barriers. Six databases were searched, articles screened by title/abstract, followed by full-text review, and quality assessment. Eligible qualitative studies documented experiences of behaviors related to weight change. Eligible quantitative studies were behavior change interventions with weight/body mass index outcomes. A thematic synthesis was undertaken for qualitative studies using the social-ecological model (SEM). Interventions were synthesized narratively including: weight/body composition change; components mapped by behavior change taxonomy; and SEM. A synthesis was undertaken to identify if interventions addressed perceived enablers/barriers. Eight qualitative (n = 169 participants) and 12 quantitative studies (n = 1142 participants) were included. Barriers predominated discussions: intrapersonal (time, fatigue, stress); interpersonal (work routines/cultural norms); organizational (fatigue, lack of: routine, healthy food options, breaks/predictable work); community (lack of healthy food options). The primary outcome for interventions was not weight loss and most did not address many identified enablers/barriers. One intervention reported a clinically significant weight loss result. Weight loss interventions that address barriers/enablers at multiple SEM levels are needed.
Collapse
Affiliation(s)
- Corinne Davis
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Australia
| | - Catherine E Huggins
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Australia
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Australia
| | - Gloria K W Leung
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Australia
| |
Collapse
|
3
|
Gibson R, D'Annibale M, Oliver N, McGowan B, Forbes G, Crayton E, Guess N, Lorencatto F. Exploration of the individual, social and environmental factors influencing dietary behaviour in shift workers with type 2 diabetes working in UK healthcare-The Shift-Diabetes Study: A qualitative study using the theoretical domains framework. Diabet Med 2024; 41:e15179. [PMID: 37452826 DOI: 10.1111/dme.15179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 05/17/2023] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Abstract
AIM To identify factors influencing dietary behaviour in shift workers with type 2 diabetes (T2D) working in UK healthcare settings. METHODS Semi-structured qualitative interviews based on the theoretical domains framework (TDF) were conducted with a convenience sample (n = 15) of shift workers (32-59 years) diagnosed with T2D who worked night shifts as part of a mixed shift schedule. The TDF was applied to analyse transcripts using a combined deductive framework and inductive thematic analysis approach. Identified influences were mapped to the behaviour change technique taxonomy to identify potential strategies to change dietary behaviour in this context. RESULTS Key barriers to healthy dietary behaviours were access and cost of food available during night work (TDF domain: Environment Context and Resources). Factors identified as both enablers and barriers included: availability of staff facilities and time to take a break, (Environment Context and Resources), the physical impact of night work (Beliefs About Consequences), eating in response to stress or tiredness (Emotion), advance planning of meals/food and taking own food to work (Behavioural Regulation). Potential techniques to address these influences and improve dietary behaviour in this context include: meal planning templates, self-monitoring and biofeedback, and increasing accessibility and availability of healthier food choices during night shifts. CONCLUSIONS The dietary behaviour of shift workers with T2D is influenced by interacting individual, socio-cultural and environmental factors. Intervention should focus on environmental restructuring and strategies that enable monitoring and meal planning.
Collapse
Affiliation(s)
- Rachel Gibson
- Department of Nutritional Sciences, King's College, London, UK
| | | | - Nick Oliver
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Barbara McGowan
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Gillian Forbes
- Centre for Behaviour Change, University College London, London, UK
| | - Elise Crayton
- Centre for Behaviour Change, University College London, London, UK
| | - Nicola Guess
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | |
Collapse
|
4
|
Leung GK, Huggins KE, Bonham MP, Kleve S. Exploring Australian night shift workers' food experiences within and outside of the workplace: a qualitative photovoice study. Public Health Nutr 2023; 26:2276-2287. [PMID: 37548181 DOI: 10.1017/s1368980023001519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
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.
Collapse
Affiliation(s)
- Gloria Kw Leung
- Department of Nutrition, Dietetics and Food, Monash University. Level 1, 264 Ferntree Gully Road, Notting Hill, VIC3168, Australia
| | - Kate E Huggins
- Department of Nutrition, Dietetics and Food, Monash University. Level 1, 264 Ferntree Gully Road, Notting Hill, VIC3168, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, Monash University. Level 1, 264 Ferntree Gully Road, Notting Hill, VIC3168, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, Monash University. Level 1, 264 Ferntree Gully Road, Notting Hill, VIC3168, Australia
| |
Collapse
|
5
|
Rubner S, D'Annibale M, Oliver N, McGowan B, Guess N, Lorencatto F, Gibson R. Individual, social and environmental factors influencing dietary behaviour in shift workers with type 2 diabetes working in UK healthcare: A cross-sectional survey. J Hum Nutr Diet 2023; 36:1992-2009. [PMID: 37452756 DOI: 10.1111/jhn.13198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The present study aimed to understand the individual, social and environmental factors influencing dietary behaviour in shift workers with type 2 diabetes (T2D) working in UK healthcare settings. METHODS A cross-sectional study was conducted using data collected from an anonymous online survey. Participant agreement was measured using five-point Likert scale (strongly disagree to strongly agree) against 38 belief statements informed by the Theoretical Domains Framework (TDF) of behaviour change. RESULTS From the complete responses (n = 119), 65% worked shifts without nights, 27% worked mixed shift rota including nights and 8% worked only night shifts. The statements ranked with the highest agreements were in the TDF domains: Environment Context/Resources (ECR) - mainly identified as a barrier to healthy eating, Behaviour Regulation (BR) and intention (IN) - identified as enablers to healthy eating. For the belief statement 'the available options for purchasing food are too expensive' (ECR), 80% of night workers and 75% non-night workers agreed/strongly agreed. Taking their own food to work to prevent making unhealthy food choices (BR) had agreement/strong agreement in 73% of non-night and 70% night workers; 74% non-night workers and 80% of night workers agreed/strongly agreed with the statement 'I would like to eat healthily at work' (IN). Mixed shift workers agreed that following dietary advice was easier when working a non-night compared to a night shift (p = 0.002). CONCLUSIONS Access and affordability of food were identified as important determinants of dietary behaviour during shifts. The findings support interventions targeting the food environment for shift workers with T2D.
Collapse
Affiliation(s)
- Sophie Rubner
- Department of Nutritional Sciences, King's College London, London, UK
| | - Maria D'Annibale
- Department of Nutritional Sciences, King's College London, London, UK
| | - Nick Oliver
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Barbara McGowan
- Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Trust, London, UK
| | - Nicola Guess
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Rachel Gibson
- Department of Nutritional Sciences, King's College London, London, UK
| |
Collapse
|
6
|
Dobrowolska-Zrałka K, Kujawa K, Regulska-Ilow B. Association of the Length of Service of 24/48 Firefighters with the Quality of Their Diet and Selected Anthropometric Parameters. Nutrients 2023; 15:4029. [PMID: 37764812 PMCID: PMC10536748 DOI: 10.3390/nu15184029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of the study was to examine the association of lengths of service (LS) ≤ 10 years and >10 years in 24/48 shifts with the quality of the observed diet based on the Nutrient Rich Food Index (NRF9.3) and selected anthropometric parameters of 130 firefighters of the State Fire Service (SFS) in Wroclaw, Poland. The study also analysed the individual components of the men's diets required to calculate the NRF9.3 index in both seniority groups. Men with LS > 10 years had statistically significant higher body weight (89.00 kg vs. 81.59 kg), body-fat level (22.80 kg vs. 17.95 kg), waist circumference (96.50 cm vs. 89.00 cm), body-fat percentage (21.94 ± 4.06% vs. 25.00 ± 5.45%), body mass index (BMI) (28.10 kg/m2 vs. 25.40 kg/m2) and waist-hip ratio (WHR) (0.84 0.92 vs. 0.84), compared to the LF ≤ 10 years group. In contrast, the quality of the men's dietary adherence, based on the calculated NRF9.3 index, did not differ between the study groups, and was 662.50 ± 103.1 and 664.78 for the LS ≤ 10 years and LS > 10 years groups, respectively. Based on a statistical analysis using the NRF9.3 diet quality index by tertile (NRF9.3-C), a leading and statistically significant association of LS > 10 years vs. ≤10 years was observed as to most of the anthropometric parameters studied. In contrast, the association of participants' diet quality, as assessed by the NRF9.3 index value, was insignificant for all anthropometric parameters studied.
Collapse
Affiliation(s)
- Karolina Dobrowolska-Zrałka
- Department of Dietetics and Bromatology, Wroclaw Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland;
| | - Krzysztof Kujawa
- Statistical Analysis Centre, Wroclaw Medical University, ul. K. Marcinkowskiego 2-6, 50-368 Wroclaw, Poland;
| | - Bożena Regulska-Ilow
- Department of Dietetics and Bromatology, Wroclaw Medical University, ul. Borowska 211, 50-556 Wroclaw, Poland;
| |
Collapse
|
7
|
Davis C, Bonham MP, Kleve S, Dorrian J, Huggins CE. Evaluation of the "Shifting Weight using Intermittent Fasting in night-shift workers" weight loss interventions: a mixed-methods protocol. Front Public Health 2023; 11:1228628. [PMID: 37744523 PMCID: PMC10517326 DOI: 10.3389/fpubh.2023.1228628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/08/2023] [Indexed: 09/26/2023] Open
Abstract
Introduction Shift workers are at a greater risk for obesity-related conditions. The impacts of working at night presents a challenge for designing effective dietary weight-loss interventions for this population group. The Shifting Weight using Intermittent Fasting in night-shift workers (SWIFt) study is a world-first, randomized controlled trial that compares three weight-loss interventions. While the trial will evaluate the effectiveness of weight-loss outcomes, this mixed-methods evaluation aims to explore for who weight-loss outcomes are achieved and what factors (intervention features, individual, social, organisational and wider environmental) contribute to this. Methods A convergent, mixed-methods evaluation design was chosen where quantitative and qualitative data collection occurs concurrently, analyzed separately, and converged in a final synthesis. Quantitative measures include participant engagement assessed via: dietary consult attendance, fulfillment of dietary goals, dietary energy intake, adherence to self-monitoring, and rates for participant drop-out; analyzed for frequency and proportions. Regression models will determine associations between engagement measures, participant characteristics (sex, age, ethnicity, occupation, shift type, night-shifts per week, years in night shift), intervention group, and weight change. Qualitative measures include semi-structured interviews with participants at baseline, 24-weeks, and 18-months, and fortnightly audio-diaries during the 24-week intervention. Interviews/diaries will be transcribed verbatim and analyzed using five-step thematic framework analysis in NVivo. Results from the quantitative and qualitative data will be integrated via table and narrative form to interrogate the validity of conclusions. Discussion The SWIFt study is a world-first trial that compares the effectiveness of three weight-loss interventions for night shift workers. This mixed-methods evaluation aims to further explore the effectiveness of the interventions. The evaluation will determine for who the SWIFt interventions work best for, what intervention features are important, and what external factors need to be addressed to strengthen an approach. The findings will be useful for tailoring future scalability of dietary weight-loss interventions for night-shift workers.Clinical trial registration: This evaluation is based on the SWIFt trial registered with the Australian New Zealand Clinical Trials Registry [ACTRN 12619001035112].
