Relação entre a distribuição alimentar circadiana e o estado nutricional de trabalhadoras em turnos da área da enfermagem

Abstract

Nursing professionals are involved in providing health services 24 hours for day which makes them a classic model of shift workers. Therefore, these professionals are commonly subjected to shift work with long working day and reduced leisure time and rest. This work schedules has been associated with health problems including increase risk of developing metabolic and nutritional disorders such as obesity. The aim of this work was to assess the meal distribution across the day (energy and macronutrients intake) and its relationship with nutritional status of nursing professionals. The study includes 221 woman nursing professionals of university hospital in Uberlandia, Brazil (HC-UFU). The participants were classified in three shifts: day shift (n=112); night shift (n=55) and day-night shift (n=54). Professionals underwent the following assessments: nutritional assessment (3-day 24 hours recall) (n=217) and anthropometric variables (weight, height, body mass index, waist circumference and hip circumference) (n=216). Night workers with inadequate BMI demonstrated consuming higher amount of carbohydrates at dinner than other two groups (p=0.01). The distribution of energy, carbohydrates, proteins and lipids intake throughout the day did not differ significantly between the three shifts. However, when the circadian distribution was evaluated separately for each shift, time of day had a significant effect for most nutritional variables in three shifts groups. In general, energy, carbohydrates, proteins and lipids intake in each of the three groups evaluated was lower at breakfast and snack, higher at lunch, and declined at dinner time (lunch > dinner; p< 0.05). Categorization according to nutritional status (individuals with normal weight versus excessive weight), time exerted a significant effect on intake throughout the day for energy and macronutrients. Moreover, when the circadian distribution was evaluated separately for eutrophic individuals, the consumption of energy and all macronutrients was higher at lunch, and these amounts declined from lunch to dinner (lunch > dinner, p< 0.05 ).However, individuals with excess of weight of the three groups showed that energy, carbohydrates and lipids intake did not decline from lunch to dinner (lunch = dinner; p> 0.05).We concluded that the distribution of meals throughout the day is associated with shift work and nutritional status of individuals working in the area of nursing in that eutrophic individuals ingest less energy and macronutrient balanced dinner for lunch , while overweight workers ingest similar amounts. Special attention needs to be given to eating circadian pattern, being a positive tool in dietetic planning and a possible strategy against overweigh/obesity.