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Exercise, Energy Balance and the Shift Worker

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Abstract

Shift work is now common in society and is not restricted to heavy industry or emergency services, but is increasingly found amongst ‘white collar’ occupations and the growing number of service industries. Participation in shift work is associated with increased body mass index, prevalence of obesity and other health problems. We review the behavioural and biological disturbances that occur during shift work and discuss their impact on leisure-time physical activity and energy balance.

Shift work generally decreases opportunities for physical activity and participation in sports. For those shift workers who are able to exercise, subjective and biological responses can be altered if the exercise is taken at unusual times of day and/or if the shift worker is sleep deprived. These altered responses may in turn impact on the longer-term adherence to an exercise programme. The favourable effects of exercise on body mass control and sleep quality in shift workers have not been confirmed. Similarly, recent reports of relationships between sleep duration and obesity have not been examined in a shift work context. There is no evidence that exercise can mediate certain circadian rhythm characteristics (e.g. amplitude or timing) for improved tolerance to shift work.

Total energy intake and meal composition do not seem to be affected by participation in shift work. Meal frequency is generally reduced but snacking is increased on the night shift. Unavailability of preferred foods in the workplace, a lack of time, and a reduced desire to eat at night explain these findings. ‘Normal’ eating habits with the family are also disrupted. The metabolic responses to food are also altered by shift work-mediated disruptions to sleep and circadian rhythms. Whether any interactions on human metabolism exist between timing or content of food intake and physical activity during shift work is not known at present.

There are very few randomized controlled studies on the efficacy of physical activity or dietary interventions during shift work. Some favourable effects of such interventions on fatigue levels at work have been reported, but biological and behavioural outcomes relevant to long-term health and energy balance have not been studied adequately. In addition, recruitment and retention of research participants for randomized controlled trials of physical activity or dietary interventions have been very difficult. We present a model of the various behavioural and biological factors relevant to exercise and energy balance during shift work as a framework for future research.

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References

  1. Harrington JM. Health effects of shift work and extended hours of work. Occup Environ Med 2001; 58: 68–72

    Article  Google Scholar 

  2. Waterhouse J, Folkard S, Minors D. Shift work, health and safety: an overview of the scientific literature 1978-1990. HSE contract research report. London: HMSO, 1992

    Google Scholar 

  3. Geliebter A, Gluck ME, Tanowitz M, et al. Work-shift period and weight change. Nutrition 2000; 16: 27–9

    Article  PubMed  CAS  Google Scholar 

  4. Rosmond R, Lapidus L, Bjorntorp P. The influence of occupational and social factors on obesity and body fat distribution in middle-aged men. Int J Obesity 1996; 20: 599–607

    CAS  Google Scholar 

  5. Parkes KR. Shift work and age as interactive predictors of body mass index among offshore workers. Scand J Work Environ Health 2002; 28: 64–71

    Article  PubMed  Google Scholar 

  6. Lasfargues G, Vol S, Caces E, et al. Relations among night work, dietary habits, biological measures, and health status. Int J Behav Med 1996; 3: 123–34

    Article  PubMed  CAS  Google Scholar 

  7. Karlsson B, Knutsson A, Lindahl B. Is there an association between shift work and having a metabolic syndrome? Results from a population based study of 27,485 people. Occup Environ Med 2001; 58: 747–52

    Article  PubMed  CAS  Google Scholar 

  8. Di Lorenzo L, De Pergola G, Zocchetti C, et al. Effect of shift work on body mass index: results of a study performed in 319 glucose-tolerant men working in a Southern Italian industry.Int J Obesity 2003; 27: 1353–8

    Article  Google Scholar 

  9. Van Amelsvoort LGMP, Schouten EG, Kok FJ. Duration of shiftwork related to body mass index and waist to hip ratio. Int J Obesity 1999; 23: 973–8

    Article  Google Scholar 

  10. Knutsson A. Health disorders of shift workers. Occup Med 2003; 53: 103–8

    Article  Google Scholar 

  11. World Health Organization. Basic documents. 39th ed. Geneva: WHO, 1992

  12. National Institute of Health (NIH). Toward higher levels of analysis: progress and promise in research on social and cultural dimensions of health. London: National Institutes of Health Publication; Office of Behavioral and Social Sciences Research, 2000