Collapse
Affiliation(s)
- Corinne Davis
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Maxine P. Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Jillian Dorrian
- UniSA Justice & Society, University of South Australia, Adelaide, SA, Australia
| | - Catherine E. Huggins
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
- Deakin University, Geelong, Australia, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| |
Collapse
|
8
|
Clark AB, Coates AM, Choi T, Meadley B, Bowles KA, Bonham MP. The Effect of Commencing Rotating Shift Work on Diet and Body Composition Changes in Graduate Paramedics: A Longitudinal Mixed Methods Study. PREHOSP EMERG CARE 2023; 28:609-619. [PMID: 37594851 DOI: 10.1080/10903127.2023.2249532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/20/2023]
Abstract
Objectives: Diet quality often changes as shift workers adjust to atypical work schedules, however, limited research exists examining the early effects of starting rotating shift work on diet and body composition. This study explored dietary behavior changes occurring in graduate paramedics during the first year of exposure to rotating shift work, and investigated dietary intake, diet quality and anthropometric changes over two years. Methods: Participants from a graduate paramedic cohort in Melbourne, Australia were approached after two years of shift work for study inclusion. Using a mixed method study approach, the qualitative component comprised individual in-depth interviews to explore perceived dietary behavior changes experienced over the first year of shift work. Interview transcripts were thematically analyzed and guided by the COM-B model (capability, opportunity, motivation, and behavior) and theoretical domains framework (TDF). Diet quality and dietary intake were quantitatively assessed by the Australian Eating SurveyTM at baseline, one year, and two years, along with body weight, waist circumference, and body mass index (BMI) to monitor changes. Results: Eighteen participants were included in the study. From the interviews, participants reported: 1. food choices are driven by wanting to fit in with coworker food habits, 2. food choices and mealtimes are unpredictable and 3. paramedics try to make healthy food choices but give in to less healthy options. While daily energy intake and diet quality scores did not differ in the first two years of shift work, daily energy from takeaway foods significantly increased (mean difference (MD): 2.96% EI; 95% CI: 0.44 - 5.48; p = 0.017) and increases in weight (MD: 2.96 kg; 95% CI: 0.89-5.04; p = 0.003), BMI (MD: 1.07 kg/m2; 95% CI: 0.26 - 1.87; p = 0.006) and waist circumference (MD: 5.07 cm; 95% CI: 1.25-8.89; p = 0.006) were also evident at two years. Conclusions: This study contributes new information on dietary changes and the current early trajectory of unintentional weight gain and takeaway reliance occurring within a graduate paramedic cohort over two years of shift work. To reduce the unintended metabolic consequences commonly observed with rotating shift schedules, workplaces could improve access to healthier food options and enable behavioral support/education to address nutrition-related health risks.
Collapse
Affiliation(s)
- Angela B Clark
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Alison M Coates
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, Australia
| | - Tammie Choi
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| | - Ben Meadley
- Department of Paramedicine, Monash University, Frankston, Australia
- Ambulance Victoria, Doncaster, Australia
- Paramedic Health and Wellbeing Research Unit, Monash University, Frankston, Australia
| | - Kelly-Ann Bowles
- Department of Paramedicine, Monash University, Frankston, Australia
- Paramedic Health and Wellbeing Research Unit, Monash University, Frankston, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Australia
| |
Collapse
|
9
|
Wirth MD, Meyer J, Jessup A, Dawson RM. Barriers and Facilitators of Diet, Physical Activity Levels, and Sleep Among Nursing Undergraduates and Early-Career Nurses: A Qualitative Descriptive Study. Am J Health Promot 2023:8901171231179437. [PMID: 37263962 DOI: 10.1177/08901171231179437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Mechanisms leading to burnout, associated with high turnover in nursing, may start as early as in nursing school. Given health habits (e.g., diet, physical activity, and sleep) can exacerbate or lessen the impact of burnout, this study examined current barriers and facilitators to healthy diet, physical activity levels, and sleep among nursing undergraduates (UGs) and early-career nurses (ECNs). RESEARCH DESIGN Qualitative descriptive study. SAMPLE 25 nursing UGs and 25 ECNs (within 3 years of graduation) from a Southeastern college of nursing. DATA COLLECTION AND ANALYSIS After development of theory-informed interview guides, participants conducted interviews either in-person or by phone, which were audio-recorded and transcribed. Braun and Clarke's six-step thematic analysis was used to analyze the transcripts. RESULTS All but one (aged 54) UG was in their early 20s and ECNs were in their early to mid-20s. Most participants were white, females. Time and stress were the strongest barriers among UGs and ECNs for adherence to healthy diet, physical activity, although stress did act as a facilitator for physical activity in a subset of both UGs and ECNs. Shiftwork was a common barrier to healthy behaviors among ECNs. CONCLUSION The fact that the more common and stronger barriers to healthier behaviors among UGs and ECNs were the same give credence to the idea that processes associated with burnout begin during or before nursing education and are persistent.
Collapse
Affiliation(s)
- Michael D Wirth
- College of Nursing, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jaclyn Meyer
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Angela Jessup
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Robin M Dawson
- College of Nursing, University of South Carolina, Columbia, SC, USA
| |
Collapse
|
10
|
Marot LP, Lopes TDVC, Balieiro LCT, Crispim CA, Moreno CRC. Impact of Nighttime Food Consumption and Feasibility of Fasting during Night Work: A Narrative Review. Nutrients 2023; 15:nu15112570. [PMID: 37299533 DOI: 10.3390/nu15112570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/23/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Luisa Pereira Marot
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38405-320, Brazil
| | - Tássia do Vale Cardoso Lopes
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38405-320, Brazil
| | | | - Cibele Aparecida Crispim
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38405-320, Brazil
| | - Cláudia Roberta Castro Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, Sao Paulo 01246-904, Brazil
| |
Collapse
|
11
|
Clark AB, Coates AM, Davidson ZE, Bonham MP. Dietary Patterns under the Influence of Rotational Shift Work Schedules: A Systematic Review and Meta-Analysis. Adv Nutr 2023; 14:295-316. [PMID: 36805319 DOI: 10.1016/j.advnut.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/08/2022] [Accepted: 01/18/2023] [Indexed: 02/04/2023] Open
Abstract
Workers employed in rotating shift schedules are at a higher metabolic risk compared with those in regular day and fixed shift schedules; however, the contribution of diet is unclear. This systematic review aimed to investigate how rotating shift work schedules affect dietary energy intake and dietary patterns compared with regular day and fixed shift schedules. In addition, intraperson energy intake and dietary pattern comparisons within rotating shift schedules were investigated. Database searches were conducted on MEDLINE, Cochrane, CINAHL, PSYCinfo, EMBASE, and Scopus, in addition to manual search of bibliographic references, to identify articles. Two separate meta-analyses compared dietary intake between day work and rotating shift work schedules and within the rotational shift work group (morning/day and night shifts). Differences in dietary patterns were synthesized narratively. Thirty-one studies (n = 18,196 participants) were included in the review, and meta-analyses were conducted with 24-hour mean energy intake data from 18 (n = 16,633 participants) and 7 (n = 327 participants) studies, respectively. The average 24-hour energy intake of rotating shift workers was significantly higher than that of workers in regular daytime schedules [weighted mean difference (WMD): 264 kJ; 95% confidence interval (CI): 70, 458 kJ; P < 0.008; I2 = 63%]. However, the mean difference in 24-hour energy intake between morning/day shifts compared with night shifts within rotational shift schedules was not statistically significant (WMD: 101 kJ; 95% CI: -651, 852 kJ; P = 0.79; I2 = 77%). Dietary patterns of rotating shift workers were different from those of day workers, showing irregular and more frequent meals, increased snacking/eating at night, consumption of fewer core foods, and more discretionary foods. This review highlights that dietary intake in rotational shift workers is potentially higher in calories and features different eating patterns as a consequence of rotating shift work schedules. This review was registered at PROSPERO as ID 182507.
Collapse
Affiliation(s)
- Angela B Clark
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia.
| | - Alison M Coates
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Zoe E Davidson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
12
|
Lin TT, Park C, Kapella MC, Martyn-Nemeth P, Tussing-Humphreys L, Rospenda KM, Zenk SN. Shift Work Domains and their Interactions with Empty Calorie Food/Beverage Consumption: A 14-day Intensive Longitudinal Study. Int J Nurs Stud 2023; 141:104490. [PMID: 37004340 DOI: 10.1016/j.ijnurstu.2023.104490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND/OBJECTIVES Shift work has been linked to unhealthy eating behaviors such as imbalanced diet, or increased empty calorie food/beverage consumption. However, most research has focused on the impact of shift timing. The concept of shift work is complex, and it contains several domains such as shift timing, intensity, and speed. Previous studies have suggested that greater shift intensity and quicker shift speed may contribute to adverse health effects. However, evidence regarding associations between other domains of shift work and empty calorie food/beverage consumption has been relatively lacking. Therefore, the purpose of this study was to evaluate how other shift work domains related to empty calorie food/beverage consumption and whether different shift work domains interacted to influence the intake of foods or beverages. DESIGN A 14-day intensive longitudinal study employing ecological momentary assessment. SETTINGS AND PARTICIPANTS Eighty registered nurses working in 24 accredited Taiwanese hospitals (i.e., 9 medical centers, 12 regional hospitals, and 3 district hospitals) were recruited. METHODS During the study period, a convenience sample of 77 participants completed 2444 momentary surveys about empty calorie food/beverage consumption on a smartphone. Three shift work domains (shift timing, intensity, and speed) were evaluated based on registry-based work schedules. To study how these shift work domains influenced empty calorie food/beverage consumption, we employed three-level mixed-effects regression models for data analyses. RESULTS Findings suggested that greater night shift intensity increased the likelihood of sugar-sweetened beverage intake (odds ratio = 1.64, 95% confidence interval [1.01, 2.68]). The impacts of work shift intensity and shift timing on sugar-sweetened beverage consumption varied by shift speed. Among participants assigned a schedule with either medium or rapid shift speed, higher work shift intensity was associated with a higher probability of sugar-sweetened beverage consumption. Compared to day shifts, those who were assigned a quicker shift speed on evening shifts were more likely to consume sugar-sweetened beverages. However, associations between night shift intensity and sugar-sweetened beverage intake did not change by shift speed. Furthermore, shift intensity and shift timing did not interact to affect empty calorie food/beverage consumption. CONCLUSIONS This study demonstrated assignments of shift schedules (i.e., high night shift intensity, more changes in shift timings) might influence workers' consumption of empty calorie foods/beverages. Therefore, identifying and mitigating hazardous shift schedules may help to improve shift workers' eating behaviors and benefit their overall health.
