{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:59:42Z","timestamp":1790866782317,"version":"4.1.0"},"reference-count":78,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Human Nutrition Diet"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Shift work is an increasingly prevalent feature of the modern workforce, with first responders constituting a critical occupational group required to sustain 24\u2010h operations. Modifiable health behaviour interventions, such as improving diet quality, may be effective in preventing or mitigating the non\u2010communicable disease onset linked to shift work. This review evaluated evidence supporting nutritional interventions in shift workers with first responder populations considered as a pre\u2010specified subgroup of interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review (PROSPERO CRD42023421400) evaluated intervention and observational studies informing dietary guidance for shift workers. Four databases (Embase, Cochrane Library, Web of Science, PubMed) were searched from inception to August 2023, with no date restrictions, and searches were updated in July 2025. Searches were supplemented by grey literature searches specifically targeting first responder populations. Studies were screened by two researchers. Studies of a randomised controlled trial (RCT), crossover\u2010RCT or observational study design, conducted in free\u2010living shiftwork populations or a laboratory\u2010controlled shiftwork setting, the intervention included a dietary component, and health\u2010related outcomes were reported. A narrative synthesis of results grouped by intervention type was conducted, with a pre\u2010specified subgroup analysis of studies in first responder populations. Quality assessment was measured using the Cochrane Risk of Bias Tools. Observational studies were evaluated using the Newcastle\u2013Ottawa Scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From the 6909 articles retrieved, 43 met the inclusion criteria. Most articles reported using a crossover (49%) or observational (33%) study design. Where specified, most studies involved free\u2010living participants (67%) in nursing and healthcare professionals (40%), with a few studies (9%) involving first responder subgroups (e.g., firefighters and police officers). Frequently reported intervention components included macronutrient adjustments (23%), time\u2010restricted eating (TRE) (21%), and meal timing and quantity (19%). Frequently reported outcomes were cardiometabolic health (40%), cognitive performance (30%), and sleep quality (12%). Methodological heterogeneity and prevalent risk of bias limited the evidence strength for determining shift worker nutritional guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The current evidence\u2010base is insufficient to formulate evidence\u2010based dietary guidelines for shift workers. The current evidence base is limited by substantial methodological heterogeneity, small sample sizes, and a moderate\u2010to\u2010high risk of bias across studies, which restricts the ability to formulate definitive evidence\u2010based dietary guidelines for shift workers. While findings may have relevance for high\u2010risk occupational groups, first responders remain underrepresented in the literature. Future research should prioritise well\u2010controlled, adequately powered, and ecologically valid intervention studies in diverse shift\u2010working populations, including first responders, to better inform practical and effective nutritional guidance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jhn.70340","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:39:02Z","timestamp":1790865542000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Systematic Review of Nutrition Interventions for Shift Workers, With Subgroup Analysis of First Responder Populations"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-6366-1648","authenticated-orcid":false,"given":"Alison Jayne","family":"Booker","sequence":"first","affiliation":[{"name":"Ministry of Defence Police, RAF Wyton Cambridgeshire UK"},{"name":"Department of Nutritional Sciences King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Powell","sequence":"additional","affiliation":[{"name":"Institute of Naval Medicine Crescent Road Gosport UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne Louise","family":"Fallowfield","sequence":"additional","affiliation":[{"name":"Royal Navy People Support Headquarters, HMS Temeraire, Burnaby Road Portsmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5823-6468","authenticated-orcid":false,"given":"Rachel","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences King's College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"1337","volume-title":"Encyclopedia of Behavioral Medicine","author":"Haney A.","year":"2017"},{"key":"e_1_2_11_3_1","unstructured":"Office for National Statistics (ONS) J.Colliass H.Javaid andH.AlhassanOffice for National Statistics.2023. 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