    Google Scholar 

  13. Moore-Ede MC, Richardson GS. Medical implications of shift work. Ann Rev Med 1985; 36: 607–17

    Article  PubMed  CAS  Google Scholar 

  14. Costa G. The impact of shift and night work on health. Appl Ergon 1996; 27(1): 9–16

    Article  PubMed  CAS  Google Scholar 

  15. Segawa K, Nakazawa S, Tsukamoto Y, et al. Peptic ulcer is prevalent among shift workers. Digest Dis Sci 1987; 32:449–53

    Article  PubMed  CAS  Google Scholar 

  16. Costa G. Shift work and occupational medicine: an overview.Occup Med 2003; 53: 83–8

    Article  Google Scholar 

  17. Knutson A, Andersson H, Berglund U. Serum lipoproteins in day and shift workers: a prospective study. Br J Ind Med 1990;47: 132–4

    PubMed  CAS  Google Scholar 

  18. Romon M, Nuttens M-C, Fievet C, et al. Increased triglyceride levels in shift workers. Am J Med 1992; 93: 259–62

    Article  PubMed  CAS  Google Scholar 

  19. Ghiasvand M, Heshmat R, Golpira R, et al. Shift working and risk of lipid disorders: a cross-sectional study. Lipids Health Dis 2006; 5: 1–5

    Article  Google Scholar 

  20. Lennernas M, Lillemor A, Hambraeus L, et al. The 24 hour intake of energy and nutrients in 3 shift workers. Ecol Food Nutr 1994; 32(3/4): 157–65

    Article  Google Scholar 

  21. Lennernas M, Hambraeus L, Akerstedt T. Nutrient intake in day and shift workers. Work Stress 1994; 8: 332–42

    Article  Google Scholar 

  22. Sudo N, Ohtsuka R. Nutrient intake among female shift workers in a computer factory in Japan. Int J Food Sci Nutr 2001; 52:367–78

    Article  PubMed  CAS  Google Scholar 

  23. Takagi K. Influence of shift work on time and frequency of meal taking. J Hum Ergol 1972; 1: 195–205

    CAS  Google Scholar 

  24. Barton J, Folkard S, Smith LR, et al. Standard Shiftwork Index manual, SAPU Memo No: 1159 MRC/ESRC. Sheffield: Social and Applied Psychology Unit, Department of Psychology,University of Sheffield, 1990

    Google Scholar 

  25. de Assis MA, Kupek E, Nahas MV, et al. Food intake and circadian rhythms in shift workers with a high workload.Appetite 2003; 40: 175–83

    Article  PubMed  Google Scholar 

  26. Reinberg A, Migraine C, Apfelbaum M. Circadian and ultradian rhythms in the eating behaviour and nutrient intake of oil refinery operators (Study 2). Chronobiologia 1979; Suppl.1:89–102

    Google Scholar 

  27. Lennernas M, Hambraeus L, Akerstedt T. Shift related dietary intake in day and shift workers. Appetite 2005; 25: 253–65

    Article  Google Scholar 

  28. Fisher M, Rutishauser IHE, Read RSD. The dietary patterns of shift workers on short rotation shifts. Comm Health Stud 1986;X: 54–6

    Google Scholar 

  29. Waterhouse J, Buckley P, Edwards B, et al. Measurement of,and some reasons for, differences in eating habits between night and day workers. Chronobiol Int 2003; 20: 1075–92

    Article  PubMed  CAS  Google Scholar 

  30. Stewart AJ, Wahiqvist ML. Effect of shift work on canteen food purchase. J Occ Med 1985; 27: 552–4

    Article  CAS  Google Scholar 

  31. Persson M, Martensson J. Situations influencing habits in diet and exercise among nurses working night shift. J Nurs Man 2006; 14: 414–23

    Article  CAS  Google Scholar 

  32. Beermann B, Nachreiner F. Working shifts: different effects for women and men. Work Stress 1995; 9: 289–97

    Article  Google Scholar 

  33. Lennernas M, Akerstedt T, Hambraeus L. Nocturnal eating and serum cholesterol in 3 shift workers. Scand J Work Environ Health 1994; 20: 401–6

    Article  PubMed  CAS  Google Scholar 

  34. Holmbäck U, Forslund A, Forslund J, et al. Metabolic responses to nocturnal eating in men are affected by sources of dietary energy. J Nutr 2002; 132: 1892–9

