The association between anxiety, hunger, the enjoyment of eating foods and the satiety after food intake in individuals working a night shift compared with after taking a nocturnal sleep: A prospective and observational study.

Subjective responses to meals are altered by shortened sleep time and anxiety state, but this effect has been poorly studied in shift workers - who act as a typical model concerning sleep restriction and present high levels of anxiety. The objective of this study was to compare subjective perceptions of meals and the levels of anxiety in the same subjects after working night shifts and after taking a nocturnal sleep, and to investigate associations between the responses to meals and the levels of anxiety under these two conditions. The study evaluated 34 male permanent night-shift workers who worked a 12-h shift followed by a 36-h rest period. Evaluations included: sleep pattern (on three days after working night shifts and after sleeping at night); hunger, enjoyment of eating foods and satiety after a meal (evaluated by visual analogue scales on three non-consecutive days after working night shifts and after nocturnal sleeps); and state of anxiety (on a day after working a night shift and a day after a nocturnal sleep). In the days following a night shift, workers had higher mean hunger scores before lunch and higher anxiety scores than when they had slept at night (p = 0.007 and 0.001, respectively). Linear regression indicated that, after a night shift, anxiety scores were negatively associated with hunger before breakfast (p = 0.04) and lunch (p = 0.03), the enjoyment of eating foods (p = 0.03) and the number of meals eaten during the course of the 24 h (p = 0.03). It is concluded that night shifts increase mean hunger and anxiety scores. Anxiety levels seem to interfere with the responses associated with food consumption.

Obesity and sleepiness in women with fibromyalgia.

Fibromyalgia (FM) is associated with a number of comorbidities, including chronic widespread pain, fatigue and non-restorative sleep. Evidence has shown that FM is closely associated with overweight and obesity. The objective of the present study was to investigate the relationship between obesity and sleepiness in women with FM. A total of 100 adult female patients with a prior medical diagnosis of FM participated in the study. Body mass, height and waist circumference were measured, and body mass index (BMI) was calculated. The diet quality was evaluated by the Healthy Eating Index. Subjective analyses of daytime sleepiness [Epworth Sleepiness Scale (ESS)] and sleep quality (Pittsburgh Sleep Quality) were performed. An obesity rate of 41 % was found in all women (56.1 % were sleepy and 43.9 % were not, p = 0.04). Obese women showed a greater level of sleepiness when compared with non-obese (10.2 and 7.0, respectively, p = 0.004). Sleepy women showed a greater weight gain after the diagnosis of FM when compared with non-sleepy women (11.7 and 6.4 kg, respectively, p = 0.04). A positive and significant correlation between BMI and sleepiness (r = 0.35, p = 0.02) was also found. In multivariate logistic regression, moderate or severe sleepiness (ESS >12) was associated with obesity (odds ratio 3.44, 95 % CI 1.31-9.01, p = 0.04). These results demonstrate an important association between sleepiness and FM, suggesting that the occurrence of obesity may be involved with sleepiness in these patients.

SOCIODEMOGRAPHIC CHARACTERISTICS RELATED TO KNOWING THE BENEFITS OF BREASTFEEDING.

OBJECTIVE: To describe the characteristics of women according to the reported number of benefits of breastfeeding and to verify its association with the duration of this practice until the sixth month of the child's life. METHODS: This was a qualitative and prospective observational study performed with postpartum mothers in two stages (n=78, and after six months n=62). Generalized linear models were used to identify the profile of the mothers as well as to determine the factors associated with the duration of breastfeeding until the sixth month of the child's life. RESULTS: The profile of women who reported fewer benefits (≤3) was: younger age (p=0.008), with lower schooling (p<0.001), single (p=0.02), unemployed (p=0.04) and who attended prenatal care at the public health service (p=0.01). The analysis of the interaction of these factors indicated that women who had only completed elementary school and who attended prenatal care at the public health service (p<0.001) or privately (p=0.01) reported fewer benefits. Factors such as: level of education, marital status, previous education/training about breastfeeding, place of prenatal care and the reported number of benefits were not associated with the duration of breastfeeding until the sixth month of the child's life. CONCLUSIONS: The lowest number of breastfeeding benefits was reported by women with elementary education and who undewent prenatal care in the public health system or privately. The number of reported benefits was not associated with the duration of this practice until the age of sixth months of the child.

