Expert Insight on Shift Work Health

Speaker 1 0:00

They can focus on a single pathway in the body and know a huge amount about that , but they don't understand how it relates to lifestyle and the big picture and the relative importance of different inputs to our health .

Speaker 2 0:21

Shift work can be brutal , but it doesn't have to be . Welcome to a healthy shift . My name is Roger Sutherland , certified nutritionist , veteran law enforcement officer and 24-7 shift worker for almost four decades . Through this podcast , I aim to educate shift workers using evidence-based methods , to not only survive the rigours of shift work , but thrive . My goal is to empower shift workers to improve their health and wellbeing so they have more energy to do the things they love . Enjoy today's show and welcome to another episode of a Healthy Shift Podcast your podcast , our podcast , the podcast where we give evidence-based strategies around shift work . Today , I am absolutely thrilled to have Dr Greg Potter , phd , on the podcast .

Speaker 2 1:15

Now , greg is someone who I have followed for some time in relation to his knowledge around shift work as a byproduct of all his other studies . Now , just to give you a bit of background on Greg Greg helps individuals and organizations sustainably improve their health and performance . Now , the way he does this is through developing and popularizing innovative businesses and products , coaching and public speaking , consulting and empowering people through educational resources such as ebooks , articles and courses . Now greg has his own podcast as well , which I highly recommend that you go and have a listen to , and I've put a link to the podcast in the show notes and it's the reason and well-being podcast , and that is also on the youtube channel as well . Now , greg has co-founded multiple startups , and these include a nutrition and supplement company , where he formulated the first product specifically designed to help counter the repercussions of sleep loss on many bodily systems . Now , prior to this , he was the chief science officer at a digital therapeutic company that aimed to automate personalized health coaching at scale .

Speaker 2 2:26

Greg's got a Bachelor of Science in Exercise Science and an MSc in Exercise Physiology . Greg's PhD research focused on sleep , circadian rhythms , nutrition and metabolism , and the highlights of Greg's career includes having this research featured in dozens of international news outlets , which includes the BBC , reuters and the Washington Post . So working with the US Naval Special Warfare Command and appearing on Channel 7 TV program as a sleep expert , having his writing featured in many newspapers and magazines , including the Metro , stylus Magazine and Newsweek . Coaching has sprinted to four gold medals at the European Championships and has helped athletes break multiple world records in ocean rowing . Now , the reason why I've got Greg onto the podcast here is obviously because of his research on sleep , circadian rhythms , nutrition and metabolism , and this is the specialty . This is where us , as shift workers , will really benefit from what Greg's got to say . So , without much further ado , welcome to the show , greg Potter . How are you today , greg ?

Speaker 1 3:38

I'm very well , thank you . As we were just discussing , I've had my two coffees this morning to get ready for what , for me , is a relatively early interview .

Speaker 2 3:47

It would be very early . I've got you before your brain's even awake , but no doubt you will be someone who has already exposed yourself to the daylight here , because you know the importance of it , and I've already given a preamble in relation to who you are and what you're all about . You are actually a doctor in your research and that's the very reason , greg , why I've got you onto this podcast . I'm excited to have you on because I've seen lectures that you've actually done through Mac Nutrition Uni , which I was a bit offended that I didn't get to do it , but when I saw yours , I can totally understand why I wasn't asked . You are certainly an expert in this field and I think our shift workers will get lots out of this . Can you do us a favor , greg ? Can you tell our listeners a bit about yourself and where you're located and what you do on the daily , your hobbies and things like

Navigating Health and Wellness Information

Speaker 2 4:36

that ?

Speaker 1 4:36

So I'll start with my work , and the common thread that runs through all the work that I do is helping people sustainably improve their health and performance through lifestyle changes , and those include changes to their nutrition , their physical activity , their sleep and various other exposures , including light . I do a few things to that end . I'm a consultant for a few different businesses . I work as a scientific advisor in some of those roles . I'm involved in formulating some supplements for a few different businesses . I work as a scientific advisor in some of those roles . I'm involved in formulating some supplements for a US startup at the moment intended to help people live longer .

Speaker 1 5:11

I do some coaching work , which I've done for about 15 years now , when I first started working as a personal trainer , and a lot of that initially was with athletes , but more recently it's often with people with chronic health conditions and people who struggle with circadian rhythm disruption and sleep issues too . Academically , my phd focused on sleep , nutrition and metabolism , and there was a chronobiology component to that . Prior to that , I did a master's in exercise physiology . My undergrad was in sport and exercise science and then , in terms of my personal life right now I'm in Worcester in England , where I am for a few more days .

Speaker 1 5:52

I'm actually heading to the Philippines shortly , because most of my work is remote and so I can work from pretty much anywhere , and therefore I often just take my laptop with me and work from relatively far-flung places , and that's in part because of my interests . So , on a personal level , I love exploring and traveling and , within that , visiting rainforests , beautiful beaches . I'm possibly addicted to scuba diving , and so I'm often drawn to places where there are beautiful reefs or interesting wrecks or what have you . And I'll pause there , because that's probably enough about me for now , and I know that we've got lots of things to get to today .

Speaker 2 6:33

I think that's fantastic . Going to the Philippines , you're going to have to sit on those god-awful beaches that they've got there , greg . You know the ones with the disgusting white sand and the aqua blue water . You'll have to put up with all of that clear stuff . I feel very , very sorry for you having to put up with that Terrible Okay , so now you've got to the stage where you've got your fingers in pies everywhere . You're highly educated in relation to that , so why do you actually do what you do ?

Speaker 1 6:58

I think it's a mix of things . I think some of it is seeing the need for it , and I'd argue that there's actually a really strong need right now for people like you and I to be doing what we do , because there's a lot of misinformation out there , and the tricky thing is that often false information propagates faster through social networks than the truth , and obviously it's hard to establish what the ground truth is , and so I say that with some trepidation . But certainly people who take extreme stances , saying this is toxic or you must do this , tends to become more popular , and that's why you look at YouTube , for example , and all of the different thumbnails that people use for videos . It's always some extreme statement using outlandish words , and the reality is always much more nuanced .

Speaker 2 7:54

It's a total dumpster fire at the moment , isn't it Social media ? It really is .

Speaker 1 7:57

A little bit , and it's completely understandable that people find it hard to pass because people don't have relevant expertise and they put their trust in people and they put some people on pedestals , maybe because of their scientific backgrounds or because of relevant training or because of the size of the followings of these people , but much of the time , the individuals who are putting this information out there aren't true experts in the subjects that they're discussing , and so we need error correction mechanisms . That are in place , and I host my own podcast , which is called Reason Wellbeing , and part of the reason for that is to try and help address some of those errors and , just as a tangent , listeners to this might find some of the episodes I've recorded so far interesting , and I have recorded a couple of episodes on shift work specifically , but also other relevant subjects , including biological rhythms and sleep , and so that's part of the reason . I think another part of the reason is that I frankly , really enjoy it and that I have some personal fit with it too , because I've been interested in these subjects from a very early age . I joke that I had a misspent youth and became very interested in nutrition and exercise first at the age of 13 when I hurt my back playing rugby and , frankly , I wanted to start looking better for girls . So I started lifting weights and changing how I ate and so on , and I'm now 34 .

Speaker 1 9:27

So I've actually been interested in these subjects for over two decades and over time , hopefully , I've updated my understanding of various subjects and continue to do so . So I'm not claiming to know the correct answer for any of the questions that you sent my way today , but hopefully , because of the breadth of my interests , I can understand something about some of the relationships between all these different things , because I think what ends up happening is that people develop quite niche expertise and they often end up knowing more and more about less and less , until they know an awful lot about something that's ultimately inconsequential . And if anybody who's listening to this is an academic , they might be able to relate to that , because if I look at some of the subjects that my friends studied or continue to study for their phds or at the postdoc level , they can focus on a single pathway in the body and know a huge amount about that , but they don't understand how it relates to lifestyle and the big picture and the relative importance of different inputs to our health .

