Portion Size for Shift Work Sleep Disorder
Recruiting in Palo Alto (17 mi)
Overseen ByMarie-Pierre St-Onge, PhD
Age: 18 - 65
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: Academic
Waitlist Available
Sponsor: Columbia University
No Placebo Group
Trial Summary
What is the purpose of this trial?This study will compare eating behaviors and measures of hunger and fullness between day and night workers in order to better understand why night workers are at increased risk for obesity and related diseases.
Do I have to stop taking my current medications for the trial?
The protocol does not specify whether you need to stop taking your current medications.
Is portion size a promising treatment for Shift Work Sleep Disorder?
Portion size control could be a promising treatment for Shift Work Sleep Disorder because it helps manage weight and improve dietary habits, which are often disrupted in shift workers. By limiting the amount of food consumed, especially during irregular hours, shift workers might better regulate their energy intake and maintain a healthier lifestyle.
235913What data supports the idea that Portion Size for Shift Work Sleep Disorder (also known as: Portion size) is an effective treatment?
The available research does not provide direct evidence that Portion Size is an effective treatment for Shift Work Sleep Disorder. Instead, the studies focus on how shift work affects eating behaviors and sleep patterns. For example, one study found that night shift workers tend to consume more empty calorie foods and beverages, which could be linked to weight gain. Another study showed that altering meal timing can affect hunger and sleepiness levels during night shifts. These findings suggest that managing portion sizes and meal timing might help shift workers maintain healthier eating habits, but there is no specific data supporting Portion Size as a treatment for the disorder itself.
2891011What safety data exists for portion size treatment in shift work sleep disorder?
The provided research does not directly address safety data for portion size treatment in shift work sleep disorder. The studies focus on the impact of portion size on energy intake, consumer behavior, and nutrition labeling, but do not evaluate safety or its application to shift work sleep disorder.
146712Eligibility Criteria
This trial is for day or night shift workers aged 20-55, with a BMI of 19-35, living in the NYC area. They must be metabolically healthy and weight stable for the past three months. It's not open to pregnant women, smokers, those with certain health conditions like cardiovascular disease or diabetes, or anyone on a recent diet program.Inclusion Criteria
I am between 20 and 55 years old.
I work at least 8 hours a day for 3 or more days each week.
Exclusion Criteria
I have type 2 diabetes.
I have a diagnosed psychiatric or sleep disorder.
I have obstructive sleep apnea.
I have high blood pressure.
I am currently pregnant or have given birth within the last year.
Participant Groups
The study is looking at how portion size affects hunger and fullness in day versus night shift workers to understand their higher obesity risk. Participants' eating behaviors will be compared based on their work shifts.
2Treatment groups
Active Control
Group I: Night workerActive Control1 Intervention
Men and women who work only night shift for at least 3 consecutive days of the week
Group II: Day workerActive Control1 Intervention
Men and women who work only day shift for at least 3 consecutive days of the week
Find A Clinic Near You
Research locations nearbySelect from list below to view details:
Columbia University Irving Medical CenterNew York, NY
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Who is running the clinical trial?
Columbia UniversityLead Sponsor
References
Increased portion size leads to a sustained increase in energy intake over 4 d in normal-weight and overweight men and women. [2009]Large food portions may be facilitating excess energy intake (EI) and adiposity among adults. The present study aimed to assess the extent to which EI and amounts of foods consumed are influenced by the availability of different-sized food portions. A randomised within-subject cross-over, fully residential design was used, where forty-three (twenty-one men and twenty-two women) normal-weight and overweight adults were randomly allocated to two separate 4 d periods where they were presented with either 'standard' or 'large' food portions of the same foods and beverages. The main outcome measures were the amount of food (g) and EI (MJ) consumed throughout each study period. Mean EI over 4 d was significantly higher on the large portion condition compared with the standard condition in the total group (59.1 (sd 6.6) v. 52.2 (sd 14.3) MJ; P = 0.020); men and women increased their EI by 17 % (10 (sd 6.5) MJ; P
The effect of sleep restriction on snacking behaviour during a week of simulated shiftwork. [2022]Due to irregular working hours shiftworkers experience circadian disruption and sleep restriction. There is some evidence to indicate that these factors adversely affect health through changes in snacking behaviour. The aim of this study was to investigate the impact of sleep restriction, prior wake and circadian phase on snacking behaviour during a week of simulated shiftwork. Twenty-four healthy males (age: 22.0 ± 3.6 years, mean ± SD) lived in a sleep laboratory for 12 consecutive days. Participants were assigned to one of two schedules: a moderate sleep restriction condition (n=10) equivalent to a 6-h sleep opportunity per 24h or a severe sleep restriction condition (n=14) equivalent to a 4-h sleep opportunity per 24h. In both conditions, sleep/wake episodes occurred 4h later each day to simulate a rotating shiftwork pattern. While living in the laboratory, participants were served three meals and were provided with either five (moderate sleep restriction condition) or six (severe sleep restriction condition) snack opportunities daily. Snack choice was recorded at each opportunity and assigned to a category (sweet, savoury or healthy) based on the content of the snack. Data were analysed using a Generalised Estimating Equations approach. Analyses show a significant effect of sleep restriction condition on overall and sweet snack consumption. The odds of consuming a snack were significantly greater in the severe sleep restriction condition (P