Social Jetlag Is Associated With Impaired Metabolic Control During a 1-Year Follow-Up.

Previous studies have identified social jetlag (SJL) as a risk factor for non-communicable chronic diseases (NCCDs), but its association with metabolic control over time is unclear in the literature. Therefore, we examined the influence of SJL on metabolic parameters and blood pressure (BP) in patients with NCCDs over a 1-year follow-up. This retrospective, longitudinal study included 625 individuals (age: 56.0 +12.0 years; 76% female) with NCCDs [type 2 diabetes mellitus (TD2), systemic arterial hypertension (SHA), obesity, or dyslipidemia]. SJL was calculated based on the absolute difference between mid-sleep time on weekends and weekdays. Current metabolic parameters and BP of the patients were compared with data from a year prior. Generalized estimating equations (GEE) and multiple linear regression analyses were used to examine the association among SJL, metabolic parameters, and BP. Multiple linear regression analyses adjusted for confounders showed that SJL was positively associated with the delta difference of fasting glucose (ß = 0.11, p = 0.02) and triglyceride levels (ß = 0.09, p = 0.04) among all subjects with NCCDs, and with fasting glucose (ß = 0.30, p = 0.0001) and triglyceride levels (ß = 0.22, p = 0.01) in the TD2 group. GEE analysis demonstrated an isolated effect of SJL on diastolic BP. High SJL impaired clinical and metabolic control in individuals with NCCDs, leading to a worse profile after a 1-year follow-up, particularly among type II diabetics.

Circadian Misalignment Is Negatively Associated with the Anthropometric, Metabolic and Food Intake Outcomes of Bariatric Patients 6 Months After Surgery.

PURPOSE: Circadian misalignment has been associated with an increased risk of overweight and obesity, as well as changes in metabolic parameters. This study evaluated the association between social jet lag (SJL), a measure of circadian misalignment, and anthropometric, metabolic and food intake outcomes 6 months after bariatric surgery. MATERIALS AND METHODS: A total of 122 bariatric patients were included (77% female, aged 33 years (range 28-41); 79.5% underwent Roux-en-Y gastric bypass). Anthropometric, food consumption and SJL were evaluated in the preoperative evaluation and in the third and sixth months after surgery. SJL was calculated based on the absolute difference between the mid-sleep time on weekends and weekdays. Generalised estimating equations and linear regression were performed to evaluate the associations between mean SJL exposure and the outcomes. RESULTS: The interaction between SJL and follow-up time negatively influenced the evolution of weight (p = 0.01), BMI (p = 0.04) and insulin levels (p = 0.01). SJL had an effect on intake of calories (p = 0.001), carbohydrate (p = 0.005) and total (p = 0.007), monounsaturated (p = 0.03) and polyunsaturated fat (p < 0.001). Linear regression showed a negative association between mean SJL exposure over the 6 months and the percentage of weight loss (coefficient = - 0.30, p = 0.006), body weight loss (kg) (coefficient = - 0.17, p = 0.03) and the reduction of BMI (coefficient = - 0.24, p = 0.007). CONCLUSIONS: SJL was negatively associated with anthropometric, metabolic and food consumption outcomes 6 months after bariatric surgery. Future studies with longer follow-up are needed to confirm these findings. TRIAL REGISTRATION: Clinical Trials.gov : NCT03485352.

Effect of consuming a late-night high-protein/moderate-carbohydrate vs. low-protein/high-carbohydrate meal by night workers on their food perceptions later during the day: a randomized crossover study.

It is typical of night workers to consume a large dinner meal before their work shift, even though this practice may increase the risk for metabolic disorders. Night workers usually eat at night to socialize with colleagues as well as to stay alert and to avoid upset stomach during the night shift. However, little is known if and how the composition of the nighttime meal by night shift workers influences their food perceptions and eating behavior later during the day. The aim of this study was to analyze the effect of a high-protein/moderate-carbohydrate (HP/MCHO) meal vs. low-protein/high-carbohydrate (LP/HCHO) meal eaten at night by night-shift workers on their food consumption and perceptions later during the day. Fourteen male night shift workers were followed-up for 7 days for their eating and sleep habits. Then, participants underwent two isocaloric dietary events - one event a HP/MCHO meal containing 45% carbohydrate, 35% protein, and 20% fat and the other event a LP/HCHO meal containing 65% carbohydrate, 15% protein, and 20% fat, with a 6-day washout period between them - at 01:00 h during their night shift. Thereafter throughout the day, participants filled a food register of all the food consumed and perceptions, including hunger before meals, enjoyment of meals, and satiety. Generalized estimating equation analyses were used to examine the effect of both conditions on food consumption and food perceptions. Appetite for salty food snacks was greater after the HP/MCHO condition than after the LP/HCHO condition (p = .041). During the day following consumption of the nighttime HP/MCHO vs. LP/HCHO meal, there was higher percentage of carbohydrate consumption during lunch and a lower percentage of fat consumption during dinner (48.14% vs. 36.98% and 27.34% vs. 40.39%, respectively). These findings suggest the composition in terms of carbohydrates, protein, and fats of the meal consumed for the night shift by night workers may affect later during the day both food consumption and perceptions.

