Meal Service for Night Shift Workers

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: State University of New York at Buffalo

Must not be taking: Glucose-lowering medications

Disqualifiers: Diabetes, Pregnancy, Kidney disease, others

Trial Summary

What is the purpose of this trial?

This trial is testing if changing the amount of protein and carbohydrates in meals can help control blood sugar levels in night shift EMS workers. The study will monitor participants' blood sugar and activity levels while they follow different meal plans. The goal is to find a diet that helps keep their blood sugar stable during night shifts.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you are taking medication to lower blood glucose.

What data supports the effectiveness of the treatment Meal service for night shift workers?

Research shows that improving meal services, like using new food service systems or electronic meal ordering, can enhance dietary intake and patient satisfaction. These strategies have been effective in hospital settings, suggesting they might also benefit night shift workers by improving their nutrition and overall satisfaction with meals. ^{1 2 3 4 5}

Is the meal service for night shift workers generally safe for humans?

The research does not provide specific safety data for meal services for night shift workers, but it highlights potential occupational risks in food service environments, such as ergonomic and chemical risks, which could be relevant to consider for safety. ^{6 7 8 9 10}

How does the meal service treatment for night shift workers differ from other treatments?

This treatment is unique because it focuses on the timing and composition of meals for night shift workers, aiming to improve sleep quality and cognitive performance by adjusting when and what they eat, rather than using medication or other traditional therapies. ^{11 12 13 14 15}

Research Team

David Hostler, PhD

Principal Investigator

University at Buffalo

Eligibility Criteria

This trial is for night shift EMS providers who have been working nights for at least a year and whose main job is patient care. It's not open to those with metabolic diseases like diabetes, pregnant women or those planning pregnancy, people with kidney disease, food allergies/intolerances, digestive disorders, or on blood glucose-lowering meds.

Inclusion Criteria

Works night shift only for at least one year

Provides patient care as primary duty

Emergency medical service (EMS) provider

Exclusion Criteria

Pregnant or planning to become pregnant

I have a digestive disorder.

I am on medication to control my blood sugar.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (virtual)

Baseline Monitoring

Participants provide health and demographic information, complete questionnaires, and are familiarized with study protocols

1 week

1 visit (virtual)

Intervention

Participants wear a continuous glucose monitor, actigraph activity monitor, document dietary intake, and rate stress levels. They are randomized to consume either a 2:1 or 1:1 protein to carbohydrate ratio during the night shift

2 weeks

Follow-up

Participants are monitored for compliance and glycemic control

2 weeks

Treatment Details

Interventions

• Meal service (Behavioural Intervention)

Trial Overview The study tests how meal services can affect blood sugar control in night shift EMS workers. It will also assess if it's practical to implement such a dietary intervention within this workforce.

Participant Groups

Group I: High protein Active Control 1 Intervention

Consuming a meal composed of 2:1 grams of protein to carbohydrate during the night shift between 7pm-7am

Group II: Moderate protein Placebo Group 1 Intervention

Consuming a meal composed of 1:1 grams of protein to carbohydrate during the night shift between 7pm-7am

Who Is Running the Clinical Trial?

State University of New York at Buffalo

Lead Sponsor

Trials

279

Recruited

52,600+

Dr. Jonathan Slonin

State University of New York at Buffalo

Chief Medical Officer since 2020

MD from University of Miami, MBA from George Washington University

Stacy Knapper

State University of New York at Buffalo

Chief Executive Officer since 2023

BSEE from University of Puerto Rico-Mayagüez, MS in Management from Rensselaer Polytechnic Institute

Findings from Research

The novel FoodforCare meal service significantly improved protein and energy intake among patients compared to the traditional meal service, with notable increases in intake on both the first and fourth days of full oral intake.

Patient satisfaction with the meal service remained stable, but the FoodforCare group reported better satisfaction regarding the appearance and smell of the meals, indicating a positive reception of the new service.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[A novel in-hospital meal service improves protein and energy intake]. Dijxhoorn, DN., van den Berg, MGA., Drenth, JPH., et al.[2018]

Implementing a co-designed mealtime assistance process in a 31-bed ward led to a significant reduction in wasted meals from an average of 3 per day to 0, which also decreased food waste by 0.43 kg per patient daily.

