Research shows job stress and shift work is contributing to obesity among nurses in America. While there is no known study linking obesity to shift work in Australia, nurses can take proactive steps to keep the extra kilos at bay and ensure they stay healthy for peak performance not only at work but in their every day lives, writes Karen Keast.

Nurses are the experts when it comes to taking care of others but nurses, especially those working shift-work, are often too busy and too tired to care for and properly nourish themselves.

A study out of the United States last year found nurses working shift work and longer hours are more stressed and in roles requiring less physical exertion and movement.

As a result, the research showed shift working nurses are more likely to be obese than their underweight or normal weight colleagues.

The University of Maryland’s School of Nursing study, published in the Journal of Nursing Administration, found 57 per cent of the 2103 female nurses surveyed in the study were obese.

“Long work hours and shift work adversely affect quantity and quality of sleep, which often interferes with adherence to healthy behaviour and increases obesity,” lead researcher Kihye Han said.

Researchers say the evidence should prompt a re-think of nurse scheduling and they also argue the importance of nurses being able to nap in the workplace to stave off the effects of work-related sleep deprivation, in a bid to reduce fatigue and boost energy for healthy behaviours.

Previous research also shows unfavourable nursing schedules not only have an impact on nurses’ health but also on hospitals and their patient care outcomes.

In Australia, while there is no known study examining the effect of shift work on nurses’ waistlines and overall health, the Australian Nursing Federation has acknowledged it’s more challenging for nurses working shifts to include regular exercise, maintain a healthy diet and achieve adequate amounts of rest.

The ANF advocates for longer breaks between late shifts and early starts, and also urges shift working nurses to keep fit and healthy.

The Dietitians Association of Australia (DAA) advises shift workers to eat from the five food groups – fruit, vegetables, lean meats, reduced fat dairy, breads and cereals - outlined in the recently updated Australian Dietary Guidelines.

Dietitians Association of Australia spokesperson and Accredited Practising Dietitian Natasha Meerding says there are no set recommendations for what shift workers should eat and at what times, instead it comes down to personal preference and lifestyles.

“It might suit some to have an evening meal at around 6pm with their family before going off to work, followed by a light meal mid-shift when they have a break, and some other healthy snacks, then to have breakfast when they returned home,” she says.

“It may suit others to have breakfast prior to work, a light meal mid-shift and then dinner on returning home. Eating patterns vary greatly from person to person.”

Ms Meerding says shift workers can face problems ranging from weight gain to weight loss along with difficulty falling asleep and high blood pressure.

“It’s hard enough for people working nine to five but shift workers have it even harder than the rest of us,” she says.

“There are things that can be done to prevent those issues - eat from the five food groups and get some activity in most days.”

A community dietitian based in Hobart, Ms Meerding says it’s important to eat healthy, meet the recommended number of serves for each food group and advises against any dramatic increase in the volume of food consumed while working shifts.

Workplace environments can also have a big impact on how shift workers eat.

Ms Meerding says vending machines, filled with high fat, high sugar drinks and food, and staff rooms with biscuit barrels and cakes often lure workers into making poor choices when tired.

She says “healthy” vending machines, filled with pots of tinned fruit, crackers and cheese, sandwiches and instant microwaveable meals, are being trialled and could soon be on the way, in the meantime it’s important for organisations to provide ample fridge space for employees to store healthy food, introduce blenders for making smoothies, and add microwaves to heat food.

Ms Meerding advises nurses cook up and freeze batches of healthy meals at home, such as curries and pasta bakes with lots of vegetables, legumes and lean meat, to take to work in small portions.

“Avoid large meals, they can cause heart burn and make you feel sleepy and sluggish,” she says.

Employees can also work together to introduce fruit bowls; where staff buy a large batch of fruit and organise a kitty where employees can pay for the fruit they eat.

Ms Meerding suggests shift workers snack on fruit and low fat yoghurt, dry roasted nuts, wholegrain crackers and reduced fat cheese, vegie sticks and dips, while they should also drink water and avoid consuming too much caffeine, cola and energy drinks.

“Even though you might feel tired, large amounts of caffeine can disturb sleep,” she says.

“It stays in your system for eight hours.

“You might be tired and exhausted but you need to stop drinking it at least four hours before going to sleep, and aim to have no more than 400mg of caffeine; the equivalent of less than four instant coffees.”

Ms Meerding says it’s also important for shift workers to move away from their work stations when they have a break, and either walk around the ward or up and down stairs to boost their energy levels.

She says shift workers who often struggle to include physical activity in their day can combine activity with social catch-ups on their days off, such as going to the gym or walking with a friend.

Choosing healthy options will not only give nurses longer lasting energy, keeping them alert and better equipped to carry out their professional duties, regardless of the time of day or night, it will also keep nurses healthier in the long term.

“What we eat is definitely important,” Ms Meerding says.

“We know it prevents things like cardiac disease later in life and getting certain cancers.

“Eating healthy and staying physically active is the best thing we can do for our own physical and mental health.”

For more information visit the Federal Government’s Eat For Health website and there are recipes and tips for smart eating at the DAA website.

For more individualised advice seek out an APD.