Healthcare, emergency services, transport, construction, security and hospitality – night shift work is part of everyday life for many workers. In the UK, around 12% of the workforce regularly works at least three hours between 11pm and 6am (TUC, 2017). Working against the body clock creates several organisational and health challenges that keep occupational health practitioners awake too: safety risks, reduced performance, and increased cardiometabolic and gastrointestinal problems.

What can organisations do to minimise the impact of night work and support this workforce? Regular breaks, health checks, carefully planned schedules and recovery time are often high on the occupational health to-do list. Yet there is another powerful lever that is too often underestimated and misused: nutrition.

It is not well understood that the right diet can support concentration, focus, performance and recovery. And it also improves key long-term health markers such as blood glucose, cholesterol and blood pressure, as well as mood and anxiety.

Workplace initiatives frequently stop at generic advice about healthy eating. Employees are told to “eat better” without practical guidance on how and what to eat during night shifts.

More importantly, these initiatives often fail to address the elephant in the room: the food environment and the reliance on convenience foods that many workers depend on to get through the night.

This article explores nutrition as an occupational health issue and outlines practical ways organisations and OH teams can better support night shift workers.

Night work as a biological and occupational risk

Humans are diurnal. Our internal body clock – the circadian rhythm – is synchronised primarily by light exposure and coordinates key physiological functions such as sleep, hormone secretion, metabolism and digestion.

Night shift work disrupts this system. Workers may need to stay alert and eat when the body is biologically primed for sleep and fasting. This misalignment affects multiple systems in the body and can have both short-term and long-term consequences.

In the short term, shift workers often report fatigue, digestive issues, reduced alertness and poorer sleep quality. Over time, research has linked long-term shift work with increased risk of cardiometabolic disease, obesity, type 2 diabetes and mood disorders (Kecklund G and Axelson J, 2016). Reduced exposure to daylight may also put night shift workers at higher risk of vitamin D deficiency, with implications for bone health, immune function and overall wellbeing (Martelli, M et al, 2022).

For occupational health teams, this matters not only from a health perspective but also from a safety standpoint. Fatigue, reduced concentration and impaired recovery can increase the likelihood of errors and accidents. In safety-critical sectors such as transport, construction and healthcare, these risks can have serious consequences.

Research suggests that injury risk is around 36% higher during night shifts compared with morning shifts (Fischer, D et al, 2017).

Food intake is not neutral in this process. There is emerging research in   (Franzago, M et al, 2023). Many metabolic processes, including glucose regulation, insulin sensitivity, and digestive function, follow a daily rhythm. Eating large meals during the biological night, when the body is less prepared to process food, may worsen metabolic disturbances and contribute to digestive symptoms frequently reported by shift workers, such as reflux, bloating, or irregular bowel habits.

From a safety perspective, nutrition strategies can also support fatigue risk management. Stable blood glucose levels, structured meal timing, and strategic caffeine intake can help sustain alertness and reduce energy crashes during long shifts. For example, replacing irregular snacking on high-sugar foods with planned meals or snacks that combine fibre, protein and complex carbohydrates may support more stable energy levels across the shift. When combined with appropriate scheduling and regular breaks, these nutrition strategies can contribute to reducing fatigue-related risk in the workplace (De Rijk, M et al, 2023).

Nutrition therefore deserves attention alongside other fatigue management measures.

Why “eat better” messaging falls short at night

Traditional public health models often assume that improving knowledge will lead to healthier choices. In practice, we know that behaviour is heavily shaped by the environment, and this is particularly relevant for night-shift workers. (Huggins, C, et al, 2023)

Night shift workers face very different conditions from day workers. Food options may be limited to vending machines, convenience foods, or fast-food outlets. Breaks may be irregular or shortened due to operational pressure. In some sectors, workers may spend long periods away from facilities such as staff kitchens or canteens. In operational environments such as rail construction, for example, workers may spend an entire shift beside the track with limited access to food preparation facilities. In those circumstances, the easiest option is often whatever food happens to be immediately available, typically snacks carried in pockets or purchased from nearby vending machines or fast-food vans.

When healthier options are not accessible, encouraging workers to make better food choices becomes irrelevant and often frustrating. Much more powerful is to rethink workplace design, access to facilities and organisational culture.