Collapse
|
13
|
Meal timing variability of rotating shift workers throughout a complete shift cycle and its effect on daily energy and macronutrient intake: a field study. Eur J Nutr 2023; 62:1707-1718. [PMID: 36797507 DOI: 10.1007/s00394-023-03106-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/31/2023] [Indexed: 02/18/2023]
Abstract
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.
Collapse
|
14
|
Meléndez-Fernández OH, Liu JA, Nelson RJ. Circadian Rhythms Disrupted by Light at Night and Mistimed Food Intake Alter Hormonal Rhythms and Metabolism. Int J Mol Sci 2023; 24:3392. [PMID: 36834801 PMCID: PMC9963929 DOI: 10.3390/ijms24043392] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
Availability of artificial light and light-emitting devices have altered human temporal life, allowing 24-hour healthcare, commerce and production, and expanding social life around the clock. However, physiology and behavior that evolved in the context of 24 h solar days are frequently perturbed by exposure to artificial light at night. This is particularly salient in the context of circadian rhythms, the result of endogenous biological clocks with a rhythm of ~24 h. Circadian rhythms govern the temporal features of physiology and behavior, and are set to precisely 24 h primarily by exposure to light during the solar day, though other factors, such as the timing of meals, can also affect circadian rhythms. Circadian rhythms are significantly affected by night shift work because of exposure to nocturnal light, electronic devices, and shifts in the timing of meals. Night shift workers are at increased risk for metabolic disorder, as well as several types of cancer. Others who are exposed to artificial light at night or late mealtimes also show disrupted circadian rhythms and increased metabolic and cardiac disorders. It is imperative to understand how disrupted circadian rhythms alter metabolic function to develop strategies to mitigate their negative effects. In this review, we provide an introduction to circadian rhythms, physiological regulation of homeostasis by the suprachiasmatic nucleus (SCN), and SCN-mediated hormones that display circadian rhythms, including melatonin and glucocorticoids. Next, we discuss circadian-gated physiological processes including sleep and food intake, followed by types of disrupted circadian rhythms and how modern lighting disrupts molecular clock rhythms. Lastly, we identify how disruptions to hormones and metabolism can increase susceptibility to metabolic syndrome and risk for cardiovascular diseases, and discuss various strategies to mitigate the harmful consequences associated with disrupted circadian rhythms on human health.
Collapse
|
15
|
Joe MJ, Hatsu IE, Tefft A, Mok S, Adetona O. Dietary Behavior and Diet Interventions among Structural Firefighters: A Narrative Review. Nutrients 2022; 14:nu14214662. [PMID: 36364927 PMCID: PMC9653630 DOI: 10.3390/nu14214662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
Structural firefighters (SFFs) are exposed to multiple occupational hazards that affect dietary behavior and can contribute to increased risks of cancer and cardiovascular disease compared to the United States’ general population. Dietary behavior is a feasible modification for positive health outcomes. The objectives of this narrative review are to summarize the diet behavior of SFFs, review findings of diet interventions that positively modify diet behavior, identify research gaps, and suggest recommendations for addressing those gaps. PubMed, MEDLINE, Scopus, and CABI Web of Science were searched between February 2020 and June 2022 for peer-reviewed articles. The inclusion criteria were as follows: (1) study population must include SFFs; (2) investigate diet or diet intervention among SFFs; (3) report results specific to SFFs; and (4) be published in the English language. Thirty-four studies were included. Results indicate that SFFs recognize the importance of a healthy dietary pattern, but do not follow one, and that food choices are often influenced by colleagues. Diet interventions, such as the Mediterranean diet, were observed to have positive health improvements, such as improved lipid levels and lower CVD risk. Team counseling was found to be more effective for adopting healthier diets compared to one-on-one counseling; and general counseling was more effective than no counseling. A gap identified by this review is the lack of information concerning differences in dietary intake, diet quality, and dietary behaviors while on- and off-shift, and throughout the career. Diet is an important risk factor for occupational disease development; therefore, effective, consistent dietary interventions are necessary.
Collapse
Affiliation(s)
- Margaux J. Joe
- Department of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Irene E. Hatsu
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA
- OSU Extension, The Ohio State University, Columbus, OH 43210, USA
| | - Ally Tefft
- Department of Human Sciences, The Ohio State University, Columbus, OH 43210, USA
| | - Sarah Mok
- Department of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
| | - Olorunfemi Adetona
- Department of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
- Correspondence:
| |
Collapse
|
16
|
Ras J, Leach L. Firefighters' Health Knowledge, Cardiovascular Disease Risk Factors, and Sociodemographic Characteristics as Predictors of Firefighters Attitudes Toward Health. J Occup Environ Med 2022; 64:e705-e713. [PMID: 35973044 DOI: 10.1097/jom.0000000000002679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of the study is to determine the predictors of firefighters' attitudes toward health based on firefighters' knowledge cardiovascular disease (CVD) risk factors and sociodemographic characteristics. METHODS The study used a web-based cross-sectional, descriptive, and correlational research design. Convenience sampling was used to recruit 110 firefighters, males, and females, aged 18 to 65 years. RESULTS Firefighters' health knowledge, age group 30 to 39 years, and having CVD risk factors present were significant predictors of firefighters' attitudes toward regular aerobic exercise ( P < 0.05). Firefighters' health knowledge was a significant predictor of firefighters liking exercise to look physically fit, and health knowledge and the age group 20 to 29 and 30 to 39 years were significant predictors of firefighters liking exercise to be fit for firefighting ( P < 0.05). CONCLUSIONS Health knowledge, age group, years of experience, and having CVD risk factors present were significant predictors of firefighters' attitudes toward health.
Collapse
Affiliation(s)
- Jaron Ras
- From the Department of Sport, Recreation and Exercise Science, University of the Western Cape, Cape Town, South Africa
| | | |
Collapse
|
17
|
Lin T, Guo YL, Gordon CJ, Chen Y, Wu H, Cayanan E, Ouyang C, Shiao JS. Snacking among shiftwork nurses related to non-optimal dietary intake. J Adv Nurs 2022; 78:3629-3640. [PMID: 35429043 PMCID: PMC9790560 DOI: 10.1111/jan.15253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 02/26/2022] [Accepted: 03/11/2022] [Indexed: 12/30/2022]
Abstract
AIMS To compare nurses' non-optimal eating behaviours across different shifts, to examine whether non-day shifts were related to deviation from optimal dietary behaviours compared with day shifts and whether such deviation was related to non-optimal macronutrient intake. DESIGN This is a 4-day intensive longitudinal study. METHODS A convenience sample of hospital nurses was recruited in Taiwan. From September 2018 through January 2019, 120 participants completed 4-days of 24-h dietary recalls. One-way ANOVA and Kruskal-Wallis H test were used to compare differences in energy and macronutrient intake and frequency of meals and snacking, respectively. Generalized linear regressions examined (1) the associations between shiftwork schedules and non-optimal eating behaviours and (2) associations between non-optimal eating and high energy contribution of non-optimal macronutrients. RESULTS Nurses consumed less energy on evening and night shifts compared with day shifts. However, energy intake from snacking was higher on evening and night shifts relative to day shifts. Nurses consumed less meals but had higher snacking frequency on non-day shifts. In addition, high energy intake from snacking was positively associated with high energy intake from saturated fat. CONCLUSIONS Nurses were more likely to have non-optimal eating behaviours on non-day shifts, which may contribute to an increased intake of saturated fat; thus, increasing their risk of chronic diseases. Strategies to improve non-day shift nurses' non-optimal eating behaviours may be beneficial to their health. IMPACT Shiftwork is known to affect nurses' eating behaviours; however, which shift is associated with unhealthy eating remains inconclusive. Despite lower energy intakes, nurses had higher intake by snacking on evening and night shifts. High snacking intake was associated with a high intake of saturated fat. Hospitals can increase the availability of healthy foods on evening or night shifts, which may improve non-day shift nurses' non-optimal eating behaviours.
Collapse
Affiliation(s)
- Ting‐Ti Lin
- School of NursingNational Defense Medical CenterTaipeiTaiwan
| | - Yue Leon Guo
- Environmental and Occupational MedicineNational Taiwan University (NTU) College of Medicine and NTU HospitalTaipeiTaiwan
| | - Christopher James Gordon
- Susan Wakil School of Nursing and MidwiferyThe Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia,CIRUS Centre for Sleep and ChronobiologyWoolcock Institute of Medical ResearchGlebeAustralia
| | - Yi‐Chuan Chen
- School of NursingCollege of MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Hsueh‐Ching Wu
- Department of NursingHsin Sheng Junior College of Medical Care and ManagementTaoyuanTaiwan
| | - Elizabeth Cayanan
- CIRUS Centre for Sleep and ChronobiologyWoolcock Institute of Medical ResearchGlebeAustralia,School of Medical SciencesThe Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia
| | - Chung‐Mei Ouyang
- Department of NutritionNational Taiwan University Hospital Hsin‐Chu BranchHsinChu CityTaiwan
| | - Judith Shu‐Chu Shiao
- Susan Wakil School of Nursing and MidwiferyThe Faculty of Medicine and HealthUniversity of SydneyCamperdownNew South WalesAustralia,School of NursingCollege of MedicineNational Taiwan UniversityTaipeiTaiwan
| |
Collapse
|
18
|
Wronska MD, Coffey M, Robins A. Determinants of nutrition practice and food choice in UK construction workers. Health Promot Int 2022; 37:6722664. [PMID: 36166265 DOI: 10.1093/heapro/daac129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The workplace is considered an effective setting for health and wellbeing interventions, including programmes focusing on nutrition, and provides opportunities to tailor programmes to meet the specific needs of industry and employees. This study explored nutrition practices amongst construction workers and managers to inform the design of a nutrition intervention. Five focus groups were conducted on three construction sites: two with managers (n = 11) and three with workers (n = 27). Construction workers and managers identified several unhealthy nutrition-related behaviours, including high consumption of convenient and fast foods, excessive coffee, alcohol, energy drinks and low fruit and vegetable intake. These behaviours were often attributed to high workloads, long working hours and physically demanding jobs. Snacking and skipping meals were repeatedly reported, attributed to short breaks and poor accessibility to food outlets. The nutritional quality of meals differed between individuals (homemade vs fast food), depending on the type of sites (temporary vs permanent) and site location. Nutrition knowledge, establishing routines, meal planning and preparation were recognized as important in sustaining healthy nutrition habits. However, meal preparation depended on the facilities available, which differed between managers and workers, highlighting the complex relationship between the workplace context and eating behaviours. Construction workers were interested in learning about nutrition and improving their eating habits through nutrition intervention. However, they highlighted that better cooking and storage facilities on site, together with fewer job demands and longer break times, would enhance the sustainability of the intervention and their ability to make healthier food choices.