Speaker 2 10:39

When we look at some of the influencers big platforms , big podcasts , nameless they do understand pathways and mechanisms , no doubt about it , and they are qualified in that area . But one of the biggest problems that we do have is those people are focusing on that pathway without the nuance of everything else that's going on around it and it doesn't work in the human body like that . Sometimes as well , they understand that pathway , but there's so many variables . You've talked about chrononutrition or chronobiology , the area that you're working in . I find this really exciting chronobiology , chrononutrition now because once I did my evidence-based practice in nutrition and learnt how to read research , how to understand and the nuance of everything that we do talk about , I started looking at the chrono , obviously because I'm a veteran shift worker and I knew there had to be something more into it . I then read Russell Foster's book Lifetime , which is probably one of the finest books I've read so far . I think it's excellent . And then I start to listen to things like the shift work episodes of your podcast as well , which I will actually link in the show notes for people to go and have a listen to , because they really are very insightful .

Speaker 2 11:52

Now you are well-researched in the area of sleep and circadian rhythms , and nutrition and metabolism . And that is the very , very reason why I've got you on this podcast , because people will really gain a lot of insight which will be evidence-based . And the reason people will tell that you're evidence-based is because you won't say this is what you must do , this is what works . You'll say well , it depends , which is what so many people say .

Importance of Biological Rhythms in Performance

Speaker 2 12:19

So what led you to research in this particular area ? As far as circadian rhythms and chronobiology , it's such an emerging area , quite an exciting stage , that this research is in at the moment , isn't it ?

Speaker 1 12:31

It is . What led me to it is that I realized that I knew very little about biological rhythms and sleep . At the time , I was studying exercise physiology , and this coincided with the rise of podcasts . There weren't many podcasts back then . I was one of the early adopters . I tuned into the four or five health shows that were out there at the time , and I recall listening to a few people speak about sleep and finding it very interesting . And then , just in my own , I started reading a few papers about sleep and biological rhythms . I remember one of the early papers I read was Frank Shear's 2009 paper looking at the effects of circadian misalignment on cardiometabolic health in PNAS and finding it fascinating . And so I thought at the time that I was going to end up in academia and therefore I wanted to find a PhD opportunity that would sustain my interest over four plus years , and I stumbled on one at the University of Leeds that , at the time , was going to focus on melatonin supplementation and people at high risk for type 2 diabetes , and ultimately the project evolved , as they always do , to be broader than that .

Speaker 1 13:50

But that really is what set me down that particular path , and I think it was fortuitous because it coincided with the release of a few popular books about sleep and about biological rhythms , and so during my PhD , all of a sudden there was this surge in interest among the general public about sleep .

Speaker 1 14:15

Previously , it had been the neglected stepchild of lifestyle and I think , in particular with the publication of Matthew Walker's book why we Sleep , all of a sudden lots of people were discussing sleep , and because I was involved in a digital health company at the time that had a podcast , I was brought on there to help out with a few things and I was invited to be a guest this was back in 2017 , to discuss chrononutrition , because I'd recently published a review article on that , and then since then , I've ended up doing quite a lot of work in science communication focusing on biological rhythms and , like you say , it's a really important subject because biological rhythms really permeate everything else .

Speaker 1 15:02

People talk about lifestyle and often use an analogy of the stool , and the idea is that you can think of nutrition as being one leg of the stool and physical activity is another and sleep is another perhaps , and maybe you add a few more legs and if you remove one of those legs , then maybe the stool can stay upright . But I think about chronobiology slightly differently , in that it's actually related to all of those other things . So you can think about exercise in the context of chronobiology , you can think about nutrition in the context of it , you can think about sleep in the context of it , you can think about light exposure in the context of it , and so I think it's that pervasiveness that continues to keep me interested in that particular subject to this day .

Speaker 2 15:47

The other thing is in relation to particularly chronobiology , the importance of that 1% for athletes , isn't it ? Because if you get the circadian rhythm timing right , then it actually helps to improve so much . Then it actually helps to improve so much . So , for argument's sake , I'm not sure that people would really realize that when they run the 100 meters final at the Olympics , people train for that time for their body , don't they ? In the lead up to it . They don't just turn up and look at the time and go , oh , we're running at 4.10 this week . They would have been training at 4.10 for the last two or three months , wouldn't they ? So that they're absolutely spot on in their cycle . Because it makes that much difference , doesn't it ?

Speaker 1 16:31

Yeah , they certainly should have been doing that , and the ones that are more tuned into the research certainly will be doing that , and there are various reasons for that , but one of them is just that one of the functions of the clocks that are in the cells and tissues throughout your body is to anticipate things that are coming up during the day , and so you have clocks in your skeletal muscles and your bones and your joints that will predict when you're going to be active each day , and these can be reset by when you exercise .

Speaker 1 17:03

And so it's likely that if you're going to be competing at 6 pm in 100 meter final , then consistently training at that time is teaching your muscles to anticipate activity at that time and therefore optimizing performance at that time .

Speaker 1 17:19

Interestingly , that time does actually just about coincide with when peak performance in strength and power exercise , such as sprinting , would likely occur regardless . And if you look across various different disciplines and this hasn't been well researched , but certainly there's evidence pointing this direction then it seems that various records are set in the early evening , evening and that's true of many records in track and field specifically and some of that relates to scheduling because people are trying to peak for certain events , and these events are televised , and they tend to occur in the evening . So much of it is due to that , but some of it is actually probably driven by biological rhythms as well and the fact that at this time of day , core body temperature is higher and so muscles are more pliable , electrical impulses are transmitted down the nerves faster , enzymes are involved in energy provision and skeletal muscles are working more quickly , and so on .

Speaker 2 18:15

And this is why performance athletes need to be doing that Soccer players and football players and it's no good training for games at two o'clock in the afternoon if you're actually going to be playing it at 7 pm at night . You want to be starting to set that . It makes it very , very difficult . But this brings us to the point around shift work as well , and why shift work just desynchronizes everything , which leaves our body in a real pickle , doesn't it Like it can't anticipate , or it does anticipate something doesn't happen , what it's expected , where we are continually putting it through literally torture , aren't we ? Because all the clocks are all completely out of sync In your time ? When it comes to shift work and chrononutrition , chronobiology , circadian rhythm , research , what would you say would be one of the most significant pieces of research that relates to shift work that you've seen that everyone went . Oh my goodness me . This could make a difference .

Speaker 1 19:12

It's a really difficult question to answer , and I don't think that this is a piece of research that necessarily got that much attention , and it is just one that I'm plucking out of thin air .

Speaker 1 19:25

I haven't thought about this too systematically , but one of the more interesting papers that has come out in recent years is a study that's published in pnas , and they looked at the effects of telling shift workers their schedules a couple of weeks in advance , and this work was just a naturalistic study because this was taking place in seattle at the time anyway and they looked pre and post to people's satisfaction with their work and their self-rated sleep and also their economic security , and they found that when people found out a couple of weeks in advance what their schedules were , they had better sleep and they had higher economic security . So , thinking about this at the level of the population and the real-world implications of this , it's quite simple telling people in advance here is your schedule and it seems , based on this evidence , that doing so can actually quite strongly affect people's health and various different determinants of that , including their financial status too , and so , while it might not be particularly interesting in terms of underlying biology , I think that , being pragmatic , it's a really important piece of work

Impact of Shift Work on Health

Speaker 1 20:48

.

