Evidence map›Paper›PMID 33622018›Full record

Observational studyJournal of sleep research2021

The association between eating frequency with alertness and gastrointestinal complaints in nurses during the night shift.

Mariëlle G de Rijk, Alexander P J van Eekelen, Elly Kaldenberg, Sanne Boesveldt, Wendy Te Woerd, Tineke Holwerda, Ceciel J M Lansink, Edith J M Feskens, Jeanne H M de Vries

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in Journal of sleep research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. A Systematic Review of Nutrition Interventions for Shift Workers, With Subgroup Analysis of First Responder Populations.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Pooled it
  2. Article
  3. Gastrointestinal Symptoms and the Assessment of Diet in Shift Workers: A Systematic Scoping Review.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2025
    Article
  4. Article
  5. Observational
  6. Article
  7. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 2 countries.

Mariëlle G de RijkDivision of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands.ORCID 0000-0002-3930-9086
Alexander P J van EekelenCircadian, Amsterdam, the Netherlands.
Elly KaldenbergSanavis, Spijk, the Netherlands.
Sanne BoesveldtDivision of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands.
Wendy Te WoerdHospital Rijnstate, Arnhem, the Netherlands.
Tineke HolwerdaHospital Gelderse Vallei, Ede, the Netherlands.
Ceciel J M LansinkDeventer Hospital, Deventer, the Netherlands.
Edith J M FeskensDivision of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands.
Jeanne H M de VriesDivision of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands.
Wageningen University & Research · NLAllergan (Netherlands) · NLCircadian (United States) · USDeventer Ziekenhuis · NLRijnstate Hospital · NLZiekenhuis Gelderse Vallei · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We investigated the association of the number of eating occasions and energy intake with alertness and gastrointestinal (GI) complaints in nurses during their night shift. During this observational study we collected data on anthropometrics and demographics, eating frequency, energy intake, alertness and GI complaints in 118 healthy female nurses, aged 20 to 61 years. Nurses completed an alertness test (psychomotor vigilance task) during the night shift and a 24-hr dietary recall and a questionnaire about GI complaints after the night shift. This was repeated three times, always on the first night shift in a night shift series. The number of eating occasions during the night shift was negatively associated with reaction times (β = -4.81 ms, 95% confidence interval [CI] -9.14 to -0.48; p = .030), and number of lapses (β = -0.04, 95% CI -0.07 to -0.00; p = .030). However, the number of eating occasions was not associated with subjective alertness and GI complaints. Energy intake during the night shift was not associated with objective or subjective alertness or with GI complaints. These associations were independent of caffeine intake, age, body mass index and dependence among the repeated measurements. The present study showed that eating frequency was positively associated with objectively measured alertness levels in female nurses during the night shift. The results need to be confirmed in an intervention study, where also timing, size and composition of the meal will be taken into account. In practice, optimising nutritional guidelines on these aspects could lead to faster responses, less (medical) errors, and a better wellbeing of night shift workers.

Indexed as

NursesSleepAttentionCircadian RhythmFemaleHumansReaction TimeWakefulnessWork Schedule Tolerancecognitive performancefatiguenutritionoccupational healthpsychomotor vigilance taskshift work

Identifiers

PMID33622018
PMCPMC8518800
OpenAlexW3131027827

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.