    PubMed  Google Scholar 

  35. Morgan L, Arendt J, Owens D, et al. Effects of the endogenous clock and sleep time on melatonin, insulin, glucose and lipid metabolism. J Endocrinol 1998; 157: 443–51

    Article  PubMed  CAS  Google Scholar 

  36. Lund J, Arendt J, Hampton S, et al. Postprandial hormone and metabolic responses amongst shift workers in Antarctica. J Endocrinol 2001; 171: 557–64

    Article  PubMed  CAS  Google Scholar 

  37. Al-Naimi S, Hampton SM, Richard P, et al. Postprandial metabolic profiles following meals and snacks eaten during simulated night and day shift work. Chronobiol Int 2004; 21:937–47

    Article  PubMed  CAS  Google Scholar 

  38. Qin LW, Li J, Wang Y. The effects of nocturnal life on endo crine circadian patterns in healthy adults. Life Sci 2003; 73:2467–75

    Article  PubMed  CAS  Google Scholar 

  39. Scheen AJ, Van Cauter E. The roles of time of day and sleep quality in modulating glucose regulation: clinical implications.Horm Res 1998; 49: 191–201

    Article  PubMed  CAS  Google Scholar 

  40. Van Cauter E, Blackland JD, Roland D, et al. Modulation of glucose regulation and insulin secretion by circadian rhythmicity and sleep. J Clin Invest 1991; 88: 934–42

    Article  PubMed  Google Scholar 

  41. Spiegel K. Knutson K, Leproult R, et al. Sleep loss: a novel risk factor for insulin resistance and type 2 diabetes. J Appl Physiol 2005; 99: 2008–19

    Article  PubMed  CAS  Google Scholar 

  42. Boden G, Ruiz J, Urbain J-C, et al. Evidence for a circadian rhythm of insulin secretion. Am J Physiol 1996; 27: E246–52

    Google Scholar 

  43. Goo RH, Moore JG, Greenberg E, et al. Circadian variation in gastric empyting of meals in humans. Gastroenterol 1987;93:515–8

    CAS  Google Scholar 

  44. Holmbäck U, Forslund A, Lowden A, et al. Endocrine responses to nocturnal eating: possible implications for night work. Eur J Nutr 2003; 42: 75–83

    Article  PubMed  Google Scholar 

  45. Hirota N, Sone Y, Tokura H. Effect of evening exposure to dim or bright light on the digestion of carbohydrate in the supper meal. Chronobiol Int 2003; 20: 853–62

    Article  PubMed  CAS  Google Scholar 

  46. Wren AM, Seal LJ, Cohen MA, et al. Ghrelin enhances appetite and increases food intake in humans. J Clin Endocrinol Metabol 2001; 86: 5992–5

    Article  CAS  Google Scholar 

  47. Simon C, Gronfier C, Schilenger JL, et al. Circadian and ultradian variations of leptin in normal man under continuous enteral nutrition: relationship to sleep and body temperature. J Clin Endocrinol Metabol 1998; 83: 1893–9

    Article  CAS  Google Scholar 

  48. Dzaja A, Dalal MA, Himmerich H, et al. Sleep enhances nocturnal plasma ghrelin levels in healthy subjects. Am J Physiol 2004; 286: E963–7

    CAS  Google Scholar 

  49. Fogteloo AJ, Pijl H, Roelfsema F, et al. Impact of meal timing and frequency on the twenty-four-hour leptin rhythm. Horm Res 2004; 62: 71–8

    Article  PubMed  CAS  Google Scholar 

  50. Schoeller DA, Cella LK, Sinha MK, et al. Entrainment of the diurnal rhythm of plasma leptin to meal timing. J Clin Invest 1997; 100: 1882–7

    Article  PubMed  CAS  Google Scholar 

  51. WHO. Diet nutrition and prevention of chronic disease. WHO technical report series, no. 916. Geneva: World Health Organization, 2003

    Google Scholar 

  52. Love HL, Watters CA, Chang W-C. Meal composition and shift work performance. Can J Diet Pract Res 2005; 66: 38–9

    Article  PubMed  Google Scholar 

  53. Lipovcan K, Larsen P, Zganec N. Quality of life, life satisfaction and happiness in shift and non-shift workers. Revi Saude Publica 2004; 38: 3–10

