Can shift workers improve their health with time-restricted eating?

(Manoogian et al., 2022)

Shift work, which refers to jobs that require working outside of standard daytime hours, has been linked to an increased risk of obesity, diabetes, and cardiovascular disease. These adverse health effects may be due to disruptions in sleep-wake cycles, light-dark patterns, and eating habits caused by shift work.

Shift work can negatively impact health, so finding feasible strategies to improve the health of shift workers is necessary. One potential strategy is to modify diet and lifestyle, with time-restricted eating (TRE) being an easy intervention that may improve cardiometabolic health. TRE is a form of intermittent fasting that involves altering the timing of food intake and has shown the potential to offer cardiometabolic benefits and offset disruptions in the body’s circadian rhythms. However, most research on TRE has focused on individuals with regular work schedules rather than shift workers.

In this study, 137 shift workers followed either a time-restricted eating (TRE) regimen or a control regimen without TRE for 12 weeks. Both groups were advised to follow a Mediterranean diet, and the TRE group was allowed to self-select their 10-hour eating window. The primary outcomes of the study were the feasibility and adherence to TRE, as well as glucose regulation. Secondary outcomes included body weight, body mass index, body fat percentage, quality of life, sleep, and cardiometabolic disease risk factors. All outcomes were assessed at the beginning and end of the 12 weeks.

The time-restricted eating (TRE) group decreased their average daily feeding window by about 3 hours and adhered to their 10-hour eating window and opted to consume their food from around 9 a.m. to 7 p.m., despite working 24-hour shifts five days per week during the study. Fasting blood glucose, HbA1c, and insulin sensitivity improved in the TRE group for participants with elevated fasting blood glucose or HbA1c levels, but insulin levels did not change in either group. Body weight and BMI decreased in the TRE group, but body fat percentage did not change in either group. No significant changes were observed in cholesterol, triglycerides, or blood pressure in either group, but very low-density lipoprotein particle size decreased in the TRE group, and CRP levels decreased in the TRE and control group for participants with elevated CRP levels. 

The TRE group reported improved overall health and decreased sleep disturbances, but there were no changes in sleep duration, sleep quality, or daytime sleepiness in either group. This is the first TRE study to focus specifically on shift workers, who make up about 16% of the population and who are at an elevated risk for cardiometabolic diseases. TRE and eating during the day instead of night time may be a potential strategy to reduce adverse health effects of shift work. 

Reference:

Manoogian ENC, Zadourian A, Lo HC, Gutierrez NR, Shoghi A, Rosander A, Pazargadi A, Ormiston CK, Wang X, Sui J, Hou Z, Fleischer JG, Golshan S, Taub PR, Panda S. Feasibility of time-restricted eating and impacts on cardiometabolic health in 24-h shift workers: The Healthy Heroes randomized control trial. Cell Metab. 2022 Oct 4;34(10):1442-1456.e7. doi: 10.1016/j.cmet.2022.08.018. PMID: 36198291; PMCID: PMC9536325.