Fasting as an intervention to alter the impact of simulated night-shift work on glucose metabolism in healthy adults: a cluster randomised controlled trial
Authors' conclusion
The timing of food intake has a critical effect on glucose metabolism during simulated night-shift work, which was readily amendable to a meal re-timing intervention.
Study context
- Population
- Healthy, non-shift-working adults without obesity (age 24.5 ± 4.8 years; BMI 24.8 ± 2.8 kg/m²); 6 day sleep laboratory stay, Adelaide, Australia1 withdrew per group
- Participants
- 55 participants
- Comparison
- Fasting-at-night vs snack-at-night vs meal-at-night during simulated night-shift work
- Fasting-at-nightn = 20reference
- Snack-at-nightn = 17
- Meal-at-nightn = 18
- Primary endpoint
- Glucose, insulin and NEFA AUC in response to a 75 g OGTT (linear mixed-effects model)
- Follow-up
- Before and after 4 consecutive nights of shift work plus 1 night of recovery sleep
Methodological detailsopen-label, multi-arm, single-site, parallel-group, Participants and assessors not blinded; statistical and laboratory staff concealed to allocation, Fed at calculated energy balance with similar macronutrient composition across conditions
- Open-label
- Multi-arm
- Single-site
- Parallel-group
- Participants and assessors not blinded; statistical and laboratory staff concealed to allocation
- Fed at calculated energy balance with similar macronutrient composition across conditions
Primary result
As reported in the abstract
Glucose AUC change
Meal-at-night
+2.00
95% CI 1.45–2.56
Snack-at-night
+0.96
CI 0.36–1.56
Fasting-at-night
+0.34
CI −0.21–0.89
Meal-at-night vs Fasting-at-night: P < 0.001 · Snack-at-night vs Fasting-at-night: P = 0.022
- Day×condition interaction in glucose AUC
- P < 0.001
Further findings
| Outcome | Fasting-at-night | Snack-at-night | Meal-at-night | P value |
|---|---|---|---|---|
| NEFA AUC changeMeal-at-night vs Fasting-at-night · higher with meal-at-night | −0.02 (CI −0.06–0.01) | 0.01 (CI −0.03–0.05) | +0.07 (CI 0.03–0.10) | P = 0.001 |
| NEFA AUC changeSnack-at-night vs Fasting-at-night · higher with snack-at-night | P = 0.045 |
- NEFA AUC change — Day×condition interaction in NEFA AUC
- p<0.001
Insulin sensitivity (all conditions)
- Night-shift work impaired insulin AUC
- P = 0.035
- Night-shift work impaired insulin sensitivity index
- P = 0.016
Insulinogenic index
- Insulin secretion increased in fasting-at-night condition only
- P = 0.030
Safety
- No adverse events occurred
Original publication
Fasting as an intervention to alter the impact of simulated night-shift work on glucose metabolism in healthy adults: a cluster randomised controlled trial. Diabetologia. Published 18 October 2024. doi:10.
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