Collapse
Affiliation(s)
| | - Margaret Coffey
- School of Health and Society, The University of Salford, Manchester, UK
| | - Anna Robins
- School of Health and Society, The University of Salford, Manchester, UK
| |
Collapse
|
19
|
Huggins CE, Jong J, Leung GKW, Page S, Davis R, Bonham MP. Shift workers’ perceptions and experiences of adhering to a nutrition intervention at night whilst working: a qualitative study. Sci Rep 2022; 12:15487. [PMID: 36109573 PMCID: PMC9477878 DOI: 10.1038/s41598-022-19582-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 08/31/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractThis study explored the feasibility of implementing a meal timing intervention during night shift work. Data were collected via semi-structured interviews. Interviews were coded inductively by two researchers independently, then three major themes were collaboratively developed. Subthemes from each major theme were mapped to the theoretical domains framework and the Capability Opportunity Motivation model of behaviour change. Seventeen night shift workers (rotating or permanent) aged between 25 and 65 years were interviewed. Participants predominately worked as health professionals. The feasibility of a simple meal timing intervention to avoid eating between 1 and 6 am on night shift is largely affected by three major influences (1) physical and emotional burden of shift work which drives food temptations; (2) the workplace context including the meal break environment, social and cultural context at work, and break scheduling; and (3) motivation of the individual. Facilitators to avoiding eating at night were, keeping busy, having co-worker support, management support, education of health benefits and/or belief that the intervention was health promoting. The barriers to avoiding eating at night were the emotional and physical toll of working at night leading to comfort eating and not having rest areas away from food environments. To support night shift workers with changing timing of meals, interventions at work should target both individual and organisational level behaviour change.
Collapse
|
20
|
Smith KL, Danyluk AB, Munir SS, Covassin N. Shift Work and Obesity Risk-Are There Sex Differences? Curr Diab Rep 2022; 22:341-352. [PMID: 35737274 DOI: 10.1007/s11892-022-01474-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE OF REVIEW Shift work is prevalent among the working population and is linked to an array of adverse health outcomes. This review summarizes current evidence on the relation between shift work and risk of obesity, with a particular emphasis on potential sex differences. RECENT FINDINGS Observational data strongly point towards an association between shift work and heightened risk of prevalent and incident obesity, and particularly abdominal obesity. Circadian misalignment and unhealthy lifestyle behaviors are the primary culprits mediating such association. As it pertains to sex differences in the impact of shift work on obesity, few studies have examined this aspect, and findings are conflicting. Shift work is an important risk factor for obesity, with likely multiple biological and behavioral mediators. However, whether there is a sex-dependent vulnerability to the obesogenic effects of shift work is unclear. This area presents opportunities for future research.
Collapse
Affiliation(s)
- Kevin L Smith
- Department of Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | | | - Sanah S Munir
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Naima Covassin
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
21
|
Silva CM, Teixeira BS, Wright KP, Maia YCDP, Crispim CA. Time-Related Eating Patterns Are Associated with the Total Daily Intake of Calories and Macronutrients in Day and Night Shift Workers. Nutrients 2022; 14:nu14112202. [PMID: 35684002 PMCID: PMC9182503 DOI: 10.3390/nu14112202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/11/2022] [Accepted: 05/19/2022] [Indexed: 12/10/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Catarina Mendes Silva
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (C.M.S.); (B.S.T.); (Y.C.d.P.M.)
| | - Bruno Simão Teixeira
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (C.M.S.); (B.S.T.); (Y.C.d.P.M.)
| | - Kenneth P. Wright
- Department of Integrative Physiology, University of Colorado Boulder, 3100 Marine Street, Boulder, CO 80309, USA;
| | - Yara Cristina de Paiva Maia
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (C.M.S.); (B.S.T.); (Y.C.d.P.M.)
| | - Cibele Aparecida Crispim
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38400-902, Brazil; (C.M.S.); (B.S.T.); (Y.C.d.P.M.)
- Correspondence: ; Fax: +55-34-3218-2084
| |
Collapse
|
22
|
Dodd N, Warren-James M, Stallman HM. How do paramedics and student paramedics cope? A cross-sectional study. Australas Emerg Care 2022; 25:321-326. [PMID: 35525725 DOI: 10.1016/j.auec.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/06/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
Despite threats to wellbeing inherent in paramedicine, little is known about how paramedics cope. This study explored the breadth of healthy and unhealthy coping strategies used by paramedics and student paramedics. A convenience sample of 198 paramedics and student paramedics completed an online survey. Wellbeing was measured using WHO-5 and coping using the Coping Index. Primary outcomes were summarised using descriptive statistics. Most of the sample had wellbeing (68%); student paramedics had significantly better wellbeing than paramedics. There was no significant difference between paramedics and student paramedics on healthy or unhealthy coping. Participants with ill-being had significantly fewer healthy and more unhealthy coping strategies than those with wellbeing, and relatively few used professional support (28%). Internationally, few studies have reported coping strategies in paramedics. This study expands our understanding of healthy and unhealthy coping strategies used by paramedics and student paramedics. The results support research that shows paramedic work affects wellbeing, however not that paramedics are at greater risk of unhealthy coping than students or the general population. The results have implications for both the prevention of overwhelming distress in the workplace and the need to increase the use of professional support to prevent unhealthy coping, including suicidality.
Collapse
Affiliation(s)
- Natalie Dodd
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia.
| | - Matthew Warren-James
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Helen M Stallman
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Birtinya, Qld, Australia
| |
Collapse
|
23
|
Impact of Rotating Shifts on Lifestyle Patterns and Perceived Stress among Nurses: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095235. [PMID: 35564629 PMCID: PMC9101667 DOI: 10.3390/ijerph19095235] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 02/05/2023]
Abstract
Although rotating shifts have a negative health impact, their association with hospital nurses’ health risks remains controversial due to incomplete adjustment in lifestyle patterns and heterogeneity of work schedules. However, whether work schedule characteristics are associated with lifestyle patterns and perceived stress remains undetermined. We assessed the correlations of work schedule characteristics, lifestyle patterns, and perceived stress among hospital nurses. This cross-sectional study included 340 nurses from two hospitals. Final data from 329 nurses regarding work schedule characteristics, lifestyle patterns (physical activity, dietary behavior, and sleep pattern), and perceived stress were analyzed via linear regression models. Fixed-day-shift nurses had reduced perceived stress (β = 0.15, p = 0.007) compared with rotating-shift nurses. Additionally, among rotating-shift nurses, fixed-evening- and fixed-night-shift nurses had longer sleep duration (β = 0.27, p < 0.001; β = 0.25, p < 0.001) compared to non-fixed-rotating-shift nurses. Longer rotating-shift work was associated with healthier dietary behaviors (β = 0.15, p = 0.008), better sleep quality (β = −0.17, p = 0.003), lower perceived stress (β = −0.24, p < 0.001), and shorter sleep duration (β = −0.17, p = 0.003). Hospital nurses’ work schedule characteristics were associated with lifestyle patterns, dietary behavior, sleep pattern, and perceived stress. Fixed-shifts were beneficial for lifestyle and lower perceived stress. Longer rotating shifts could help nurses adjust their lifestyles accordingly.
Collapse
|
24
|
Burris JC, Werner CM, Woolf K. The Relationship Between Dietary Intake and Dietary-Focused Lifestyle Interventions on Risk Factors Associated with Cardiovascular Disease in Firefighters. Curr Nutr Rep 2022; 11:206-224. [PMID: 35347666 DOI: 10.1007/s13668-022-00406-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW Cardiovascular disease (CVD) is the leading cause of death to on-duty firefighters and is a substantial health concern. Preventative measures, including dietary interventions, may improve CVD in firefighters. The purpose of this review is to examine the literature on the relationship between dietary intake, dietary lifestyle interventions, and risk of CVD in firefighters. RECENT FINDINGS Existing evidence, albeit limited, suggests that firefighters do not meet dietary guidelines. Lifestyle modifications featuring dietary interventions are effective in improving risk factors associated with CVD in firefighters. Unfortunately, no consistent nutrition-related trend was identified across the retrieved studies and only a limited number of randomized controlled trials have examined the efficacy of lifestyle intervention studies on CVD in firefighters. Although this review suggests dietary lifestyle interventions may facilitate decreases in risk factors associated with CVD in firefighters, current evidence is limited, and additional research is needed.
Collapse
Affiliation(s)
- Jennifer C Burris
- Department of Nutrition, Saddleback College, 2800 Marguerite Pkwy, Mission Viejo, CA, 92692, USA
| | - Charlotte Marie Werner
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, 411 Lafayette Street, 5th Floor, New York, NY, 10003, USA
| | - Kathleen Woolf
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, 411 Lafayette Street, 5th Floor, New York, NY, 10003, USA.
| |
Collapse
|
25
|
Dietary Intake in Law Enforcement Personnel: Occupation Is an Additional Challenge for Changing Behavior. Nutrients 2022; 14:nu14071336. [PMID: 35405950 PMCID: PMC9002495 DOI: 10.3390/nu14071336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/21/2022] [Accepted: 03/22/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Law enforcement is a dangerous, stressful, and health-threatening occupation. This study investigated the association between demographic factors including sex, age, and types of law enforcement occupation and described self-reported barriers to healthy and enjoyable diets within a cohort of law enforcement personnel. Methods: This mixed-methods study explored cross-sectional data from the Perceived Barriers to Healthy Eating validated survey. The survey included eight questions obtaining quantitative data and two open ended question obtaining qualitative data. A framework thematic analysis using the theory of planned behavior was undertaken to describe self-reported barriers to a healthy and enjoyable dietary intake. Results: 159 participants (median age = 27 (range 19–60) years; 74% males) were surveyed. In general, demographic factors are not associated with the dietary beliefs and behavior of law enforcement personnel. Self-reported barriers (generated themes) to a healthy and enjoyable diet included individual preferences, social influences, internal drive, capacity to change and occupational influences, which broadly aligned with the theory of planned behavior. Conclusions: Dietary intake in law enforcement personnel is impacted by occupational considerations, including busy schedules, long working hours, inconsistent meal breaks, tiredness, and shift work. The study provides useful information to support dietary interventions.
