The challenges of shift work on diet, sleep, and well-being

By Dr. Liji Thomas, MDReviewed by Lauren HardakerAug 25 2025

From skipping meals to restless nights, new research exposes how shift schedules lead healthcare workers towards unhealthy habits, and what hospitals can do to help.

Study: A qualitative study on nutrition and well-being of healthcare shift workers. Image credit: Nicoleta Ionescu/Shuterstock.com

Shift work has become an integral part of modern life, but it also carries its own set of health issues. Nutrition is an unquestioned strategy to improve health, but little qualitative research exists on this specific context. A paper published in Scientific Reports assesses the challenges faced by healthcare shift workers, particularly as they try to maintain a healthy and balanced diet.

Introduction

Shift workers typically work irregular hours, often at different times of the day. Millions of healthcare shift workers work extended hours throughout the day and night or on fixed or rotating shifts. This throws the body clocks out of order, disrupting sleep-wakefulness cycles, and eating and metabolism patterns.

Poor dietary habits worsen shift-related fatigue and cognitive strain, further impairing health. For instance, shift workers often skip breakfast and other meals, eat late at night, and snack on unhealthy foods high in saturated fats, sugar, and salt, along with soft drinks. Their diet often lacks the right proportions of diverse food groups. They consume too few fruits and vegetables, and their diet typically lacks vitamins and minerals. 

In addition, shift workers have altered biochemistry and psychological impairments, including anxiety, stress, and depression. These are not inevitable outcomes but represent increased risks that can eventually cause metabolic or lifestyle conditions like cardiovascular disorders, diabetes, and obesity. Such reasons underline the high rates of burnout due to constant or recurrent stress and a poor quality of life, especially when shifts are not properly rotated to protect against their negative impacts.

Chrononutrition is a field that looks at how eating habits affect health in conjunction with their timing relative to the circadian rhythm. It could help to plan better nutrition and metabolic health for these workers.

About the study

The current study aims to assess poor eating habits in this workforce. It used interview data from 40 healthcare shift workers, 80% of whom were female. Most participants were nurses, medical assistants, or health attendants rather than doctors. They worked three shifts: a morning, afternoon, and evening shift, each lasting eight hours, or two shifts of 12 hours each.

Over 60% were obese or overweight. As they struggled to maintain their health and well-being, three areas were of prime concern for the workers: their feeding habits, sleep quality, and physical activity.

Food concerns

Concerns included skipping meals or not being able to eat their main meals on time, not being able to get nourishing food during night shifts, too little sleep, and multiple barriers to physical activity.

The main reason for skipping meals was that they lacked time amidst the demands of their work, especially when they had urgent tasks directed towards their patients. Self-care took a backseat when faced with the need for patient care, especially during intense shifts.

Additionally, again due to their work responsibilities, they tended to grab something to eat on the run rather than having meals on time. This often led to the practice of eating only when hungry. Especially at night, they had limited access to nutritious food, making do with snacks and unhealthy foods.

The widespread view was that hospitals and other healthcare facilities with shift workers should ensure food is provided at least at night. The authors note this recommendation was raised by participants, who often relied on vending machine snacks or food delivery apps when healthier options were unavailable.

Sleep issues

The second theme concerned too little sleep, poor quality sleep, and the ability to adapt and still enjoy good sleep. Many workers reported unrestful sleep because their minds were wound up by job responsibilities even during their off hours. Other studies suggest that this is dangerous for both the staff and the patients as it increases the chances of human error and potentially of injury.  

However, a smaller group of participants said they had adapted to irregular schedules and could maintain good sleep quality, often by sticking to consistent rest routines.

Exercise obstacles

Despite the known benefits of physical exercise against cardiometabolic disease and cancers, many workers said they were overwhelmed by job commitments and changing work hours, losing their motivation and time to exercise. Some said their housework and jobs provided enough walking so they did not need extra physical activity.

A few exercised on their rest days, citing interest in physical exercise but lack of opportunities during working days due to physical inaccessibility and lack of time. Others consistently prioritized exercise as a form of self-care and stress relief, making time for activities like gym sessions or home-based exercises.

How diet, sleep, and activity interact

Most studies on shift work reflect these findings, showing irregular eating patterns and poor dietary intake in this workforce. This leads to inadequate energy intake, causing them to pick up instant foods and snacks at the cost of nutrition. This is more common among night shift workers, who do not have time to prepare home-cooked meals or have healthy food choices at night.

Irregular eating coupled with sleep deprivation poses the highest risk of metabolic disorders, especially since these workers often eat energy-dense foods late at night and skip breakfast. The extended eating window disrupts the circadian rhythm and leads to long periods of fat synthesis in the body, piling up in various fat depots.

The study also showed that these factors were interwoven with the others. All three must be simultaneously addressed to bring about durable and relevant improvements in the health and well-being of shift workers in this field. The authors further highlight that Malaysian cultural norms, such as communal eating practices, fasting during Ramadan, and rice-based diets, may also shape dietary choices and coping strategies, adding important context to these findings.

Healthcare facilities should provide exercise facilities and conduct awareness/training programs on wellness, involving physical trainers and dietitians to promote exercise behavior.

Conclusions

The dietary and sleep deprivation of shift care workers, combined with difficulties in participating in enjoyable physical exercise, reduce their quality of life, increase the risk of lifestyle disease, and make them prone to burnout. 

“Workplace health promotion interventions should be implemented to improve the health and well-being of healthcare shift workers.”

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