When patients who work a night shift share their health goals with primary care doctors, a common issue discussed is eating healthier. Challenges abound when working nontypical hours. To help, you may need to offer suggestions about meal preparation, a balanced diet, and help patients understand how this can all play a part in overall well-being. Here is how to be a support to your patients who work a night shift job.

Start with smart goals, said Michael Richardson, MD, a family physician in Boston.

“Specific, measurable, achievable, relevant time-based goals will have the highest chance of succeeding compared to abstract goals to eat healthier,” he said.

Explain the Night Shift Conundrum

Working a night shift may conflict with the body's natural circadian rhythm.

“Beyond fatigue, chronic disruption of the body’s sleep-wake cycle interferes with metabolism, hormone production, and immune function,” said Jamie Mok, a Los Angeles-based registered dietitian nutritionist, spokesperson for the Academy of Nutrition and Dietetics, and owner of Yogini RD LLC, a nutrition private practice.

She also said a conflict of circadian rhythm increases the risk for cardiometabolic disease, digestive disorders, sleep disorders, poor mental health, miscarriage, and preterm birth.

How Timing Affects Biology

Working night shifts disrupt the body’s natural circadian rhythm, which is regulated by sunlight, said Mok.

“This disruption of the body’s internal clock suppresses the production of sleep hormones like melatonin and disrupts metabolic hormones, making the body less efficient at processing food,” she said. “These effects increase the risk of conditions like obesity and type 2 diabetes and also compromise your immune system, increasing your body’s susceptibility to illness.”

Obtainable Goals

Adopting healthy eating habits can be difficult for night shift workers, explained Mok, because they have limited access to nutritious food at night and disrupted hunger hormones when their circadian rhythm “is thrown off.” In combination with fatigue and social isolation, the diet quality of night shift workers often suffers. To help night shift workers improve their diet, patients can focus on three key habits: 

Optimizing diet quality. Suggest your patients select more nutrient-dense foods and less added fat, sugar, and salt. “Since sleep patterns are disrupted, ensure your food choices are packed with vitamins and minerals to support overall health and immune function,” she said.

Prioritizing meal planning and prepping. “By preparing nutritionally balanced meals in advance, night shift workers can take control over the diet quality and avoid relying on a limited selection of unhealthy convenience foods available at off-hours,” Mok said. She said carving out time each week to plan meals is also another successful strategy.

Maintaining consistent mealtimes. Explain to your patients how aregular schedule can help their wellness goals. “Eating at relatively consistent times during your awake hours helps regulate your body,” said Mok. Also, primary care doctors can tell patients to consider digestibility of food choices, especially before sleep, and to avoid very heavy or greasy meals that can interfere with sleep.

Staying hydrated. Emphasize that night shift workers should stay well-hydrated throughout their shift by keeping a reusable water bottle readily accessible.

Follow a Consistent Sleep Routine

Even if following a nontraditional work schedule, night shift employees can benefit from adhering to some sleep practices. This involves creating a “light” and “dark” schedule that mimics a normal day, such as starting the shift with timed bright light exposure and using black out curtains when they are ready to go to sleep, Family Physician Richardson said.

How Can a Registered Dietician (RD) or Registered Dietician Nutritionist (RDN) Help

Many insurance plans cover the cost of nutritional counseling from a RD or an RDN. Because they are experts in food, they can effectively offer individualized advice, Mok said. Richardson also supports nutritional counseling.

“Registered dieticians can help by providing tailored dietary advice and meal plans that are customized to the patient’s specific needs and chronic health issues,” he said.