Collapse
|
26
|
Mohd Fuad SH, Juliana N, Mohd Azmi NAS, Mohd Fahmi Teng NI, Azmani S, Abu IF, Das S. Circadian Disruption and Occupational Toxicants Exposure Affecting the Immunity of Shift Workers During SARS CoV-2 Pandemic. Front Public Health 2022; 10:829013. [PMID: 35392476 PMCID: PMC8980348 DOI: 10.3389/fpubh.2022.829013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
In several regions of the world, the recent Coronavirus Disease-2019 (COVID-19) pandemic outbreak increased morbidity and mortality. The pandemic situation disrupted many workers' previously established lifestyles. The main aim of the present review was to describe the circadian disruption and occupational toxicant exposure affecting the immunity of shift workers during the SARS CoV-2 pandemic. We retrieved pertinent published literature from the Google Scholar, PubMed, and Scopus databases. In the present review, we discuss the circadian rhythm involving the hypothalamic-pituitary-adrenal (HPA) axis at the molecular level, its disruption, occupational toxicant exposure causing immunomodulatory effects, and the role of immunity during the SARS CoV-2 pandemic. The severity of the progression of the viral infection depends on multiple factors affecting immunity. Hence, shift workers may need to be aware of those factors such as circadian rhythm disruption as well as occupational toxicant exposure. The timing of shift workers' energy intake is also important concerning the shift of the workers. The information in the present review may be important for all workers who are at risk during the pandemic. In the absence of any published literature related to association of circadian rhythm disruption with occupational toxicant exposure, the present review may have greater importance.
Collapse
Affiliation(s)
- Siti Hanisah Mohd Fuad
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Norsham Juliana
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | | | | | - Sahar Azmani
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
| | - Izuddin Fahmy Abu
- Institute of Medical Science Technology, Universiti Kuala Lumpur, Kajang, Malaysia
| | - Srijit Das
- Department of Human & Clinical Anatomy, College of Medicine and Health Sciences, Muscat, Oman
| |
Collapse
|
27
|
Impact of Income and Industry on New-Onset Diabetes among Employees: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031090. [PMID: 35162114 PMCID: PMC8834605 DOI: 10.3390/ijerph19031090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/13/2022] [Indexed: 12/04/2022]
Abstract
The purpose of this study was to investigate the impact of income and industry type on the risk of developing diabetes among Japanese workers, including how this impact is affected by sex. A total of 24,516 employees at small- and medium-sized enterprises in Japan aged 40–74 years who underwent health examinations in fiscal years 2010–2015 were included in this retrospective cohort study. Generalized linear regression models were used to assess the association between new-onset diabetes and income and industry. In men, the cumulative incidence rate was significantly higher in the low-income group; it was highest in the transportation and postal service industries. Although income and industry were independent risk factors for developing diabetes in men, an interaction was found between income and industry, which was affected by participants’ sex: in specific industries (i.e., lifestyle-related, personal services, and entertainment services), men had a significantly higher risk of developing diabetes in the high-income group, and women had a significantly higher risk of developing diabetes in the low-income group. These findings highlight important factors to consider in assessing diabetes risk and suggest that efficient primary and secondary prevention should be encouraged in industries where workers have a high risk of diabetes.
Collapse
|
28
|
Ras J, Leach L. Relationship Between Physical Activity, Coronary Artery Disease Risk Factors and Musculoskeletal Injuries in the City of Cape Town Fire and Rescue Service. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2022; 59:469580221084485. [PMID: 35341350 PMCID: PMC8958692 DOI: 10.1177/00469580221084485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Musculoskeletal injuries in firefighters are a common occurrence, that increase as firefighters age, and may be related to the firefighters’ physical activity habits outside of the job. Certain CAD risk factors, such as obesity, cigarette smoking and ageing may be linked to increased injury risk in firefighters. Although firefighters may meet the recommended minimum physical activity minutes, they may remain at risk for sustaining musculoskeletal injuries. Therefore, this study aims to determine the relationship between physical activity and CAD risk factors, between CAD risk factors and musculoskeletal injuries and between physical activity and musculoskeletal injuries. A total of 124 full-time firefighters, males and females, were conveniently recruited from the City of Cape Town Fire and Rescue Service. A researcher-generated questionnaire was used to collect injury, CAD risk factor and physical activity data. The proportion of firefighters who participated in leisure-time physical activity (LTPA) was 63.7%, and those who were physically inactive was 69.4%. The prevalence musculoskeletal injuries among all firefighters was 27.4%. The most prevalent musculoskeletal injury was shoulder injuries in 35.3% of firefighters, followed by multiple injuries in 26.5% and back injuries in 14.7%. Age was a significant predictor of physical inactivity in firefighters [P = .002, OR = 1.08], BMI was a significant predictor of physical inactivity [P = .050, OR = 1.08], cigarette smoking was a significant predictor of firefighters not exercising [P = .007, OR = 2.31] and the total amount of vigorous-intensity exercise was a significant predictor of musculoskeletal injuries [P = .050, OR = 1.00]. In conclusion, older firefighters were more physically inactive and had a higher prevalence of musculoskeletal injuries, and the latter decreased significantly after the age of 50 years. Emphasis should be placed on firefighters exercising in their leisure-time, especially as they aged.
Collapse
Affiliation(s)
- Jaron Ras
- Department of Sport, Recreation and Exercise Science, 56390University of the Western Cape, Bellville, Western Cape, South Africa
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, 56390University of the Western Cape, Bellville, Western Cape, South Africa
| |
Collapse
|
29
|
Wang C, Almoosawi S, Palla L. Relationships Between Food Groups and Eating Time Slots According to Diabetes Status in Adults From the UK National Diet and Nutrition Survey (2008-2017). Front Nutr 2021; 8:692450. [PMID: 34660656 PMCID: PMC8514704 DOI: 10.3389/fnut.2021.692450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Chaochen Wang
- Department of Public Health, Aichi Medical University, Nagakute, Japan
| | - Suzana Almoosawi
- Faculty of Medicine, School of Public Health, Imperial College London, London, United Kingdom
| | - Luigi Palla
- Department of Public Health and Infectious Diseases, University of Rome La Sapienza, Rome, Italy.,Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, United Kingdom.,Department of Global Health, School of Tropical Medicine and Global Health, University of Nagasaki, Nagasaki, Japan
| |
Collapse
|
30
|
Free-Living Dietary Intake in Tactical Personnel and Implications for Nutrition Practice: A Systematic Review. Nutrients 2021; 13:nu13103502. [PMID: 34684503 PMCID: PMC8537156 DOI: 10.3390/nu13103502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022] Open
Abstract
Tactical personnel (including military, law enforcement, and fire and rescue) are responsible for ensuring national and public safety. Dietary intake is an important consideration to support optimal health and performance. The aims of this systematic review were to: (1) describe the reported free-living dietary intake (energy and macronutrients) of tactical personnel, and (2) describe the practical implications of reported dietary intakes to support the physical and dietary requirements of tactical personnel. A systematic search of databases (MEDLINE, EMBASE, CINAHL and Web of Science) was conducted following the PRISMA guidelines. English and full text research articles were identified and screened against inclusion and exclusion criteria. Demographic and dietary intake data were extracted, tabulated, and synthesized narratively. The quality of the studies was assessed using the Academy of Nutrition and Dietetics Quality Criteria Checklist. Twenty-two studies (15 military, 4 law enforcement, and 2 fire and rescue) were eligible to inform this review. The volume of evidence suggested that tactical personnel met dietary protein and exceeded dietary fat recommendations but failed to meet energy and carbohydrate recommendations. Therefore, practical approaches to support optimized energy, fat and carbohydrate intake in tactical personnel is important.
Collapse
|
31
|
López-Bermudo L, Gómez-Landero LA. Healthy Habits in Firefighters: Assessment in Shift Days Versus Days Off. J Occup Environ Med 2021; 63:e580-e585. [PMID: 34491966 DOI: 10.1097/jom.0000000000002289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to compare dietary habits, sleep habits, and injury incidence between shift days and days off among Spanish firefighters. METHODS 24-Hour dietary recalls, and sleep and injury questionnaires on both days were collected from 28 Sevillian professional firefighter, as well as anthropometric measurements and a physical activity questionnaire. RESULTS Firefighters consumed 433 more kilocalories (P < 0.001), 2.4% and 3.1% more kilocalories from fat and monounsaturated fatty acids, respectively (P < 0.05), had 3.7 times greater chance of being injured and slept 2 hours and 18 minutes less (P < 0.001) in their shift days. Higher body fat percentages were found in older and less active firefighters. CONCLUSIONS Shift work appears to influence their dietary habits, injury incidence, and sleep habits, so measures to alleviate the consequences of shift work in firefighters should be taken.
Collapse
Affiliation(s)
- Lucía López-Bermudo
- Pablo de Olavide University, Seville, Spain (Mrs López-Bermudo and Dr Gómez-Landero), Andalusian Center of Molecular Biology and Regenerative Medicine (Cabimer), Seville, Spain (Mrs López-Bermudo)
| | | |
Collapse
|
32
|
Govender L, Pillay K, Siwela M, Modi AT, Mabhaudhi T. Assessment of the Nutritional Status of Four Selected Rural Communities in KwaZulu-Natal, South Africa. Nutrients 2021; 13:2920. [PMID: 34578797 PMCID: PMC8465248 DOI: 10.3390/nu13092920] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/26/2021] [Accepted: 08/19/2021] [Indexed: 11/17/2022] Open
Abstract
Under- and over-nutrition co-exist as the double burden of malnutrition that poses a public health concern in countries of the developing regions, including South Africa (SA). Vulnerable groups such as pregnant women and children under five years are the most affected by malnutrition, especially in rural areas. Major contributing factors of malnutrition include food and nutrition insecurity, poverty, and unhealthy lifestyles. The current study aimed to assess the nutritional status, using selected anthropometric indices and dietary intake methods (repeated 24 h recall and food frequency), of four rural communities in KwaZulu-Natal (SA). Purposive sampling generated a sample of 50 households each in three rural areas: Swayimane, Tugela Ferry, and Umbumbulu and 21 households at Fountain Hill Estate. The Estimated Average Requirement cut-point method was used to assess the prevalence of inadequate nutrient intake. Stunting (30.8%; n = 12) and overweight (15.4%; n = 6) were prevalent in children under five years, whilst obesity was highly prevalent among adult females (39.1%; n = 81), especially those aged 16-35 years. There was a high intake of carbohydrates and a low intake of fibre and micronutrients, including vitamin A, thus, confirming the need for a food-based approach to address malnutrition and micronutrient deficiencies, particularly vitamin A deficiency.
