{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T22:42:54Z","timestamp":1779921774792,"version":"3.53.1"},"reference-count":59,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,9,2]],"date-time":"2019-09-02T00:00:00Z","timestamp":1567382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Unfavourable dietary behaviours of female nurses, especially among shift-working nurses, including high snacking frequency, short fasting period and large day-to-day energy intake variability may be linked with adverse health. In this study we: (1) examined the relationship between dietary behaviour and cardiometabolic and psychological health in female nurses; and, (2) compared dietary behaviour, cardiometabolic and psychological health between shift-working and non-shift-working female nurses. A total of 73 nurses had their cardiometabolic health indicators evaluated and completed psychological health questionnaires; 55 completed a 3-day dietary log. Associations between dietary behaviour and health measures were examined using Spearman\u2019s partial correlation analysis. Analysis of covariance (ANCOVA) was used to compare dietary behaviour and health indicators between shift- and non-shift-working nurses. The majority of snacks consumed by nurses (70%) were unhealthy snacks (e.g., chocolate and chips), and higher snacking frequency was associated with greater percent body fat (r(50) = 0.287, p = 0.039), and worse mood-tension (r(48) = 0.327, p = 0.021) and anger-hostility (r(48) = 0.289, p = 0.042) scores. Day-to-day energy intake variability was positively associated with body mass index (BMI, r(50) = 0.356, p = 0.010) and waist circumference (r(50) = 0.283, p = 0.042). Shift-working nurses exhibited shorter fasting duration, larger day-to-day energy intake variability and higher total mood disturbance score when compared to their non-shift-working colleagues (all p &lt; 0.05). The results of the present study suggested that addressing dietary behaviours may improve the cardiometabolic and psychological health of female nurses. Shift-working nurses may require a more specific dietary program to improve their psychological health.<\/jats:p>","DOI":"10.3390\/nu11092054","type":"journal-article","created":{"date-parts":[[2019,9,3]],"date-time":"2019-09-03T03:06:14Z","timestamp":1567479974000},"page":"2054","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Dietary Behaviour Is Associated with Cardiometabolic and Psychological Risk Indicators in Female Hospital Nurses\u2014A Post-Hoc, Cross-Sectional Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Tasuku","family":"Terada","sequence":"first","affiliation":[{"name":"Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matheus","family":"Mistura","sequence":"additional","affiliation":[{"name":"Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Tulloch","sequence":"additional","affiliation":[{"name":"Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada"},{"name":"Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Pipe","sequence":"additional","affiliation":[{"name":"Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada"},{"name":"Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8006-8555","authenticated-orcid":false,"given":"Jennifer","family":"Reed","sequence":"additional","affiliation":[{"name":"Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, ON K1Y 4W7, Canada"},{"name":"Faculty of Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada"},{"name":"School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,2]]},"reference":[{"key":"ref_1","unstructured":"Canadian Federation of Nurses Unions (2019, May 11). The Nursing Workforce. Available online: http:\/\/www.nsnu.ca\/site\/media\/nsnu\/Nursing%20Workforce%20bgrounder.pdf."},{"key":"ref_2","unstructured":"Shields, M., and Wilkins, K. (2006). Findings from the 2005 National Survey of the Work and Health of Nurses, Ministry of Industry."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1097\/NAQ.0b013e3182a2f99a","article-title":"We cannot ignore nurses\u2019 health anymore: A synthesis of the literature on evidence-based strategies to improve nurse health","volume":"37","author":"Letvak","year":"2013","journal-title":"Nurs. Adm. Q."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"142","DOI":"10.3389\/fphys.2018.00142","article-title":"The impact of web-based feedback on physical activity and cardiovascular health of nurses working in a cardiovascular setting: A randomized trial","volume":"9","author":"Reed","year":"2018","journal-title":"Front. Physiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/01.NAJ.0000411176.15696.f9","article-title":"Nurses\u2019 presenteeism and its effects on self-reported quality of care and costs","volume":"112","author":"Letvak","year":"2012","journal-title":"Am. J. Nurs."