Caloric midpoint is associated with total calorie and macronutrient intake and body mass index in undergraduate students.

Studies have suggested that eating at later times may be a risk factor for being overweight. The aim of this study was to investigate the association of caloric midpoint on the anthropometric profile and calorie and macronutrient intake during the day. The study included 718 Brazilian undergraduate students (20.5 ± 2.9 years old; 67% women). Dietary intake was assessed by 24-h recall and the diurnal variation of calorie consumption was evaluated by caloric midpoint average time at which 50% of daily energy were consumed. Participants were classified into two groups according to caloric midpoint median; early eaters (caloric midpoint ≤ 3:00 pm) or late eaters (caloric midpoint > 3:00 pm). Body weight and waist circumference were measured and body mass index (BMI) was determined. Generalized linear models adjusted for confounding variables were used to determine the association between variables. The late eaters presented higher BMI when compared to early eaters (23.0 kg/m2 ± 0.3 vs. 22.1 kg/m2 ± 0.2, respectively; p = .02). Late eaters reported a higher total daily consumption of energy (p < .001) and proportion consumed after 9:00 pm (p < .001), as well as total daily carbohydrate (p < .001), protein (p < .001), fat (p < .001), saturated fat (p < .001), and cholesterol (p = .04) intake when compared with early eaters. We conclude that concentrating food intake later in the day is associated with higher total energy and macronutrient intake as well as a higher average BMI.

Association between social jetlag food consumption and meal times in patients with obesity-related chronic diseases.

Chronic disruption of the synchronous relationship between endogenous and exogenous circadian timing is associated with the development of obesity and metabolic disease. Social jetlag is a measure of circadian misalignment and has been identified as a risk factor for overweight and related diseases. However, the mechanisms involved in this relationship remain underexplored. The objective of this study was to investigate the association between social jetlag and food consumption at late meal timing in patients with obesity-related chronic diseases. This study included 792 individuals (73% female; age 55.9 ± 12.4 years) in which the prevalence of social jetlag (>1h) was 24.4% (n = 194). Participants with social jetlag reported late meal timing for breakfast, early afternoon snack and dinner. Individuals with social jetlag also reported a higher intake of total calories (kcal), protein, total fat, saturated fat, cholesterol, and servings of meat and eggs and sweets in relation to those without social jetlag. Regarding the consumption during each meal of the day, participants with social jetlag had consumed more calories, saturated fat and cholesterol during dinner; more protein, total fat, saturated fat, and cholesterol during lunch; and more total fat and saturated fat during morning snack. In addition, individuals with social jetlag had a higher risk of inadequate consumption of total fat, saturated fat and cholesterol intake when compared with those without social jetlag. We conclude that social jetlag is associated with a poor diet and later meal times, which should be avoided in individuals with obesity-related chronic diseases. More studies are needed to confirm these findings.

Eveningness is associated with skipping breakfast and poor nutritional intake in Brazilian undergraduate students.

