Table 4. Summary of research on the fourth theme of this review, ‘Why shiftworkers choose to 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 |
|---|---|---|---|---|---|---|
| 4.1 Time available | ||||||
| Bonnell, Huggins, 201746) | Australia, 42 males and females | Mixed method, cross-sectional | Rotating | Firefighting | Focus groups and 24 h dietary recalls | Shift schedule was a main influence on dietary intake. |
| 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 | Drivers ate their main meals on the road and food choice was influenced by factors such as convenience, cost and time. |
| Persson and Mårtensson, 2006119) | Sweden, 27 males and females | Qualitative, cross-sectional | Fixed nightshift | Healthcare | Interviews analysed with the critical incident technique | Leisure-related factors (eg don’t have the time to prepare healthy food) influence the choice to eat on shift. |
| Waterhouse, Buckley, 200375) | United Kingdom, 93 males and females | Quantitative, cross-sectional | Fixed nightshift and non-shiftworkers | Healthcare | Food intake questionnaire | On work days the reasons for eating were schedule, with a decrease in citing social and hunger as reasons. The reason determining the type of food eaten was time available significantly more on workdays. When eating during the nightshift, hunger motivated workers less and habit motivated them more. |
| 4.2 Eating with colleagues | ||||||
| Anstey, Tweedie, 201642) | Australia, 15 males and females | Qualitative, cross-sectional | Rotating | Healthcare (paramedics) | Interviews | Psychosocial factors influenced food choice. |
| Bonnell, Huggins, 201746) | Australia, 42 males and females | Mixed method, cross-sectional | Rotating | Firefighting | Focus groups and 24 h dietary recalls | The attitudes and decisions of co-workers influenced dietary intake. |
| Kniffin, Wansink, 201569) | USA, specific sample size and participant sex not provided | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Firefighting | Semi-structured group interviews | Participants reported a strong tradition of eating and cooking together. A significant correlation was found between work-group performances and eating. |
| Persson and Mårtensson, 2006119) | Sweden, 27 males and females | Qualitative, cross-sectional | Fixed nightshift | Healthcare | Interviews analysed with the critical incident technique | Work related factors (eg influence of colleagues) influence the decision to eat on shift. |
| Phiri, Draper, 201461) | South Africa, 102 participants (participant sex not provided) | Qualitative, cross-sectional | Fixed nightshift, dayshift and non-shiftworkers | Healthcare | Focus group | Some nurses suggested that the food choices of colleagues influenced their food choice, both positively and negatively. |
| Strickland, Eyler, 201566) | USA, 102 males and females | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare and retail | Focus group | Nearly all participants reported that their healthy eating would improve with social support and accountability to colleagues. |
| Torquati, Kolbe-Alexander, 201664) | Australia, 17 males and females | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Focus groups | Stress eating was commonly reported by nurses and related to emotional eating and craving high-fat, high-sugar foods. Nurses could limit the intake of unhealthy snacks during the nightshift if there was a group commitment to this goal. Snacks were eaten continuously during the nightshift to help nurses stay awake. |
| Wandel and Roos, 2005120) | Norway, 46 males | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Carpenter, engineering and transport | Interviews | Eating on shift was considered a social occasion to meet colleagues, get to know each other and have work-related discussions. Drivers also had cafeterias that were frequently visited and would meet up with colleagues there. |
| 4.3 Health | ||||||
| Anstey, Tweedie, 201642) | Australia, 15 males and females | Qualitative, cross-sectional | Rotating | Healthcare (paramedics) | Interviews | Paramedics reported concern that not eating for an extended period on shift could be potentially unsafe and detrimental to their health. |
| Bonnell, Huggins, 201746) | Australia, 42 males and females | Mixed method, cross-sectional | Rotating | Firefighting | Focus groups and 24 h dietary recalls | Knowledge of the relationship between food and health impacted dietary intake. |
| Naweed, Chapman, 201770) | Australia, 29 males and females | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Train drivers | Focus group | Participants reported experiencing negative and judgemental reactions from fellow drivers when they discussed healthier eating habits. |
| Nyberg and Lennernäs Wiklund, 201760) | Denmark and Sweden, 20 males and females | Qualitative, cross-sectional | Short- and long-haul flights | Aviation (flight attendants) | Interviews | Flight attendants reported eating less during a flight in order to stay fit. |
| Phiri, Draper, 201461) | South Africa, 102 participants (participant sex not provided) | Qualitative, cross-sectional | Fixed nightshift, dayshift and non-shiftworkers | Healthcare | Focus group | Nightshift workers reported a balanced diet as a main aspect of staying healthy, including eating breakfast in the morning. |
| 4.4 Alertness | ||||||
| Baba, Darina Indah Daruis, 2011121) | Malaysia, 117 males | Quantitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Aviation | Questionnaire | Before and during a flight, nutritious food is considered a strategy used to overcome fatigue. |
