Work based policies must be designed to target barriers that night shift workers face when managing weight and metabolic health conditions, according to a study by researchers at Monash University, Melbourne, Australia.
The University-led review has found night-shift workers make up some 13%–27% of the workforce, however there are no systems in place to assist night shift workers to make healthier lifestyle choices, despite having an increased risk of weight gain, and a higher risk of weight-related conditions such as type 2 diabetes and cardiovascular disease.
Their mixed-methods systematic review which was led by the Department of Nutrition, Dietetics and Food at Monash, investigated the barriers that night shift workers face in enabling them to make healthier lifestyle choices.
Such barriers identified in eight studies in Australia, Sweden, Nigeria, the US and Botswana include:
Personal - time constraints, fatigue, stress
Social - work routines and cultural norms
Organisational - work-related fatigue, lack of routine, limited healthy food options at night, lack of meal breaks
Community - limited healthy food options surrounding work at night
"The fatigue and disruption to routine that often accompanies working at night is challenging for night shift workers and we need to make it easier for them to choose healthier food options,” commented the study’s first author, Corinne Davis, a PhD candidate from the Department of Nutrition, Dietetics and Food at Monash University.
The review also analysed the data from 12 intervention studies in in Europe, Australia, US and Canada. It found the studies targeting weight management behaviours for night shift workers demonstrated limited weight loss results, with only one intervention reporting a clinically significant weight loss result. The existing interventions had largely focused on addressing only a limited number of barriers faced by night shift workers.
"Night shift workers are critical to our 24-hour society, yet interventions to improve their health fail to acknowledge the physiological and behavioural challenges of their work schedule,” added the study’s senior author, Professor Maxine Bonham, from Monash University's Faculty of Medicine, Nursing and Health Sciences
The authors called for more research that takes into consideration the complexities of shift work and consideration of weight loss approaches that account for timing and quality of food intake as well as exploring the impact of sleep quality for night shift workers on weight management. Future interventions should also focus on eliminating the key barriers faced by night shift workers such as facilitating the availability of healthier food options within the workplace at night.
“Although night shift workers are at an increased risk of weight gain and have a high prevalence of overweight and obesity, there are currently no reported interventions to effectively manage weight loss. It is critical that interventions for night shift workers are designed to target the known enablers and barriers identified by night shift workers,” the study concluded. “The evidence base needs robust, high-quality studies of a range of interventions across the levels of intrapersonal, interpersonal, organisational, and community, to address the risk of weight gain and related metabolic consequence caused by working at night.”
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