A Randomized Controlled Crossover Lifestyle Intervention to Improve Metabolic and Mental Health in Female Healthcare...

Background: Circadian rhythm disruption caused by shift work alters metabolic and hormonal pathways, which accelerates chronic disease onset, leading to decreased quality and quantity of life. This study aimed to determine whether a practical lifestyle intervention emphasizing nutrition timing and recovery habits could mitigate the metabolic and psychological effects of night-shift work. We conducted a randomized, open-label, crossover trial with two 8-week periods. Methods: Female healthcare workers (n = 13) aged 18-50 years with a body mass index (BMI) between 27 and 40 kg/m² and working predominantly night shifts (≥30 h/week for ≥6 months) were randomized. During the 8-week intervention phase, participants received daily text messages with guidance on food, sleep/rest, and physical activity and were provided with whey protein isolate powder and grain-based snack bars to consume during work shifts. The program targeted improved nutrient timing, adequate protein intake, and structured rest without formal exercise training, allowing evaluation of dietary and behavioral effects feasible for this population. Total caloric (~30 kcal/kg lean mass) and protein (2 g/kg lean mass) needs were measured, along with sleep/rest goals of 6-8 h/24 h. Primary outcome measures were change in visceral fat percentage (VF%) by DXA and mental/physical quality of life (RAND SF-12). Secondary outcomes included fasting triglycerides, ALT, blood glucose, LDL, actigraphy, and fecal microbiome. Mixed-design two-way ANOVA was conducted to assess the effects of group (immediate [IG] and delayed [DG]), time (baseline, 8-week crossover, and week 16), and Group × Time (GxT) interactions, and Bonferroni correction was applied to post hoc t-tests. Results: Eleven participants completed the study. Both groups increased dietary protein intake (p < 0.001), and a GxT interaction for VF% (p = 0.039) indicated DG reduced VF% to a greater extent (-0.335 ± 0.114% (p = 0.003) vs. 0.279 ± 0.543% (p = 0.158)). Mental and physical QOL, objectively measured physical activity and sleep, serum lipids and inflammatory markers, and fecal microbiota remained unchanged (p > 0.05 for all GxT). Conclusions: The findings suggest that targeted nutrition and recovery strategies can modestly improve dietary intake and visceral fat; however, consistent with prior work, interventions without structured exercise may be insufficient to reverse broader metabolic effects of circadian disruption. This trial was registered at ClinicalTrials.gov, identifier: NCT06158204, first registered: 28 November 2023.