Acute sleep deprivation increases portion size and affects food choice in young men. [2022]Acute sleep loss increases food intake in adults. However, little is known about the influence of acute sleep loss on portion size choice, and whether this depends on both hunger state and the type of food (snack or meal item) offered to an individual. The aim of the current study was to compare portion size choice after a night of sleep and a period of nocturnal wakefulness (a condition experienced by night-shift workers, e.g. physicians and nurses). Sixteen men (age: 23 ± 0.9 years, BMI: 23.6 ± 0.6 kg/m(2)) participated in a randomized within-subject design with two conditions, 8-h of sleep and total sleep deprivation (TSD). In the morning following sleep interventions, portion size, comprising meal and snack items, was measured using a computer-based task, in both fasted and sated state. In addition, hunger as well as plasma levels of ghrelin were measured. In the morning after TSD, subjects had increased plasma ghrelin levels (13%, p=0.04), and chose larger portions (14%, p=0.02), irrespective of the type of food, as compared to the sleep condition. Self-reported hunger was also enhanced (p
Effect of reducing portion size at a compulsory meal on later energy intake, gut hormones, and appetite in overweight adults. [2023]Larger portion sizes (PS) are associated with greater energy intake (EI), but little evidence exists on the appetitive effects of PS reduction. This study investigated the impact of reducing breakfast PS on subsequent EI, postprandial gastrointestinal hormone responses, and appetite ratings.
Sleep Duration and Chronic Fatigue Are Differently Associated with the Dietary Profile of Shift Workers. [2022]Shift work has been associated with dietary changes. This study examined factors associated with the dietary profiles of shift workers from several industries (n = 118, 57 male; age = 43.4 ± 9.9 years) employed on permanent mornings, nights, or rotating 8-h or 12-h shifts. The dietary profile was assessed using a Food Frequency Questionnaire. Shift-related (e.g., sleep duration and fatigue), work-related (e.g., industry), and demographic factors (e.g., BMI) were measured using a modified version of the Standard Shift work Index. Mean daily energy intake was 8628 ± 3161 kJ. As a percentage of daily energy intake, all workers reported lower than recommended levels of carbohydrate (CHO, 45%-65%). Protein was within recommended levels (15%-25%). Permanent night workers were the only group to report higher than recommended fat intake (20%-35%). However, all workers reported higher than recommended levels of saturated fat (>10%) with those on permanent nights reporting significantly higher levels than other groups (Mean = 15.5% ± 3.1%, p < 0.05). Shorter sleep durations and decreased fatigue were associated with higher CHO intake (p ≤ 0.05) whereas increased fatigue and longer sleep durations were associated with higher intake of fat (p ≤ 0.05). Findings demonstrate sleep duration, fatigue, and shift schedule are associated with the dietary profile of shift workers.
An evaluation of portion size estimation aids: Consumer perspectives on their effectiveness. [2019]This qualitative study aimed to investigate consumer opinions on the usefulness of portion size estimation aids (PSEA); consumer preferences in terms of format and context for use; and the level of detail of guidance considered necessary for the effective application of PSEA.
Impact of Front-of-Pack Nutrition Labels on Portion Size Selection: An Experimental Study in a French Cohort. [2022]In the European Union (EU) three coloured graded Front-of-Pack labels (FoPLs), two endorsed by governments (Nutri-Score and Multiple Traffic Lights (MTL)) and one designed by industry (Evolved Nutrition Label (ENL)) are currently being discussed. This study aimed to investigate the impact of these FoPLs on portion size selection, specifically for less healthy products. In 2018, participants from the French NutriNet-Santé cohort study (N = 25,772) were exposed through a web-based self-administered questionnaire to products from three food categories (sweet biscuits, cheeses, and sweet spreads), with or without FoPLs, and were invited to select the portion they would consume (in size and number). Kruskall-Wallis tests, and mixed ordinal logistic regression models, were used to investigate the effects of FoPLs on portion size selection. Compared to no label, Nutri-Score consistently lowered portion sizes (OR = 0.76 (0.74⁻0.76)), followed by MTL (OR = 0.83 (0.82⁻0.84)). For ENL, the effects differed depending on the food group: It lowered portion size selection for cheeses (OR = 0.84 (0.83⁻0.87)), and increased it for spreads (OR = 1.19 (1.15⁻1.22)). Nutri-Score followed by MTL appear efficient tools to encourage consumers to decrease their portion size for less healthy products, while ENL appears to have inconsistent effects depending on the food category.