Speaker 2 20:48

I honestly believe that that is the reason why we , as human beings , thrive on routine . We need routine , and shift workers don't have a routine . But this is why I actually get my clients , in particular , to schedule so that they know what's coming and what they're doing . Because if you schedule things out , I find that my shift work clients really start to thrive , because they can see it written , they can anticipate it , they know . So that really supports that evidence , doesn't it , greg ? It does .

Speaker 1 21:20

Yeah , and then you can plan what you're going to do with your spare time as well and you can start to organize the rest of your life around your work , because your work has a massive effect on that that .

Speaker 1 21:47

Other people who don't work shift don't experience , and obviously shift work has knock-on effects to the people around the shift workers . Some people , like sachin panda , will speak about second-hand shift workers who live with these individuals simply knowing , okay , this is when I'm going to be at work and therefore this is when I need to be up and therefore this is when I'm going to get back from work and I've got these days off and so I can see friends then can help people arrange their lives in ways that support their health . Recognizing that even putting circadian biology and sleep disruption and so on to the side , which dramatically do affect the health of shift workers hard to show experimentally , but that is almost certainly the case there are other factors that could compromise the health of these people , and they include things like social stress , so trying to navigate complex relationships in a world where they're up and about and sleeping out of sync with the rest of society , including their loved ones .

Speaker 2 23:43

It really impacts on mental health in a huge way . I love that you've raised just that . What you thought was maybe an insignificant piece of research that I can give very categoric anecdotal evidence from clients around that scheduling and knowing what's coming in your week and how important that is , is a game changer for shift workers . And also you talk about the impact on relationships . I actually take my shift work clients to the stage where they get a whiteboard and they put it up on the whiteboard so when they are seriously fatigued they can look at it . Not only that , but their husband or wife or children can look at it as well , and it just avoids one further conversation . That could be the conversation that you just don't need . They can look at the board and go , oh yeah , mum's working or dad's working , or can we do this ?

Speaker 2 24:32

But you can also schedule in the you and me time , as you said , navigating those complex relationships , because shift work really impacts on people's mental health and it's very isolating , and I think if you schedule , you can plan ahead and you can make that really really good as well . So you're well-researched in this area . Can you just tell our shift workers why it is that it has such an impact on us biologically , like if I go from nine to five to starting shift work . Why is it ? I feel chronically fatigued , I feel lethargic , my mental health starts to take a hit . I can't cope , I can't function , I can't sleep during the day , I can't properly sleep overnight . What's the biological impact that it's actually having and why ?

Speaker 1 25:18

I think there are many factors that are at play here . One of them is what we were just discussing the psychosocial side of things . One of them relates to lifestyle behaviors , and there's probably a two-way relationship that's at play here . But what I'm referring to is that if you look cross-sectionally at shift workers versus non-shift workers , then certainly there is evidence that in many ways their lifestyles are less healthy , so they tend to smoke a bit more , for example , they might consume more sugar , sweetened beverages , and they might have differences in their patterns of physical activity . So there are all of these types of factors that are at play and I think that those can , of course , potentially negatively affect things like sleep . But also the sleep disruption that shift workers experience make it harder to actually stick to healthy behaviors while awake as well , and that's what I meant by that type of bidirectional relationship . But then , moving beyond behaviors , I think the two key players here are sleep disruption and disruption to the biological clock , and those are , of course , related to each other .

Speaker 1 26:36

But if we start with the biological clock , then I mentioned that we have this system of clocks throughout our bodies that anticipates certain things during the day .

Speaker 1 26:47

So we are , as a species , diurnal , daytime active , under strong time cues , so clear cycles of light and dark , and resting and fasting , and physical activity and inactivity , and what we see is that our bodies are anticipating being awake , being physically active and food intake when the sun is up , during the daytime and obviously I'm speaking here about regions that aren't too far from the equator , because high latitudes can have very extreme light-dark cycles and then during the nighttime , inactivity and fasting and sleep .

Speaker 1 27:31

Because if our bodies were trying to do everything all at once all the time , so always trying to build things and break them down and have the immune system on high gear to fend off pathogens , that would be very costly energetically , and so instead , what our bodies do is they separate the timing of processes that are largely incompatible , so that during the daytime our bodies are ready for activity and they're ready to fight pathogens , whether those are from food or other sources , and they're ready to digest food , but then at night , the body has a chance to restore itself , repair some of the damage that's taken place during the daytime , and the issue here is that the circadian system of clocks that give rise to these 24-hour changes in our biology need strong time cues each day , because , while the system anticipates what's going on , it also adapts to the environment as well , and this is why , if you fly across many time zones , your body clock doesn't just stay stuck on your home time zone .

Speaker 1 28:42

you can actually get past the jet lag . So the time cues are most important for the circadian system

Managing Circadian Rhythms and Shift Work

Speaker 1 28:48

are the light dark cycle , but also when you eat and when you fast , and when you're active and when you're inactive , and the relative importance of those probably differs according to the tissue in question . So the light dark cycle is most important to the sleep wake cycle and the body clock part of the regulation of that , whereas the eating fasting cycle might be particularly important to tissues that are involved in digesting and metabolizing food , and physical activity might be particularly important to when your musculoskeletal system is anticipating timing during the day , and so if we think about shift workers now , then the issue is that these time cues exposure to light and dark when they're eating each day , when they're active and inactive are very variable , and so the clock system is constantly trying to anticipate what's going on and adapt to what's going on . But what's going on is always changing and so , as a result , it's , but what's going on is always changing and so , as a result , it's likely the case that many of these clocks in the system , in different tissues , lose their appropriate timing relationships with each other , and then that in turn contributes to increased risk of various different chronic diseases . We know , for instance , that shift workers have roughly a 25% higher risk of developing coronary heart disease , 5% higher risk of stroke , they might be predisposed to weight gain and so on , and some of that probably relates to this clock disruption , based on some of the careful experiments that have been done mostly on non-shift workers , but some of them have been done on shift workers in which you manipulate things like the light-dark cycle and food intake and do so in a way that disrupts the system of clocks .

Speaker 1 30:39

But then the other variable that's at play is sleep disruption , and some of that , of course , relates to clock disruption , because if you look at how sleep is regulated , then broadly it's regulated by two processes , and one of these is driven by your body's clock and that produces this drive to be awake each day . But the other relates to the fact that your body's clock and that produces this drive to be awake each day , but the other relates to the fact that your body actively tries to defend how much sleep it gets . So sleep is homeostatically regulated , meaning that your body wants to keep the total amounts of sleep in a particular type of sleep within a relatively narrow range from day to day . And this is also the case , of course , for things like your blood pressure and your blood sugar , the concentrations of various electrolytes in your blood . So if you look at the course of a typical day , then what should happen is that you wake in the morning and overnight you've paid off a lot of the hunger to sleep that's accumulated in prior days and so you don't have a strong sleep hunger or homeostatic sleep drive . But then , the longer that you've been awake , the greater this drive is , the greater your body hunger for sleep is , the more it craves sleep . And then , when you fall asleep the following night , you start to sate that hunger and pay it off and to counteract that increase in drive for sleep , your body's clock produces this increase in drive to be awake and then , around the time that you typically fall asleep , a sudden drop in this wake drive no longer opposes all of that sleep hunger that's accumulated and hopefully quickly fall asleep and stay asleep .

Speaker 1 32:16

The problem is in shift workers that they're often trying to sleep at a time of day when their

Understanding Shift Work Sleep Disorder

Speaker 1 32:23

body's clocks aren't producing a really weak drive to be awake .

Speaker 1 32:29

That might sound difficult to pass , but because they're trying to sleep at times when their body's clocks are actually promoting wakefulness , they might have a substantial hunger for sleep that's accumulated previously .