    Article  Google Scholar 

  54. Costa G.Factors influencing health of workers and tolerance to shift work. Theor Issues Ergon Sci 2003; 4: 263–88

    Article  Google Scholar 

  55. Pati AK, Chandrawanshi A, Reinberg A. Shift work: consequences and management. Current Sci 2001; 81: 32–52

    Google Scholar 

  56. Baker A, Ferguson S, Dawson D. The perceived value of time:controls versus shift workers. Time Soc 2003; 12: 27–39

    Article  Google Scholar 

  57. Atkinson G, Reilly T. Circadian variation in sports performance.Sports Med 1996; 21(4): 292–312

    Article  PubMed  CAS  Google Scholar 

  58. Eriksen W, Bruusgaard D. Do physical leisure time activities prevent fatigue? A 15-month prospective study of nurses’ aides. Br J Sports Med 2004; 38: 331–6

    Article  PubMed  CAS  Google Scholar 

  59. Fischer FM, Moreno CR de C, Fernandez RL, et al. Day- and shiftwokers’ leisure time. Ergonomics 1993; 36: 43–9

    Article  PubMed  CAS  Google Scholar 

  60. Hornberger S, Knauth P. Interindividual differences in the subjective valuation of leisure time utility. Ergonomics 1993;36:255–64

    Article  Google Scholar 

  61. Frese M, Okonek K. Reasons to leave shift work and psychological and psychosomatic complaints of former shift workers.J Appl Psychol 1984; 69: 509–14

    Article  PubMed  CAS  Google Scholar 

  62. Atkinson G, Reilly T. Effects of age on the circadian character istics of physically active subjects. In: Vellas BJ, Atharede JL, Garry PJ, editors. Facts and research in gerontology. Paris:Serdi Publisher, 1995: 149–60

    Google Scholar 

  63. Wedderburn A, Scholarios D. Guidelines for shift workers:trials and errors? Ergonomics 1993; 36: 211–8

    Article  Google Scholar 

  64. Härmä M.Ageing, physical fitness and shift work tolerance.Appl Ergon 1996; 27: 25–9

    Article  PubMed  Google Scholar 

  65. Vidacek S, Kaliterna L, Radoseevic-Vidacek B, et al. Individual differences in circadian rhythm parameters and short-term tolerance to shift work: a follow-up study. Ergonomics 1993;36: 117–23

    Article  PubMed  CAS  Google Scholar 

  66. Harma MI, Ilmarinen J, Yletyinen I. Circadian variation of physiological functions in physically average and very fit dayworkers. J Hum Ergol 1982; 11 Suppl.: 33–46

    Google Scholar 

  67. Harma MI, Ilmarinen J, Knauth P, et al. Physical-training intervention in female shift workers: 2.The effects of intervention on the circadian-rhythms of alertness, short-term-memory, and body-temperature. Ergonomics 1988; 31: 51–63

    Article  PubMed  CAS  Google Scholar 

  68. Atkinson G, Coldwells A, Reilly T, et al. A comparison of circadian rhythms in work performance between physically active and inactive subjects. Ergonomics 1993; 36: 273–81

    Article  PubMed  CAS  Google Scholar 

  69. Akerstedt T, Froberg JE. Interindividual differences in circadian patterns of catecholamine excretion, body temperature, performance, and subjective arousal. Biol Psychol 1976;4:277–92

    Article  PubMed  CAS  Google Scholar 

  70. Youngstedt SD. Effects of exercise on sleep. Clin Sports Med 2005; 24: 355–65

    Article  PubMed  Google Scholar 

  71. Shapiro CM, Warren PM, Trinder J, et al. TFitness facilitates sleep. Eur J Appl Physiol 1984; 53: 1–4

    Article  CAS  Google Scholar 

  72. Horne JA. Sleep function with particular reference to sleep deprivation. Ann Clin Res 1985; 17: 199–208

    PubMed  CAS  Google Scholar 

  73. Horne JA, Staff LHE. Exercise and sleep: body-heating effects.Sleep 1983; 6: 36–46

    PubMed  CAS  Google Scholar 

  74. Murphy PJ, Campbell SS. Nighttime drop in body temperature:a physiological trigger for sleep onset? Sleep 1997; 20: 505–11

    PubMed  CAS  Google Scholar 

  75. Youngstedt SD, Kripke DF, Elliott JA. Is sleep disturbed by vigorous late-night exercise? Med Sci Sports Exerc 1999;31:864–9