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1161\/CIR.0b013e31820faaf8","article-title":"Effectiveness-based guidelines for the prevention of cardiovascular disease in women--2011 update: A guideline from the American Heart Association","volume":"123","author":"Mosca","year":"2011","journal-title":"Circulation"},{"key":"ref_7","unstructured":"World Health Organization (2019, August 04). Mental Health. Available online: https:\/\/www.who.int\/mental_health\/prevention\/genderwomen\/en\/."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1161\/CIRCULATIONAHA.106.176158","article-title":"Diet and lifestyle recommendations revision 2006: A scientific statement from the American Heart Association Nutrition Committee","volume":"114","author":"Lichtenstein","year":"2006","journal-title":"Circulation"},{"key":"ref_9","unstructured":"Dieticians of Canada (2019, May 28). The Role of Nutrition in Mental Health Promotion and Prevention. Available online: https:\/\/www.dietitians.ca\/Downloads\/Public\/Nutrition-and-Mental-Health-1.aspx."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Arnett, D.K., Blumenthal, R.S., Albert, M.A., Buroker, A.B., Goldberger, Z.D., Hahn, E.J., Himmelfarb, C.D., Khera, A., Lloyd-Jones, D., and McEvoy, J.W. (2019). 2019 ACC\/AHA Guideline on the primary prevention of cardiovascular disease: Executive summary: A report of the American College of Cardiology\/American Heart Association Task Force on clinical practice guidelines. J. Am. Coll. Cardiol.","DOI":"10.1161\/CIR.0000000000000677"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/s00394-015-1078-8","article-title":"Prospective study on the association between diet quality and depression in mid-aged women over 9 years","volume":"56","author":"Lai","year":"2017","journal-title":"Eur. J. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Meegan, A.P., Perry, I.J., and Phillips, C.M. (2017). The association between dietary quality and dietary guideline adherence with mental health outcomes in adults: A cross-sectional analysis. Nutrients, 9.","DOI":"10.3390\/nu9030238"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1038\/sj.ijo.0802550","article-title":"Promoting long-term weight control: does dieting consistency matter?","volume":"28","author":"Gorin","year":"2004","journal-title":"Int. J. Obes."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"321","DOI":"10.21101\/cejph.a4451","article-title":"Higher energy intake variability as predisposition to obesity: novel approach using interquartile range","volume":"25","author":"Forejt","year":"2017","journal-title":"Cent. Eur. J. Public Health"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.3945\/jn.116.244749","article-title":"Meal frequency and timing are associated with changes in body mass index in adventist health study 2","volume":"147","author":"Kahleova","year":"2017","journal-title":"J. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1111\/nure.12104","article-title":"Time-restricted feeding and risk of metabolic disease: a review of human and animal studies","volume":"72","author":"Rothschild","year":"2014","journal-title":"Nutr. Rev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/cob.12142","article-title":"Energy intake highs and lows: how much does consistency matter in weight control?","volume":"6","author":"Rosenbaum","year":"2016","journal-title":"Clin. Obes."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2715","DOI":"10.3945\/jn.115.219808","article-title":"Eating frequency is positively associated with overweight and central obesity in U.S. adults","volume":"145","author":"Murakami","year":"2015","journal-title":"J. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Paoli, A., Tinsley, G., Bianco, A., and Moro, T. (2019). The Influence of meal frequency and timing on health in humans: The role of fasting. Nutrients, 11.","DOI":"10.3390\/nu11040719"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1146\/annurev.nutr.25.050304.092526","article-title":"Energy intake, meal frequency, and health: a neurobiological perspective","volume":"25","author":"Mattson","year":"2005","journal-title":"Annu. Rev. Nutr."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.1016\/j.outlook.2012.04.005","article-title":"Nurses\u2019 self-care behaviors related to weight and stress","volume":"60","author":"Nahm","year":"2012","journal-title":"Nurs. Outlook"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.apnr.2015.10.009","article-title":"Poor dietary behaviors among hospital nurses in Seoul, South Korea","volume":"30","author":"Han","year":"2016","journal-title":"Appl. Nurs. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1016\/j.ijnurstu.2010.01.001","article-title":"The association between shift duty and abnormal eating behavior among nurses working in a major hospital: a cross-sectional study","volume":"47","author":"Wong","year":"2010","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_24","first-page":"33","article-title":"Barriers to healthy eating in the nursing profession: Part 1","volume":"15","author":"Faugier","year":"2001","journal-title":"Nurs. Stand."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"19","DOI":"10.4278\/ajhp.141107-LIT-562","article-title":"Promoting diet and physical activity in nurses","volume":"31","author":"Torquati","year":"2017","journal-title":"Am. J. Health Promot."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1093\/occmed\/kqr001","article-title":"Shift work and chronic disease: the epidemiological evidence","volume":"61","author":"Wang","year":"2011","journal-title":"Occup. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1038\/sj.ijo.0801028","article-title":"Duration of shiftwork related to body mass index and waist to hip ratio","volume":"23","author":"Schouten","year":"1999","journal-title":"Int. J. Obes. Relat. Metab. Disord."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"811","DOI":"10.2486\/indhealth.MS1093","article-title":"Sleep, mental health status, and medical errors among hospital nurses in Japan","volume":"48","author":"Arimura","year":"2010","journal-title":"Ind. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1539\/joh.46.448","article-title":"Mental health status, shift work, and occupational accidents among hospital nurses in Japan","volume":"46","author":"Suzuki","year":"2004","journal-title":"J. Occup. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1001\/jama.2016.4454","article-title":"Association between rotating night shift work and risk of coronary heart disease among women","volume":"315","author":"Vetter","year":"2016","journal-title":"JAMA"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/0002-8223(94)90158-9","article-title":"Comparative advantage of 3-day food records over 24-hour recall and 5-day food frequency validated by observation of 9- and 10-year-old girls","volume":"94","author":"Crawford","year":"1994","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1123\/ijsnem.13.4.521","article-title":"Eating patterns and meal frequency of elite Australian athletes","volume":"13","author":"Burke","year":"2003","journal-title":"Int. J. Sport Nutr. Exerc. Metab."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1080\/02640414.2012.733019","article-title":"Changes in energy availability across the season in Division I female soccer players","volume":"31","author":"Reed","year":"2013","journal-title":"J. Sports Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1016\/j.jand.2013.07.001","article-title":"Day-to-day variation in food intake and energy expenditure in healthy women: The Dietitian II Study","volume":"113","author":"Champagne","year":"2013","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_35","unstructured":"American College of Sports Medicine (2017). ACSM\u2019s Guidelines for Exercise Testing and Prescription, Wolters Kluwer\u2014Lippincott Williams & Wilkins."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1080\/026404199365425","article-title":"Development and validation of a mood measure for adolescents","volume":"17","author":"Terry","year":"1999","journal-title":"J. Sports Sci."},{"key":"ref_37","unstructured":"Garner, D. (2004). Eating Disorder Inventory-3. Professional Manual, Psychological Assessment Resources, Inc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s10862-010-9207-4","article-title":"Validating the Eating Disorder Inventory-3 (EDI-3): A comparison between 561 female eating disorders patients and 878 females from the general population","volume":"33","author":"Clausen","year":"2011","journal-title":"J. Psychopathol. Behav. Assess."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"363","DOI":"10.13075\/mp.5893.00816","article-title":"The association between night shift work and nutrition patterns among nurses: A literature review","volume":"14","author":"Peplonska","year":"2019","journal-title":"Med. Pracy"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1111\/j.1745-7599.2008.00319.x","article-title":"Overweight and obesity in nurses, advanced practice nurses, and nurse educators","volume":"20","author":"Miller","year":"2008","journal-title":"J. Am. Acad. Nurse Pract."