Speaker 1 32:44

But if their clocks are telling them that it's the daytime , then they're going to really struggle to sleep well . And there is actually a condition called shift work disorder . It affects about a quarter of shift workers and it's characterized by this daytime fatigue , which is somewhat related to this increased sleep hunger that they haven't managed to pay off previously while they are awake , and then nighttime insomnia and , importantly this , is absent any other factors that could contribute to that type of pattern . So sometimes someone might take a medication that could produce similar symptoms , for example . So if we do away with confounding variables , then basically people feel relatively miserable during the day and they're fatigued and they're sleepy and they struggle to concentrate and they're irritable , and then when they do end up trying to sleep , they really struggle with insomnia type symptoms and there are various things that we can do to address that . Of course , maybe we'll get to that later in this conversation .

Speaker 2 33:51

I hope you're enjoying the show . If you are , please don't forget to rate and review once you've finished . This helps the show's reach enormously . And have you got my free ebook the Best Way to Eat on Night Shift ? Well , this is a comprehensive guide to the overnight fast , why we should fast and how to best go about it . I've even included a few recipes to help you . I've put a link to the ebook in the show notes .

Speaker 2 34:12

And are you really struggling with shift work and feel like you're just crawling from one shift to the next ? Well , I've got you . If you would like to work with me , I can coach you to thrive , not just survive , while undertaking the rigours of 24-7 shift work . I also conduct in-house live health and wellbeing seminars where I will come to your workplace and deliver evidence-based information to help your wellbeing team to reduce unplanned leave and increase productivity in your workplace . I've put the links in the show notes to everything mentioned . You can find me at healthyshiftcom or on Instagram at a underscore healthy , underscore shift .

Speaker 2 34:57

Now let's get back to the show . I've just written a full blog on shift work sleep disorder to help people to understand what it is . I actually have changed since I started coaching shift workers through nights , because majority of shift workers will do two or three nights or as a general rule . I know some do seven nights of eight hours , but most do two or three . And what I've done is I've completely changed my thinking , greg , around this as well , now that if you take the pressure off yourself , come home , go to sleep , because that sleep hunger is there . A lot of mums or parents have been awake all day . Then they go to work all night , so their sleep hunger is massive . And then when they go to sleep , they do sleep , but they find they wake up in about three hours . And what I've done now is I've just said to them get up , don't try and force yourself because you won't go back to sleep and certainly don't take medications . And I'm just saying to them , because you're only doing this for two or three nights or two nights or three nights at the most , just get up and go through it , then have a nap before you go back in again for the next night , to help them to actually try and stay in sync without phase shifting , and then also it avoids that sleep anxiety as well , and that has been a complete change in my thinking in the last probably two months . And I've just said go to bed , get that sleep . When you wake up your sleep , hunger is gone . The more you try and sleep , the worse it's actually going to be . So just get up , get that sleep . When you wake up your sleep , hunger is gone . The more you try and sleep , the worse it's actually going to be . So just get up and get that daylight , get that movement , eat at the normal times , have your nap and then go back to work that night . It will help you to re-synchronize back into your normal routine . So I think your explanation was fantastic .

Speaker 2 36:42

Around what the impacts are , I think I've heard Dr Alan Flanagan talk about this as well .

Speaker 2 36:47

It's like the orchestra conductor and he is conducting an orchestra and everyone's now playing their own piece of music which doesn't go with the orchestra . So in a normal nine to five that goes to bed and gets up at roughly the same time , everyone's on the same piece of music and they're all playing the same . So the body anticipates , the body does , the hormones are released . Everything happens at exactly the right time . In a shift worker , it's like the conductor standing there with his stick and he is actually conducting , but you've got 40 people in front of you , all playing completely different pieces of music , and that's how the body doesn't function in any way . But with all of your research and the knowledge that you have to today around shift work and its impacts

Strategies for Coping With Shift Work

Speaker 2 37:34

, if I said to you , from next week you're starting 24-7 shift work on rotating shifts . Some days you're going to be on nights , some days , some afternoons , and you're going to be doing this for the next six months , what would be your main priorities from a health perspective , from what you've learned to actually cope with that ?

Speaker 1 37:53

I'll make some broad recommendations , not thinking about this so much in terms of my own life , just instead assuming that I'm arriving at this as a blank slate and I don't have some of the things in place that I personally have in place already , just because I think a lot of people they won't have those things in place . So , with that said , I actually just want to quickly pick up on what you were just discussing , because it is important and it's relevant to this context too . So , in addressing shift work disorder , one of the core recommendations relates to trying to regularize the timing of sleep to the greatest extent possible . So you might look across the different shifts that you have and try and identify a window of sleep opportunity that you're going to try and get in every day that you can get in . Because if you're doing this type of rotating shift work , then your shifts are probably rotating at a rate at which your body's clock can't adjust to , and so your your clock is probably largely going to stay stuck in time , meaning that sometimes you're going to be at work and up during the day at a time when your clock is promoting wakefulness . So if you are a morning type , that would be a morning shift . But if you were a night owl then you might actually find the night shift relatively easy . But there'll be other times when you're going to be at work and it's going to be really hard because your clock will be promoting sleep .

Speaker 1 39:20

So regularizing the timing of your sleep opportunity is important , and then doing the same for your nutrition and trying to keep a consistent eating window each day . And based on the little research that's been done so far , it seems that about a 10 hour eating window is practical for a lot of people . There's been some nice work on firefighters by emily manugian and sachin panda and some others showing that they can generally stick to this quite well , and they had people self-select a 10-hour window such that they were trying to only consume anything that contains calories during this 10-hour window each day . And again , for most people , trying to fix the timing of this window at a time that's relatively consistent with the time that they would be eating were they not working shifts is going to work well , because if we're in this type of situation where the shifts are moving around the clock , then you'll probably find that the timing of your body's clock is actually quite similar to how it would be where you're not working shifts and instead just working a day job , as many people do .

Speaker 1 40:35

So try and keep the timing of your eating relatively consistent , and then , if you eat outside of that window , I would probably try and only consume up to about 10% of your total daily energy intake outside of the window . So if you're consuming 2000 calories a day , that would mean up to 200 calories from snacks at this time . The composition of what you eat does matter too , and what I would probably try and do is limit any snacks outside of that window to snacks that have some protein and have some fiber , but have little carbohydrate and probably relatively little fat too . So some good examples would be having a protein shake , if you're that way inclined , and a piece of fruit , or you could have a protein bar if you've got access to relatively healthy ones . They're very convenient , so we need to bear that in mind . You could have some relatively low fat cheese , that kind of thing , because at this time , your blood sugar control , and probably your blood lipid control too , is going to be worse than it would be were you not working shifts , and so really , what we're trying to do is provide a snack that's satiating but that's not going to disturb your blood lipids or your blood sugar too much when you're eating outside of this window . So then , otherwise , now that we've addressed the timing of sleep and the timing of nutrition , I think being practical and trying to make this simple for people .

Speaker 1 42:15

There are some interesting apps out there , and you mentioned an app before you hit record that I'm not familiar with , but , yeah , it sounds similar to some other products that are either on the market or coming to the market , and one that I've come across previously that I imagine is a very good product is one that's made by Stephen Lockley and his colleagues . So they have this company called Time Shifter , and within that , they have the Jetlag app , which was their first product , which is very effective , and within that , they have the Jetlag app , which was their first product , which is very effective , and it's based on modeling how circadian rhythms respond to things like light exposure , but also understanding that homeostatic sleep drive that I mentioned earlier , and they have been working on an app for shift workers , and so , given how good their first product was , I imagine that their shift working app is also very effective too , and I've spoken with Steven about this briefly , and he said to me that among people who stick to recommendations , they have really , really good results , and most people are able to stick to it too , and I don't know if they've published research on it yet , but I think that kind of thing is helpful because you can just plug your shift schedule into the app and it's going to give you personalized guidance about when to see light , when to avoid light , when to sleep , when to consume caffeine and so on . So I would consider doing that too .

