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Published in: Trials 1/2022

Open Access 01-12-2022 | Obesity | Study protocol

Meal replacement as a weight loss strategy for night shift workers with obesity: a protocol for a randomized controlled trial

Authors: Piumika Sooriyaarachchi, Ranil Jayawardena, Toby Pavey, Neil A. King

Published in: Trials | Issue 1/2022

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Abstract

Background

Shift work is considered a risk factor for a number of chronic health conditions including obesity. Weight reduction in obese patients lowers the risk for cardiovascular disease, diabetes, certain cancers, and mortality. Achieving a negative energy balance by providing low-calorie meal replacements is widely used for weight management. This study aims to evaluate the impact of a low-calorie “meal-replacement” on the weight and metabolic parameters of shift workers with obesity.

Methods

This trial will be conducted in a parallel, randomized controlled design for a period of 8 weeks. A total of 44 shift workers with body mass index over 25 kg/m2 will be recruited after assessing eligibility. Participants will be randomly assigned to the test and control groups on a 1:1 ratio. The intervention group (N = 22) will be provided with a low-calorie (~200 kcal) meal replacement shake as dinner, and the control group (N = 22) will continue their habitual diets. The visits and the evaluations will be done as follows: screening (visit 0), 4 weeks (visit 1), and 8 weeks (visit 2). Anthropometric measurements will be taken at 0, 4, and 8 weeks. Body composition, biochemical parameters, dietary intake, and physical activity will be assessed during the first and the last visit.

Outcomes

The primary outcome will be the proportion of participants that had a 5% body weight loss from baseline. The secondary outcomes will be post-intervention changes in other metabolic parameters.