Collapse
Affiliation(s)
- Laurencia Govender
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg 3201, South Africa; (K.P.); (M.S.)
| | - Kirthee Pillay
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg 3201, South Africa; (K.P.); (M.S.)
| | - Muthulisi Siwela
- Dietetics and Human Nutrition, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg 3201, South Africa; (K.P.); (M.S.)
| | - Albert Thembinkosi Modi
- Centre for Transformative Agricultural and Food Systems, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg 3201, South Africa; (A.T.M.); (T.M.)
| | - Tafadzwanashe Mabhaudhi
- Centre for Transformative Agricultural and Food Systems, School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Private Bag X01, Scottsville 3209, Pietermaritzburg 3201, South Africa; (A.T.M.); (T.M.)
| |
Collapse
|
33
|
Ulusoy HG, Sanlier N, Rakıcıoğlu N. Do Rotating Night Shifts Change Nurses' Nutritional Status? A Cross-Sectional Study. J Am Coll Nutr 2021; 41:608-616. [PMID: 34376120 DOI: 10.1080/07315724.2021.1947413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Shift work disrupts circadian rhythms through environmental factors such as disruption of the light-dark and rest-activity cycle. This study aims to evaluate the nutritional status, circadian phenotype, sleep quality, and anthropometric measurements in nurses working in rotating night shifts. METHOD The study included 44 nurses working in rotating night shifts. Physical activity records for 4 days and 24-hour dietary recalls for 7 days were taken. To evaluate the circadian phenotypes and sleep quality, the Morningness-Eveningness Questionnaire and the Pittsburg Sleep Quality Index were used, respectively. RESULTS Most nurses were evening chronotype and had poor sleep quality. Shift work was associated with higher daily energy intake and lower total daily energy expenditure (p < 0.05). On the night shifts, while fiber-rich foods such as beans and fruit consumption decrease, the consumption of fats, sweets, and cereals increases. While carbohydrates, total fat, and cholesterol intake were higher in only women on the night shift (p < 0.05), saturated fat and calcium intake were higher in all nurses (p < 0.05). While the water intake of the nurses was lower on the night shift (p < 0.05), tea intake was higher in women (p < 0.05). A correlation was found between total shift work duration, body mass index (r = 0.525), waist circumference (r = 0.577), waist-height ratio (r = 0.584), and body fat percentage (r = 0.513) (p < 0.001). CONCLUSIONS Nurses should be encouraged to ensure adequate water intake and to make healthy food choices during the night shift to maintain health and work performance.
Collapse
Affiliation(s)
- Hande Gül Ulusoy
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Altındağ, Ankara, Turkey
| | - Nevin Sanlier
- Department of Nutrition and Dietetics, School of Health Sciences, Ankara Medipol University, Altındağ, Ankara, Turkey
| | - Neslişah Rakıcıoğlu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Altındağ, Ankara, Turkey
| |
Collapse
|
34
|
Ras J, Mosie D, Strauss M, Leach L. Knowledge and attitude toward health and CVD risk factors among firefighters in Cape Town, South Africa. J Public Health Res 2021; 11. [PMID: 34351095 PMCID: PMC8859729 DOI: 10.4081/jphr.2021.2307] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/04/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Firefighting is a hazardous occupation, and the firefighters' fitness for duty is affected by their knowledge of and attitudes toward their health and their relationship in the development of cardiovascular disease (CVD). The aim of this study was to assess knowledge and attitude toward health and CVD risk factors among firefighters in South Africa. DESIGN AND METHODS The study used a cross-sectional research design. A sample of 110 firefighters, males and females, aged 18 to 65 years were conveniently sampled from the City of Cape Town Fire and Rescue Service. A researcher-generated self-administered questionnaire was completed online to obtain data from firefighters. A p-value of less than 0.05 indicated statistical significance. RESULTS The results showed that 52.8% of firefighters had a poor knowledge of health, and 47.2% had a good knowledge of health, while 10% reported a negative attitude towards health and 90.0% had a positive attitude towards health. There was a significant difference between firefighters' knowledge of health and their attitudes toward health (p<0.05), particularly related to marital status, age, years of experience and in those with CVD risk factors (p<0.05). Significant correlations were found between knowledge of CVD and knowledge of health-risk behaviors (p<0.05). CONCLUSION Significant differences in health knowledge and attitudes toward health were present in married, aged and hypertensive firefighters. Overall health knowledge and health-risk behaviours were significant predictors of attitudes toward health.
Collapse
Affiliation(s)
- Jaron Ras
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Cape Town.
| | - Duncan Mosie
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Cape Town.
| | - Matthew Strauss
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Cape Town.
| | - Lloyd Leach
- Department of Sport, Recreation and Exercise Science, University of the Western Cape, Cape Town.
| |
Collapse
|
35
|
Meadley B, Wolkow AP, Smith K, Perraton L, Bowles KA, Bonham MP. Cardiometabolic, Dietary and Physical Health in Graduate Paramedics during the First 12-Months of Practice - A Longitudinal Study. PREHOSP EMERG CARE 2021; 26:524-536. [PMID: 34232788 DOI: 10.1080/10903127.2021.1949081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: Shift work is an established risk factor for poor health yet is necessary for paramedics to provide continuous care to the public. It is unknown how early into a career shift work may begin to impact health. This study sought to identify changes in cardiometabolic health, diet, aerobic capacity, physical activity and health-related quality of life (HRQoL) in graduate paramedics during the first 12-months of their career.Methods: Fifty-six paramedics with no history of regular shift work (28 female, 28 male; median age 24.5, IQR 23-26 years) were recruited for this study. Dietary patterns (food frequency questionnaires) and HRQoL (36-Item Short Form Questionnaire) were assessed at baseline, 6- and 12-months. Body weight, body mass index (BMI) and blood samples (fasting lipids, glucose, insulin and C-reactive protein) were measured at baseline and 12-months to ascertain cardiometabolic health risk. A subset of participants (n = 19; 10 female, 9 male) wore a physical activity monitor for 12 months and completed baseline and 12-month maximal aerobic capacity assessments (V̇O2max).Results: Body weight and BMI decreased in males and increased in females (-0.7% versus 1.7%, p = 0.02). HRQoL and dietary intake did not change over 12-months, except for a small decrease in fat intake (-1%). Consumption of core/healthy foods was lower than recommended at all timepoints. Biomarkers of cardiometabolic health were within normal range and did not change over 12-months, excepting insulin where a small non-significant increase was seen (+0.5 mIU/L, p = 0.61). Baseline V̇O2max was 41.4 (37.1-49.1) ml.kg-1.min-1, with no change noted at 12-months. Comparison of quarterly physical activity data showed no difference in steps per day (p = 0.47) or moderate to vigorous physical activity (MVPA, p = 0.92) across the 12-months. Paramedics completed less MVPA on day shifts compared to rostered days off (-14.68 minutes, p = 0.04).Conclusions: Dietary patterns, HRQoL, cardiometabolic health, aerobic capacity and physical activity levels did not change meaningfully in the first year of practice. Some dietary behaviors and physical activity levels could be improved and may mitigate health effects of exposure to shift work. Long-term follow-up of this group may aid in developing programs to enhance health for paramedics and other health workers.
Collapse
Affiliation(s)
- Ben Meadley
- Received April 1, 2021 from Paramedic Health and Wellbeing Research Unit, Monash University, Frankston, Australia (BM, APW, KS, LP, KAB, MPB); Department of Paramedicine, Monash University, Frankston, Australia (BM, KS, KAB); Ambulance Victoria, Doncaster, Australia (BM, KS); Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia (APW); Department of Physiotherapy, Monash University, Frankston, Australia (LP); Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia (MPB). Revision received June 21, 2021; accepted for publication June 23, 2021
| | - Alexander P Wolkow
- Received April 1, 2021 from Paramedic Health and Wellbeing Research Unit, Monash University, Frankston, Australia (BM, APW, KS, LP, KAB, MPB); Department of Paramedicine, Monash University, Frankston, Australia (BM, KS, KAB); Ambulance Victoria, Doncaster, Australia (BM, KS); Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia (APW); Department of Physiotherapy, Monash University, Frankston, Australia (LP); Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia (MPB). Revision received June 21, 2021; accepted for publication June 23, 2021
| | - Karen Smith
- Received April 1, 2021 from Paramedic Health and Wellbeing Research Unit, Monash University, Frankston, Australia (BM, APW, KS, LP, KAB, MPB); Department of Paramedicine, Monash University, Frankston, Australia (BM, KS, KAB); Ambulance Victoria, Doncaster, Australia (BM, KS); Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia (APW); Department of Physiotherapy, Monash University, Frankston, Australia (LP); Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia (MPB). Revision received June 21, 2021; accepted for publication June 23, 2021
| | - Luke Perraton
- Received April 1, 2021 from Paramedic Health and Wellbeing Research Unit, Monash University, Frankston, Australia (BM, APW, KS, LP, KAB, MPB); Department of Paramedicine, Monash University, Frankston, Australia (BM, KS, KAB); Ambulance Victoria, Doncaster, Australia (BM, KS); Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia (APW); Department of Physiotherapy, Monash University, Frankston, Australia (LP); Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia (MPB). Revision received June 21, 2021; accepted for publication June 23, 2021
| | - Kelly-Ann Bowles
- Received April 1, 2021 from Paramedic Health and Wellbeing Research Unit, Monash University, Frankston, Australia (BM, APW, KS, LP, KAB, MPB); Department of Paramedicine, Monash University, Frankston, Australia (BM, KS, KAB); Ambulance Victoria, Doncaster, Australia (BM, KS); Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia (APW); Department of Physiotherapy, Monash University, Frankston, Australia (LP); Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia (MPB). Revision received June 21, 2021; accepted for publication June 23, 2021
| | - Maxine P Bonham
- Received April 1, 2021 from Paramedic Health and Wellbeing Research Unit, Monash University, Frankston, Australia (BM, APW, KS, LP, KAB, MPB); Department of Paramedicine, Monash University, Frankston, Australia (BM, KS, KAB); Ambulance Victoria, Doncaster, Australia (BM, KS); Turner Institute for Brain and Mental Health, Monash University, Clayton, Australia (APW); Department of Physiotherapy, Monash University, Frankston, Australia (LP); Department of Nutrition, Dietetics and Food, Monash University, Clayton, Australia (MPB). Revision received June 21, 2021; accepted for publication June 23, 2021
| |
Collapse
|
36
|
Nehme PA, Marot LP, Nogueira LFR, Marqueze EC, Crispim CA, Moreno CRC. A Nutritional Counseling Program Prevents an Increase in Workers' Dietary Intake and Body Weight During the COVID-19 Pandemic. Front Physiol 2021; 12:703862. [PMID: 34366892 PMCID: PMC8335487 DOI: 10.3389/fphys.2021.703862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/17/2021] [Indexed: 11/13/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Patricia A Nehme
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Luisa P Marot
- Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Elaine C Marqueze
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo, Brazil.,Public Health Graduate Program, Catholic University of Santos, Santos, Brazil
| | | | - Claudia R C Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo, Brazil.,Psychology Department, Stockholm University, Stockholm, Sweden
| |
Collapse
|
37
|
Leung GKW, Davis R, Huggins CE, Ware RS, Bonham MP. Does rearranging meal times at night improve cardiovascular risk factors? An Australian pilot randomised trial in night shift workers. Nutr Metab Cardiovasc Dis 2021; 31:1890-1902. [PMID: 33994064 DOI: 10.1016/j.numecd.2021.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/22/2021] [Accepted: 03/09/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Shift workers face an increased risk of cardiovascular disease (CVD), type-2 diabetes and obesity. Eating during the night is a likely contributing factor, as it coincides with the time at which postprandial metabolism is least efficient. In this pilot randomised crossover trial, we examine the effects of a short overnight fast on CVD risk markers (primarily postprandial triglyceride and glucose response) of night shift workers. METHODS AND RESULTS Night shift workers with abdominal obesity underwent 4-week intervention and control periods, separated by ≥ 2 weeks washout. In the intervention period, an overnight fast (0100 h-0600 h) was implemented, by redistributing 24-h energy intake. Usual dietary habits were followed in the control period. Outcomes between intervention and control were compared using mixed effects linear regression models. Nineteen adults completed the trial [13 females, mean (±SD) age 41 ± 10 years, BMI 30.7 ± 5.7 kg/m2]. Postprandial triglyceride and glucose response post intervention were not different to post control. The overnight fast was well-tolerated by participants with an adherence rate of 95%, assessed by weekly 24-h dietary recalls. Exploratory analysis indicates lower mean body weight post intervention compared to post control (mean difference: -0.9 kg, 95% CI: -1.3 to -0.4). CONCLUSIONS Night shift workers who habitually ate during their night shifts were able to rearrange their meal times to maintain a small overnight fast, which may have promoted small weight changes. This warrants further investigation into the role of meal timing in mitigating the metabolic consequences of night shift work. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (http://anzctr.org.au/) registered on the 30th May 2017 (ACTRN12617000791336).