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1017\/S000711451500269X","article-title":"The cross-sectional association between snacking behaviour and measures of adiposity: The Fenland Study, UK","volume":"114","author":"Brage","year":"2015","journal-title":"Br. J. Nutr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"428","DOI":"10.3945\/ajcn.2009.28421","article-title":"Snacking is associated with reduced risk of overweight and reduced abdominal obesity in adolescents: National Health and Nutrition Examination Survey (NHANES) 1999\u20132004","volume":"92","author":"Keast","year":"2010","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.appet.2007.05.004","article-title":"Immediate effects of chocolate on experimentally induced mood states","volume":"49","author":"Macht","year":"2007","journal-title":"Appetite"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.jad.2006.02.007","article-title":"Mood state effects of chocolate","volume":"92","author":"Parker","year":"2006","journal-title":"J. Affect. Disord."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.pcad.2011.03.007","article-title":"Impact of exercise training on psychological risk factors","volume":"53","author":"Lavie","year":"2011","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s11136-011-9846-2","article-title":"Validation of POMS questionnaire in postmenopausal women","volume":"20","author":"Wyrwich","year":"2011","journal-title":"Qual. Life Res."},{"key":"ref_47","unstructured":"McNair, D.M., Lorr, M., and Droppleman, L.F. (1992). Manual for the Profile of Mood States, Educational and Industrial Testing Services."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.physbeh.2011.01.009","article-title":"Stress augments food \u2018wanting\u2019 and energy intake in visceral overweight subjects in the absence of hunger","volume":"103","author":"Lemmens","year":"2011","journal-title":"Physiol. Behav."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"515","DOI":"10.3390\/nu3050515","article-title":"Breakfast and snacks: Associations with cognitive failures, minor injuries, accidents and stress","volume":"3","author":"Chaplin","year":"2011","journal-title":"Nutrients"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"10","DOI":"10.3389\/fnut.2014.00010","article-title":"Positive effects of a healthy snack (fruit) versus an unhealthy snack (chocolate\/crisps) on subjective reports of mental and physical health: A preliminary intervention study","volume":"1","author":"Smith","year":"2014","journal-title":"Front. Nutr."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Iorga, M., Manole, I., Pop, L., Muraru, I.D., and Petrariu, F.D. (2018). Eating disorders in relationship with dietary habits among pharmacy students in Romania. Pharmacy, 6.","DOI":"10.3390\/pharmacy6030097"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e011987","DOI":"10.1136\/bmjopen-2016-011987","article-title":"Association of eating behaviours with diurnal preference and rotating shift work in Japanese female nurses: A cross-sectional study","volume":"6","author":"Yoshizaki","year":"2016","journal-title":"BMJ Open"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1006\/appe.1995.0060","article-title":"Shift related dietary intake in day and shift workers","volume":"25","author":"Lennernas","year":"1995","journal-title":"Appetite"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1081\/CBI-120025536","article-title":"Measurement of, and some reasons for, differences in eating habits between night and day workers","volume":"20","author":"Waterhouse","year":"2003","journal-title":"Chronobiol. Int."},{"key":"ref_55","first-page":"33","article-title":"Barriers to healthy eating in the nursing profession: Part 2","volume":"15","author":"Faugier","year":"2001","journal-title":"Nurs. Stand."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1038\/nrendo.2009.23","article-title":"Effects of poor and short sleep on glucose metabolism and obesity risk","volume":"5","author":"Spiegel","year":"2009","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1097\/HCO.0000000000000545","article-title":"Women\u2019s heart health: a focus on nurses\u2019 physical activity and sedentary behavior","volume":"33","author":"Reed","year":"2018","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.ijnurstu.2018.02.001","article-title":"Influence of the workplace on physical activity and cardiometabolic health: Results of the multi-center cross-sectional Champlain Nurses\u2019 study","volume":"81","author":"Reed","year":"2018","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/S0002-8223(21)05669-8","article-title":"Validity of the 24-hr. dietary recall and seven-day record for group comparisons","volume":"73","author":"Gersovitz","year":"1978","journal-title":"J. Am. Diet. Assoc."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/11\/9\/2054\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:16:02Z","timestamp":1760188562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/11\/9\/2054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,2]]},"references-count":59,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9]]}},"alternative-id":["nu11092054"],"URL":"https:\/\/doi.org\/10.3390\/nu11092054","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,2]]}}}