Night shift work is increasingly common worldwide, with 15% to 33% of the working population engaged in it, especially among healthcare workers. Night shift work increases the risk of developing diabetes, heart disease, and obesity. It disrupts the body’s circadian rhythms-the 24-hour internal “clock” that controls when you sleep and wake. Studies have shown that eating at night alters the body’s metabolism; specifically, it impairs your ability to process blood sugar, or glucose. Fortunately, there are strategies night shift workers can use to manage their weight effectively.
The Impact of Night Shift Work on Health
Previous studies have suggested that night shift work may result in circadian disruption, sleep disturbances, and other behavioral changes, leading to increased risk of chronic diseases, mental disorders, cognition impairment, and mortality. The World Health Organization’s International Agency for Research on Cancer concludes that shift work is probably carcinogenic for humans.
For decades, researchers have seen an association between shift work and the risk of heart attacks and heart disease. One review of the research found that shift work seems to raise the risk of cardiovascular disease by 40%. In general, the risks seem to grow the longer a person continues to work nights. One analysis found that the risk of stroke increased by 5% for every five years a person performed shift work.
A number of studies have found that shift work seems to be a risk factor for diabetes. Shift work has also been linked with metabolic syndrome, a combination of health problems like high blood pressure, high blood sugar, obesity, and unhealthy cholesterol levels. It’s a serious risk factor for diabetes, heart attacks, and stroke. One 2007 study followed more than 700 healthy medical workers over four years.
There are several possible reasons for the link between obesity and shift work. Poor diet and lack of exercise might be part of the problem. Hormone balance seems to be important too. The hormone leptin plays a key role in regulating our appetite; it helps make us feel full.
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Some studies have found that shift workers are more likely to suffer from symptoms of depression and other mood disorders. The social isolation of shift work surely takes a psychological toll. Shift work might also affect brain chemistry directly.
For more than 50 years, researchers have noticed that shift work seems to increase the risk of peptic ulcers. Research has shown that shift work can affect a woman’s reproductive system. One study looked at flight attendants, who typically work in shifts. The results showed that flight attendants who worked during pregnancy were twice as likely to have a miscarriage as flight attendants who did not.
There is some strong evidence - from both human and animal studies - that shift work poses an increased risk of cancer. Two analyses of data from different studies found that night work increased the risk of breast cancer by 50%. Working shifts on airplanes, like pilots and flight attendants do, increased the risk by 70%.
The Golden Rule: Limit Eating to Daytime
One study suggests there may be a way to combat these effects of night shift work: limit eating to daytime. Eating only during the day prevented the high blood sugar linked to night shift work. The study found that nighttime eating boosted blood sugar levels. High blood sugar is a risk factor for diabetes. Eating at night increased blood glucose by 6.4% on average. Eating meals only during daytime prevented this effect.
Practical Tips for Weight Loss on the Night Shift
The rules for weight loss don’t change because you work nights. What changes are the strategies you use to meet the requirements for optimal health and well-being. Here's a scientifically-proven guide to losing weight on the night shift:
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1. Create a Log
Reaching your weight loss goals doesn’t mean giving up everything you love to eat and drink, but you do have to make choices to create a calorie deficit. Writing down exactly what you are eating and drinking, how much sleep you’re getting, and the amount of exercise gives you a starting point. Then you can decide if you need to work on just your diet or focus on exercise. If you are not where you want to be in any category, don’t criticize yourself. Pick one area to work on first, then add others gradually. This is a strategy that works for many things, and the most critical step is to begin.
2. Prioritize Protein
Get in the habit of eating before you start your shift, so your body has time to transfer those calories into energy. Make sure it is a high-protein meal with complex carbohydrates, healthy fat, fruits, and vegetables.
3. Prepare Healthy Meals
Instead of one large meal, eat smaller, low-fat snacks throughout your shift. Choose local, fresh, organic foods as much as possible. Although almost every type of fruit and vegetable is available year-round, matching your diet to what is in season where you live can help your body reclaim the benefits of natural cycles.
4. Get Your Vitamin D
When you are sleeping during the day, you aren’t getting any time in the sun, which is a significant source of vitamin D. Your body needs 600 IU daily of this nutrient to help absorb calcium, magnesium, phosphate, and other minerals that can decrease overall body fat. You can increase your intake of vitamin D with supplements and diet. Focus on eating foods such as salmon, tuna, mushrooms, egg yolks, and fortified milk and yogurt. If possible, use your break time at work to go outside and soak up some rays.
