The Effect of Meal Glycemic Index and Meal Frequency on Glycemic Control and Variability in Female Nurses Working Night Shifts: A Two-Arm Randomized Cross-Over Trial

BACKGROUND:Night shift workers are exposed to circadian disruption, which contributes to impaired glucose tolerance. Although fasting during the night shift improves glucose homeostasis, adhering to this dietary strategy may be challenging. OBJECTIVES:This study evaluated the effect of fasting compared with the consumption of meals with different combinations of glycemic index (GI, low or high) and frequency (1 or 3 times) during the night shift on continuous glucose monitoring metrics. METHODS:A 2-arm randomized cross-over trial was conducted on female nurses working night shifts. In each of those arms, the participants were either provided with no meal (fasted), low GI, or high-GI meal during the night shift with a meal frequency according to which arm they were randomly allocated to, either 1-MEAL or 3-MEAL. Outcome variables were glycemic control and variability (GC and GV) metrics during the night shift (21:30-7:00), in the morning after the night shift (07:00-13:00), and in the 24 h period (18:00-18:00). RESULTS:Compared to no meal, the consumption of 1 high-GI meal increased all GV metrics not only during the night shifts but also in the morning, for instance, as observed in the coefficient of variation (β = 0.03 mmol/L; 95% CI: 0.01, 0.05), and GV percentage (β = 4.13; 95% CI: 2.07, 6.18). The consumption of 1 or 3 low GI meals did not raise GC or GV metrics except for continuous overall net glycemic action during the night shifts after consuming 3 low GI meals. When controlling for GI, night shift meal frequency did not affect any metrics in any timeframe. CONCLUSIONS:High meal GI but not higher meal frequency during the night shift increased GC and GV in female night shift workers. Results for 1 low-GI meal during the night shift were not different from a glucose profile after no meal. This trial was registered at trialsearch.who.int as NL8715.