Discussion

To our knowledge, this is one of the first randomized controlled trials evaluating the effects of a meal replacement as the night meal for weight loss in shift workers with obesity. Moreover, improvement of metabolic parameters in shift workers will be an added benefit to this high-risk group.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000231​741. Registered on 09 February 2022.
Appendix
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Literature
1.
go back to reference Antunes LC, Levandovski R, Dantas G, Caumo W, Hidalgo M. Obesity and shift work: chronobiological aspects. Nutr Res Rev. 2010;23(1):155–68.CrossRef Antunes LC, Levandovski R, Dantas G, Caumo W, Hidalgo M. Obesity and shift work: chronobiological aspects. Nutr Res Rev. 2010;23(1):155–68.CrossRef
2.
go back to reference Zhang Q, Ying CS, Shan LSH, Pak-Chun CJ, Schwade M, Zhao X. Association between shift work and obesity among nurses: a systematic review and meta-analysis. Int J Nurs Stud. 2020;112:103757. Zhang Q, Ying CS, Shan LSH, Pak-Chun CJ, Schwade M, Zhao X. Association between shift work and obesity among nurses: a systematic review and meta-analysis. Int J Nurs Stud. 2020;112:103757.
3.
go back to reference Sun M, Feng W, Wang F, Li P, Li Z, Li M, et al. Meta-analysis on shift work and risks of specific obesity types. Obes Rev. 2018;19(1):28–40.CrossRef Sun M, Feng W, Wang F, Li P, Li Z, Li M, et al. Meta-analysis on shift work and risks of specific obesity types. Obes Rev. 2018;19(1):28–40.CrossRef
4.
go back to reference Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25 Part B):2985–3023.CrossRef Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25 Part B):2985–3023.CrossRef
6.
go back to reference Jayawardena R, Byrne NM, Soares MJ, Katulanda P, Hills AP. Prevalence, trends and associated socio-economic factors of obesity in South Asia. Obes Facts. 2013;6(5):405–14.CrossRef Jayawardena R, Byrne NM, Soares MJ, Katulanda P, Hills AP. Prevalence, trends and associated socio-economic factors of obesity in South Asia. Obes Facts. 2013;6(5):405–14.CrossRef
7.
go back to reference Helble M, Francisco K. The imminent obesity crisis in Asia and the Pacific: first cost estimates; 2017. Helble M, Francisco K. The imminent obesity crisis in Asia and the Pacific: first cost estimates; 2017.
8.
go back to reference Jayawardena R, Byrne NM, Soares MJ, Katulanda P, Hills AP. The obesity epidemic in Sri Lanka revisited. Asia Pac J Public Health. 2012;27(2):1298–9.CrossRef Jayawardena R, Byrne NM, Soares MJ, Katulanda P, Hills AP. The obesity epidemic in Sri Lanka revisited. Asia Pac J Public Health. 2012;27(2):1298–9.CrossRef
9.
go back to reference Somasundaram N, Ranathunga I, Gunawardana K, Ahamed M, Ediriweera D, Antonypillai CN, et al. High prevalence of overweight/obesity in urban Sri Lanka: findings from the Colombo urban study. J Diabetes Res. 2019;2019:2046428.CrossRef Somasundaram N, Ranathunga I, Gunawardana K, Ahamed M, Ediriweera D, Antonypillai CN, et al. High prevalence of overweight/obesity in urban Sri Lanka: findings from the Colombo urban study. J Diabetes Res. 2019;2019:2046428.CrossRef
10.
go back to reference Peplonska B, Bukowska A, Sobala W. Association of rotating night shift work with BMI and abdominal obesity among nurses and midwives. PLoS One. 2015;10(7):e0133761-e.CrossRef Peplonska B, Bukowska A, Sobala W. Association of rotating night shift work with BMI and abdominal obesity among nurses and midwives. PLoS One. 2015;10(7):e0133761-e.CrossRef
11.
go back to reference Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1(3):e62.CrossRef Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med. 2004;1(3):e62.CrossRef
12.
go back to reference Hulsegge G, Boer JM, van der Beek AJ, Verschuren WM, Sluijs I, Vermeulen R, et al. Shift workers have a similar diet quality but higher energy intake than day workers. Scand J Work Environ Health. 2016;42(6):459–68. Hulsegge G, Boer JM, van der Beek AJ, Verschuren WM, Sluijs I, Vermeulen R, et al. Shift workers have a similar diet quality but higher energy intake than day workers. Scand J Work Environ Health. 2016;42(6):459–68.
13.
go back to reference Asher G, Sassone-Corsi P. Time for food: the intimate interplay between nutrition, metabolism, and the circadian clock. Cell. 2015;161(1):84–92.CrossRef Asher G, Sassone-Corsi P. Time for food: the intimate interplay between nutrition, metabolism, and the circadian clock. Cell. 2015;161(1):84–92.CrossRef
14.