5. Make Time for Exercise
Doing some resistance training right before bed will increase your resting metabolic rate for about the next 16 hours. Even if you’re not crazy about suiting up for the gym in the middle of the night, doing some bodyweight exercises like push-ups, pull-ups, squats, and dips at home can do the job. Or get a jump rope and make it fun!
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6. Hydrate, Hydrate, Hydrate
You can reduce fatigue and increase mental alertness by making sure you are drinking enough water. In addition to consuming water during your workday, drink 20 to 32 ounces shortly after waking. It gives your metabolism a boost and can give you more energy while minimizing your appetite. Avoid sugary sodas and fruit juices, which will make your blood sugar spike and then crash.
7. Create a Sleep Routine
The amount of sleep you get can dramatically affect how your body responds to food. Doing the same things every night an hour before bedtime can help program sleep triggers. Your brain will start to associate these rituals with the end of the day and help you fall asleep quicker. Because sleep is a critical factor in weight loss, it needs to be as much of a priority as diet and exercise.
8. Prioritize Sleep
It’s helpful to cluster your shifts and stick to a night work sleep schedule even on your off days. One study found that nurses who worked rotating shifts-a group of night shifts followed by day shifts-reported lower job satisfaction, reduced quality and quantity of sleep and more frequent fatigue. The daily routine for night shift workers may not be practical for everyone. If you want to return to a more traditional schedule after working overnight during the week, try sleeping in the morning, waking up in the early afternoon and staying active until bedtime. Take power naps during the next couple of days.
Practice good sleep hygiene by keeping a regular sleep schedule and creating an environment conducive to a good night’s sleep. Since exposure to bright light disrupts deep sleep, another working overnight tip is to avoid light as much as possible when sleeping during the day.
9. Manage Caffeine Intake
When thinking about how to work night shift and stay healthy, most of us rely on a certain amount of caffeine to wake up and remain productive. Caffeine can improve memory, mood and physical performance. Consider avoiding energy drinks high in sugar and caffeine.
10. Focus on Mental Health
Working night shift can adversely impact nurses, so actively focus on your mental health. These tips for working night shift will allow you time to self-reflect, reconnect with yourself and better understand how you’re feeling. Finding a mentor, co-worker or friend who offers advice or listens to your concerns can be invaluable. It might also help you to develop a philosophy of nursing so you can fall back on this in tough times.
11. Prime Your Mindset
Upon waking, even in the evening, implement a nourishing routine that gets you into a positive frame of mind. At first, working overnight can be challenging.
Practical Ways to Improve Sleep Quality and Quantity
Whether you work nights or days, getting the quality sleep you need is frequently the first thing that gets sacrificed when life gets in the way. Sleep deprivation slows your metabolism, making it nearly impossible to turn down high-calorie, high-fat foods. In addition to weight gain, it can also leave you with no energy to exercise or stick to any kind of fitness or exercise program. The National Sleep Foundation recommends adults get seven to eight hours of sleep.
Do what you can to control your sleep environment and maximize the quantity and quality of your sleep. Darken your drive home with a pair of dark-tinted wraparound sunglasses. Turn your bedroom into a calming den you can retreat to after work. Use heavy blackout curtains to keep the lighting dim, and be sure to close the curtains before you leave for work. Keep the temperature between 65 and 70 degrees and cover computer screens or other digital devices that can disturb your sleep. Go to bed as soon as you can when you get home and choose relaxing activities to help you get to sleep.
Set a reasonable goal and get consistent with it. Figure out how much more sleep you can get if you go to bed 30 to 60 minutes earlier. Commit to your goal for at least five days a week, re-evaluate each month and see if you can make further improvements. If you end up off the track, don’t give up, life happens. Get back on track when you can and leave any guilt behind.
Some foods can make it challenging to get the necessary sleep you need. Foods to avoid four hours before bed include:
- Chocolate
- Alcohol
- High-Fat Foods like ice cream, fried chicken
- Dried Fruit
- Spicy Foods like hot peppers
- High Sugar Cereals
- Pizza
- Raw Onions
- Caffeine
- Ketchup
If at all possible, you should avoid eating between midnight and six am. However, going to bed hungry doesn’t help matters at all. If you do need to eat before going to bed, be careful what you eat.
Additional Healthy Snacks: Whole-grain cereal with milk and fruit, smoothie, or a piece of whole-grain toast with a little peanut butter. Cottage cheese contains casein protein to slow digestion and tryptophan to promote sleep.