Some studies have proposed that self-reported eveningness, which reflects the preference of performing activities in the evening, may harm nutritional health and influence the eating behavior and nutritional status of individuals. However, the relationship between these variables (eveningness and nutritional status) and the consumption of breakfast, which is currently considered a marker of health, has been insufficiently explored by studies. The aim of this study was to investigate, in undergraduate students, the association between diurnal preference, being overweight, and food consumption (with special focus on breakfast). The study included 721 undergraduate students from a Brazilian public university. Dietary intake was assessed by 24-hour food recall, and the usual time for breakfast was identified. Body weight, height, and waist circumference were measured by trained researchers. Diurnal preference was determined by the Horne and Ostberg questionnaire validated for the Brazilian population, and the participants were classified into three categories: evening (coefficient: 16-41), intermediate type (coefficient: 42-58) or morning type (coefficient: 59-86). The prevalence of skipping breakfast was higher among the evening types (p = 0.02), when compared with morning and intermediate types. A negative association between the diurnal preference coefficient and total caloric (coefficient -0.25, p = 0.007, r2 adjusted = 0.12), carbohydrate (coefficient -0.19, p = -0.04, r2 adjusted = 0.04) and lipid intake (coefficient -0.18, p = 0.04, r2 adjusted = 0.05) was also found in the breakfast skippers but not in breakfast eaters. In other words, breakfast skippers with diurnal preference values indicative of eveningness consumed more calories, carbohydrates and fats. Evening types presented significant odds of skipping breakfast (OR = 1.7, CI = 1.1-2.9, p = 0.02) when compared with morning and intermediate chronotypes. We conclude that eveningness is associated with skipping breakfast and a higher consumption of calories, carbohydrates and fats in breakfast skippers. These eating behaviors may predispose these individuals to being overweight.

Social jetlag and metabolic control in non-communicable chronic diseases: a study addressing different obesity statuses.

Social jetlag - a measure of disruption of the circadian system - has been linked to obesity, but its association with metabolic complications in non-communicable chronic diseases (NCCDs) is unknown in the literature. We examined the associations between social jetlag and obesity status and metabolic parameters among individuals with NCCDs. Patients (n = 792) with NCCDs (obesity, systemic arterial hypertension, type 2 diabetes mellitus or dyslipidaemia) attended clinics of the public health service of the city of Uberlândia, Minas Gerais State, Brazil. They were classified in three obesity statuses: non-obese: BMI < 30 kg/m2; metabolically healthy obese (MHO): BMI ≥ 30 kg/m2 and less than three high-risk biomarkers for metabolic syndrome; and metabolically unhealthy obese (MUO): BMI ≥ 30 kg/m2 and with high-risk values on three or more biomarkers for metabolic syndrome. After adjustments for confounding variables, social jetlag was positively associated with fasting glucose levels among all subjects (ß = 0.08, p = 0.03) and MUO subjects (ß = 0.32, p < 0.001). Patients with social jetlag (>1 h) presented a significant odds ratio (OR) of being overweight (OR = 2.0, confidence interval (CI) = 1.2-3.6, p = 0.006) and MUO (OR = 1.8, CI = 1.1-2.8, p = 0.01). These results suggest that social jetlag is associated with a higher risk of overweight and related metabolic complications in individuals with NCCDs.

Social Jetlag Among Night Workers is Negatively Associated with the Frequency of Moderate or Vigorous Physical Activity and with Energy Expenditure Related to Physical Activity.

This cross-sectional study analyzed the association between physical activity (PA) and social jetlag (SJL) among shift workers. We evaluated 423 employees, aged between 18 and 60 years, who worked in a poultry-processing company in Brazil. Physical activity levels (PAL) were determined by the short form of the International Physical Activity Questionnaire (IPAQ-SF). SJL was calculated as the absolute difference between the time of mid-sleep on work and free days. The percentage of workers insufficiently active was high on all shifts, with no significant differences between the 3 shifts. The amount of time spent in sedentary behavior on workdays did not differ between shifts. Among night-shift workers, negative associations were observed between SJL and 1) the duration and weekly energy expenditure while walking; 2) the frequency of moderate and vigorous PA; and 3) the total energy expenditure related to PA. Even though PAL did not differ among workers on different shifts, we found a high prevalence of subjects who were insufficiently active or too sedentary among all groups. Also, SJL was negatively associated with PA in night-shift workers. These results suggest that PA should be encouraged among shift workers and that SJL may be an important factor in reducing PA in this cohort.

