Ways to manage the digestive impact of disrupted eating patterns
Over the years, I’ve been contacted by dozens of people who work shifts (in health and social care, emergency and security services, as well as in many manufacturing industries) and who have digestive issues. Nurses who work on the maternity ward tell me that they struggle with ‘nightshift belly’ – looking so bloated that they feel more pregnant than the women in their care; others report issues with constipation, indigestion and heartburn. They all tell me how fatigued they are, but tend to put this down to lack of sleep. But one effect; that many of these shift workers may have overlooked is what and when they are eating.
Working shifts can mean that it can be hard to establish a good eating routine when your hours are all over the place. When your sleep is disrupted, this can have an impact on the production of the hormones leptin and ghrelin, which can affect your appetite and sometimes make you feel hungrier. What’s more, it has been shown that fatigue reduces your motivation to exercise. These factors, combined with limited access to healthy food in certain workplaces, can be a recipe for disaster. Let’s look at what’s going on in your body when you work shifts and how you can navigate the disruptions by making healthy lifestyle choices to protect your digestive health and overall wellbeing.
The body’s circadian rhythms and the impacts of shift work
Many of our biological systems including our sleep and wake cycle, our appetite and digestive system function, body temperature, and mood follow daily patterns known as circadian rhythms. Circadian rhythms are 24-hour cycles that are part of the body’s internal clock. They are set by circadian clock genes that are found in nearly every cell in our bodies. The scheduling of our circadian rhythm is heavily impacted by when our eyes first detect light. The light tells our bodies to wake up. On the contrary, when it becomes dark, the hormone melatonin is secreted by our pineal gland in the brain to help promote sleep. Night shift work can alter our sleep patterns and mean lightness and darkness cues are disrupted, which can cause various circadian dysregulations including sleep, appetite and digestive function, which increases the risk for poor health outcomes.
Evidence suggests that persistent night shift work resulting in circadian disruption can cause human cancer and The International Agency for Research on Cancer (IARC) concluded that night shift work is “probably carcinogenic to humans.” There are a few mechanisms thought to be involved, one being the nightly suppression of melatonin – one of the body’s most potent antioxidant agents that protects against cancers. There are other factors to consider too, including shift workers having poorer opportunities for healthy lifestyles due to time constraints.
Ways to reduce your risk
- Eat a balanced diet with plenty of fruits, veggies and other fibres, ensuring an abundance of antioxidants in your diet. Try to limit ultra processed foods.
- Exercise regularly.
- Maintain a healthy weight.
- Limit alcohol intake.
- Don’t smoke.
- Get enough sleep (7-9 hours per day).
- Try to get daylight whenever possible and avoid use of blue light devices before bed.
In addition to cancer, night shift work has been linked with digestive disorders, sleep issues, stress, depression, type 2 diabetes, heart disease, stroke and metabolic disorders.
Shift working and poor sleep
Shift work can cause poor sleep, also known as Shift Work Sleep Disorder (SWSD), because it disrupts the body’s circadian rhythm. When you have SWSD, there is a conflict between your body’s circadian rhythms and your work schedule. You may have to be at work when your body wants to sleep. Then when you should sleep, your body expects to be awake.
SWSD causes you to have trouble sleeping or be severely tired. The quality of sleep may be poor, and you may wake up feeling unrefreshed. You may feel fatigued or have trouble concentrating. This can hurt your performance at work and can put you at risk for making a costly mistake or getting injured on the job. Not everyone who does shift work has SWSD. Many people have difficulty initially adjusting to a new shift. If after several weeks you continue to have difficulty falling asleep or staying asleep, or if you feel tired even after sleeping 7-8 hours, you may have SWSD.
The need to eat at different times due to shift work can also cause an issue with sleep. Late-night eating can make it harder to fall and stay asleep because it interrupts your natural circadian rhythm. This happens because food requires digestion, which affects hormones and metabolism.
What and when to eat after a night shift to promote good sleep
Eating a lot of simple carbs before bed may negatively impact sleep quality, leading to shorter sleep, more time spent awake in bed, and less restorative sleep. This can occur because carbohydrates eaten alone will result in blood glucose levels spiking and then plummeting; the body responds by increasing cortisol to bring the blood glucose back up again into a safe range. However, cortisol is our stress hormone which wakes us up as our body perceives danger from the blood sugar dropping too low.
Eating a balanced meal before bed that contains protein, healthy fats and wholegrain carbohydrates will help to prevent this from happening.
It would be beneficial to try and eat your largest meal at the beginning of the day and keeping the last meal nice and light. If possible, try to avoid eating larger meals at least one hour before bed.
People tend to struggle with the last meal after shift work because of the desire to grab something convenient and quick so they can get to sleep after a tiring shift. You come home and grab something easy, such as toast or cereal. However, instead of eating a slice of toast on its own after your shift has ended, pair it with a source of fat and protein (think avocado, hummus, scrambled egg, peanut butter, smoked salmon, cottage cheese, turkey slices, etc). Also make sure you opt for a wholegrain bread or sourdough and avoid the ultra-processed supermarket-bought white bread options.
Instead of a quick bowl of cereal and milk before bed, try opting for a bowl of Greek yoghurt instead which is rich in protein and fats, topped with a low sugar, high protein granola.
Another alternative to cereal would be porridge, however make sure that you include protein to balance out the carbohydrates so add nuts, seeds, an egg yolk, collagen or protein powder.
Omelettes, frittatas, or scrambled eggs that include veggies are all healthy choices, with a side of sourdough toast.
You could also consider some ready-made or home-made soups as they are quick to heat up when you get home. Just make sure you try and pick one that contains a source of protein – lentils, chicken, beans etc.
Shift work and gut health
It has been documented that circadian disruption can alter the gut microbiome, leading to an inflammatory state. Research has shown that disrupted circadian rhythms in the gut are linked to gastrointestinal disorders such as constipation and IBS.
Compared with day workers, shift workers more frequently report gastrointestinal symptoms: abdominal pain, gas, diarrhoea, constipation, nausea, vomiting, change in appetite (either increased or decreased), indigestion, and heartburn.
How to support your gut health as a shift worker
- Time your meals in 4-hour intervals during a 12-hour window – this pattern has been shown to support circadian rhythms in shift workers. Not snacking in between these meals also helps to let the digestive system do its ‘cleaning’ work between meals, removing any bacteria and debris. To last 4 hours between meals with no snacks, make sure you eat enough protein and fats with each meal. These two macronutrients help to keep you satiated for much longer than carbohydrates alone.
- As a general rule, avoid high-fat ultra processed foods, fried or spicy foods, but particularly before bed as they may contribute to indigestion and gas.
- Pack healthy meals to take with you to work as this will ensure that you are able to eat minimally processed, well balanced meals which will help support your gut microbiome and health in general.
- Try to minimise caffeine consumption during your shift (as hard as that may seem) – not only can it affect your sleep later as it takes up to 10 hours to clear from your system, but excessive caffeine has a dehydrating effect on the bowels and may lead to an increase in gut symptoms.
- Take probiotics, such as our Live Bacteria capsules, and eat fermented foods daily to support the good bacteria in your gut, as well as eating a wide variety of plant-based foods in your diet to feed these bacteria.
- Take Digestive Enzymes, particularly before eating the last meal of the day to help the digestive system to break food down before bed.
If you have any questions about a digestive and gut health issue or would like to know more about our supplements, please get in touch.