go back to reference Haus E, Reinberg A, Mauvieux B, Le Floc’h N, Sackett-Lundeen L, Touitou Y. Risk of obesity in male shift workers: a chronophysiological approach. Chronobiol Int. 2016;33(8):1018–36.CrossRef Haus E, Reinberg A, Mauvieux B, Le Floc’h N, Sackett-Lundeen L, Touitou Y. Risk of obesity in male shift workers: a chronophysiological approach. Chronobiol Int. 2016;33(8):1018–36.CrossRef
15.
go back to reference Cain SW, Filtness AJ, Phillips CL, Anderson C. Enhanced preference for high-fat foods following a simulated night shift. Scand J Work Environ Health. 2015;41(3):288–93. Cain SW, Filtness AJ, Phillips CL, Anderson C. Enhanced preference for high-fat foods following a simulated night shift. Scand J Work Environ Health. 2015;41(3):288–93.
16.
go back to reference Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord. 1992;16(6):397–415.PubMed Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes Relat Metab Disord. 1992;16(6):397–415.PubMed
17.
go back to reference Sartorio A, Ottolini S, Agosti F, Massarini M, Lafortuna C. Three-week integrated body weight reduction programme markedly improves performance and work capacity in severely obese patients. Eat Weight Disord. 2003;8(2):107–13.CrossRef Sartorio A, Ottolini S, Agosti F, Massarini M, Lafortuna C. Three-week integrated body weight reduction programme markedly improves performance and work capacity in severely obese patients. Eat Weight Disord. 2003;8(2):107–13.CrossRef
18.
go back to reference Lasikiewicz N, Myrissa K, Hoyland A, Lawton CL. Psychological benefits of weight loss following behavioural and/or dietary weight loss interventions. A systematic research review. Appetite. 2014;72:123–37.CrossRef Lasikiewicz N, Myrissa K, Hoyland A, Lawton CL. Psychological benefits of weight loss following behavioural and/or dietary weight loss interventions. A systematic research review. Appetite. 2014;72:123–37.CrossRef
19.
go back to reference Heymsfield S, Van Mierlo C, Van der Knaap H, Heo M, Frier H. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int J Obes (Lond). 2003;27(5):537–49.CrossRef Heymsfield S, Van Mierlo C, Van der Knaap H, Heo M, Frier H. Weight management using a meal replacement strategy: meta and pooling analysis from six studies. Int J Obes (Lond). 2003;27(5):537–49.CrossRef
20.
go back to reference Cheskin LJ, Mitchell AM, Jhaveri AD, Mitola AH, Davis LM, Lewis RA, et al. Efficacy of meal replacements versus a standard food-based diet for weight loss in type 2 diabetes a controlled clinical trial. Diabetes Educ. 2008;34(1):118–27.CrossRef Cheskin LJ, Mitchell AM, Jhaveri AD, Mitola AH, Davis LM, Lewis RA, et al. Efficacy of meal replacements versus a standard food-based diet for weight loss in type 2 diabetes a controlled clinical trial. Diabetes Educ. 2008;34(1):118–27.CrossRef
21.
go back to reference Davis LM, Coleman C, Kiel J, Rampolla J, Hutchisen T, Ford L, et al. Efficacy of a meal replacement diet plan compared to a food-based diet plan after a period of weight loss and weight maintenance: a randomized controlled trial. Nutr J. 2010;9:11.CrossRef Davis LM, Coleman C, Kiel J, Rampolla J, Hutchisen T, Ford L, et al. Efficacy of a meal replacement diet plan compared to a food-based diet plan after a period of weight loss and weight maintenance: a randomized controlled trial. Nutr J. 2010;9:11.CrossRef
22.
go back to reference Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.CrossRef Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.CrossRef
23.
go back to reference Christensen R, Astrup A, Bliddal H. Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial. Osteoarthr Cartil. 2005;13(1):20–7.CrossRef Christensen R, Astrup A, Bliddal H. Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial. Osteoarthr Cartil. 2005;13(1):20–7.CrossRef
24.
go back to reference Somasundaram N, Rajaratnam D, Wijeyarathne P, Katulanda P, de Silva KSH, Wickramasinghe P, et al. Management of obesity. Sri Lanka J Diabetes, Endocrinol Metabol (SJDEM). 2014;1:55–70. Somasundaram N, Rajaratnam D, Wijeyarathne P, Katulanda P, de Silva KSH, Wickramasinghe P, et al. Management of obesity. Sri Lanka J Diabetes, Endocrinol Metabol (SJDEM). 2014;1:55–70.
25.
go back to reference Rush E, Chandu V, Plank L. Prediction of fat-free mass by bioimpedance analysis in migrant Asian Indian men and women: a cross validation study. Int J Obes (Lond). 2006;30(7):1125–31.CrossRef Rush E, Chandu V, Plank L. Prediction of fat-free mass by bioimpedance analysis in migrant Asian Indian men and women: a cross validation study. Int J Obes (Lond). 2006;30(7):1125–31.CrossRef
26.
go back to reference Jayawardena R, Swaminathan S, Byrne NM, Soares MJ, Katulanda P, Hills AP. Development of a food frequency questionnaire for Sri Lankan adults. Nutr J. 2012;11(1):1–6.CrossRef Jayawardena R, Swaminathan S, Byrne NM, Soares MJ, Katulanda P, Hills AP. Development of a food frequency questionnaire for Sri Lankan adults. Nutr J. 2012;11(1):1–6.CrossRef