Speaker 1 43:36

And then , just to get into some specifics a little bit , I would probably buy a few things , assuming I didn't already have these . I would buy myself a good eye mask , I would buy myself some silicon earplugs , I would buy myself some blue blocking glasses , and the reason for that is all to support my sleep health , bearing in mind that at this time , there are going to be occasions when you want to nap , sometimes opportunistically , sometimes for safety reasons , and often you're going to be napping during the day , when it's noisy and when there's light streaming in through your windows , maybe when it's relatively warm as well . So you could consider buying something like a fan , and you can use these things to make napping at those times more straightforward . So just pop your eye mask on , pop your earplugs in , set your alarm , stick the fan on if need be , and that way you're likely to improve the quality of your naps and make them more restorative . Thinking about nutrition , I would consider reducing the amount of carbohydrate in my diet a little bit , so having a relatively high protein , low carbohydrate , high fiber diet .

Speaker 1 44:53

For the reasons that I alluded to earlier , namely that cardiovascular function and metabolic control are probably going to be a bit worse during this time when my clocks are constantly disrupted and I'm not sleeping so well , I would use caffeine judiciously . If you look at some of the work that's been done on extended weight from this , then it seems that relatively low dose of caffeine , consumed frequently , are probably a better strategy than consuming heroic doses of caffeine infrequently . Some of the best work on this was done early on by David Dinges , and what Dinges and his colleagues found was that consuming something like 50 milligrams of caffeine every hour or two was better able to support cognitive function during wakefulness and also reduce what's called sleep inertia , which is the process that gives rise to that groggy feeling if you wake up from a nap , particularly if you wake from one of the deeper stages of sleep . So I'd consider using caffeine in that type of way . 50 milligrams of caffeine is about the amount that's in a relatively small instant coffee . But you could also use something like caffeinated gum at this time if you need something to give you a strong jolt and alertness quickly . Because if you consume caffeine by way of gum instead of a drink or food , it will enter your system because it's actually taken up in the mouth rather than further down the digestive tract . So you could use some caffeinated gum if you need that for safety purposes . Could use some caffeinated gum if you need that for safety purposes .

Speaker 1 46:25

And then otherwise I would try and maintain some exercise and I probably somewhat prioritize doing some resistance training . I might dial down the frequency of that . So if previously I'd been doing four resistance training sessions a week , I might only do three and they might be briefer and lower volume . But I would focus on trying to keep the intensity of that relatively high to basically maintain the function of my musculoskeletal system and the size of my skeletal muscles and then possibly have a little bit of additional training on top of that to support my cardiovascular health . But obviously a lot of people aren't doing any structured exercise , so getting them to do something is going to be beneficial . And this raises the idea that during these times when our clocks are distracted and we're not sleeping well , exercise can help offset some of the negative effects of those . And this has probably been best shown by some people on your side of the pond . Roger nicholas zaner and his colleagues who think are at Melbourne have shown that during repeated sleep restriction , if you have people do high-intensity intermittent training , so repeated bouts of high-intensity cycling , then that type of cycling exercise can help maintain metabolic health , mitochondrial function at this time , whereas if people don't do the exercise , then those temporarily go out the window .

Speaker 1 47:49

So I try and maintain some exercise and then I'd consider taking a few things supplementally too to support my health . So if , for example , I anticipated that my diet was going to be worse than previously , then I might just take a multivitamin and a multimineral as a kind of insurance policy . If I wanted something to help me cope with the poor sleep that I'm experiencing , then I'd probably take creatine monohydrate and I'd probably take that anyway . I think for most people it's a really good option , and that relates to the fact that creatine seems to influence that sleep hunger that we experience the longer that we've been awake , and if you compare it with caffeine , then the contrast is interesting , because what caffeine does is it antagonizes the sleep promoting effects of adenosine in the brain . It's an adenosine receptor antagonist that all of the adenosine receptors , and so what it's doing is it's blocking that I'm hungry for sleep signal and its interaction with the receptors for that . What creatine is doing , though , is , rather than blocking that signal , it's actually reducing the sleep hunger signal in the first place . So the amount of that hunger that accumulates during wakefulness seems to be lower phosphates in the brain . Your brain is able to better maintain atp levels atp being the so-called energy currency of cells during extended wakefulness , and so , given that that sleep hunger signal is now lower , you probably actually need slightly less sleep , and you can certainly get away with less sleep when you're consuming creatine , and when you're consuming creatine , your performance during insufficient sleep is likely to be better than where you're not consuming it , and so I'd probably supplement creatine monohydrate , and , had I not been taking that previously , I'd probably consider taking a loading dose .

Speaker 1 50:00

A loading dose isn't necessary for most people , but by taking what's called this loading dose , you can boost the stores of creatine in your skeletal muscles and your brain faster than you would otherwise , and the way that's typically practiced is taking something like five grams of creatine four times a day for five days . So you could just take a dose of creatine with each of your meals . So let's say you're consuming three meals a day . You could just take a dose of creatine with each of your meals . So let's say you're consuming three meals a day . You could take seven gram dose with each of those meals for five days and then after that you could take a maintenance dose . For the maintenance dose , I think for most people most of the time , something like 0.05 grams per kilo is about right . But in this type of context where you're not getting enough sleep , you might consider taking a higher dose , something closer to 0.1 grams per kilo . So if you're 70 kilos , that would be7 grams a day after that loading phase and that's going to help support your brain health and brain function , but also your metabolic health and the size of your skeletal muscles and your total fat-free mass during this particularly strenuous time .

Speaker 1 51:09

So those are some of the things that I'd probably think about , and there are certainly many others that we could go into , but hopefully there's some practical information in there .

Speaker 1 51:18

So I'd get a few things maybe the creatine , maybe the multivitamin , maybe some protein powder and protein bars , the eye mask , the earplugs , the blue blockers . I would probably use one of these apps to help me identify when to engage in certain behaviors . I would try and maintain some activity , I'd reduce the carbohydrate content of my diet and then otherwise I would not worry about things if possible , because I think , especially if you're interested in health , it's easy to be really concerned about the negative effects of shift work . We've all heard about these , and I think the actual process of ruminating and worrying about the shift work can be bad for people , and so you should always just be focused on controlling what you can control , and then there's going to otherwise be chaos in your life and some of these things you're exposed to won't be good for you . But if you can accept that and just move on and not otherwise worry about it to the degree that you can , then that's likely to be beneficial for you in the long term .

Speaker 2 52:28

Absolutely fantastic . What a great summary . Controlling the controllable is another thing that I talk about all the time .

Risks of Using Sleep Medications

Speaker 2 52:34

So much of it is out of control . The more you worry about it , the more you catastrophize it , the worse it actually gets , particularly around our sleep . I'm mindful of the time , but I did want to cover a couple of things with you .

Speaker 2 52:46

I want to go back into the creatine after this , but a lot of shift workers are taking medications for sleep . They come home after night shift without even trying and not getting all the basics right . They're taking all these rest of it and et cetera , et cetera to make them sleep . What's the other one Nurses , helper or whatever there is ? What's your thoughts around taking medications to sleep on night shift ?

Speaker 2 53:08

Now , I'm excluding melatonin out of this , but I'm talking about actual medications , because the biggest problem that we have today and I've just read a new piece of research around this , which is excellent work by Amy Reynolds out of Adelaide , which is talking about that 40% of Australians actually have sleep disorders , like 40% of middle-aged Australians have sleep disorders anyway but shift workers think , oh , I'm just a shift worker , so I'm not going to try and sleep right or I'm not going to go and get help in relation to it . I'm just a shift worker , but doctors need to look harder at what the issue actually is , and I've done a podcast on this just recently . So , with that in mind , when people go and see doctors , it's very easy for a doctor to say oh , you're a shift worker , here's a medication to help you to sleep and I'm not trying to pitch you against the doctor , but what are your thoughts around what the body goes through by just having medicated sleep ?