Subjective Hunger, Gastric Upset, and Sleepiness in Response to Altered Meal Timing during Simulated Shiftwork. [2020]Shiftworkers report eating during the night when the body is primed to sleep. This study investigated the impact of altering food timing on subjective responses. Healthy participants (n = 44, 26 male, age Mean ± SD = 25.0 ± 2.9 years, BMI = 23.82 ± 2.59kg/m2) participated in a 7-day simulated shiftwork protocol. Participants were randomly allocated to one of three eating conditions. At 00:30, participants consumed a meal comprising 30% of 24 h energy intake (Meal condition; n = 14, 8 males), a snack comprising 10% of 24 h energy intake (Snack condition; n = 14; 8 males) or did not eat during the night (No Eating condition; n = 16, 10 males). Total 24 h individual energy intake and macronutrient content was constant across conditions. During the night, participants reported hunger, gut reaction, and sleepiness levels at 21:00, 23:30, 2:30, and 5:00. Mixed model analyses revealed that the snack condition reported significantly more hunger than the meal group (p < 0.001) with the no eating at night group reporting the greatest hunger (p < 0.001). There was no difference in desire to eat between meal and snack groups. Participants reported less sleepiness after the snack compared to after the meal (p < 0.001) or when not eating during the night (p < 0.001). Gastric upset did not differ between conditions. A snack during the nightshift could alleviate hunger during the nightshift without causing fullness or increased sleepiness.
Free-Living Sleep, Food Intake, and Physical Activity in Night and Morning Shift Workers. [2021]Objective: Shift work is associated with risk for adverse health outcomes including cardiovascular disease, type 2 diabetes, cancer, and obesity. Short sleep duration combined with disruptions to the circadian system may alter factors involved with the behavioral regulation of energy intake and expenditure. We aimed to determine how shift work affects sleep, food intake, and physical activity.Methods: This was a field-based observational study using objective assessments of sleep and physical activity and a 24-hour dietary recall in shift workers. Day (n = 12) and night (n = 12) hospital shift workers (nurses and technicians) who were women had their free-living sleep and physical activity tracked via accelerometry, and completed a computer-assisted 24-hour food recall, during a series of work shifts.Results: Compared to day workers, night workers had significantly shorter sleep duration and reported more premature awakenings and feeling less refreshed upon awakening. Daily self-reported energy and macronutrient intakes were not different between groups, although the night shift workers reported a significantly longer total daily eating duration window than day workers. Objectively recorded physical activity levels were not different between groups.Conclusions: The present findings confirm that sleep is disturbed in women night workers, while there are relatively less effects on objectively recorded physical activity and self-reported food intake. We also observed a prolonged daily eating duration in night vs. day workers. These observations can help inform the design of novel behavioral interventions, including, potentially, time restricted feeding approaches (e.g., by limiting daily eating episodes to within a 10-12 h window), to optimize weight management in shift workers.
Shift work relationships with same- and subsequent-day empty calorie food and beverage consumption. [2021]Objectives Shift work may contribute to unhealthy eating behaviors. However, the evidence is built mainly on comparisons of eating behaviors between shift and non-shift workers. Growing research has suggested daily experiences and exposures may contribute to daily fluctuations in people's food consumption. The purpose of this study was to examine within-person associations between shift work and same- and subsequent-day empty calorie food/beverage consumption. Methods This was a 14-day intensive longitudinal study using ecological momentary assessment. A convenience sample of 80 hospital registered nurses working a rotating shift in Taiwan completed a 21-item food checklist assessing their empty food/beverage consumption (ie, fast/fried food, sweet and salty snacks, sugar-sweetened beverages) four times at random daily. Daily shift work (ie, day, evening, or night shift) was derived from the registry-based work schedule. Three-level mixed-effects regression models were employed for hypothesis testing. Results A total of 77 participants with 2444 momentary assessments were included in the final analysis. The results suggested that participants on night compared to day shifts had higher likelihoods of fast/fried food intake [adjusted odds ratio (OR adj) 1.7, 95% CI 1.2-2.6] and sugar-sweetened beverage consumption (OR adj1.5, 95% CI 1.0-2.1). However, there were no significant associations between shift work and subsequent-day empty calorie food/beverage consumption. Conclusions Night shift work is associated with same-day increased empty calorie food/beverage consumption among workers. Strategies that help to prevent unhealthy eating behaviors on night shifts may help to reduce rotating shift workers' empty calorie food/beverage consumption and ultimately improve their health.