Sociodemographic characteristics related to knowing the benefits of breastfeeding / Características sociodemográficas relacionadas ao conhecimento dos benefícios do aleitamento materno

ABSTRACT Objective: To describe the characteristics of women according to the reported number of benefits of breastfeeding and to verify its association with the duration of this practice until the sixth month of the child's life. Methods: This was a qualitative and prospective observational study performed with postpartum mothers in two stages (n=78, and after six months n=62). Generalized linear models were used to identify the profile of the mothers as well as to determine the factors associated with the duration of breastfeeding until the sixth month of the child's life. Results: The profile of women who reported fewer benefits (≤3) was: younger age (p=0.008), with lower schooling (p<0.001), single (p=0.02), unemployed (p=0.04) and who attended prenatal care at the public health service (p=0.01). The analysis of the interaction of these factors indicated that women who had only completed elementary school and who attended prenatal care at the public health service (p<0.001) or privately (p=0.01) reported fewer benefits. Factors such as: level of education, marital status, previous education/training about breastfeeding, place of prenatal care and the reported number of benefits were not associated with the duration of breastfeeding until the sixth month of the child's life. Conclusions: The lowest number of breastfeeding benefits was reported by women with elementary education and who undewent prenatal care in the public health system or privately. The number of reported benefits was not associated with the duration of this practice until the age of sixth months of the child.

RESUMO Objetivo: Descrever o perfil das mulheres de acordo com o número relatado de benefícios do aleitamento materno e verificar sua associação com a duração dessa prática até o 6º mês da criança. Métodos: Trata-se de um estudo observacional qualitativo e prospectivo realizado com puérperas em duas etapas (n=78 e, após seis meses, n=62). Modelos lineares generalizados foram usados para identificar o perfil das puérperas, assim como para determinar os fatores associados à duração do aleitamento materno até o 6º mês da criança. Resultados: O perfil das mulheres que relataram menos benefícios (≤3) foi: mulheres mais jovens (p=0,008), com menor nível de escolaridade (p<0,001), solteiras (p=0,02), desempregadas (p=0,04) e que fizeram o pré-natal na rede pública de saúde (p=0,01). A análise da interação desses fatores indicou que as mulheres que tinham somente o ensino fundamental que fizeram pré-natal na rede pública de saúde (p<0,001) ou de modo privado (p=0,01) relataram um número menor de benefícios. Fatores como nível de escolaridade, estado civil, recebimento de prévias orientações sobre o aleitamento materno, local de pré-natal e número de benefícios relatados não se associaram à duração do aleitamento materno até o 6º mês da criança. Conclusões: O menor número de benefícios do aleitamento materno foi relatado pelas mulheres com ensino fundamental e que fizeram o pré-natal na rede pública de saúde ou de modo privado. O número de benefícios relatados não se associou com a duração dessa prática até o 6º mês de vida.

Chronotype, social jetlag and sleep debt are associated with dietary intake among Brazilian undergraduate students.

Undergraduate students experience a form of circadian misalignment - known as "social jetlag" - that represents the discrepancy in timing between their circadian and social clocks. Whilst social jetlag is not dependent upon chronotype, the two phenomena tend to be related; evening types show a tendency to have a greater social jetlag, for example. Moreover, evening types have been found to be more likely to have inadequate eating habits than do morning types. The objective of this study was to examine the relationship between chronotype, social jetlag, perceived sleep debt and dietary intake in Brazilian undergraduate students. The chronotype was derived from mid-sleep time on free days (MSF) at the weekend. Social jetlag was calculated as the absolute difference between mid-sleep time on weekdays and weekends. Perceived sleep debt was calculated using the difference between students' preferred weekday sleep duration and their self-reported actual weekday sleep duration. Correlations were found between chronotype and breakfast time (r = 0.24, p = 0.003) and lunch time (r = 0.19, p = 0.01). Multiple regression analyses showed that chronotype was positively associated with consumption of meat (ß = 0.21; p = 0.003); social jetlag was negatively associated with consumption of beans (ß = -0.16; p = 0.02) and perceived sleep debt was positively associated with consumption of beverages (ß = 0.15; p = 0.02) and dairy products (ß = 0.17; p = 0.01) and negatively associated with consumption of cereals and pasta (ß = -0.16; p = 0.02). It is concluded that, in undergraduate students, chronotype (MSF), social jetlag and perceived sleep debt can influence the type and amount of some food groups consumed at mealtimes.

Association between chronotype, food intake and physical activity in medical residents.