| Gifkins, Johnston, 201873) | 21 females | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Interviews | Healthy eating was a self-care activity reported by participants to prepare for a shift. |
| Haus, Reinberg, 201689) | France | 7 males (5 rotating shiftworkers, 2 non-shiftworkers) | Oil refinery | Food diary | Work during the nightshift was considered so boring that snacks such as biscuits, candy bars, seeds, sweets and sandwiches were consumed to stay awake. | |
| Kräuchi, Nussbaum, 199051) | Switzerland, 28 males and females | Quantitative, cross-sectional | Nightshift | Healthcare | Daily food and drink frequency questionnaire | An increase of sweet foods on shift was associated with less self-reported fatigue. |
| Nea, Pourshahidi, 201774) | Ireland, 109 males and females | Qualitative, cross-sectional | Rotating, fixed day shift, fixed nightshift | Accommodation and food services, health and social care sector, manufacturing/industry sector | Focus groups | Tiredness was reported as a barrier to healthy eating, as it lead to a lack of motivation and will-power. |
| Novak and Auvil-Novak, 199641) | USA, 45 females | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Focus group | Nurses reported refraining from eating during the 12 h work period to reduce drowsiness. |
| Zadeh, Shepley, 2017122) | USA, 136 males and females | Mixed-methods cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Questionnaire including questions on identifying aids to improve alertness and reduce sleepiness on shift | Dietary strategies were reported as the greatest behavioural tactic used to maintain alertness and reduce sleepiness. |
| 4.5 Gastric upset | ||||||
| Novak and Auvil-Novak, 199641) | USA, 45 females | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Focus group | Many nurses reported putting on wright after eating meals and snacks during nightshifts. |
| Nyberg and Lennernäs Wiklund, 201760) | Denmark and Sweden, 20 males and females | Qualitative, cross-sectional | Short- and long-haul flights | Aviation (flight attendants) | Interviews | Some flight attendants described eating during the nightshift as leading to stomach aches. |
| Persson and Mårtensson, 2006119) | Sweden, 27 males and females | Qualitative, cross-sectional | Fixed nightshift | Healthcare | Interviews analysed with the critical incident technique | Nurses reported maintaining a healthy diet to aid digestion. |
| 4.6 Stress eating | ||||||
| Almajwal, 2016123) | Central Saudi Arabia, 365 females | Quantitative, cross-sectional | Fixed shift and non-shiftworkers | Healthcare | Questionnaire | Nurses with high stress had more eating problems. Those working nightshifts were more likely to experience restrained eating (which, under stress, is associated with eating more than usual and binge eating) . |
| Han, Choi-Kwon, 201650) | Korea, 240 females | Quantitative, cross-sectional | Rotating and fixed | Healthcare | Questionnaire | Nurses with greater food intake than normal while under stress were more frequently found among those with rotating shifts compared to fixed shift nurses. Only 11% of nurses reported no overeating. |
| Jordan, Khubchandani, 2016124) | USA, 120 males and females | Quantitative, cross-sectional | Fixed day and nightshift | Healthcare | Questionnaire | 70% of nurses reported a greater consumption of junk food and 63% reported consuming more food than normal as a way of coping with work-place stress. |
| Monaghan, Dinour, 201865) | USA, 20 females | Qualitative, cross-sectional | Rotating, fixed day shift, fixed nightshift | Healthcare | Interviews | Unhealthy foods, such as cookies and brownies, were often eaten during stressful shifts. |
| 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 appetite and satisfaction of workers was lower after eating during the nightshift than after morning or afternoon shifts. |
| Silva, Lopes, 2017126) | Brazil, 34 males | Quantitative, cross-sectional | Fixed nightshift | Security | 6-d food diary and a questionnaire evaluating perceptions related to meals | After a nightshift, participants enjoyed eating breakfast, lunch and dinner less than after a night of sleep. |
| Wong, Wong, 2010125) | Hong Kong, 378 males and females | Quantitative, cross-sectional | Fixed shifts and non-shiftwork | Healthcare | Questionnaire | The majority of nurses had abnormal eating scores. Shift duties at least 4 times per month were associated with abnormal emotional eating behaviour. |
| 4.7 Shiftwork experience | ||||||
| Gifkins, Johnston, 201873) | 21 females | Qualitative, cross-sectional | Shiftwork (specific shift type(s) not provided) | Healthcare | Interviews | The more experienced workers ensured the less experienced nurses took breaks and had time to eat. |
| Morikawa, Miura, 2008100) | Japan, 2,254 males | Quantitative, cross-sectional | Rotating | Factory workers | Questionnaire | 20–29 year olds, intakes of meat and vegetables were the lowest in shiftworkers with midnight shifts and among 40–49 year olds, intake of meat, fat and oil were lowest in shiftworkers with midnight shifts. |
| Mota, De-Souza, 201386) | Brazil, 72 males and females | Quantitative, longitudinal | Shiftwork (specific shift type(s) not provided) | Healthcare | Dietary recall | 80.5% of residents reported negative changes in eating habits after beginning their residency. |
The table is organised by factor.
Studies may appear multiple times in the table as the findings address more than one factor.