Meal Service for Night Shift Workers

Overseen By Tegan H Mansouri, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: State University of New York at Buffalo

Must not be taking: Glucose-lowering medications

Disqualifiers: Diabetes, Pregnancy, Kidney disease, others

Compensation: Varies

Number of Visits: 2

40 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how different meal types affect blood sugar levels in night shift EMS workers. Participants will try a meal service with either moderate or high protein content during their night shift to determine which better controls blood sugar. The trial aims to discover if a specific diet can improve health for overnight workers. Ideal participants are EMS providers who have worked night shifts exclusively for at least a year and whose primary duty is patient care. As an unphased trial, this study offers a unique opportunity to contribute to research that could enhance the well-being of night shift workers.

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 prior data suggests that this meal service is safe for night shift workers?

Studies have shown that eating a high-protein, low-carbohydrate meal at night can significantly reduce blood sugar spikes by 71.4%. This suggests that high-protein meals might help control blood sugar levels for night shift workers. Additionally, research indicates that consuming protein does not reduce alertness during these hours.

Early findings suggest that these high-protein meals are safe and easy to digest. Although night shift workers generally face a higher risk of accidents, the meal itself has not been linked to any specific safety issues. Overall, evidence suggests that these meals are well-tolerated by night shift workers. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores the impact of meal composition on the health and performance of night shift workers. Unlike typical diet recommendations that don't consider the unique challenges of night shifts, this study specifically tests meals with different protein-to-carbohydrate ratios. The trial aims to uncover whether a higher protein intake during night shifts can better support workers' energy levels and overall health compared to a balanced ratio. This could lead to tailored nutritional strategies that improve the well-being and efficiency of those working irregular hours.

What evidence suggests that this trial's meal service could be effective for glycemic control in night shift EMS providers?

This trial will compare the effects of different meal compositions for night shift workers. Research has shown that a high-protein meal can help control blood sugar levels during night shifts. Specifically, one study found that a meal high in protein and low in carbs at night reduced blood sugar spikes by 71.4%. This is crucial because night shift workers often eat at irregular times, leading to high blood sugar. Although not all studies agree, these findings suggest that meals with more protein and fewer carbs might help manage blood sugar for night shift workers. Participants in this trial will receive either a high-protein meal or a moderate-protein meal to assess their impact on blood sugar levels. ^{4 6 7 8 9}

Who Is on the Research Team?

David Hostler, PhD

Principal Investigator

University at Buffalo

Are You a Good Fit for This Trial?

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.

Timeline for a Trial Participant

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

What Are the Treatments Tested in This Trial?

Interventions

• Meal service

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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 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]

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 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]

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]

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 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]

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]

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 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]

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]

Citations

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2. medrxiv.org medrxiv.org/content/10.1101/2025.10.19.25338338v1.full

The nutritional and metabolic impact of night shift work in a ... Furthermore, consuming a high protein and low carbohydrate meal at night significantly reduced postprandial glucose excursions by 71.4%.

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A putative association between food intake, meal timing ... Night workers tend to eat at irregular times and to prefer high calorie-dense foods. Short sleep duration was associated with greater animal protein intake.

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The Effect of 24 h Shift Work on the Nutritional Status of ... A study conducted with nurses found that consuming high-glycemic-index meals during the night shift increased glycemic control and variability ...

5. nature.com nature.com/articles/s41598-025-11534-5

A qualitative study on nutrition and well-being of healthcare ... For example, shift workers are more likely to skip meals, especially breakfast, and engage in nocturnal eating. Shift work may influence the ...

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Shift Work, Shifted Diets: An Observational Follow-Up ... This study aimed to investigate the change in diet quality in addition to dietary adherence to the planetary health diet during night shifts in healthcare ...

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Consequences of Shift Work and Night Work: A Literature ... In terms of safety, some studies [25,26] have pointed to a greater risk of occupational accidents occurring when there is shift work, at night, ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S2161831323000066

Dietary Patterns under the Influence of Rotational Shift ... Night shift workers are reported to have more frequent eating occasions overnight with fewer fasting intervals [23], higher intake of saturated fat and ...

9. frontiersin.org frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1245420/full

Macronutrient intake and alertness during night shifts Protein consumption did not appear to have a distinct association with alertness levels or appeared to have the least negative impact on alertness levels ...