Working ‘Against the Clock’ - Nutrition for Shift Workers

New blog Working 'against the clock' - nutrition for shift workers (2)

Jimmy Lee - Research Dietitian, 03 August 2023

There is no doubt that shift workers play a vital role in our society. Shift work is defined as a work schedule that falls outside of the standard working hours of 7am and 6pm (1). In Australia, an estimated 16% of the population are shift workers across multiple industries, such as health, transportation and retail (2). What does working outside of regular and fixed daylight hours mean to our body?

Part of our body clock, also known as ‘circadian rhythm’, is designed to be awake during day time and asleep during the night. However, for those who work irregular shifts, especially night workers, the disruption of this natural wake-sleep cycle can affect the body and leave the individual feeling tired, moody or having trouble falling asleep. Research has also shown that shift workers have a higher risk of chronic diseases, such as diabetes and cardiovascular disease (3-4), than those who work regular daytime hours.

An Australian systematic review published this year found that the average daily dietary energy intake of rotating shift workers was higher than regular daytime workers. They also demonstrated more irregular dietary patterns and consumed more discretionary foods than regular daytime workers (5).

From a diet perspective, shift workers may be more likely to:

  • Consume meals in irregular patterns, particularly before bedtime
  • Opt for takeaway meals, convenient meals or fast food
  • Snack on sugary snacks or drinks during (or after) the shift

This could be due to multiple factors, such as:

  • The limited availability of food choices at their workplace outside of regular hours
  • Lack of food storage to store homemade foods safely
  • Consuming discretionary foods to improve productivity, increase motivation and/or during shift
  • Irregular break times, busy at work due to lack of staff, having to handle emergency situations

So what can we do from a diet (and low FODMAP!) perspective?

Nutritional considerations (7) Food options with a low FODMAP serving size
Low GI foods - Glycaemic Index (GI) is a number that indicates how quickly a carbohydrate-containing food is digested and converted into energy for the body. Foods with a low GI are digested slowly and release energy gradually into our body, therefore providing long lasting energy and also leaves us feeling fuller for longer. Combining carbohydrate foods with protein can also lower the overall GI of your meal. Please refer to the link at the bottom of this table for a number of low GI foods with a low FODMAP serving size.

We have also included an * next to low GI fruits and vegetables in the table below.
Protein - Protein is an essential nutrient to ensure well growth and repair of our muscles, cells, bones and tissues, which all play an important role in keeping our body function at its best. Protein-rich foods also tend to keep us feeling fuller for longer. -Plain cooked meat, seafood (e.g. using canned tuna in oil/brine as a sandwich filling)
-Eggs
-Firm tofu
-Using peanut or almond butter as a sandwich spread
-Canned lentils (great for adding into soups, curries, casserole etc.)
-Peanuts, macadamia, walnuts 
-Soy protein milk, lactose-free milk, unsweetened almond milk
Whole grains - whole grain foods are packed with nutrients, such as carbohydrates for energy, iron, protein, dietary fibre and minerals.


https://www.monashfodmap.com/blog/grains-low-fodmap-diet/
Multigrain gluten free bread, brown rice, spelt sourdough bread, rolled oats, quinoa
Fruits and vegetables - Don’t forget to enjoy a range of fruit and vegetables as part of a balanced diet, as they are a great source of vitamins, minerals that are needed for all parts of the body. And of course they are also full of dietary fibre, great for keeping our gut moving at its best! Fruits:
-Kiwi fruit*
-Blueberries*
-Orange*
-Mandarin*
-Pineapple
-Papaya
-Firm banana*

Vegetables: 
-Cucumber*
-Carrot*
-Green capsicum*
-Lettuce*
-Spinach*
-Choy sum*
-Bok choy*

Low GI low FODMAP carbohydrates: https://www.instagram.com/p/CtKWb_fLkIP/?img_index=1

Remember to use the Monash FODMAP App for a comprehensive database of low FODMAP foods and their low FODMAP serving sizes.

Having a structured eating pattern (three meals per day and two to three snacks in between), regardless of your shift time, can also help with maintaining energy levels and achieving a balanced diet.

Other helpful dietary strategies include:

  • Having a small meal or protein-rich snack before bedtime to prevent waking up in the middle of the night from hunger
  • Refrain from having caffeinated drinks 6 hours before bedtime
  • If you do not have a fridge at work, consider using a thermos for warm foods, or an ice pack or freezer bag for cold foods, to keep your low FODMAP meal or snack safe for consumption during your shift
  • Remember to stay hydrated and choose water as your first choice of fluid

Below are some low FODMAP recipes that are easy to prepare for shift workers:

Nutritional requirements differ between individuals. Be sure to speak to a Registered Dietitian to discuss how your diet can be best personalised for your physical requirements and nutritional needs.

References:

  1. Redeker NS, Caruso CC, Hashmi SD, Mullington JM, Grandner M, Morgenthaler TI. Workplace Interventions to Promote Sleep Health and an Alert, Healthy Workforce. Journal of Clinical Sleep Medicine [Internet]. 2019 Apr 15;15(04):649–57. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6457507/
  2. Reynolds AC, Ferguson SA, Appleton SL, Crowther ME, Melaku YA, Gill TK, et al. Prevalence of Probable Shift Work Disorder in Non-Standard Work Schedules and Associations with Sleep, Health and Safety Outcomes: A Cross-Sectional Analysis. Nature and Science of Sleep. 2021 May;Volume 13:683–93.
  3. Torquati L, Mielke GI, Brown WJ, Kolbe-Alexander T. Shift work and the risk of cardiovascular disease. A systematic review and meta-analysis including dose–response relationship. Scandinavian Journal of Work, Environment & Health [Internet]. 2017 Dec 16 [cited 2020 Mar 23];44(3):229–38.
  4. Gan Y, Yang C, Tong X, Sun H, Cong Y, Yin X, et al. Shift work and diabetes mellitus: a meta-analysis of observational studies. Occupational and Environmental Medicine. 2014 Jul 16;72(1):72–8.
  5. Clark AB, Coates AM, Davidson ZE, Bonham MP. Dietary Patterns under the influence of Rotational Shift Work Schedules: A Systematic Review and Meta-Analysis. Advances in Nutrition. 2023 Feb;
  6. McIntosh E, Ferguson SA, Dorrian J, Coates AM, Leung G, Gupta CC. “Mars Bar and a Tin of Red Bull Kept Me and My Patients Alive”: Exploring Barriers to Healthy Eating through Facebook Comments of Shiftworkers. Nutrients [Internet]. 2023 Jan 1;15(4):959.
  7. Workplace Health and Safety Queensland. Shifting nutrition - a shift workers guide to nutrition. Queensland: Workplace Health and Safety Queensland; 2018. 16p. Report No. 1
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