Table 2. Summary of research on the second theme of the review, ‘What shiftworkers eat during the nightshift’, including the authors, participants, food related measure, key findings and the factor within this theme to which this article relates.
| Author(s), year | Country & Participant information | Study design | Shift-type | Industry | Eating behaviour methodology | Findings |
|---|---|---|---|---|---|---|
| 2.1 Meal Size | ||||||
| Bonnell, Huggins, 201746) | Australia, 42 males and females | Mixed method, cross-sectional | Rotating | Firefighting | Focus groups and 24 h dietary recalls | On nightshifts a greater proportion of snacks were consumed (chocolates, ice-cream, sweet pastries). |
| De Freitas, Canuto, 201547) | Brazil, 1,206 males and females | Quantitative, cross-sectional | Fixed day and nightshifts | Poultry slaughterhouse | Diet questionnaire | Nightshift workers report greater incidence of snacking during the afternoon and less breakfast and morning snack consumption. |
| Gander, Gregory, 199891) | USA, 74 males | Observational, longitudenal | Shiftwork (short-haul flights) | Aviation | Observational monitoring | More snacks were eaten on shift than pre-shift or post-shift. The provision of crew meals did not affect the number of meals or snacks eaten on shift. |
| Gander, Gregory, 199892) | USA, 34 males and females | Observational, longitudinal | Shiftwork (8-d trip patterns) | Aviation | Observational monitoring | More snacks reported on duty days than pre-shift, post-shift or days off. |
| Gifkins, Johnston, 201873) | 21 females | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Interviews | Nurses reported more snacking behaviour during shiftwork, particularly nightshifts. Most of the participants believed their diets had changed since starting shiftwork, with some reporting less healthy diets since starting shiftwork. |
| Han, Choi-Kwon, 201650) | Korea, 240 females | Quantitative, cross-sectional | Rotating and fixed | Healthcare | Questionnaire | Rotating nurses with night shifts snacked the most frequently, whereas rotating nurses without nightshifts snacked mostly in the afternoon. |
| Haus, Reinberg, 201689) | France, 7 males | Quantitative, longitudinal | Rotating and non-shiftwork | Oil refinery | 56-d food diary | Nibbling behaviour occurred during the nightshift, and included sweet foods and carbohydrate consumption. |
| Holmes, Power, 199693) | USA, 63 males and females | Quantitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Transport | Questionnaire on health and nutrition habits | On weekdays, most drivers ate a dinner meal while on the road, and snacks were also frequently eaten. |
| Lennernäs, Åkerstedt, 199484) | Sweden, 22 males | Quantitative, longitudinal | Rotating | Industrial factory workers | 24 h dietary recall | Across morning, afternoon and night shifts, total 24 h energy intake did not differ. On the nightshift 30–40% of 24 h energy intake was consumed, compared to 40–50% of intake consumed on morning and afternoon shifts. |
| Novak and Auvil-Novak,1996 41) | USA, 45 females | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Focus group | Working the nightshift made it harder to eat nutritionally balanced meals and meal splitting was utilised to maintain a balanced diet. Some nurses refrained from eating while on shift. |
| Reeves, Newling-Ward, 200454) | UK, 36 males and females | Quantitative, longitudinal | Nightshift and day-shift | Healthcare | 6-d food diary | On work days, male shiftworkers ate the greatest amount of kilojoules at 4 pm, compared to 1 pm on rest-days. Female food intake peaked at 7 pm on both work and rest days and when working the nightshift they were more likely to eat during the night and less during the day. |
| Sahu and Dey, 201194) | India, 75 participants (sex of participants not provided) | Quantitative, cross-sectional | Rotating | Healthcare | Questionnaire on shiftwork, digestive problems, food habits, food intake, ratings of eating satisfaction and appetite, and diet surveys | The number of full meals eaten during the nightshift was less than eaten during morning and afternoon shifts, and the number of snacks was greater during the nightshift. |
| Torquati, Kolbe-Alexander, 201664) | Australia, 17 males and females | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Focus groups | Working the nightshift was considered by nurses to be one of the major barriers for following a healthy diet. Irregular meal patterns resulted from nightshifts. |
| 2.2 Type of food | ||||||
| Balieiro, Rossato, 201495) | Brazil, 150 males | Quantitative, cross-sectional | Fixed nightshift and dayshift | Transport (bus drivers) | Food frequency questionnaire | Nightshifts were associated with greater vegetable, fruit, milk and dairy product and dessert intake. |
| Bonnell, Huggins, 201746) | Australia, 42 males and females | Mixed method, cross-sectional | Rotating | Firefighting | Focus groups and 24 h dietary recalls | Total energy intake did not differ between day or nightshifts. During a 24h period that included nightshift a higher % of energy was from sugar than during a 24h period with a day shift. |
| De Assis, Nahas, 200383) | Brazil, 66 participants (sex of participants not provided) | Quantitative, longitudinal | Fixed nightshift and dayshift | Garbage collectors | 24 h recall and two 24 h records of food intake | A traditional Brazilian meal was provided to workers during the nightshift, this consisted of meat, rice, beans, roots and/or pulses, vegetables and fruit). Meat was the biggest contributor to daily energy intake across different shift types. |