An individual's chronotype is a trait which reflects his/her diurnal preferences for the times of rest and activities, and displays a continuum from morningness to eveningness. Studies have shown that eveningness tends to be associated with a less healthy lifestyle, including increased likelihood of developing obesity. In this study, we examined the relationship between chronotype and food intake, physical sleep and activity in 72 resident physicians (52 women and 20 men). Assessments included chronotype evaluation by the Horne and Ostberg Morningness-Eveningness questionnaire (MEQ); food intake pattern through a self-administered food diary that was kept over the course of 3 non-successive days; physical activity level, using the Baecke questionnaire (BQ); sleep quality and quantity using the Pittsburgh Sleep Quality Index (PSQI); and sleepiness, Epworth Sleepiness Scale (ESS). Linear regression analyses, after adjustments for age, sex, body mass index (BMI), hours of additional work per week ESS and total physical activity score, showed that the chronotype score was negatively associated with cholesterol (coefficient = -0.24; p = 0.04), sweets (coefficient = -0.27, p = 0.03) and vegetables (coefficient = -0.26; p = 0.04) intakes. Following the same statistical adjustments, the chronotype score was positivity associated with leisure-time index (coefficient = 0.26, p = 0.03) and BQ total score (coefficient = 0.27, p = 0.03). We concluded that most issues related to nutrition problems and unhealthy lifestyle were associated with scores indicative of eveningness. These findings emphasize the importance of assessing an individual's chronotype when examining feeding behavior.

[Nutritional damages and disturbances in the sleep pattern of nursing workers]. / Prejuízos nutricionais e distúrbios no padrão de sono de trabalhadores da Enfermagem.

This article presents an integrative review of national and international scientific publications that investigate the sleep habits, the feed intake and nutritional status of nursing professionals. It was analyzed articles published in national and international journals in the period 2002 to 2014 and made available in the database PubMed / MEDLINE (USA National Library of Medicine), Lilacs / SciELO (Scientific Eletronic Library Online) and Google Scholar. Thirty one articles met the criteria. In the analysis of these studies it has been found a high prevalence of overweight and obesity, a negative change in the eating habits, as well as losses in the sleep patterns of nursing professionals.

Nutritional status and eating habits of bus drivers during the day and night.

The aim of this study was to compare anthropometry and food intake patterns in bus drivers working during the day and night. One hundred and fifty males (81 night workers and 69 day workers) participated in the study. Dietary intake was assessed using a validated semi-quantitative food frequency questionnaire. Measurements of height, weight, waist circumference (WC), systolic and diastolic blood pressure, blood glucose, and lipid profile were obtained. A significant difference between groups was observed for mean WC (98.5 ± 10.7 cm in day workers versus 103.2 ± 9.7 cm in night workers; p = 0.005). Night workers had higher prevalence of being overweight and obese (BMI ≥ 25 kg/m(2)) than day workers (78.2% day workers versus 90.2% night workers; p = 0.004) and increased WC (>94 cm) (72.4% day workers versus 86.4% night workers; p = 0.03). Significant differences were found for meat consumption (2.3 servings ±0.9 for night workers versus 2.0 servings ±0.7 day workers, p = 0.04) and fruit intake (0.9 servings ±0.4 for night workers versus 0.7 servings for day workers ±0.5; p = 0.006). Night workers had a lower intake of vegetables than recommended compared to day workers (100 versus 92.7%, respectively, p = 0.01) and higher intake of oil (40.7 versus 24.6%, p = 0.03). Multivariate logistic regression analysis indicated that night work was associated with being overweight (OR = 2.94, 95% IC: 1.14-7.66, p = 0.03) and abnormal values of WC (OR = 2.82, 95% IC: 1.20-6.69, p = 0.009) after adjusting for potential confounders. It is concluded that night workers had a higher prevalence and risk of being overweight/obese and increased WC compared with day workers. Night workers also presented a higher proportion of inappropriate intakes of food groups when compared to day workers, even though both groups were eating poor diets. These results demonstrate the need of lifestyle-intervention programs in these workers.

Sleep pattern is associated with adipokine levels and nutritional markers in resident physicians.