Sip Tea: Rooibos tea is naturally decaffeinated and contains a powerful flavonoid called Aspalathin. This compound can reduce the stress hormones that trigger fat storage and hunger.
A surprising and less well-known treatment for insomnia is Montmorency tart cherry juice. Drinking 100% tart cherry juice one hour before bed can improve your sleep quality and increase the time you sleep by 84 minutes! It enhances sleep, fights inflammation in the body, lowers total cholesterol and harmful LDL levels, and reduces muscle soreness.
Dietary Considerations for Night Shift Workers
There isn’t a specific diet that works specifically for night shift workers to aid weight loss. Instead, focus on healthy ways to eat that combat the detrimental effects of the night shift.
Breakfast: No matter what time you get up, your first meal of the day is the best way to kick-start your metabolism.
- Whole grains cereal
- Oatmeal
- Fresh fruit
- Low-fat dairy products
- Scrambled egg whites
- Turkey bacon
- Black coffee
Lunch: This should be your main meal where you consume the most calories. You need to give your body a steady flow of energy that will keep you going throughout your shift.
- Grilled chicken
- Veal
- Tuna
- Vegetables
- Potatoes
- Whole-wheat pasta or bread
Dinner: A meal that is easy to digest, not frozen, and not junk food from the vending machine is a wise decision. Avoid fried or spicy foods, red meat, and rich desserts. Drink water instead of soda or coffee.
- Poultry
- Fish
- Vegetables
- Soups
- Salads
- Sandwiches
Snacks: Keep snacks to a minimum by waiting until you are truly hungry. Sometimes being dehydrated can fool you, so start with water.
- Nuts
- Popcorn
- Baked crackers
- Cereal
- Vegetables
Working nights or 12-hour shifts limit your options and leave you vulnerable to fast-food restaurants or whatever you can find in the cafeteria. These are not nutrient-rich foods, so you need to pack your lunch and snacks. Choose foods that sustain energy, are low in fat, and high in fiber and lean protein. Some great food ideas include:
- Lean Protein and L-tryptophan: turkey, chicken, cheese, fish, yogurt, and eggs
- Complex Carbs & Fiber: grains, potatoes, beans, oatmeal, and whole-grain cereal and bread.
- Good Fats: fish, nuts, flax and chia seeds, canola oil, and flaxseed oil, especially salmon
Take the time to make an eating schedule and create meal plans. Invest in your health by scouring the internet for food ideas that you like and fit into your budget.
The Importance of Hydration
Experts recommend eight 8-ounce glasses of water throughout the day, which equals half a gallon. The amount you need can vary depending on where you live, the season, and how active you are. If you are on your feet all night, you’ll need more than someone sitting at a desk. Drinking water before meals can help you manage your appetite and maintain a healthy weight. Adequate hydration can also increase mental alertness and reduce fatigue.
Meal Replacement Strategies for Weight Loss
Weight reduction in obese patients lowers the risk for cardiovascular disease, diabetes, certain cancers, and mortality. Achieving a negative energy balance by providing low-calorie meal replacements is widely used for weight management. In comparison to standard energy-deficit diets that simply prescribe a reduction in energy intake, evidence shows that meal replacement diets result in greater weight loss, and better compliance is more likely to provide an appropriate intake of essential nutrients, and have higher satisfaction and lower drop-out rates.
A study was conducted in a parallel, randomized controlled design for a period of 8 weeks. A total of 44 shift workers with body mass index over 25 kg/m2 were recruited after assessing eligibility. Participants were randomly assigned to the test and control groups on a 1:1 ratio. The intervention group (N = 22) was provided with a low-calorie (~200 kcal) meal replacement shake as dinner, and the control group (N = 22) continued their habitual diets. The primary outcome was the proportion of participants that had a 5% body weight loss from baseline.
The test group was provided with a 200-kcal meal replacement shake consisting of 20.0 g of protein, 4.5 g of fat, 18.2 g of carbohydrate, and 3.6 g of fiber with other vitamins and minerals. Participants were instructed to prepare the liquid shake by mixing 53 g of powdered meal replacement with 400 mL of water. They were asked to consume one serving of the meal replacement shake to replace dinner for 5 days of the week for a period of 8 weeks. Participants were instructed not to consume any additional food between dinner in the evening, and breakfast the following morning. The control group was asked to continue their usual dinner meals during the study period. In addition, both the groups were given general dietary and lifestyle advice through the distribution of leaflets which includes basic dietary advice according to Sri Lankan food-based dietary guidelines.