Characterising studies to inform dietary recommendations for shift workers – a systematic review
Notice bibliographique
Résumé
This abstract was awarded the student prize for best oral presentation. Shift work is integral to the operational function of emergency service and first responder professions. However, it is associated with health consequences due to chronic disruptions in circadian rhythms,(1) sleep patterns(2) and less healthy diets.(3-4) Modifiable health behaviour interventions, such as improving diet quality, may be effective to prevent, mitigate or delay the onset of non-communicable diseases linked to shift work.(5) However, there is a lack of consensus on evidence-based guidelines.(3) This review aims to evaluate the evidence to support nutritional interventions in this population. A systematic review (PROSPERO CRD42023421400) was conducted to evaluate the literature that may inform dietary guidance for shift workers. Four databases were searched (Embase, Cochrane Library, Web of Science, PubMed). An additional three databases (Police MyAthens, ProQuest, Clinical Trials registries) were searched for relevant grey literature alongside a physical search at the National Police Library. Studies were screened by two researchers and included if of a randomised controlled trial (RCT), crossover-RCT, observational study design, conducted in free-living shiftwork populations or laboratory-controlled shiftwork setting. Papers were accepted where the intervention included a dietary component, and health-related outcomes were reported. Quality assessment was assessed using the Cochrane Risk of Bias Tools. Observational studies were evaluated using the Ottawa Scale. From the 6909 articles retrieved, 43 met the inclusion criteria. Most articles reported using a crossover design (49%), followed by observational studies (33%). Where specified, most studies involved free-living participants (67%) and were carried out with nursing and healthcare professionals (40%). Of included studies, 30% were conducted under simulated conditions. Only 9% of studies were conducted in first responder groups. Years in shift work were often not reported (40%) and, likely due to the prevalence of simulated protocols, a moderate number of studies involved participants with no shift work experience (28%). The quality assessment highlighted that 66% of the included papers were judged to be of concern (15%) or a high risk of bias (51%), signifying challenges to conducting research in shift working populations. The most frequently reported intervention components were Time-Restricted Eating (21%), macronutrient adjustments (21%), and food diaries (19%). The most frequently reported outcomes were cardiometabolic health (39.5%), cognitive performance (27.9%), and sleep quality (11.6%). Heterogeneity in interventions, outcome measures and reporting across studies made it difficult to synthesise findings to inform shift worker dietary guidelines. There was an under representation of studies conducted in first responder occupations and limited studies conducted in the UK. The high risk of bias re-iterates a requirement for more rigorous research to understand the complex relationship between shift work and first responders’ health. Addressing these limitations will help contextualise findings and inform development of evidence-based dietary strategies to mitigate the adverse health effects of shift work in this critical workforce.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,040 | 0,146 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,014 | 0,012 |
| Bibliométrie | 0,029 | 0,017 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,005 | 0,007 |
| Science ouverte | 0,003 | 0,004 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».