Patients who received mealtime assistance showed no new incidences of aspiration pneumonia or swallowing difficulties, indicating that the intervention not only improved meal access but also enhanced patient safety and nutritional outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reducing risk of development or exacerbation of nutritional deficits by optimizing patient access to mealtime assistance. Teeling, SP., Coetzee, H., Phillips, M., et al.[2020]

A systematic review of five studies involving 720 patients found that electronic bedside meal ordering systems significantly improved patient dietary intake, satisfaction, and reduced plate waste compared to traditional menu systems.

Despite these positive outcomes, the review highlights a need for more research to fully understand the impact of these digital systems on patient and organizational outcomes in hospital foodservices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of electronic bedside meal ordering systems on dietary intake, patient satisfaction, plate waste and costs: A systematic literature review. MacKenzie-Shalders, K., Maunder, K., So, D., et al.[2020]

A systematic review of 36 studies found that various hospital food service strategies, such as menu modifications and new food service systems, can significantly improve food consumption among hospitalized patients.

Multidisciplinary approaches that include mealtime assistance and attractive meal presentation have been shown to enhance food intake, nutritional status, and patient satisfaction, ultimately improving the quality of life for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hospital Food Service Strategies to Improve Food Intakes among Inpatients: A Systematic Review. Osman, NS., Md Nor, N., Md Sharif, MS., et al.[2023]

Patients rated the quality of meal service higher in hospitals where dietary employees delivered meal trays compared to those where nursing employees did, indicating that the type of staff delivering meals can influence patient satisfaction.

While both dietary and nursing employees showed similar personal motivation to provide service, dietary employees felt they received better organizational support for their roles, which may impact the overall quality of meal service.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Quality of patient meal service in hospitals: delivery of meals by dietary employees vs delivery by nursing employees. Gregoire, MB.[2019]

A study of school food service workers in Bahia, Brazil, revealed that most food handlers (98.6%) are female, with a mean age of 46.85 years, and over half (52.8%) had no training on occupational risks, despite working in high-risk environments.

The study found that ergonomic risks were particularly concerning, with only 7.69% adequacy, indicating a very high risk, while overall, the food service environments were classified as having high occupational risk, contributing to issues like obesity and hypertension among workers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Study on Perception and Exposure to Occupational Risks at Public School Food Services in Bahia, Brazil. Ferreira, JDS., Araújo, MDPN., Botelho, RBA., et al.[2022]

Injuries from foreign bodies can be fatal, especially for infants and young children, highlighting the critical need for effective safety packaging to prevent such accidents.

The study emphasizes the importance of thorough research into packaging safety, suggesting that better data collection on the types and origins of foreign bodies is essential for improving public health and preventing injuries.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Proper packaging for food and no-food products to avoid injuries. Passali, D., Gregori, D., Foltran, F.[2012]

A survey of 35 healthcare facilities in Germany and Italy revealed significant variability in the storage and usability of electronic food menu data, which is crucial for investigating healthcare-associated foodborne outbreaks (HA-FBOs).

All German healthcare facilities and one-third of Italian facilities served potentially risky food items, highlighting the need for standardized data collection to improve food safety and outbreak investigations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Catering of high-risk foods and potential of stored food menu data for timely outbreak investigations in healthcare facilities, Italy and Germany. Boone, I., D'Errico, ML., Iannetti, L., et al.[2023]

About 12% of food workers reported working while experiencing vomiting or diarrhea on multiple occasions in the past year, highlighting a significant public health concern.

Factors such as high meal volume, absence of illness reporting policies, lack of on-call staff, inexperienced managers, and male gender were linked to this behavior, suggesting that improved workplace policies could help reduce the incidence of food workers working while ill.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Factors associated with food workers working while experiencing vomiting or diarrhea. Sumner, S., Brown, LG., Frick, R., et al.[2023]

A study involving 101 children aged 3 to 5 years in Head Start centers found that adherence to time and temperature standards during food preparation and service significantly influenced the amount of food consumed, particularly milk.

Food served was well accepted by the children and received high ratings from adult preference panels, indicating that proper handling and serving conditions can enhance meal consumption in early childhood settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adherence to time and temperature standards and food acceptability. Garey, JG., Simko, MD.[2010]

The study found that rotating 3-shift work does not significantly impact the nutritional quality of meals and snacks consumed by shift workers, suggesting that their dietary habits remain stable despite changing work schedules.