Speaker 1 54:04

It's a tricky one , because I think the reality is that many medical doctors aren't trained in sleep medicine and they have a limited amount of time with patients and they want to help these people . They might not be familiar with some behavioral interventions to help people sleep better , and so reaching for a prescription for a medication is simple and the patient can go away and feel like they've got some sort of solution to their problem . But much of the time it's not the best solution , and instead they'd be better off getting some instruction about how to enact some elements of cognitive behavioral therapy and otherwise addressing shift work disorder through some of the things that we've mentioned so far , like regularizing the timing of the sleep opportunity and so on . The actual medications themselves differ dramatically in their effects , including both positive and negative effects , and historically , a lot of the drugs frankly aren't great for health , as far as we can tell . They don't necessarily affect sleep structure or sleep architecture in ways that are beneficial and that recapitulate how sleep would otherwise be in a healthy person who's not experiencing this type of disruption . They tend to lead to tolerance over time , such that you have to take an escalating dose of the medication to maintain the positive effects on sleep and also withdrawal effects , so that when you stop taking the medication you might , for instance , have rebound insomnia . Some of the newer drugs that are coming to market are interesting , um , in particular the drugs that are targeting orexin or hypocretin receptors . So some of these DORA drugs dual orexin receptor antagonists seem to be a lot better than many of the drugs that have come before them . They seem to maintain a more healthy normal sleep architecture compared to , for example , some of the benzodiazepines , and they might be a little bit safer too over time and lead to fewer adverse effects .

Speaker 1 56:17

But I think in the context of shift work there are also some other considerations that are relevant

Sleep Medications and Food Timing Effects

Speaker 1 56:23

. So one of them would be if you're working shifts and your sleep opportunities are shorter or you're not able to maintain sleep for as long , then if you take a drug that has a relatively long half-life and stays in your system for a while , then some of the effects of the sleep drugs that you might not experience while you're sleeping , at a time that's more congruent with your body's clock and when it's promoting sleep , become realized , and you might , for instance , take one of these medications and then try and sleep and then only get four hours of sleep and when you wake up you're still under the throes of this medication , and so your function is compromised and you have to deal with those effects . And if you would then try and drive , for example , then you might find your driving performance is substantially worse than it would be had you not taken the drug . So I don't want to be categorical and say that sleep medications are bad , and there's definitely a time and a place for them , but they're not all created equal , and I think that for the most part , people need to start with some other behavioral interventions and see how they get on with those and not discount the idea of using one of these medications at some point , but just not use them as the first port of call .

Speaker 1 57:41

And then I'm glad that you mentioned melatonin , because melatonin is exceptional in some ways , and that what melatonin is really doing is targeting the body's clockwork , as opposed to some of the neuromodulators that are more strongly involved in sleep weight regulation , and it's those other neuromodulators that some of these alternative medications typically target .

Speaker 1 58:04

And so I think well-timed use of melatonin , which is pure melatonin , can be helpful for shift workers , but it's difficult to get that right , particularly if you're working rotating shifts and if you look at some of the research that's been done on melatonin , then it's actually used melatonin to try and stop people's clocks moving around , so to try and fix their clocks at a point in time , even though these people are working shift schedules that are moving around , and that is to basically try and keep the clocks in time , regardless of what their work schedules are , temporarily during this disruption , and then afterwards you can do away with the melatonin . One of the nice things about melatonin is that it's got an excellent safety profile and it doesn't seem to lead to long-term negative consequences . It doesn't lead to that type of tolerance or withdrawal effect that I mentioned earlier , but we , as always , need more research on that .

Speaker 2 59:01

Always Melatonin . The other thing we have to be very careful of for people that are listening to this as well , is the actual efficacy of melatonin , because boy , oh boy , there's been some research done on the efficacy of melatonin , which has left it floundering , hasn't it really , with a lot . But I think if someone wants to look at melatonin , I think we need to more than likely go and see a physician and actually get it prescribed to us properly , so that we're getting a pharmaceutical dose or a proper dose of melatonin as well . Do you agree with that ?

Speaker 1 59:31

I do , yeah , and there have been a couple of studies in recent years that have just taken melatonin products off the shelves of supplement shops in various parts of the world and found that the concentrations of melatonin in these supplements differs dramatically from what's on the label . Much of the time it can range from about 80% less than what's on the label to about 480% more than what's on the label , and some of these products have also been found to be contaminated with other metabolites that are in the same pathway , including serotonin . So if you're going to take a melatonin supplement , then it would be best to get it prescribed by a physician and then otherwise , I do think there are some supplement manufacturers that reliably make products that contain what the label claims are , and so actually knowing something about those manufacturers can be really helpful . But I'm not so familiar with the supplement and nutraceutical landscape in Australia , so I'd be a little bit reluctant to point people to a particular company in this case .

Speaker 2 1:00:30

I wouldn't dare touch it at the moment , especially in the supplement . Now , with our time , just very briefly does the timing of what we eat and when we eat it impact how we metabolize and store nutrients ?

Speaker 1 1:00:42

It certainly does , and I suppose the highlights of this would be that , in general , your body is primed for food intake and digestion and metabolism in the first half of your waking day , goes to bed at 10 pm , then you'd probably find that for most people , most of the time , concentrating a lot of their food intake between about 8 am and 2 pm is likely to be beneficial , and that's based on some of the research that's been done on a particular form of time restricted eating , time restricted eating being only consuming anything that contains calories within a period of 12 hours or less each day .

Speaker 1 1:01:27

Some of the research on this has focused on early time-restricted eating , which , in these studies , is often only consuming calories between about 8 am and 2 or 3 pm each day , and of the different studies that have been done , the ones that have shown the most impressive benefits have used this type of early time-restricted eating strategy , have used this type of early time-restricted eating strategy .

Speaker 1 1:01:48

And we know , based on some other experiments , in particular experiments that have tried to disentangle the effects of the behavioral cycle and the body's clock and how they affect things like metabolism , that variables such as blood sugar control are substantially better in the biological morning than they are in the biological evening . Lovely work by Frank Shear a few years ago showing that that glucose tolerance so the degree to which your blood sugar swings after a bonus of carbohydrate , is about 18 higher at 8 am than 8 pm for most people and that's been supported by various other studies over time . So if we think about the waking day , then obviously it depends on when you're active and so on . But for most people most of the time , especially if they're sedentary , having a majority of their carbohydrate intake in particular in the first half of the waking day is likely to be good for them . Spreading their protein intake out relatively evenly across meals , and probably doing the same with fat , is likely to be beneficial .

Speaker 2 1:02:53

I talk about this and I think when people we talk about the intermittent fasting crew , who fast from 8 pm

Optimal Nutrition and Supplement Strategies

Speaker 2 1:02:59

at night to midday the next day , they've actually got it around the wrong way , haven't they ? They're better off actually eating from 7 am to 3 pm and then fasting from 3 pm to the following 7 am . I talk about this because the research is quite clear on what the metabolic advantage to us of doing that Calorie deficit still stands . Obviously , as in , it's got to be balanced one way or another . But I'm talking about the biological , the way we store and digest nutrients . If you were going to fast , fast from 3 pm in the afternoon until 7 in the morning , there will be a huge difference there , because this research accidentally found that satiety was actually increased , wasn't it ? So people didn't feel hungry after 3 pm . Because I think most people go oh , no way , there is no way could I fast from 3 pm . Because I think most people go oh , no way , there is no way could I fast from 3 pm to 7 am the next day . But people condition themselves to it because the body is designed to do that and I thought that was a fantastic piece of research as well . Around that that satiety is increased , so you don't eat in the evening . So , therefore , you are only eating at the time that you're optimal , and I thought that was fantastic .