| Fernandes Jda, Portela, 201396) | Brazil, 2,279 males and females | Quantitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Health questionnaire | Male nurses reported greater consumption of fried foods and lower consumption of fruit and vegetables compared to the female nurses. For female nurses, longer working hours was associated with greater consumption of fried foods. |
| Fisher, Rutishauser, 198697) | Australia, 25 males | Mixed-method, longitudinal | Rotating | Oil refinery workers | Interviews during one nightshift, one afternoon shift and one day shift, and 24 h food record | On nightshifts, milk/milk products, non-alcoholic beverages and yellow and green vegetables were consumed more frequently than on other shift types. |
| Han, Choi-Kwon, 201698) | Korea, 240 females | Quantitative, cross-sectional | Rotating and fixed | Healthcare | Questionnaire | Of the sample, 76% of nurses reported having a healthy dietary intake. 30% of nurses ate high carbohydrates snacks every day. |
| Haus, Reinberg, 201689) | France, 7 males | Quantitative, longitudinal | Rotating and non-shiftwork | Oil refinery | 56-d food diary | No differences between the groups in caloric intake, protein, lipids and carbohydrates. Lower intake of fat and greater carbohydrate consumption during a nightshift compared to a day shift. |
| Heath, Coates, 201699) | Australia, 118 males and females | Quantitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Printing, postal, nursing, oil and gas industries | Food frequency questionnaire | Permanent night workers were the only group to report higher than recommended fat intake. All workers reported lower than recommended levels of carbohydrate, and protein was in the recommended levels (as a percentage of daily intake). |
| Hemiö, Puttonen, 201578) | Finland, 1,478 males and females | Quantitative, cross-sectional | Shiftwork and non-shiftwork | Aviation | Food intake questionnaire | Male and female in-flight workers used high-fat milk products more than the day workers. For males, estimated energy intake from fat and saturated fat was the highest in the shift work group and lowest in the in-flight group. For females, energy intake from saturated fat was higher among shift workers compared with day workers. In shift-working men who did not work nightshifts, sucrose intake was lower compared with men who worked at least three nights per month. |
| Holmes, Power, 199693) | USA, 63 males and females | Quantitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Transport | Questionnaire on health and nutrition habits | The drivers’ favourite meals were steak and burgers, and the preferred snacks were chips and fruit. |
| Kräuchi, Nussbaum, 199051) | Switzerland, 28 males and females | Quantitative, longitudinal | Fixed nightshift | Healthcare | Daily food and drink frequency questionnaire | Total food intake and overall sweets intake did not change across different shift types. Caffeine rich drinks and milk intake were consumed more during the nightshift. |
| Lennernäs, Hambraeus, 199585) | Sweden, 96 males | Quantitative, longitudinal | Rotating and day shift | Industrial factory workers | 24 h dietary recall | Shiftwork did not affect the 24h intake of energy and nutrients but caused a redistribution of food intake. For three-shift workers, the intake of energy, protein, total carbohydrates, sucrose, total fat, calcium and selenium were significantly lower during nightshifts compared to afternoon shifts. |
| Morikawa, Miura, 2008100) | Japan, 2,254 males | Quantitative, cross-sectional | Rotating | Factory workers | Questionnaire | No difference in macronutrients consumed among different shift types. |
| Mota, De-Souza, 201386) | Brazil, 72 males and females | Quantitative, longitudinal | Shiftwork (specific shift type(s) not provided) | Healthcare | Dietary recall | Data evaluated using the adapted healthy eating index. The average overall score of residents was 82.6, indicating the diet needs improvement. |
| Mota, Waterhouse, 201487) | Brazil, 72 males and females | Quantitative, longitudinal | Shiftwork (specific shift type(s) not provided) | Healthcare | Dietary recall | A shorter duration of sleep was associated with a greater intake of cereals, meat and cholesterol. Poorer sleep quality was associated with increased hours of additional work per week and a decrease in fruit and bean consumption. |
| Roskoden, Krüger, 201788) | Germany, 44 males and females | Quantitative, longitudinal | Rotating and non-shiftwork | Healthcare | Food diary | Total energy intake was similar between the shiftwork and non-shiftworking groups. There was a higher percentage of fat intake among the office staff compared to the shiftworking and non-shiftworking nurses. The percentage of carbohydrate intake was less in the office group compared to shiftworking nurses. |
| Sahu and Dey, 201194) | India, 75 participants (sex of participants not provided) | Quantitative, cross-sectional | Rotating | Healthcare | Questionnaire on shiftwork, digestive problems, food habits, food intake, ratings of eating satisfaction and appetite, and diet surveys | When working the nightshift, the mean energy intake of carbohydrate, protein and fat were less than other shift types. |
| Zapka, Lemon, 2009101) | USA, 194 males and females | Quantitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Food frequency questionnaire | Participants consumed less servings of fruit and vegetables per day than government guidelines and had a higher average percentage of calories from fat compared to government guidelines. Overweight participants reported fewer fruit and vegetable servings as those who perceived themselves as just right or underweight. |
The table is organised by factor.
Studies may appear multiple times in the table as the findings address more than one factor.