Shift work and long hours of work are common in medical training and have been associated with a higher propensity for developing nutritional problems and obesity. Changes in leptin and ghrelin concentrations - two hormones that contribute importantly to the central regulation of food intake - are poorly described in this population. The aim of this study was to identify possible negative associations between sleep patterns, nutritional status and serum levels of adipokines. The study included 72 resident physicians (52 women and 20 men) who underwent the following assessments: nutritional assessment (3-day dietary recall evaluated by the Adapted Healthy Eating Index), anthropometric variables, fasting metabolism, physical activity level, sleep quality and sleepiness. Resident physicians with poor sleep quality reported greater weight gain after the beginning of residency (5.1 and 3.0 kg, respectively; p = 0.01) and higher frequency of abnormal waist circumference (44.2 and 17.6%, respectively; p = 0.04) than those with better sleep quality. Mean ghrelin concentration was greater in volunteers with poor sleep quality (64.6 ± 67.8 and 26.2 ± 25.0 pg/mL, respectively; p = 0.04). Women identified as having excessive daytime sleepiness had lower levels of leptin (9.57 ± 10.4 ng/mL versus 16.49 ± 11.4 ng/mL, respectively; p = 0.03) than those without excessive sleepiness. Furthermore, correlations were found between hours of additional work per week and: intake of cereals, bread and pasta (r = 0.22, p = 0.01); intake of servings of fruits (r = -0.20; p = 0.02) and beans (r = -0.21; p = 0.01); and global score for Adapted Healthy Eating Index (r = -0.23; p = 0.008; Table 3). The sleep quality total score correlated with servings of beans (r = -0.22; p = 0.01) and servings of oils (r = 0.23; p = 0.008). Significant correlations were found between mean of time of sleep and servings of cereals, bread and pasta (r = 0.20; p = 0.02), servings of meat (r = -0.29; p = 0.02) and cholesterol levels (r = 0.27; p = 0.03). These observations indicate that sleep patterns and long working hours of resident physicians are negatively associated with biological markers related to central food control, the lipid profile, cholesterol levels and eating healthy foods. These factors may predispose these shift workers to become overweight and develop metabolic disorders.

Dietary patterns, metabolic markers and subjective sleep measures in resident physicians.

Shiftwork is common in medical training and is necessary for 24-h hospital coverage. Shiftwork poses difficulties not only because of the loss of actual sleep hours but also because it can affect other factors related to lifestyle, such as food intake, physical activity level, and, therefore, metabolic patterns. However, few studies have investigated the nutritional and metabolic profiles of medical personnel receiving training who are participating in shiftwork. The aim of the present study was to identify the possible negative effects of food intake, anthropometric variables, and metabolic and sleep patterns of resident physicians and establish the differences between genders. The study included 72 resident physicians (52 women and 20 men) who underwent the following assessments: nutritional assessment (3-day dietary recall evaluated by the Adapted Healthy Eating Index), anthropometric variables (height, weight, body mass index, and waist circumference), fasting metabolism (lipids, cortisol, high-sensitivity C-reactive protein [hs-CRP], glucose, and insulin), physical activity level (Baecke questionnaire), sleep quality (Pittsburgh Sleep Quality Index; PSQI), and sleepiness (Epworth Sleepiness Scale; ESS). We observed a high frequency of residents who were overweight or obese (65% for men and 21% for women; p = 0.004). Men displayed significantly greater body mass index (BMI) values (p = 0.002) and self-reported weight gain after the beginning of residency (p = 0.008) than women. Poor diet was observed for both genders, including the low intake of vegetables and fruits and the high intake of sweets, saturated fat, cholesterol, and caffeine. The PSQI global scores indicated significant differences between genders (5.9 vs. 7.5 for women and men, respectively; p = 0.01). Women had significantly higher mean high-density lipoprotein cholesterol (HDL-C; p < 0.005), hs-CRP (p = 0.04), and cortisol (p = 0.009) values than men. The elevated prevalence of hypertriglyceridemia and abnormal values of low-density lipoprotein cholesterol (LDL-C; >100 mg/dL) were observed in most individuals. Higher than recommended hs-CRP levels were observed in 66% of the examined resident physicians. Based on current recommendations, a high prevalence of low sleep quality and excessive daytime sleepiness was identified. These observations indicate the need to monitor health status and develop actions to reassess the workload of medical residency and the need for permission to perform extra night shifts for medical residents to avoid worsening health problems in these individuals.