Speaker 2 1:04:13

Last question for you , which is what everybody wants to know , which is the supplements are very topical , obviously , because everyone wants to take a cocktail of this and a cocktail of that . But if you were shift working , what agent would you be considering and in what doses , and why would you do that ? We discussed creatine , and I'll start with creatine . Creatine monohydrate is all people need . I always say that everyone should be on five to seven grams of creatine daily , full stop , but we've started to see evidence emerge around superdosing creatine as well , for people who are definitely in a period of sleep loss . You've discussed what the effect of it is . 0.35 grams per kilogram is the last figure that I've seen . What would you say as far as a super dose ?

Speaker 1 1:04:53

Yeah . So that's based on this study that came out that looked at the effects of creatine on cognitive performance during extended wakefulness . That 0.35 grams per kilo roughly corresponds to a typical loading dose anyway , and so we've got to bear in mind that with creatine you can only push your tissue stores so high , and based on that , what you'd probably find is that after a while supplementing a lower dose of creatine , you'd probably reach roughly the same tissue concentrations of creatine and phosphocreatine whether you take in the loading dose or not . So I don't think people necessarily need these types of mega doses if they're just consistently taking a lower dose of creatine . So , going back to what I said earlier , I think if you want to push your tissue stores as high as possible in a short period , then you can do a loading dose for about five days and then after that just the maintenance dose , and the maintenance dose for non-shift workers might be between about two and a half and five grams , and for shift workers it might be between about five and ten grams if they wanted to err on the side of caution , bearing in mind that their tissue energy status can be more compromised if they're experiencing sleep disruption than had they been sleeping better . So that's creatine . Touched on caffeine too .

Speaker 1 1:06:10

I touched on a multivitamin multimineral , which really is just a way of supporting general nutrient intake . You could be more targeted than that which would make most sense if you were doing some sort of testing to identify nutrient status . But commonly the nutrients that people aren't going to get enough of if we're thinking about micronutrients specifically include magnesium of the minerals , and magnesium supplementation is really beneficial for most people . Most people just don't consume enough , in part because the concentrations of magnesium in foods is dwindling over time , because the amount of magnesium in soil is going down , and so a lot of people stand to benefit a lot from taking between about 150 and 450 milligrams of elemental magnesium each day . Honestly , I don't think the form matters too much . Magnesium oxide is going to cause some people some gastrointestinal distress . Citrate is the best studied and it's really cheap . Glycinate might have some advantages for people with very sensitive tummies . I don't think you need to go the three and eight route . Even though it's really popular among the influencers and the scientist influencers , it just doesn't make sense financially for most people . But if you take magnesium and you're not consuming enough by way of your diet , then you will probably experience some positive effects , in particular on your cardiometabolic health . So your blood sugar control , your blood pressure especially , but also possibly in your sleep brain . Magnesium concentrations are substantially higher during the sleep period than they are during wakefulness , and in people who are magnesium insufficient , it could be that magnesium positively affects sleep , although that hasn't been that well demonstrated .

Speaker 1 1:07:50

The other micronutrient that people might consider is vitamin d supplementation . If you're living in australia , probably not something you need to worry about , because you probably get an awful lot more sun than most people do and you have a very outdoorsy culture . But if you look at other parts of the world that are also really hot , like the middle east , ironically a lot of those people are vitamin d deficient because they're constantly trying to stay out of the sun , and many of those people also have quite high skin melanin concentrations , and so they need a larger dose of uvb radiation to synthesize adequate amounts of vitamin d . So for many people , especially shift workers , who aren't getting as much daylight exposure as non-shift workers , and especially during the winter , when the amount of UVB radiation they're exposed to will be low or possibly even non-existent in some parts of the world , vitamin D supplementation at those times can be an option , definitely best to test . But if I had to provide very generic recommendations , then I think one to two thousand international units per day during those months when you're exposed to very little of that type of radiation is going to be beneficial . So here in the uk , for example , I'd personally be comfortable taking that . I'd probably take a thousand international units each day from about November until February and I wouldn't have any concerns about toxicity at that dose .

Speaker 1 1:09:14

Issue with vitamin D , like vitamins A and E and K , is that it's fat soluble and so it can accumulate in your body over time . You won't just excrete at all . So you definitely don't want to be mega dosing vitamin D , particularly if you're exposed to lots of sun too . So you could consider that , and then otherwise there are lots of supplements that we could mention . And regarding specific sleep aids , if you are financially secure and you've got plenty of disposable income , I think one of the better ones is tart cherry concentrate . There's been quite a lot of research on this in the context of older adults , and some of those people have insomnia too , showing that when they supplement tart cherry concentrates typically 30 mils twice a day with one dose shortly before bed , they do tend to sleep better . Some of that probably relates to the fact that there's a small amount of plant-based melatonin in cherries .

Speaker 1 1:10:10

Melatonin is quite ubiquitous . It's in lots of plants . Pistachios , interestingly , have an enormous quantity of melatonin in them relative to their mass . Kiwi fruit's very good too . I don't know if that is mediated by melatonin , but there has been a study of kiwi fruit consumption . The issue with those types of studies that show positive effects of , in this instance , kiwi fruit consumption , the issue with those types of studies that show positive effects of , in this instance , kiwi fruit on sleep , is that you can't control them . No , so if you're spreading people sleep and then you're giving them kiwis , then some of the participants might realize okay , they're trying to work out what the effects of these kiwis on my sleep . And the same type of research has been done with a particular type of tomato called beefsteak tomatoes , again showing positive effects of the tomatoes on sleep , which , in the instance of tomatoes , seems to be mediated by melatonin .

Speaker 1 1:10:54

But watch this space , I think regardless . I mean plenty of fruits and vegetables is going to be a good thing , but you could go the tart cherry route , in part because tart cherries have a bunch of really interesting positive effects on other aspects of health too . So they're quite strongly anti-inflammatory . They've been shown to improve recovery from exercise and reduce markers of muscle damage , increase the rate at which muscle function returns to normal after damaging exercise , reduce delayed onset muscle soreness . They also have some beneficial effects on the cardiovascular system . They can improve endothelial function , for example , which influences things like your blood pressure and therefore your cardiovascular risk . So that would be an interesting one to consider .

Speaker 1 1:11:36

And then otherwise , I would just think about generally supporting nutritional status and making things convenient for yourself .

Speaker 1 1:11:46

So if you're a shift worker , then that might mean getting a good protein powder which might be whey protein based .

Speaker 1 1:11:52

If you're an omnivore if you don't consume dairy , then it would probably be a mix of different plant proteins , bearing in mind that almost all plants have very imbalanced amino acid profiles , and so having a blend of , for example , rice and pea is going to be better than having an equivalent quantity of just one of those , and then maybe doing the same with protein bars . I doubt these are available in australia , but there is a protein bar company on this side of the pond which is called eat all real . They make excellent products . It's actually an irish company . It's the one protein bar that I've come across that I actually personally like and would eat on a regular basis . And I don't because I just don't need that in terms of convenience and I rely mostly on whole foods , but it's a great option . I imagine there are some good products in australia too , because so many people are interested in health and there are so many nutrition businesses over there that surely there are some solid options too .

Speaker 2 1:12:49

So just to go over that magnesium doesn't really matter what type , about 150 to 200 milligrams to supplement that Vitamin D surprisingly great Vitamin D . Australians are shown to be deficient in vitamin D and the reason being is because of the sunblock and the slip slop . Slap the cover up , put a hat on . You know we don't get the sun that people think A lot of athletes and that will , obviously . The other thing was the creatine . You've talked about caffeine and you've talked about the proteins . The one that I would recommend highly , for shift workers as well , is an omega-3 , because we don't get good fatty fish here and just to support the triglycerides and the cardiovascular health and brain health at the same time , because shift workers are shown to have elevated triglycerides in their bloodstream and I think the omega-3s can help to combat that as well . So I would support that . Do you agree with that one ?

