Time-Restricted Eating for Shift Work Sleep Disorder

(SHINE Trial)

Overseen By Ellen Lyon, MS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Colorado State University

Disqualifiers: Sleep disorders, Eating disorders, Diabetes, Cardiovascular disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

50 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how time-restricted eating (a dietary approach limiting eating to certain hours) might benefit shift workers who often experience sleep disruptions. It aims to determine if restricting eating to specific hours can improve heart health and reduce Type 2 diabetes risk by examining its effects on blood fats and sugar metabolism. The trial includes two groups: one will limit eating during the night, while the other will eat as usual during night shifts. The study seeks night shift workers who have been on the job for at least a year and sleep 5-9 hours per day. As an unphased trial, it offers participants the opportunity to contribute to innovative research that could enhance health outcomes for shift workers.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Previous studies have shown that time-restricted eating is safe. Research indicates that this eating pattern can aid weight loss and improve body shape and blood pressure, benefiting heart health. Importantly, the studies found no negative effects on sleep, mood, or quality of life, suggesting that most people can easily manage time-restricted eating. Reports of harmful side effects were rare, indicating that most participants did not experience problems. Overall, the evidence suggests that time-restricted eating is a safe option for many. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about time-restricted eating for managing Shift Work Sleep Disorder because it offers a non-drug approach that aligns with our natural biological rhythms. Unlike typical treatments that might involve medications or light therapy to regulate sleep patterns, this method focuses on restricting eating during the biological night. This approach aims to reduce the negative effects of eating at times when the body is less prepared to process food, potentially enhancing overall health and sleep quality for night shift workers. By maintaining the same daily energy intake and nutrient distribution, it provides a balanced way to potentially improve sleep without changing dietary habits drastically.

What evidence suggests that this trial's treatments could be effective for shift work sleep disorder?

This trial will compare time-restricted eating (TRE) with control eating for shift workers. Research has shown that TRE can improve sleep and health by aligning meal times with the body's natural rhythms. Studies have found that following an 8-week TRE plan can help regulate appetite and improve sleep in adults who lack sufficient rest. Evidence also suggests that TRE might enhance the body's ability to process sugar for energy. This method does not appear to negatively affect sleep, mood, or quality of life. TRE involves consuming all meals within a specific time frame each day, potentially benefiting shift workers by syncing meals with their natural schedule. ^{3 6 7 8 9}

Who Is on the Research Team?

Josiane L Broussard, PhD

Principal Investigator

Colorado State University

Are You a Good Fit for This Trial?

This trial is for chronic night shift workers who may have sleep and circadian rhythm disorders, insulin sensitivity or resistance issues, metabolic diseases, high blood pressure but not severe allergies.

Inclusion Criteria

Worked the night shift for the last 1 year or more

Habitually sleep 5-9 hours per 24h period

Body mass index (BMI) of 20.0 - 35.0 kg/m2 and weight stable (plus or minus 5% of current body weight in the last 6 months)

Exclusion Criteria

Following any TRE (time-restricted eating) or intermittent fasting plan in the last year

I have been following a special diet like keto or vegan that could affect my cholesterol levels.

I have a diagnosed sleep or eating disorder.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment - Time-restricted eating (TRE)

Participants follow a time-restricted eating schedule during overnight work shifts for 4 weeks, refraining from eating during the biological night while maintaining the same sleep opportunity and daily energy intake.

4 weeks

1 visit (inpatient) at the end of 4 weeks

Washout

Participants undergo a 4-week washout period between treatment conditions.

4 weeks

Treatment - Control

Participants eat during the biological night as typically done in night shift workers for 4 weeks.

4 weeks

1 visit (inpatient) at the end of 4 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment.

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Control eating
• Time-restricted eating

Trial Overview The study investigates if eating within a set time frame (time-restricted eating) versus regular eating patterns (control eating) affects heart health and sugar metabolism in people with disrupted body clocks due to shift work.

How Is the Trial Designed?

Group I: Time-restricted eating during overnight work shift Experimental Treatment 1 Intervention

For 4 weeks, participants will refrain from eating during the biological night while maintaining the same sleep opportunity and daily energy intake and macronutrient distribution without changing 24h energy intake.

