Shift work and its relation with meal and snack patterns among healthcare workers.

Objective Unfavorable eating patterns might contribute to the adverse health effects of shift work. Our objective was to examine differences in meal and snack frequency, as well as the quality of snacks, between shift and day workers and between different types of shifts. Methods Cross-sectional data from 485 healthcare workers aged 18-65 years of the Klokwerk+ cohort study was used. Dietary intake was assessed using 3-day food diaries, and meals and snacks were classified by the food-based classification of eating episodes method. Using multivariable-adjusted regression analyses, we estimated differences in meal and snack frequency and the quality of snacks between shift and day workers. Within the shift working group, eating frequency on day, evening, and night shifts were compared to work-free days. Results Meal and snack frequency as well as the quality of snacks showed no significant differences between shift and day workers (P≥0.05). Shift workers had a higher frequency of high-quality snacks [ß 0.29, 95% confidence interval (CI) 0.12-0.46] and a lower frequency of low-quality snacks (ß -0.29, 95% CI -0.49- -0.09) on evening shifts compared to their work-free days. Compared to work-free days, shift workers had a higher frequency of high-quality snacks on days shifts (ß 0.24, 95% CI 0.10-0.38), and only those aged ≤40 years had a higher frequency of snacks on night shifts (ß 0.53, 95% CI 0.06-1.00) (interaction by age P<0.05). Conclusion This study observed no differences between day and shift workers either in meal and snack frequency or in the quality of snacks. However, snacking patterns differed across shifts. Future research should investigate whether these snacking patterns contribute to the adverse health effects of shift work.

The effectiveness of workplace health promotion interventions on physical and mental health outcomes - a systematic review of reviews.

Objective This systematic review aimed to provide an overview of the effectiveness of health promotion interventions at the workplace on physical and mental health outcomes related to chronic diseases. Methods A search for reviews published between 2009 and 2018 was performed in electronic databases. References of the included reviews were checked for additional reviews. Workplace health promotion interventions were included if they studied metabolic risk factors as important predictors of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) or if they studied mental or musculoskeletal health outcomes. Review quality was assessed using the AMSTAR checklist. Results Of the 23 reviews included, 9 were of high quality. For weight-related outcomes, there was strong evidence for favorable effects of workplace interventions, especially for interventions targeting physical activity and/or diet. For the remaining metabolic risk factors, there was no evidence for a positive effect of workplace health promotion interventions due to the absence of high quality reviews and mixed conclusions between the reviews. There was also strong evidence for a positive, small effect on the prevention of mental health disorders of workplace psychological interventions, especially those that use e- health and cognitive behavioral therapy techniques. Furthermore, strong evidence was found for the prevention of musculoskeletal disorders through workplace interventions, especially resistance exercise training. Conclusions This review found evidence for the effectiveness of workplace interventions on the prevention of weight-related outcomes as well as mental health and musculoskeletal disorders. Future research is however needed on the factors that contribute to the successful implementation of an intervention.