27.
go back to reference Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.CrossRef Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.CrossRef
28.
go back to reference Joseph B, Joseph M. The health of the healthcare workers. Indian J Occup Environ Med. 2016;20(2):71–2.CrossRef Joseph B, Joseph M. The health of the healthcare workers. Indian J Occup Environ Med. 2016;20(2):71–2.CrossRef
29.
go back to reference Abubakar MB, Uthman YA, Ibrahim KG. Prevalence of overweight and obesity among health-care workers in Ghana: a systematic review. Nigerian J Exp Clin Biosci. 2021;9(1):47.CrossRef Abubakar MB, Uthman YA, Ibrahim KG. Prevalence of overweight and obesity among health-care workers in Ghana: a systematic review. Nigerian J Exp Clin Biosci. 2021;9(1):47.CrossRef
30.
go back to reference Garrido RA, Semeraro MB, Temesgen SM, Simi MR. Metabolic syndrome and obesity among workers at Kanye Seventh-day Adventist Hospital, Botswana. S Afr Med J. 2009;99(5):331-4. Garrido RA, Semeraro MB, Temesgen SM, Simi MR. Metabolic syndrome and obesity among workers at Kanye Seventh-day Adventist Hospital, Botswana. S Afr Med J. 2009;99(5):331-4.
31.
go back to reference Geliebter A, Gluck ME, Tanowitz M, Aronoff NJ, Zammit GK. Work-shift period and weight change. Nutrition. 2000;16(1):27–9.CrossRef Geliebter A, Gluck ME, Tanowitz M, Aronoff NJ, Zammit GK. Work-shift period and weight change. Nutrition. 2000;16(1):27–9.CrossRef
32.
go back to reference Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, et al. Prioritizing the mental health and well-being of healthcare workers: an urgent global public health priority. Front Public Health. 2021;9:679397. Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, et al. Prioritizing the mental health and well-being of healthcare workers: an urgent global public health priority. Front Public Health. 2021;9:679397.
33.
go back to reference Souza RV, Sarmento RA, de Almeida JC, Canuto R. The effect of shift work on eating habits: a systematic review. Scand J Work Environ Health. 2018;45(1):7–21.CrossRef Souza RV, Sarmento RA, de Almeida JC, Canuto R. The effect of shift work on eating habits: a systematic review. Scand J Work Environ Health. 2018;45(1):7–21.CrossRef
34.
go back to reference De Assis MAA, Nahas M, Bellisle F, Kupek E. Meals, snacks and food choices in Brazilian shift workers with high energy expenditure. J Hum Nutr Diet. 2003;16(4):283–9.CrossRef De Assis MAA, Nahas M, Bellisle F, Kupek E. Meals, snacks and food choices in Brazilian shift workers with high energy expenditure. J Hum Nutr Diet. 2003;16(4):283–9.CrossRef
35.
go back to reference Lopez-Minguez J, Gómez-Abellán P, Garaulet M. Timing of breakfast, lunch, and dinner. Effects on obesity and metabolic risk. Nutrients. 2019;11(11):2624.CrossRef Lopez-Minguez J, Gómez-Abellán P, Garaulet M. Timing of breakfast, lunch, and dinner. Effects on obesity and metabolic risk. Nutrients. 2019;11(11):2624.CrossRef
36.
go back to reference Lowden A, Moreno C, Holmbäck U, Lennernäs M, Tucker P. Eating and shift work—effects on habits, metabolism, and performance. Scand J Work Environ Health. 2010;36(2):150–62. Lowden A, Moreno C, Holmbäck U, Lennernäs M, Tucker P. Eating and shift work—effects on habits, metabolism, and performance. Scand J Work Environ Health. 2010;36(2):150–62.
37.
go back to reference Phoi YY, Keogh JB. Dietary interventions for night shift workers: a literature review. Nutrients. 2019;11(10):2276.CrossRef Phoi YY, Keogh JB. Dietary interventions for night shift workers: a literature review. Nutrients. 2019;11(10):2276.CrossRef
38.
go back to reference Noakes M, Foster PR, Keogh JB, Clifton PM. Meal replacements are as effective as structured weight-loss diets for treating obesity in adults with features of metabolic syndrome. J Nutr. 2004;134(8):1894–9.CrossRef Noakes M, Foster PR, Keogh JB, Clifton PM. Meal replacements are as effective as structured weight-loss diets for treating obesity in adults with features of metabolic syndrome. J Nutr. 2004;134(8):1894–9.CrossRef
Metadata
Title
Meal replacement as a weight loss strategy for night shift workers with obesity: a protocol for a randomized controlled trial
Authors
Piumika Sooriyaarachchi
Ranil Jayawardena
Toby Pavey
Neil A. King
Publication date
01-12-2022
Publisher
BioMed Central
Keywords
Obesity
Obesity
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06784-x

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