Night shift work and dietary behaviors: a comparative analysis of European night shift and day workers from the SHIFT2HEALTH online survey

Abstract Background Night shift workers are more likely to exhibit unfavorable dietary behaviors than day workers. However, these differences remain insufficiently explored within the European workforce. This study aims to examine differences in dietary behaviors (food intake frequency, eating frequency) by night shift exposure (history, frequency, duration) to investigate eating frequency, meal timing, and food choice determinants during night shifts, and to explore gender differences across Europe. Methods Data were collected via an online survey (May 2024-January 2025) in eight countries (Austria, Germany, Denmark, Greece, Italy, the Netherlands, Poland, Spain). Participants self-reported sociodemographics, occupational sector, current work schedules, shift work history, lifestyle characteristics, and dietary behaviors. A shortened Food Frequency Questionnaire (FFQ) assessed dietary intake, alongside questions on eating rate and frequency on work and non-work-days. Current night shift workers additionally reported eating frequency, timing, and food choice determinants during night shifts. Analyses compared dietary behaviors by night shift exposure (current, former, vs. day worker). Among current night shift workers, associations with night shift frequency (nights/month) and duration (years) were examined. Secondary analyses were stratified by gender. Results A total of 6,260 individuals were included (mean age 40.7, SD 10.7; 50.5% female). Overall, 60.4% were current night shift workers, 19.6% former night shift workers, and 20% day workers. Compared to day workers, current night shift workers reported significantly faster eating rates (OR = 1.21, 95% CI: 1.06–1.37), more frequent intake of sugar-sweetened (OR = 1.30, 95% CI: 1.14–1.48) and caffeinated beverages (OR = 1.14, 95% CI: 1.01–1.30), and lower fruit intake (OR = 0.87, 95% CI: 0.77–0.98). Higher monthly night shift load and longer duration of night work were associated with less favorable dietary patterns. Most current night shift workers reported one to two eating occasions per night, typically at the beginning or middle of their shift. Food choices were primarily driven by appetite, time, and food availability. Gender differences were observed only in food choice determinants. Conclusions Night shift and day workers in Europe showed differences in dietary behaviors, particularly in sugar-sweetened beverage intake and eating rate. These findings highlight the need for targeted interventions to promote healthy eating among shift working populations.