Using a qualitative classification system for meals and snacks can be an effective and cost-efficient method for evaluating the eating habits of shift workers, especially when precise quantitative dietary assessments are challenging.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutrition and shiftwork: the use of meal classification as a new tool for qualitative/quantitative evaluation of dietary intake in shiftworkers. Lennernäs, MA., Hambraeus, L., Akerstedt, T.[2016]

In a study with 39 healthy participants, consuming a snack during nightshifts led to better cognitive performance and alertness compared to having a large meal or not eating at all.

Participants who had a meal at night reported greater sleepiness and performed worse on cognitive tasks, suggesting that shift workers should prefer snacks over large meals to maintain safety and performance during night shifts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Altering meal timing to improve cognitive performance during simulated nightshifts. Gupta, CC., Centofanti, S., Dorrian, J., et al.[2020]

In a study of 30 female nursing professionals working night shifts, it was found that reducing the time between the last meal and sleep onset by one hour increased diurnal sleep duration by approximately 0.39 hours.

The composition of the last meal also affected sleep, with higher intakes of fat and carbohydrates leading to longer sleep onset times, suggesting that both meal timing and content are important for improving sleep quality in night workers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Timing and Composition of Last Meal before Bedtime Affect Sleep Parameters of Night Workers. Nogueira, LFR., Pellegrino, P., Cipolla-Neto, J., et al.[2021]

Flight attendants face significant challenges in managing their meals due to irregular work schedules and fragmented time, leading to a reliance on snacks rather than regular meals.

The study revealed that FAs adopt various strategies to cope with their unpredictable meal situations, such as eating in advance, using emergency food supplies, and sometimes skipping meals altogether.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impossible meals? The food and meal situation of flight attendants in Scandinavia - A qualitative interview study. Nyberg, M., Lennernäs Wiklund, M.[2018]

In a study of 34 male night-shift workers, it was found that working night shifts led to increased feelings of hunger and anxiety compared to when they had a normal nocturnal sleep, indicating that sleep disruption can significantly affect meal perceptions.

Higher anxiety levels after night shifts were linked to decreased hunger and enjoyment of food, suggesting that anxiety may negatively impact food consumption and overall eating behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

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. Santa Cecília Silva, AA., Lopes, TDVC., Teixeira, KR., et al.[2018]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

[A novel in-hospital meal service improves protein and energy intake]. [2018]

2. England pubmed.ncbi.nlm.nih.gov

Reducing risk of development or exacerbation of nutritional deficits by optimizing patient access to mealtime assistance. [2020]

3. Australia pubmed.ncbi.nlm.nih.gov

Impact of electronic bedside meal ordering systems on dietary intake, patient satisfaction, plate waste and costs: A systematic literature review. [2020]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Hospital Food Service Strategies to Improve Food Intakes among Inpatients: A Systematic Review. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Quality of patient meal service in hospitals: delivery of meals by dietary employees vs delivery by nursing employees. [2019]

6. Switzerland pubmed.ncbi.nlm.nih.gov

A Study on Perception and Exposure to Occupational Risks at Public School Food Services in Bahia, Brazil. [2022]

7. Ireland pubmed.ncbi.nlm.nih.gov

Proper packaging for food and no-food products to avoid injuries. [2012]

8. England pubmed.ncbi.nlm.nih.gov

Catering of high-risk foods and potential of stored food menu data for timely outbreak investigations in healthcare facilities, Italy and Germany. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Factors associated with food workers working while experiencing vomiting or diarrhea. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Adherence to time and temperature standards and food acceptability. [2010]

11. England pubmed.ncbi.nlm.nih.gov

Nutrition and shiftwork: the use of meal classification as a new tool for qualitative/quantitative evaluation of dietary intake in shiftworkers. [2016]

12. England pubmed.ncbi.nlm.nih.gov

Altering meal timing to improve cognitive performance during simulated nightshifts. [2020]

13. Switzerland pubmed.ncbi.nlm.nih.gov

Timing and Composition of Last Meal before Bedtime Affect Sleep Parameters of Night Workers. [2021]

14. England pubmed.ncbi.nlm.nih.gov

Impossible meals? The food and meal situation of flight attendants in Scandinavia - A qualitative interview study. [2018]

15. England pubmed.ncbi.nlm.nih.gov

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. [2018]