Energy intake of shift workers compared to fixed day workers: A systematic review and meta-analysis.

Shift work is an established risk factor for a number of chronic conditions associated with excess energy intake including obesity, cardiovascular disease and type 2 diabetes. This systematic review investigated whether the 24 h energy intake of shift workers differs to that of fixed day workers. Included articles compared energy intake of shift workers (shift included midnight) with fixed day workers. There were 10 367 day workers and 4726 shift workers from 12 studies included in the qualitative analysis and meta-analyses. The standardised mean difference (95% CI) in energy intake between shift and day workers was -0.04 (-0.11, 0.03); I(2) = 54%. Qualitative results on macronutrient intakes were conflicting. Reported energy intakes were not different between day workers and shift workers, suggesting that other factors such as circadian misalignment, meal timing, food choice and diurnal variation of energy metabolism at night may be responsible for the increased rates of obesity observed in shift workers. Guidance on health and well-being is required for this at-risk population group.