Group II: Control eating during overnight work shift Experimental Treatment 1 Intervention

For 4 weeks, participants will eat during the biological night as is typically done in night shift workers.

Who Is Running the Clinical Trial?

Colorado State University

Lead Sponsor

Trials

138

Recruited

38,200+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

University of Colorado, Denver

Collaborator

Trials

1,842

Recruited

3,028,000+

Published Research Related to This Trial

In a 12-week study involving 14 adults with obesity, time-restricted feeding (8-hour eating window) led to a significant weight loss of about 2 kg, indicating potential efficacy for weight management.

Despite the weight loss, the study found no significant changes in the diversity or composition of the gut microbiome, suggesting that time-restricted feeding may not impact gut health in terms of microbial diversity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of time restricted feeding on the gut microbiome in adults with obesity: A pilot study. Gabel, K., Marcell, J., Cares, K., et al.[2022]

Time-restricted eating (TRE) can lead to a weight loss of 1-4% over 1-16 weeks in individuals with obesity, primarily due to unintentional reductions in daily calorie intake of about 350-500 kcal.

TRE is effective in improving cardiovascular health by lowering fat mass, blood pressure, triglyceride levels, and markers of oxidative stress, and it is considered safe with few adverse events reported.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Time-Restricted Eating to Improve Cardiovascular Health. Gabel, K., Cienfuegos, S., Kalam, F., et al.[2021]

Time-restricted eating (TRE) has shown promising therapeutic effects in rodent studies, particularly in relation to body weight and metabolic health, but results in humans are inconsistent due to varying study designs and populations.

This review highlights the need for more standardized research on TRE in humans to better understand its effects and interactions with circadian biology, as well as to identify gaps in current knowledge for future studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Complex physiology and clinical implications of time-restricted eating. Petersen, MC., Gallop, MR., Flores Ramos, S., et al.[2023]

In a pilot study of 50 participants with obesity over 12 weeks, time-restricted eating (TRE) led to a modest average weight loss of 2.6 kg, with greater weight loss observed in those who adhered to the regimen at least five days a week.

While TRE showed similar weight loss results compared to more complex weight management methods, it did not significantly impact blood pressure or lipid profiles, suggesting its primary benefit may be in weight management rather than metabolic health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Time restricted eating as a weight loss intervention in adults with obesity. Przulj, D., Ladmore, D., Smith, KM., et al.[2021]

Time-restricted feeding (TRF) focuses on when meals are consumed rather than calorie content, showing potential benefits in rodent studies for preventing obesity and improving insulin sensitivity, which could translate to human health improvements.

Current evidence suggests that aligning eating windows with waking hours may optimize cardiometabolic health, particularly for individuals in high-stress jobs, although more human trials are needed to confirm these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Time-restricted feeding for the prevention of cardiometabolic diseases in high-stress occupations: a mechanistic review. Waldman, HS., Renteria, LI., McAllister, MJ.[2020]

In a study involving 24 healthy males living in a sleep laboratory for 12 days, those experiencing severe sleep restriction (4 hours of sleep) consumed significantly more snacks, especially sweet snacks, compared to those with moderate sleep restriction (6 hours of sleep).

The findings suggest that severe sleep restriction may increase the risk of obesity and related health issues among shiftworkers due to higher snack consumption and a preference for unhealthy snack choices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of sleep restriction on snacking behaviour during a week of simulated shiftwork. Heath, G., Roach, GD., Dorrian, J., et al.[2022]

In a study of 23 obese adults following an 8-hour time-restricted feeding (TRF) schedule for 12 weeks, sleep quality remained consistently good, as indicated by a Pittsburgh Sleep Quality Index score below 5 throughout the trial.

The research found that TRF did not change subjective measures of sleep duration or timing, suggesting that this dietary approach does not negatively impact sleep in individuals with obesity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of 8-h time-restricted feeding on sleep quality and duration in adults with obesity. Gabel, K., Hoddy, KK., Burgess, HJ., et al.[2020]

The Healthy Heroes Study is a year-long randomized controlled trial involving 150 firefighters, investigating the effects of a 10-hour time-restricted eating (TRE) regimen on health parameters related to cardiometabolic disease risks.

