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1. Consumption of 1 or 3 low-glycemic index meals did not lead to significant changes in glucose homeostasis compared to fasting overnight.

2. Consumption of 1 high-glycemic index meal significantly increased all glycemic control variables not only during the night shifts but also in the morning.

Evidence Rating Level: 1 (Excellent)

Night-shift workers make up a significant portion of our workforce but have significantly higher risks of all-cause, cardiovascular and cancer mortality compared to day-time workers. One possible risk factor is meal mistiming with consumption of meals during circadian rest phase (nighttime). This study evaluated the effect of glycemic index (GI) and frequency of meals on glucose homeostasis during and after nightshifts.

This was a randomized cross-over trial that included 53 adult female nurses working night shifts for at least the past 3 months in the Netherlands. Individuals with diabetes, hypoglycemia, or unexplained weight loss were excluded. Participants were randomized to two arms and either received meals once (1-MEAL) or three times (3-MEAL) during the night. Within each arm, participants were provided with either no meal (fasted), low, or high-GI meals for three nights followed by 2-week washout periods in between each type of meal. The test meals were semi-skimmed yogurt with varying sugar amounts added. The primary outcome measured was glycemic control (GC) during the night, in the morning, and 24hr period after the night shift. This was measured using a continuous glucose monitor placed on abdomen of each participant.

The results demonstrated that compared to no meal, consumption of 1 or 3 low- GI meals did not lead to significant changes in glucose homeostasis compared to fasting overnight. In contrast, consumption of 1 high-GI meal significantly increased all glycemic control variables not only during the night shifts but also in the morning. This study was limited by individual variability in timing of consumption of meal. Nonetheless, these results offer valuable insight into ways to help optimize meal consumption for night workers to help reduce their increased cardiovascular risk.

Click here to read this study in The Journal of Nutrition

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