Collapse
Affiliation(s)
- Gloria K W Leung
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia
| | - Rochelle Davis
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia
| | - Catherine E Huggins
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, N78, 2.34, Nathan Campus, 170 Kessels Road, Nathan, QLD 4111, Australia
| | - Maxine P Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC 3168, Australia.
| |
Collapse
|
38
|
Meadley B, Perraton L, Smith K, Bonham MP, Bowles KA. Assessment of Cardiometabolic Health, Diet and Physical Activity in Helicopter Rescue Paramedics. PREHOSP EMERG CARE 2021; 26:380-390. [PMID: 33760682 DOI: 10.1080/10903127.2021.1907492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Shift work is an established risk factor for weight gain, cardiovascular disease, Type II diabetes mellitus, and impaired health-related quality of life (HRQoL). Prolonged exposure to shift work is common in paramedics and other emergency medical service (EMS) providers. Sub-populations of EMS workers may have varying health outcomes when exposed to shift work, but the reasons for this have not been investigated. We sought to describe cardiometabolic health, dietary patterns, physical activity, and health-related quality of life (HRQoL) in a sample of experienced intensive care flight paramedics (ICFPs) working for a Helicopter Emergency Medical Service (HEMS).Methods: Fifteen paramedics (median age 45, IQR 42-48 years) were recruited to undertake a range of health assessments. These included a food frequency questionnaire to assess dietary patterns, sampling of biomarkers to determine cardiometabolic health risk, maximal aerobic capacity assessment via treadmill running and assessment of HRQoL via the SF-36 survey. In an extension of the study protocol, ten of the fifteen participants wore a physical activity monitor for one year.Results: Median (IQR) weight was 79.9 (72.3-89.3) kg, body fat percentage 23.3 (21.9-26.5) %, body mass index (BMI) 25.1 (21.9-27.4) kg.m2, and waist to height ratio 0.48 (0.45-0.54). Dietary analyses showed high discretionary food intake. Biomarkers of cardiometabolic health risk were all within normal range. HRQoL was 86.2/100 for physical health and 85.1/100 for mental health. V̇O2max was 47.0 (43.0-54.6) mL.kg-1.min-1. The ten participants that wore activity monitors completed 11,235 (8334-15,380) steps per day and undertook 50 (12-98) minutes per day/350 (84-686) minutes per week of moderate to vigorous physical activity. The least amount of physical activity was conducted on day shifts.Conclusions: For ICFPs included in this study, HRQoL, cardiometabolic and physical activity outcomes are representative of good health. Although shift work influences the amount of physical activity, ICFPs exceeded minimum recommendations even when rostered to duty. Despite lengthy careers in EMS, ICFPs demonstrate an excellent health profile that is likely due to high physical activity levels and healthy BMI. This information may be useful in guiding health interventions in the wider EMS workforce.
Collapse
|
39
|
Shockey TM, Tsai RJ, Cho P. Prevalence of Diagnosed Diabetes Among Employed US Adults by Demographic Characteristics and Occupation, 36 States, 2014 to 2018. J Occup Environ Med 2021; 63:302-310. [PMID: 33350659 PMCID: PMC8669571 DOI: 10.1097/jom.0000000000002117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To assess the prevalence of diagnosed diabetes among employed US adults from 36 states by occupation group using data from 2014 to 2018 Behavioral Risk Factor Surveillance System. METHODS Prevalence of diabetes was calculated by 22 broad and 93 detailed occupation groups among a sample of 366,633 employed respondents. Wald chi-square values were used to determine the significance of associations between diabetes and occupation groups after adjusting for sex, age, and race/ethnicity. RESULTS The prevalence of diabetes was 6.4% among employed US adults. The three broad occupation groups with the highest adjusted prevalence of diabetes were protective services (8.9%), farming, fishing, and forestry (8.8%), and community and social services (8.4%). CONCLUSIONS Prevalence of diabetes differed by occupation. Work-related factors (eg, shift work, job stress) should be further examined in relation to risk of developing diabetes.
Collapse
Affiliation(s)
- Taylor M Shockey
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio (Dr Shockey, Dr Tsai); Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Cho)
| | | | | |
Collapse
|
40
|
Work Shift, Lifestyle Factors, and Subclinical Atherosclerosis in Spanish Male Workers: A Mediation Analysis. Nutrients 2021; 13:nu13041077. [PMID: 33810210 PMCID: PMC8065668 DOI: 10.3390/nu13041077] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/20/2021] [Accepted: 03/23/2021] [Indexed: 12/22/2022] Open
Abstract
(1) Background: Working night shifts has been associated with altered circadian rhythms, lifestyle habits, and cardiometabolic risks. No information on the potential association of working shift and the presence of atherosclerosis is available. The aim of this study was to quantify the association between different work shifts and the presence of subclinical atherosclerosis objectively measured by imaging. (2) Methods: Analyses were conducted on the baseline data of the Aragon Workers Health Study (AWHS) cohort, including information on 2459 middle-aged men. Categories of shift work included central day shift, rotating morning-evening or morning-evening-night shift, and night shift. The presence of atherosclerotic plaques was assessed by 2D ultrasound in the carotid and femoral vascular territories. Multivariable logistic models and mediation analysis were conducted to characterize and quantify the association between study variables. (3) Results: Participants working night or rotating shifts presented an overall worse cardiometabolic risk profile, as well as more detrimental lifestyle habits. Workers in the most intense (morning-evening-night) rotating shift presented higher odds of subclinical atherosclerosis (odds ratio: 1.6; 95% confidence interval: 1.12 to 2.27) compared to workers in the central shift, independently of the presence of lifestyle and metabolic risk factors. A considerable (21%) proportion of this association was found to be mediated by smoking, indicating that altered sleep-wake cycles have a direct relationship with the early presence of atherosclerotic lesions. (4) Conclusions: Work shifts should be factored in during workers health examinations, and when developing effective workplace wellness programs.
Collapse
|
41
|
Salah RA, Malak MZ, Bani Salameh AK. Relationship between shift-work and life-style behaviors among emergency department nurses in Jordan. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2020; 77:27-34. [PMID: 33319635 DOI: 10.1080/19338244.2020.1841721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Shift-work can alter the nurses' lifestyle behaviors, which negatively influence health. This study is purposed to assess the relationship between shift-work and selected lifestyle behaviors including, dietary habits, physical activity, and nicotine dependence among Jordanian nurses who work at the emergency department. A cross-sectional, descriptive correlational design was used. A total of 275 Jordanian nurses from the emergency department of Jordanian hospitals participated in the questionnaire. The results showed that 50.2% of the nurses suffered from poor dietary habits, 81.8% of them were physically inactive, and 65.1% had nicotine dependence. There was a positive correlation between shift-work, dietary habits, physical activity, and nicotine dependence. Therefore, the effects of shift-work should be considered when planning and developing interventional programs to enhance nurses' health and promote healthy behaviors among nurses workforce during shift-work.