Nutrition, from fatigue management to recovery

Diet can influence several factors that matter directly for occupational health, including energy levels, alertness, digestion and recovery (Lowden, A et al, 2010). Many shift workers rely heavily on sugary snacks or energy drinks to stay awake. While these products can provide a short-term boost, they are often followed by energy crashes that can worsen fatigue later in the shift.

Digestive problems are also common among night workers. Gut function is regulated by the circadian rhythm, and at night gut motility slows down, reducing the body’s ability to process nutrients such as fats and carbohydrates. Reflux, bloating and irregular bowel habits are frequently reported. Eating large meals high in fat or sugar during the biological night may worsen these symptoms and disrupt sleep after the shift (Alyami, S et al, 2025).

One useful way to think about nutrition in shift work is through the lens of performance and recovery. Night shift workers often operate in demanding physical and cognitive environments where maintaining energy and alertness throughout the shift is essential. In this sense, they can be viewed as “industrial athletes”, needing to prepare before a shift, perform during it and recover afterwards.

For example:

• Eating a balanced meal before the shift can help stabilise energy levels.
• During the shift, lighter meals and planned snacks may be easier to tolerate than heavy meals.
• Strategic use of caffeine can help maintain alertness, but it should be reduced toward the end of the shift to protect sleep.
• After the shift, a light snack may prevent hunger from interrupting daytime sleep.

The aim of good nutrition is to help workers maintain energy, enhance recovery after a shift and, in the longer term, build resilience despite circadian disruption.

The role of the workplace environment

As mentioned previously, strategies focusing on personal choices are helpful, but they can only achieve so much. The workplace environment remains a key determinant of behaviour. By adjusting the environment, adding new options, and making the healthy choice the easy choice, behaviours can begin to shift.

Take the example of vending machines. On the TransPennine Route Upgrade project, the health and wellbeing team experimented by introducing healthier snack options alongside existing items rather than replacing them. Encouragingly, around half of purchases shifted to healthier alternatives.

This highlights an important principle in workplace health promotion: providing better options can nudge behaviour without restricting choice, an approach consistent with the Nuffield Intervention Ladder (Nuffield Council, 2009).

Several practical measures can be effective for shift workers: (D’Annibale, M et al, 2021)

• Providing access to refrigeration and microwaves so workers can bring meals from home.
• Ensuring protected meal breaks during night shifts.
• Offering healthier vending or catering options overnight
• Encouraging hydration by making water easily available
• Where not already in place, developing fatigue management programmes that include evidence-based nutrition and recovery messages.

Putting nutrition on the occupational health agenda

Nutrition for shift workers remains an under-researched area (Azmi, N et al, 2020). Much of the existing evidence focuses on healthcare staff, with fewer studies examining other sectors such as construction, transport, or manufacturing.

Despite these gaps, there is enough evidence to justify action. Improving the food environment, supporting better meal timing, and integrating nutrition into fatigue management strategies can all contribute to healthier and safer workplaces.

For OH teams, a useful starting point may be to ask a few simple questions:

• Are nutrition and hydration included in regular health assessments for night workers?
• What food options are realistically available for nightshift workers?
• Are facilities in place for staff to store and heat meals?
• Do fatigue management or health and wellbeing policies consider nutrition and hydration?
• Are night workers represented in wellbeing initiatives?

At a more strategical level, there is also an opportunity to strengthen the role of occupational health is this area. This could include training OH nurses and technicians to provide practical nutrition guidance during safety-critical medicals, helping to embed nutrition as a routine component of occupational health practice for shift workers.

Night shift work will always place strain on the body’s natural rhythms. But nutrition can either amplify that strain or help workers cope with it. Diet should therefore be considered an occupational health issue rather than simply a lifestyle one. When supporting workers during night shifts, it is also essential to recognise that what they eat is shaped less by individual choice than by the environment organisations create.

If nutrition is left out of fatigue management and occupational health strategies, an important opportunity to reduce risk is missed. Recognising nutrition as part of the occupational health toolkit – alongside scheduling, rest breaks and fatigue monitoring, can help organisations better protect the safety, health and resilience of their night shift workforce.