Nutritionists offer tips for staying alert at night

Food, caffeine choices can make a difference

Keeping health care workers healthy when they work the night shift has long presented an occupational health challenge, and nutritionists at Los Angeles' Cedars-Sinai Medical Center have assembled some tips for using diet as one tool to boost health when work schedules interrupt the body's natural sleep-wake cycle.

Not only does the night shift change the body's circadian rhythms, it can also throw off perspective when it comes to food.

"Some night shift workers eat at work in order to maintain their stamina, then go home and eat with their families. People can lose sight of portion control," says Netty Levine, RD, a registered dietitian and diabetes educator at Cedars-Sinai. Levine and colleagues set about to draft some guidelines that would help the hospital's shift workers maintain healthy eating and sleep habits.

"People working the night shift may consume large amounts of caffeine-laden beverages to stay awake, then — if they are parents — they may be forced to stay awake during the day in order to drive their children to and from school and other activities," she added. Recent students have shown that people who do not get sufficient sleep are more prone to being overweight, she points out.

Other studies have shown that gastrointestinal problems, particularly ulcers, are more prevalent among shift workers than workers on a day schedule. This is because the digestive system is relatively inactive at night; therefore, some foods can cause digestive problems at night yet be well tolerated if eaten during the day.

Other culprits contributing to gastrointestinal problems are snack foods with a high fat content (readily available from vending machines during the wee hours), caffeine, and meals eaten in a rush or at irregular times. To prevent heartburn or indigestion, Levine recommends avoiding cabbage, cucumbers, onions, high-fat or fried meals, and spicy foods.

Other suggestions noted by the Cedars-Sinai nutritionists include:

Exercise midway or before working a night shift, to maintain alertness and cardiac health;

Bring healthy snacks (fruit, vegetables, low-fat yogurt, cottage cheese, whole wheat crackers, pretzels, popcorn) from home to encourage avoidance of the less-nutritious vending machine selections;

Eat small, regular meals with a balance of whole grain carbohydrates, protein, and heart-healthy fats before 1 a.m. Choose carbohydrates that are low in fat and high in fiber like whole grain bread, fruit, and low-fat dairy;

Eat a turkey sandwich on whole grain bread with a green salad or fruit on the side. Try mustard or hummus on the bread instead of mayonnaise, and substitute spinach for lettuce;

Don't forget about last night's dinner — prepare more than you can eat, and take some leftovers for lunch;

A frozen, low-fat, low-sodium dinner can be supplemented with a piece of fruit, veggies, or low-fat yogurt;

Avoid caffeine at least five hours before bedtime; and,

When the shift is over, have a very light meal or snack before going to bed.