The study aims to assess the feasibility and efficacy of TRE compared to standard Mediterranean diet counseling, monitoring various health metrics such as blood glucose, body weight, and biomarkers, to determine if TRE can help mitigate health risks associated with chronic circadian rhythm disruption in firefighters.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Protocol for a randomised controlled trial on the feasibility and effects of 10-hour time-restricted eating on cardiometabolic disease risk among career firefighters doing 24-hour shift work: the Healthy Heroes Study. Manoogian, ENC., Zadourian, A., Lo, HC., et al.[2021]

In a study of 49 adults with obesity, both 4-hour and 6-hour time-restricted feeding (TRF) led to significant weight loss (around 3.4 to 3.9 kg) over 8 weeks, but did not improve sleep quality or duration compared to a control group.

Neither 4-hour nor 6-hour TRF affected insomnia severity or the risk of obstructive sleep apnea, indicating that while TRF can aid in weight loss, it may not enhance sleep-related outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of 4-h versus 6-h time restricted feeding on sleep quality, duration, insomnia severity and obstructive sleep apnea in adults with obesity. Cienfuegos, S., Gabel, K., Kalam, F., et al.[2022]

In an 8-week pilot study involving 78 participants with obesity, those following a 14-hour time-restricted eating (TRE) schedule lost an average of 8.5% of their body weight, which was statistically significant compared to a 12-hour TRE group that lost 7.1%.

The 14:10 TRE group also experienced a significant reduction in fasting blood glucose levels by 7.6 mg/dl, indicating potential metabolic benefits, especially for those with elevated blood glucose at baseline.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of time restricted eating on body weight and fasting glucose in participants with obesity: results of a randomized, controlled, virtual clinical trial. Peeke, PM., Greenway, FL., Billes, SK., et al.[2021]

Citations

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The Effectiveness of Time-Restricted Eating as an ... Time-restricted eating (TRE) could improve glucose metabolism by aligning food intake with the circadian clock, but its effectiveness remains unclear.

2. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2835594

Time-Restricted Eating and Sleep, Mood, and Quality of ... We found that TRE, irrespective of the eating window timing, was not associated with adverse effects on sleep, mood, or quality of life in ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC7262456/

Time-Restricted Eating: Benefits, Mechanisms, and ... Time-restricted eating (TRE) is a dietary approach that consolidates all calorie intake to 6- to 10-h periods during the active phase of the day.

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11322763/

The effects of time-restricted eating on sleep in adults Animal studies have shown that time-restricted feeding (TRF) has a positive effect on sleep and health, by aligning food intake with the animal ...

5. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0261561425001220

Time-restricted eating improves appetite regulation and ... An 8-week, 10-h TRE protocol positively affects appetite regulation and sleep characteristics in normal-weight young adults with insufficient or poor sleep.

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC6953486/

Ten-hour time-restricted eating reduces weight, blood ... Time-restricted eating led to weight loss, healthier body composition, lower blood pressure, and decreased levels of cardiovascular disease-promoting lipids.

7. sciencedirect.com sciencedirect.com/science/article/pii/S1550413123004540

Time-restricted eating: Watching the clock to treat obesity Time-restricted eating (TRE) has become a popular strategy to treat obesity. TRE involves confining the eating window to 4–10 h per day and fasting for the ...

8. academic.oup.com academic.oup.com/edrv/article/43/2/405/6371193

Time-restricted Eating for the Prevention and Management of ... Time-restricted eating or feeding (TRE or TRF) is a nutrition intervention approach in which daily caloric intake is restricted to a consistent window of ...

9. clinicalnutritionjournal.com clinicalnutritionjournal.com/article/S0261-5614(25)00122-0/abstract

Time-restricted eating improves appetite regulation and ... An 8-week, 10-h TRE protocol positively affects appetite regulation and sleep characteristics in normal-weight young adults with insufficient or poor sleep. TRE ...