    Article  PubMed  CAS  Google Scholar 

  76. Atkinson G, Edwards B, Reilly T, et al. Exercise as a synchroniser of human circadian rhythms: an update and discussion of the methodological problems. Eur J Appl Physiol 2007;99:331–41

    Article  PubMed  Google Scholar 

  77. Peppard PE, Young T. Exercise and sleep-disordered breathing:an association independent of body habitus. Sleep 2004; 27:480–4

    Google Scholar 

  78. Moreno CRC, Louzada FM, Teixeira LR, et al. Short sleep is associated with obesity among truck drivers. Chronobiol Int 2006; 23: 1295–303

    Article  PubMed  CAS  Google Scholar 

  79. Vorona RD, Winn MP, Babineau TW, et al. Overweight and obese patients in a primary care population report less sleep than patients with a normal body mass index. Arch Intern Med 2005; 165: 25–30

    Article  PubMed  Google Scholar 

  80. Bonnefond A, Harma M, Hakola T, et al. Interaction of age with shift-related sleep-wakefulness, sleepiness, performance, and social life. Exp Aging Res 2006; 32: 185–208

    Article  PubMed  CAS  Google Scholar 

  81. Schneider S, Becker S. Prevalence of physical activity among the working population and correlation with work related factors: results from the first German national health survey.J Occup Health 2005; 47: 414–23

    Article  PubMed  Google Scholar 

  82. Burton NW, Turrell G. Occupation, hours worked, and leisure time physical activity. Prev Med 2000; 3: 673–81

    Article  Google Scholar 

  83. Popham F, Mitchell R. Leisure time exercise and personal circumstances in the working age population: longitudinal analysis of the British household panel survey. J Epidemiol Comm Health 2006; 60: 270–4

    Article  Google Scholar 

  84. Dietz WH. The role of lifestyle health: the epidemiology and consequences of inactivity. Proc Nutr Soc 1996; 55: 829–40

    Article  PubMed  CAS  Google Scholar 

  85. Dishman RK, Oldenburg B, O’Neal MA, et al. Worksite physical activity interventions. Am J Prev Med 1988; 15: 344–61

    Article  Google Scholar 

  86. Kahn EB, Ramsey LT, Brownson RC, et al. The effectiveness of interventions to increase physical activity: a systematic review.Am J Prev Med 2002; 22: 73–107

    Article  PubMed  Google Scholar 

  87. Shephard RJ. Worksite fitness and exercise programs: a review of methodology and health impact. Am J Health Prom 1996;10:436–45

    Article  CAS  Google Scholar 

  88. Harma MI, Ilmarinen J, Knauth P, et al. Physical training intervention in shift workers: 1. The effects of intervention on fitness, fatigue, sleep, and psychomotor symptoms. Ergonomics 1988; 31: 39–50

    Article  PubMed  CAS  Google Scholar 

  89. Kivimaki MKP, Virtanen M, Elovainio M, et al. Does shift work lead to poorer health habits? A comparison between women who had always done shift work with those who had never done shift work. Work Stress 2001; 15: 3–13

    Article  Google Scholar 

  90. Tepas DI, Barnes-Farrell JL, Bobko N, et al. The impact of night work on subjective reports of well-being: an exploratory study of health care workers from five nations. Rev Saude Publica 2004; 38: 26–31

    Article  PubMed  Google Scholar 

  91. Atlantis E, Chow C-M, Kirby A, et al. Worksite intervention effects on physical health: a randomised controlled trial. Health Promot Int 2006; 21: 191–200

    Article  PubMed  Google Scholar 

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Acknowledgements

Sarah Fullick and Charlotte Grindey are funded by the National Prevention Research Initiative (http://www.npri.org.uk) for the project ‘Shift work and health: optimal timing of meals and physical activity’ (Medical Research Council grant 75373).

The authors have no potential conflicts of interest related to the contents of this article.

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  1. Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Henry Cotton Campus, L3 2ET, Liverpool, UK

    Greg Atkinson, Sarah Fullick, Charlotte Grindey & Don Maclaren

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  1. Greg Atkinson
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Correspondence to Greg Atkinson.

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Atkinson, G., Fullick, S., Grindey, C. et al. Exercise, Energy Balance and the Shift Worker. Sports Med 38, 671–685 (2008). https://doi.org/10.2165/00007256-200838080-00005

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