American Nurse, a journal of the American Nurses Association, (June 2020 Vol. 15. 6, p 21) introduces us to the words of Florence Nightingale: “No amount of medical knowledge will lessen the accountability for nurses to do what nurses do; that is, manage the environment to promote positive life processes.” This includes the 24-hour, 7-day-a-week nature of the work, which affects nurses’ health and well-being, including nutrition, particularly when working night shift according to an article by Sharon Tucker, PhD, APRN-CNS, NC-BC, EBP-C, FNAP, FAAN. Hospital inpatient nursing positions new hires quickly experience the reality of 12-hour-plus shifts, rotating shifts and overtime. Working nights interferes with our body’s natural circadian rhythm (24-hour sleep/wake cycle). Circadian rhythm is a natural process that regulates the sleep/wake cycle and repeats roughly every 24 hours. It is linked to our body’s internal clock. Brain wave activity, hormone production, cell regeneration and other important biological processes are determined by this cycle. Chrononutrition – the balance between biology and diet suggests that feeding and fasting can synchronize our biological and solar clocks. The rhythm cycles involve 4 ideas: light-dark, sleeping-waking, activity-rest, feeding-fasting. (Stronger By Science Chrononutrition: Why Meal Timing and Nutrition, Calorie Distribution & Feeding Windows Really Do Matter Nov. 18, 2019). Serious health problems can occur when the circadian rhythm and chrononutrition are disrupted. It’s called chronodisruption. Working as a night shift nurse, surviving on coffee and a partially eaten doughnut at 2 am surely alters and probably misaligns a nurse’s circadian rhythm and throws them into chronodisruption. Night-shift work may alter eating patterns (which impact your body’s regulator responses to metabolism) and food choices. Several studies have shown a relationship between altered circadian rhythms, eating patterns, and obesity. These studies have important implications not only for night-shift and rotating-shift nurses but everyone of us wishing to maintain our health and wellbeing.

The “Nursing, night shift, and nutrition” article and the scientific field of Chronobiology outline a strategy that maximizes nutrition benefits throughout the day. When and how we eat has the potential to synchronize our circadian rhythm. Therefore, we need to align our internal cycles. Eating at our biological night is a bad idea and the larger the calorie intake the more detrimental it is during the biological night. Our tissues are more sensitive to insulin in the morning than at night with a decrease in sensitivity to insulin across the day. Eating a good breakfast can help promote good energy levels throughout the day. During sleep the body is in a fasting state that promotes the release of stored glucose for central nervous system function. Eating during this time disrupts the system. Research shows that if you consume most of your daily calories within 4 hours of going to sleep you will have more body fat than than people who don’t eat within that 4 hour span. Avoiding large carbohydrate loads in the evening is a good idea. Night-shift nurses may find their circadian rhythm centered by choosing light snacks – such as fruits, vegetables, protein (nuts, yogurt, tune), and salads – that will increase energy. Also, eating the main meal before going to work will provide more fuel for their shift. Caffeine is a double-edge sword. Systemic reviews demonstrate moderate consumption can improve alertness, vigilance and psychomotor performance; however, caffeine can interrupt sleep when night-shift workers want to rest. Avoiding caffeine 4 to 6 hours before planned sleep is a good idea because caffeine can reduce sleep efficiency, sleep duration, and slow-wave and REM sleep. High-fat and high-sugar substances will ultimately make fatigue and energy swings more challenging. So, if you’re tempted to grab that last minute snack at the convenience store on your way to night-shift work – think twice, plan ahead and bring a packed meal from home.

Stronger By Science – Chrononutrition and Nursing, night shift, and nutrition offer a perspective for keeping our rhythm synchronized. WORK TOGETHER:

• Establish norms and healthy food guidelines – Shift work doesn’t always allow for family meals but at least plan for weekly, nutritious meals earlier in the day
• Arrange to have healthy foods available both to prepare for the meal and to take to work for the night-shift “time-clock”
• Prepare meals ahead of time so that you’re not tempted to grab a quick last-minute, fat-filled, calorie-laden snack to go along with your 4th cup of caffeinated coffee

FOLLOW THE LIGHT:

• People in the US spend about 87% of their time in enclosed buildings when you factor in work schedules and indoor environments – this can cause chromodisruption. We need to get out into the sunlight, at least 20 minutes a day. Of course, do this cautiously keeping in mind the powerful rays of the sun an its potential to burn your skin with ultraviolet rays – always use sunscreen.
• However, “the light” does not mean the light from using electronic devices that can inhibit your ability to sleep and rest. That includes the light from cell phones, laptops, computers, or any other play items whether for children or adults that emits electronic light. Sending your child or toddler to bed with an electronic, light-emitting toy may disrupt their sleep.
• If you are a night-shift worker try to get 20 minutes of daytime sun

STAY ACTIVE:

• Regular physical activity is associated with increased mental and physical health
• Conditioning exercises reduce your risk of heart attack and helps to manage your ideal weight
• Physical activity helps to prevent chronic disease and maintain stronger muscles

Keeping your rhythm, keeping your sway, keeping your to-and-fro is the key whether you work night shift or you punch the clock from 9-5.