Prejuízos nutricionais e distúrbios no padrão de sono de trabalhadores da Enfermagem / Nutritional damages and disturbances in the sleep pattern of nursing workers / Prejuicios nutricionales y alteraciones en los patrones de sueño de los trabajadores de Enfermería

Este artigo apresenta uma revisão integrativa das publicações científicas da última década, que investigaram os hábitos de sono, a ingestão alimentar e o estado nutricional de profissionais de enfermagem. Foram analisados artigos publicados em periódicos nacionais e internacionais no período de 2002 a 2014, disponibilizados na base de dados PubMed/MEDLINE (USA National Library of Medicine), Lilacs / SciELO (Scientific Eletronic Library Online) e Google Acadêmico. Trinta e um artigos preencheram os critérios estabelecidos. Na análise destes estudos foi identificada elevada prevalência de sobrepeso e obesidade, além de uma modificação negativa nos hábitos alimentares, bem como prejuízos na dinâmica do sono dos profissionais da área de enfermagem.

This article presents an integrative review of national and international scientific publications that investigate the sleep habits, the feed intake and nutritional status of nursing professionals. It was analyzed articles published in national and international journals in the period 2002 to 2014 and made available in the database PubMed / MEDLINE (USA National Library of Medicine), Lilacs / SciELO (Scientific Eletronic Library Online) and Google Scholar. Thirty one articles met the criteria. In the analysis of these studies it has been found a high prevalence of overweight and obesity, a negative change in the eating habits, as well as losses in the sleep patterns of nursing professionals.

En este artículo se presenta una revisión integradora de las publicaciones científicas nacionales e internacionales que investigan los hábitos de sueño, el consumo de alimento y el estado nutricional de los profesionales de enfermería. Se analizaron los artículos publicados en revistas nacionales e internacionales en el período de 2002 a 2014, disponibles en la base de datos PubMed / MEDLINE (USA Biblioteca Nacional de Medicina), Lilacs / SciELO (Scientific Eletronic Library Online) y Google Scholar. Treinta y uno artículos cumplieron con los criterios de inclusión. En el análisis de estos estudios se encontró una alta prevalencia de sobrepeso y obesidad, un cambio negativo en los hábitos alimenticios, así como prejuicios en la dinámica del sueño de los profesionales de enfermería.

Estilo de vida e formação médica: impacto sobre o perfil nutricional / Lifestyle and medical education: impact on the nutritional profile

A formação do profissional médico impõe modificações nocivas ao estilo de vida, predispondo ao ganho de peso. O objetivo deste estudo foi realizar uma revisão acerca das prevalências de sobrepeso e obesidade e possíveis fatores causais destas taxas em estudantes de Medicina (EM) e médicos residentes (MR). Realizou-se uma busca nas bases de dados on-line PubMed/Medline (US National Library of Medicine), Scielo e Lilacs, com as palavras-chave: "estudantes de medicina" e "médicos residentes", associadas com cada um dos termos: "índice de massa corporal (IMC)"; "obesidade"; "sobrepeso"; "ingestão alimentar"; "sedentarismo" e "sono", e suas traduções para a língua inglesa. Foram selecionados 31 estudos, dos quais 25 foram realizados com EM, cinco com MR e um com ambas as populações. Dezesseis estudos retrataram altas prevalências de sobrepeso e obesidade (taxas de 15% a 83%). Em relação aos fatores associados ao aumento de peso, destacaram-se os hábitos alimentares inadequados. Sonolência excessiva diurna, privação do sono e sedentarismo também foram amplamente identificados. Estes resultados ressaltam a necessidade de desenvolver ações para minimizar os efeitos negativos da rotina imposta pelo processo de formação médica, em especial os aspectos relacionados a excesso de peso.

The training of the medical profession imposes harmful changes to lifestyle, which predisposes to weight gain. The aim of this study was to review the prevalence of overweight and obesity and possible causative factors in these rates in medical students (MS) and residents physicians (RP). We conducted a search of the databases online: PubMed / Medline (U.S. National Library of Medicine), Scielo and Lilacs with the keywords: "medical students" and "residents" associated with each of the terms: "body mass index (BMI)", "obesity", "overweight", "food intake", "sendentarism" and "sleep", and using the translation of these terms for the English language Thirty one studies were selected, where 25 were performed with EM, five with MR and one with both the populations. Sixteen studies indicated high prevalences of overweight and obesity (ranging between 15% and 83%). Regarding factors associated with weight gain, have stand out inadequate food intake. The excessive daytime sleepiness, sleep deprivation and sedentarism were widely identified. These results underscore the need to develop actions to minimize the negative effects of routine imposed by the process of medical training, especially those aspects related to excess weight.