Collapse
Affiliation(s)
- Rayyan A Salah
- Adult Health Nursing, Ministry of Health, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Malakeh Z Malak
- Community Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Ayman K Bani Salameh
- Pediatric Health Nursing, Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| |
Collapse
|
42
|
Nechifor RE, Popita C, Bala C, Vonica C, Ciobanu D, Roman G, Mocan A, Sima D, Inceu G, Craciun A, Pop RM, Craciun C, Rusu A. Regional homogeneity and degree of centrality in social jetlag and sleep deprivation and their correlations with appetite: a resting-state fMRI study. BIOL RHYTHM RES 2020. [DOI: 10.1080/09291016.2020.1854991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Ruben Emanuel Nechifor
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania
- Institute of Research, Development and Innovation in Applied Natural Science, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Cristian Popita
- Department of Radiology and Medical Imaging, The Oncology Institute “Prof. Dr. Ion Chiricuţă”, Cluj-Napoca, Romania
| | - Cornelia Bala
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Camelia Vonica
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dana Ciobanu
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gabriela Roman
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andreia Mocan
- Clinical Center of Diabetes, Emergency Clinical County Hospital Cluj, Cluj-Napoca, Romania
| | - Diana Sima
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Georgeta Inceu
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Anca Craciun
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Raluca Maria Pop
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristian Craciun
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adriana Rusu
- Department of Diabetes and Nutrition Diseases, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| |
Collapse
|
43
|
Lin TT, Park C, Kapella MC, Martyn-Nemeth P, Tussing-Humphreys L, Rospenda KM, Zenk SN. Shift work relationships with same- and subsequent-day empty calorie food and beverage consumption. Scand J Work Environ Health 2020; 46:579-588. [PMID: 32449516 PMCID: PMC7737792 DOI: 10.5271/sjweh.3903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Objectives Shift work may contribute to unhealthy eating behaviors. However, the evidence is built mainly on comparisons of eating behaviors between shift and non-shift workers. Growing research has suggested daily experiences and exposures may contribute to daily fluctuations in people's food consumption. The purpose of this study was to examine within-person associations between shift work and same- and subsequent-day empty calorie food/beverage consumption. Methods This was a 14-day intensive longitudinal study using ecological momentary assessment. A convenience sample of 80 hospital registered nurses working a rotating shift in Taiwan completed a 21-item food checklist assessing their empty food/beverage consumption (ie, fast/fried food, sweet and salty snacks, sugar-sweetened beverages) four times at random daily. Daily shift work (ie, day, evening, or night shift) was derived from the registry-based work schedule. Three-level mixed-effects regression models were employed for hypothesis testing. Results A total of 77 participants with 2444 momentary assessments were included in the final analysis. The results suggested that participants on night compared to day shifts had higher likelihoods of fast/fried food intake [adjusted odds ratio (OR adj) 1.7, 95% CI 1.2-2.6] and sugar-sweetened beverage consumption (OR adj1.5, 95% CI 1.0-2.1). However, there were no significant associations between shift work and subsequent-day empty calorie food/beverage consumption. Conclusions Night shift work is associated with same-day increased empty calorie food/beverage consumption among workers. Strategies that help to prevent unhealthy eating behaviors on night shifts may help to reduce rotating shift workers' empty calorie food/beverage consumption and ultimately improve their health.
Collapse
Affiliation(s)
- Ting-Ti Lin
- School of Nursing, National Defense Medical Center, No. 161, Sec. 6, Minquan E Rd., Neihu District, Taipei City, 11490, Taiwan.
| | | | | | | | | | | | | |
Collapse
|
44
|
Marot LP, Rosa DE, Lopes TDVC, Moreno CRDC, Crispim CA. Eating Duration throughout a Rotating Shift Schedule: A Case Study. J Am Coll Nutr 2020; 40:624-631. [PMID: 32970537 DOI: 10.1080/07315724.2020.1814899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
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.
Collapse
Affiliation(s)
| | | | | | - Claudia Roberta de Castro Moreno
- School of Public Health, University of São Paulo, São Paulo, Brazil.,Stress Research Institute, Stockholm University, Stockholm, Sweden
| | | |
Collapse
|
45
|
Kelly C, Nea FM, Pourshahidi LK, Kearney JM, O'Brien V, Livingstone MBE, Corish CA. Adherence to dietary and physical activity guidelines among shift workers: associations with individual and work-related factors. BMJ Nutr Prev Health 2020; 3:229-238. [PMID: 33521533 PMCID: PMC7841828 DOI: 10.1136/bmjnph-2020-000091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 12/30/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Ciara Kelly
- Department of Public Health, Merlin Park Regional Hospital, Galway, Ireland.,School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Fiona M Nea
- School of Biological Sciences, Technological University of Dublin, Dublin, Ireland
| | - L Kirsty Pourshahidi
- Nutrition Innovation Centre for Food and Health (NICHE), Centre for Molecular Biosciences, Ulster University, Coleraine, UK
| | - John M Kearney
- School of Biological Sciences, Technological University of Dublin, Dublin, Ireland
| | - Victoria O'Brien
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute of Food and Health, University College Dublin, Dublin, Ireland.,School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - M Barbara E Livingstone
- Nutrition Innovation Centre for Food and Health (NICHE), Centre for Molecular Biosciences, Ulster University, Coleraine, UK
| | - Clare A Corish
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute of Food and Health, University College Dublin, Dublin, Ireland
| |
Collapse
|
46
|
Relationship between Sleep and Hedonic Appetite in Shift Workers. Nutrients 2020; 12:nu12092835. [PMID: 32947981 PMCID: PMC7551988 DOI: 10.3390/nu12092835] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/11/2020] [Accepted: 09/12/2020] [Indexed: 12/12/2022] Open
Abstract
Short and/or poor sleep are established behavioral factors which can contribute to excess food intake, and emerging evidence suggests that disturbed circadian rhythms may also impact food intake regulation. Together, disturbed sleep and circadian rhythms may help explain the excess risk for obesity seen in shift workers. To date, however, the details of how shift work may impact food intake regulation are still not fully defined. Here we examined the relationship between sleep characteristics and hedonic control of appetite in shift workers. A total of 63 shift workers (mean (M) age: 36.7 years, standard deviation (SD): 12.0; 59% women) completed an online survey comprising self-reported measures of body weight regulation, sleep (Pittsburgh Sleep Quality Index, Sleep Hygiene Index), and hedonic control of appetite (Food Craving Inventory, Power of Food Scale). Seventy-one percent reported some weight change since starting shift work, and 84% of those reported weight gain (M = +11.3 kg, SD = 9.1). Worse sleep quality and shorter sleep duration were associated with more food cravings, and worse sleep quality and hygiene were associated with higher appetitive drive to consume palatable food (greater hedonic drive). This preliminary study suggests hedonic pathways are potentially contributing to weight gain in shift workers with disturbed sleep.
Collapse
|
47
|
Silva CM, Cunha NBD, Mota MC, Marot LP, Teixeira KRC, Cunha TM, Crispim CA. 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. Chronobiol Int 2020; 37:1392-1399. [PMID: 32854537 DOI: 10.1080/07420528.2020.1807561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
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.
Collapse
Affiliation(s)
- Catarina Mendes Silva
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Nayara Bernardes Da Cunha
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Maria Carliana Mota
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Luisa Pereira Marot
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
| | | | - Thulio Marquez Cunha
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
| | - Cibele Aparecida Crispim
- Graduate Program of Health Sciences, Faculty of Medicine, Federal University of Uberlândia, Minas Gerais, Brazil
| |
Collapse
|
48
|
Potter GDM, Wood TR. The Future of Shift Work: Circadian Biology Meets Personalised Medicine and Behavioural Science. Front Nutr 2020; 7:116. [PMID: 32850937 PMCID: PMC7426458 DOI: 10.3389/fnut.2020.00116] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 06/22/2020] [Indexed: 12/15/2022] Open
Abstract
Shift work is commonplace in modern societies, and shift workers are predisposed to the development of numerous chronic diseases. Disruptions to the circadian systems of shift workers are considered important contributors to the biological dysfunction these people frequently experience. Because of this, understanding how to alter shift work and zeitgeber (time cue) schedules to enhance circadian system function is likely to be key to improving the health of shift workers. While light exposure is the most important zeitgeber for the central clock in the circadian system, diet and exercise are plausible zeitgebers for circadian clocks in many tissues. We know little about how different zeitgebers interact and how to tailor zeitgeber schedules to the needs of individuals; however, in this review we share some guidelines to help shift workers adapt to their work schedules based on our current understanding of circadian biology. We focus in particular on the importance of diet timing and composition. Going forward, developments in phenotyping and "envirotyping" methods may be important to understanding how to optimise shift work. Non-invasive, multimodal, comprehensive phenotyping using multiple sources of time-stamped data may yield insights that are critical to the care of shift workers. Finally, the impact of these advances will be reduced without modifications to work environments to make it easier for shift workers to engage in behaviours conducive to their health. Integrating findings from behavioural science and ergonomics may help shift workers make healthier choices, thereby amplifying the beneficial effects of improved lifestyle prescriptions for these people.
Collapse
Affiliation(s)
| | - Thomas R Wood
- Division of Neonatology, Department of Pediatrics, University of Washington, Seattle, WA, United States.,Division of Human Health, Performance and Resilience, Institute for Human and Machine Cognition, Pensacola, FL, United States
| |
Collapse
|
49
|
Circadian Misalignment Is Negatively Associated with the Anthropometric, Metabolic and Food Intake Outcomes of Bariatric Patients 6 Months After Surgery. Obes Surg 2020; 31:159-169. [PMID: 32728839 DOI: 10.1007/s11695-020-04873-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/18/2020] [Accepted: 07/22/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE Circadian misalignment has been associated with an increased risk of overweight and obesity, as well as changes in metabolic parameters. This study evaluated the association between social jet lag (SJL), a measure of circadian misalignment, and anthropometric, metabolic and food intake outcomes 6 months after bariatric surgery. MATERIALS AND METHODS A total of 122 bariatric patients were included (77% female, aged 33 years (range 28-41); 79.5% underwent Roux-en-Y gastric bypass). Anthropometric, food consumption and SJL were evaluated in the preoperative evaluation and in the third and sixth months after surgery. SJL was calculated based on the absolute difference between the mid-sleep time on weekends and weekdays. Generalised estimating equations and linear regression were performed to evaluate the associations between mean SJL exposure and the outcomes. RESULTS The interaction between SJL and follow-up time negatively influenced the evolution of weight (p = 0.01), BMI (p = 0.04) and insulin levels (p = 0.01). SJL had an effect on intake of calories (p = 0.001), carbohydrate (p = 0.005) and total (p = 0.007), monounsaturated (p = 0.03) and polyunsaturated fat (p < 0.001). Linear regression showed a negative association between mean SJL exposure over the 6 months and the percentage of weight loss (coefficient = - 0.30, p = 0.006), body weight loss (kg) (coefficient = - 0.17, p = 0.03) and the reduction of BMI (coefficient = - 0.24, p = 0.007). CONCLUSIONS SJL was negatively associated with anthropometric, metabolic and food consumption outcomes 6 months after bariatric surgery. Future studies with longer follow-up are needed to confirm these findings. TRIAL REGISTRATION Clinical Trials.gov : NCT03485352.
Collapse
|
50
|
Meadley B, Caldwell J, Perraton L, Bonham M, Wolkow AP, Smith K, Williams B, Bowles KA. The health and well-being of paramedics - a professional priority. Occup Med (Lond) 2020; 70:149-151. [DOI: 10.1093/occmed/kqaa039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Ben Meadley
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
- Ambulance Victoria, Doncaster, Victoria, Australia
| | - Joanne Caldwell
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Physiology, Monash University, Clayton, Victoria, Australia
| | - Luke Perraton
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - Maxine Bonham
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia
| | - Alexander Powell Wolkow
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Karen Smith
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
- Ambulance Victoria, Doncaster, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Brett Williams
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
| | - Kelly-Ann Bowles
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
| |
Collapse
|