A cross-sectional survey to evaluate the status of digestion in rotating- and fixed-shift workers

In the sustainment of health, the role of a well-functioning gut and effective digestion in sustaining health and contributing to disease development is immensely important. According to Ayurveda, digestive function is governed by Jaṭharāgni (digestive fire), and an impaired Jaṭharāgni (Mandagni) is considered a key factor in the initiation of many diseases. There are four types of expression of digestive fire (Jaṭharāgni) based on the predominance of the three humors, such as Vishamāgni (irregular digestion), 2. Tīkṣṇāgni (excessively intense digestion), 3. Mandāgni (slow digestion), and 4. Samāgni (balanced digestion). The state of Jaṭharāgni is influenced by several physiological factors, including season, time of day, age, constitution, dosha balance, and the quality and quantity of food consumed. Among shift workers, especially those engaged in rotating shifts, maintaining a regular lifestyle and dietary habits is often challenging. Disrupted sleep-wake cycle and an altered diet habit adversely affect normal gut physiology and impair digestion, metabolism, and gut transit time. The rising importance of shift work in modern society and an increase in the prevalence of metabolic and gastrointestinal disorders associated with the disruption of circadian rhythm highlight the need for research on digestive health among shift workers. Understanding the scientific framework on the relationship between Jaṭharāgni and altered work shifts and suggesting balanced lifestyle practices may contribute to the prevention of bad impacts on metabolic and digestive health.

A comparative, cross-sectional study was conducted among Information Technology (IT) employees from various companies in Technopark, Thiruvananthapuram, to assess the status of Jaṭharāgni among fixed-shift and rotating-shift workers. The sample size was calculated using Nassiuma's formula, and 350 employees were selected, comprising 175 fixed-shift workers and 175 rotating-shift workers (alternating between day and night shifts monthly) using a convenience sampling technique. Agnibala was assessed using a validated questionnaire published by Aparna Singh, Girish Singh, Kishore Patwardhan, and Sangeeta Gehlot, Department of Kriya Śarīra, Banaras Hindu University (BHU), Varanasi, India (2016 May) (27381899; PMCID: PMC 5871217). The questionnaire was validated using a Cronbach's alpha of 0.73 for the overall scale. For fixed-shift workers, Agnibala assessment was performed once during their routine work schedule. For rotating-shift workers, the assessment was carried out twice, once during the day-shift cycle and again during the night-shift cycle, with data collection conducted at the end of each respective shift period to capture the influence of different work schedules on Jaṭharāgni status. Data were analyzed using the chi-squared test and the McNemar test. A p-value of < 0.05 was considered statistically significant. Cramer's V test and Cohen's test were used to calculate effect sizes for the chi-squared test and McNemar test, respectively.

The study indicated that most fixed-shift workers had an Agnibala status consistent with their Prakriti. In contrast, 61.7% of rotating-shift workers reported a change in their Agni status due to their job nature, with many shifting to Vishamagni during their night shifts. Statistical analysis confirmed that the nature of work significantly affects the Jaṭharāgni status, along with other factors such as Prakriti, habits, and diet. Based on these findings, it was recommended to adopt a diet and lifestyle plan tailored to Agni status to mitigate health impacts.

This study findings suggest that rotating-shift work is associated with changes in the status of Agnibala, which may reflect disturbances in digestive and metabolic functioning. These observations indicate a possible relationship between shift work, circadian rhythm disruption, and digestive health. Although this study provides useful insights, further research involving larger populations, longitudinal designs, and molecular investigations is warranted to better understand these associations.