title: Influences on Dietary Choices during Day versus Night Shift in Shift Workers: A Mixed Methods Study.
abstract: Shift work is associated with diet-related chronic conditions such as obesity and cardiovascular disease. This study aimed to explore factors influencing food choice and dietary intake in shift workers. A fixed mixed method study design was undertaken on a convenience sample of firefighters who continually work a rotating roster. Six focus groups (n= 41) were conducted to establish factors affecting dietary intake whilst at work. Dietary intake was assessed using repeated 24 h dietary recalls (n= 19). Interviews were audio recorded, transcribed verbatim, and interpreted using thematic analysis. Dietary data were entered into FoodWorks and analysed using Wilcoxon signed-rank test;p< 0.05 was considered significant. Thematic analysis highlighted four key themes influencing dietary intake: shift schedule; attitudes and decisions of co-workers; time and accessibility; and knowledge of the relationship between food and health. Participants reported consuming more discretionary foods and limited availability of healthy food choices on night shift. Energy intakes (kJ/day) did not differ between days that included a day or night shift but greater energy density (EDenergy, kJ/g/day) of the diet was observed on night shift compared with day shift. This study has identified a number of dietary-specific shift-related factors that may contribute to an increase in unhealthy behaviours in a shift-working population. Given the increased risk of developing chronic diseases, organisational change to support workers in this environment is warranted.
authors.affiliation: Department of Nutrition, Dietetics and Food, Level 1, 264 Ferntree Gully Road, Monash University, Melbourne, Notting Hill VIC 3168, Australia. emilykbonnell@gmail.com.
authors.forename: Emily K
authors.initials: EK
authors.lastname: Bonnell
authors.affiliation: Department of Nutrition, Dietetics and Food, Level 1, 264 Ferntree Gully Road, Monash University, Melbourne, Notting Hill VIC 3168, Australia. Catherine.huggins@monash.edu.
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Huggins
authors.affiliation: Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston VIC 3199, Australia. chris.huggins@monash.edu.
authors.forename: Chris T
authors.initials: CT
authors.lastname: Huggins
authors.affiliation: Department of Nutrition, Dietetics and Food, Level 1, 264 Ferntree Gully Road, Monash University, Melbourne, Notting Hill VIC 3168, Australia. tracy.mccaffrey@monash.edu.
authors.forename: Tracy A
authors.initials: TA
authors.lastname: McCaffrey
authors.affiliation: Department of Nutrition, Dietetics and Food, Level 1, 264 Ferntree Gully Road, Monash University, Melbourne, Notting Hill VIC 3168, Australia. claire.palermo@monash.edu.
authors.forename: Claire
authors.initials: C
authors.lastname: Palermo
authors.affiliation: Department of Nutrition, Dietetics and Food, Level 1, 264 Ferntree Gully Road, Monash University, Melbourne, Notting Hill VIC 3168, Australia. Maxine.bonham@monash.edu.
authors.forename: Maxine P
authors.initials: MP
authors.lastname: Bonham
mesh_terms: D000328:Adult; D001315:Australia; D015992:Body Mass Index; D001835:Body Weight; D002755:Choice Behavior; D002940:Circadian Rhythm; D004032:Diet; D005260:Female; D061388:Firefighters; D017144:Focus Groups; D005518:Food Preferences; D006801:Humans; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D014937:Work; D014940:Work Schedule Tolerance
keywords: communicative disease; nutrition; qualitative methodology; shift work