Shift work has changed the daily work patterns that do not follow the conventional 8-hour daytime work period.1 When compared to standard work hours, individuals working shifts have reported to be at a higher risk of a wide range of conditions such as obesity, type 2 diabetes, cardiovascular disease, digestive problems, sleep disorders, depression, cancer, infections and vitamin D deficiency.2-4 Furthermore, night shift work is estimated to increase coronary heart disease risk by 40%.4

Night shift requires us to be alert and ready to make precise tactical decisions hastily, often in split seconds in life or death situations. This night-shift reality in aviation, military, healthcare, security, safety, emergency response services and other industries cannot be understated.

So, what are the causes of these negative health effects?
Circadian rhythm – a 24-hour biological clock, controls the body’s sleep/awake cycles and automates the key functions related to digestion, cell growth and repair, and keeps the immune system strong. If circadian rhythm is disrupted, body does not optimize these functions. A recent study shows that prolonged sleep restriction and circadian disruption alters metabolism, decreases resting metabolic rate and increases blood glucose levels.6 Additionally, psychosocial stress and physical inactivity may also contribute to a disrupted metabolism.3 In a nutshell, eating at night, even if it’s the same food we would normally eat during the day, will not be metabolized efficiently leading to a short-term energy deficit and long-term negative impact on your body.

So, what can be done to maximize productivity, efficiency and precision without compromising health?
The negative effects of night shift-work can be mitigated by controlling nighttime nutrition. If done right, it can help cope with blood sugar, cholesterol, hormones, and digestion and immune system irregularities. Therefore, when we eat and don’t eat is a key factor that can control our body’s adaptation to changes in circadian rhythm.

So, When to Eat and what to Eat?
Dietary recommendations are difficult for shift workers but all organizations and/or individuals can follow the broad guiding principles for healthy eating and fatigue management.
¨ Groups/Squadrons should develop a nutrition strategy to ensure healthy choices are offered/available in a relaxed eating environment.
¨ Design shift schedules to ensure adequate and a regular meal-time is provided. Schedulers should also ensure that Airmen have adequate time between shifts to maintain a healthy lifestyle (physical fitness, sleep).
¨ Individuals should stick as closely as possible to a normal day-and-night pattern of food intake, i.e. avoid eating large meals between midnight and 6 am and eat their main meal before the shift starts.
Breakfast when you go home7
Lunch when you wake7
Dinner before the shift starts7
Light snacks during the night shift7
¨ Drink fluids (Water), regularly to help prevent dehydration and reduce fatigue and improve mental alertness
¨ Caffeine in small doses can help mental alertness. But, be cautious, consuming large doses can have side effects and can also interfere with the sleep cycles.7
Start with two 8 ounce cups of coffee (200 mg) at least 30 – 60 minutes before shift start. Repeat every 3-4 hours as needed.
Don’t consume over 600 mg per day (unless sustaining operations, where you can have up to 800 mg)
Stop 4-6 hours before you plan to sleep
Avoid popular energy drinks (caffeine and sugar is unregulated)
¨ Don’t snack on junk food or eat heavy meals at night.
¨ Avoid alcohol as a means of getting to sleep
The reality of shift work in 24/7 high ops tempo world cannot be changed. The organizations at the Wing/Group and Squadron levels should at a minimum ensure that individuals are provided with adequate time to maintain healthy lifestyles and are provided with appropriate education and resources to eat nourishing food. At the flight and individual level, members should choose, plan and manage their daily routines and actively get involved in leading a healthy lifestyle. After all, doing the night shift right can help optimize performance, improve productivity, enhance safety, minimize health risks and cut costs.

References:

1. Eberly R. & Feldman H (2010). Obesity and shift work in the general population. Internet Journal Allied Health Sciences and Practices 8 (3).
2. Antunes LC, et al. (2010). Obesity and shift work: chronobiological aspects. Nutrition Research Review 23:155-168
3. Lowden A. et Al. (2010). Eating and shift work – effects on habits, metabolism and performance. Scandinavian Journal Work, Environment & Health 36(2): 150-162
4. Thomas C & Power C (2010). Shift work and risk factors for cardiovascular disease: a study at age 45 years in the 1958 British birth cohort. European Journal Epidemiology 35(5):305-314
5. Atkinson G, et al. (2008). Exercise, energy balance and the shift worker. Sports Medicine 38(8): 671-685
6. Buxton Om, et al. (2012). Adverse metabolic consequences in humans of prolonged sleep restriction combined with circadian disruption. Science Translational Medicine 4(129):129ra43
7. Bravo, R., Ugartemendia, L., Uguz, C., Rodríguez, A., & Cubero, J. (2017). Current Opinions in Chrononutrition and Health. Journal of Clinical Nutrition & Dietetics, 03(01), 1–3. doi:10.4172/2472-1921.100040