The Negative Impact of Night Shifts on Diet in Emergency Healthcare Workers

Abstract

Despite the consequences of night-shift work, the diet of night-shift workers has not been widely studied. To date, there are no studies related to food intake among emergency healthcare workers (HCWs). We performed a prospective observational study to assess the influence of night work on the diet of emergency HCWs. We monitored 24-h food intake during a day shift and the consecutive night, and during night work and the daytime beforehand. We analyzed 184 emergency HCWs' food intakes. Emergency HCWs had 14.7% lower (-206 kcal) of their 24-h energy intake during night shifts compared to their day-shift colleagues (1606.7 ± 748.2 vs. 1400.4 ± 708.3 kcal, p = 0.049) and a 16.7% decrease in water consumption (1451.4 ± 496.8 vs. 1208.3 ± 513.9 mL/day, p = 0.010). Compared to day shifts, night-shift had 8.7% lower carbohydrates, 17.6% proteins, and 18.7% lipids. During the night shift the proportion of emergency HCWs who did not drink for 4 h, 8 h and 12 h increased by 20.5%, 17.5%, and 9.1%, respectively. For those who did not eat for 4 h, 8 h and 12 h increased by 46.8%, 27.7%, and 17.7%, respectively. A night shift has a huge negative impact on both the amount and quality of nutrients consumed by emergency healthcare workers.

Keywords: nutrients; prevention; public health; quality of life; well-being; work.

Figure A1

Univariate analysis that found a strong tendency on the impact of night shift on energy intake, water consumption, carbohydrate, lipid, protids, simple fatty acid, monounsaturated fatty acid, polyunsaturated fatty acid and cholesterol. Coefficient up to 0 induces a positive impact of the variable (right side of the reference line). Negative coefficient induces a negative impact of the variable (left side of the reference line); 95% CI: 95% confidence interval. Other significant results are described in the results part.

Figure 1

Study design. Among five French emergency departments we were able to recruit 192 emergency health care workers. Eight were excluded because of pregnancy or no data completion. Food intake was studied for 99 emergency health care workers during a day shift and 83 during a night shift.

Figure 2

Food intake variations between night and day shifts. Differences in total energy intake, carbohydrates, lipids, protein, calcium, cholesterol, fiber, and water consumptions between day and night shifts among 184 questionnaires. Differences expressed in percentage with day shift as reference. Results: a night shift induces a decrease of all components related to daily ingesta except on sugar. SE standard error; p-value with * are significant (if <0.05).

Figure 3

Risk of no-intakes for emergency health care workers during shifts. Percentage of participants declaring not drinking/not eating, over 4-, 8-, or 12-h during night- and day-shifts. A total of 136 questionnaires were analyzed. Odds ratio (OR) was used to access the impact of nightshifts using day-shifts as reference. 95% CI = 95% confidence intervals; *** represent p-value which are all <0.018 (significant if <0.05).

Figure 4

Univariate analysis that found a strong tendency on the impact of night shifts on energy intake, water consumption. Coefficient up to 0 induce a positive impact of the variable (right side of the reference line). Negative coefficient induce a negative impact of the variable (left side of the reference line); 95% CI: 95% confidence interval.