Relationship between Sleep and Hedonic Appetite in Shift Workers. [2021]Short and/or poor sleep are established behavioral factors which can contribute to excess food intake, and emerging evidence suggests that disturbed circadian rhythms may also impact food intake regulation. Together, disturbed sleep and circadian rhythms may help explain the excess risk for obesity seen in shift workers. To date, however, the details of how shift work may impact food intake regulation are still not fully defined. Here we examined the relationship between sleep characteristics and hedonic control of appetite in shift workers. A total of 63 shift workers (mean (M) age: 36.7 years, standard deviation (SD): 12.0; 59% women) completed an online survey comprising self-reported measures of body weight regulation, sleep (Pittsburgh Sleep Quality Index, Sleep Hygiene Index), and hedonic control of appetite (Food Craving Inventory, Power of Food Scale). Seventy-one percent reported some weight change since starting shift work, and 84% of those reported weight gain (M = +11.3 kg, SD = 9.1). Worse sleep quality and shorter sleep duration were associated with more food cravings, and worse sleep quality and hygiene were associated with higher appetitive drive to consume palatable food (greater hedonic drive). This preliminary study suggests hedonic pathways are potentially contributing to weight gain in shift workers with disturbed sleep.
Individual differences and moderating participant characteristics in the effect of reducing portion size on meal energy intake: Pooled analysis of three randomized controlled trials. [2023]Portion size impacts on the amount of energy consumed during a meal. However, research findings on participant characteristics that moderate the effect of portion size on energy intake are mixed. Using data pooled across three randomized control trials, we examined the impact of reducing meal portion size on meal energy intake in 111 adult participants varying in sex (55 M, 56 F), body weight (BMI range = 19-42) and a broad range of participant characteristics, including usual portion size, restrained, emotional and external eating, satiety responsiveness, plate clearing tendencies, concerns about wasting food and self-control. In each trial, a repeated-measures design was used and participants consumed three ad-libitum lunchtime meals differing in portion size; large-normal portion size condition (100%) vs. small-normal portion size condition (~ 75%) vs. smaller than normal portion size condition (~ 50%). In mixed ANOVAs, we did not find convincing evidence that any participant characteristic reliably moderated the impact that reducing portion size had on energy intake. For the majority of participants energy intake decreased when portion size was reduced and it was more common for participants to consistently reduce their energy intake than consume a similar amount when portion size was reduced. We also found little evidence that a sub-group of participants existed whose energy intake was consistently resistant to portion size reductions. Portion size may be a universal driver of energy intake, as reducing meal portion size appears to decrease meal energy intake among most people. Food portion downsizing may therefore be an equitable intervention approach to reducing population level energy intake.
The Effect of Commencing Rotating Shift Work on Diet and Body Composition Changes in Graduate Paramedics: A Longitudinal Mixed Methods Study. [2023]Objectives: Diet quality often changes as shift workers adjust to atypical work schedules, however, limited research exists examining the early effects of starting rotating shift work on diet and body composition. This study explored dietary behavior changes occurring in graduate paramedics during the first year of exposure to rotating shift work, and investigated dietary intake, diet quality and anthropometric changes over two years.Methods: Participants from a graduate paramedic cohort in Melbourne, Australia were approached after two years of shift work for study inclusion. Using a mixed method study approach, the qualitative component comprised individual in-depth interviews to explore perceived dietary behavior changes experienced over the first year of shift work. Interview transcripts were thematically analyzed and guided by the COM-B model (capability, opportunity, motivation, and behavior) and theoretical domains framework (TDF). Diet quality and dietary intake were quantitatively assessed by the Australian Eating SurveyTM at baseline, one year, and two years, along with body weight, waist circumference, and body mass index (BMI) to monitor changes.Results: Eighteen participants were included in the study. From the interviews, participants reported: 1. food choices are driven by wanting to fit in with coworker food habits, 2. food choices and mealtimes are unpredictable and 3. paramedics try to make healthy food choices but give in to less healthy options. While daily energy intake and diet quality scores did not differ in the first two years of shift work, daily energy from takeaway foods significantly increased (mean difference (MD): 2.96% EI; 95% CI: 0.44 - 5.48; p = 0.017) and increases in weight (MD: 2.96 kg; 95% CI: 0.89-5.04; p = 0.003), BMI (MD: 1.07 kg/m2; 95% CI: 0.26 - 1.87; p = 0.006) and waist circumference (MD: 5.07 cm; 95% CI: 1.25-8.89; p = 0.006) were also evident at two years.Conclusions: This study contributes new information on dietary changes and the current early trajectory of unintentional weight gain and takeaway reliance occurring within a graduate paramedic cohort over two years of shift work. To reduce the unintended metabolic consequences commonly observed with rotating shift schedules, workplaces could improve access to healthier food options and enable behavioral support/education to address nutrition-related health risks.