Speaker 1 1:13:40

Yeah , absolutely so . Omega-3 would probably be the other essential nutrient I would consider supplementing with . I think it's actually quite easy to address through nutrition , but some people really don't like the taste of fish . What I will say is that the reason I didn't mention that is that I don't think that the omega-3 supplements are as good as eating fish , because when you consume fish , you get other things that are beneficial , so things like astaxanthin , which , going by recent research , seems to be really beneficial , and I also think that the dose of the omega-3s that you get from oily fish is is quite high , so you don't need that much of it .

Speaker 1 1:14:18

And many omega-3 products that are on the market contain oils that have become oxidized and so they have to be stored appropriately , because these types of long-chain unsaturated fatty acids are very chemically unstable , so if you expose them to temperature high temperatures , that is and you expose them to light , they will degrade quite quickly .

Speaker 1 1:14:39

So you've got to be careful and ensure that you store them in the fridge and get them from a reputable manufacturer , and the products that you get probably should contain an added antioxidant to prevent that type of oxidation of the fats that produces that rancidity . So , yeah , definitely good recommendation , the dose would probably be between one and two grams for most people if they don't consume much oily fish , and that's one or two grams of total EPA and DHA . Oily fish , and that's one or two grams of total EPA and DHA . And if they are vegans , then I would use an algal based supplement probably isn't oil as opposed to a powder . The algal products are currently quite a lot more expensive and they can be quite expensive yeah , are they ever ? But they're good products and they're a lot more sustainable to environmentally .

Speaker 2 1:15:26

It's just that they come with a hefty price tag just to wrap it up , is there anything that you would like to just throw in here at the moment to finish us off ?

Speaker 1 1:15:33

The only other important thing to bring up , of course , is how shift schedules are structured

Designing Shift Schedules for Employee Health

Speaker 1 1:15:40

and thinking about this at another level . So we focus really on the person level here , the person level here , but obviously we think about this in the context of society at large and the people who are involved in actually determining the types of shift schedules , that people work and trying to make workplaces conducive to employee health . If these are shift working operations , I think there's a separate conversation to be had about all of those subjects . That's really important . So considering things like having chronotype personalized shift schedules so doing away with the night shift for early birds and doing away with the morning shifts for night owls that type of thing can have a dramatic effect on people's job satisfaction , their quality of life , their health-related quality of life too . So that's one for another time , but certainly it's a really important conversation .

Speaker 2 1:16:29

I'm liaising at the moment with Circadian Australia who are working . Dr Martin Moore-Ede , who's the light doctor I've had him on the podcast as well . He's put me onto Circadian Australia , who do a lot of fatigue management , greg , and what they do is they assist organizations corporate organizations to actually structure their rostering to suit the different types of chronotypes and things like that as well . Watch this space because I'm working on something at the moment that's pretty exciting and we're doing some work together , which is really good . I'm looking forward to just bringing that into the corporate space . My belief .

Speaker 2 1:17:05

I think we need to strip our 24-7 shift working environments right down and rebuild them as 24-7 shift working environments so that they have structures in place to actually make them function properly to reduce that unplanned leave , that illness , the gypsy type of people coming in and out all the time and retain staff . Over time . This will happen . I'm sure it's got to happen because it's a health and safety issue . Now , anyway , greg , where can people find you so that people can go across ? I will definitely be putting a link to your podcast in the show notes for you , and also your YouTube channel and your personal Instagram as well , but if you want to let people know where they can find you , and then they can go and click on the links in the show notes yeah , thanks , roger .

Speaker 1 1:17:49

So reason well-being is the name of the podcast . You can find that apple spotify , google podcasts . Wherever you can find a podcast on youtube , the channel handle is at reason and well-being . And then I use social media . Very sporadically , I have what mostly is a hate relationship as opposed to a love hate relationship with social media . Very sporadically , I have what mostly is a hate relationship as opposed to a love-hate relationship with social media . My social media handle is at Greg Potter PhD , which sounds very indulgent , but it's just because at Greg Potter was taken and that's a handle that was available across different platforms .

Speaker 1 1:18:22

So I am on Instagram . I'm on Twitter as well . I actually prefer Twitter and I'm not calling it X for collating helpful information , because there are lots of good scientists who are somewhat addicted to Twitter . Interestingly , I kind of wish that they would spend more time working on their science rather than on Twitter , but then , at the same time , they share some good stuff too . So I actually find it quite helpful when it comes to identifying interesting recent research and avenues that I wouldn't otherwise be exposed to . And then Instagram I occasionally will share something , and that might be something from the podcast , but it also might be something different too . You can get in touch with me through those channels if you'd like to discuss anything that's not directly about what we've discussed today , or about the podcast that I host myself .

Speaker 2 1:19:10

Yeah , fantastic . Or , you know , give you ideas for the podcast . We're always looking for ideas . Greg , I just want to say thank you so much for joining us on the podcast as a reward because I've just won billions of dollars and I'm retiring I can build a house for you or buy a house for you anywhere in the world that you want to live . Now you're off to the philippines and you like diving whereabouts . Am I going to build this house for you ?

Speaker 1 1:19:33

for six months of the year . It's interesting because I I give you probably different answers on different days of the week and depending on what I'm after at a particular point in time . The first place that comes to mind is sardinia , which is somewhere that I've spent a lot of time in the last few years . I lived there for about three months for three years on the crop in the last few years and I just love it for so many reasons . It can be brutally hot .

Speaker 1 1:19:58

If you go in July or August , when most people go , that is not the best time to go . The best time to go is definitely mid-September to late october . But it's a gorgeous place . The natural world there is stunning , the people are very friendly , it has a lovely vibe , it's very walkable , there's delicious food , it's not too expensive and it's very interesting culturally too . So sardinia would be up there . But there are other places that come to mind that probably marginally better for things like diving . Sardinia , diving is quite good . Actually , there's a nice system of caves up that west coast . But I'd also be tempted to mention other places too , like the galapagos and like parts of southeast asia . But I think that living there for six months each year would probably be a little tricky , in part because it wouldn't be so conducive to actually getting any work done .

Speaker 2 1:20:51

Well , I'll tell you what . I'll build you a house in Sardinia , all right , and then I can come and visit , because we're planning to come and visit Sardinia hopefully . Well , you've said August now and I'm a bit worried , but we were planning to visit Sardinia next August or September . And the reason why I want to go and visit Sardinia is because , if people are unaware , it's one of the blue zones in the world and it's purely because of the lifestyle that people live there and I want to go and see it and experience it .

Speaker 1 1:21:16

Are you going to be going to the blue zone specifically ? The blue zone is on the East Coast , it's in the Nuwara province and , yeah , it's not my favorite part of Sardinia personally , but certainly if you want to go and explore the blue zones and you want to tick off Okinawa and these other places too , then that would be fun .

Speaker 2 1:21:32

Oh , absolutely . My partner wants to go to Sardinia anyway , so if she says we're going , we're going . That's all there is to it . Greg , Thank you so much . I sincerely appreciate your time with the podcast sharing your knowledge around shift work . We must do this again sometime in 12 months . I'm sure we will have more to talk about then anyway , but I sincerely appreciate your time . Thank you , Pleasure Thanks .

Speaker 1 1:21:52

Roger .

Speaker 2 1:21:53

And there you have it . That's Greg Potter Fantastic interview . I really do enjoy talking . There's a lot more that I could have spoken to Greg about , but he was very restricted with his time this morning . I know we've gone well over time and it's quite a long one , but Greg seriously is such an expert in this area . We sort of nutted into a few areas there that I would have loved to have continually dived into and gone further and further in , but we just aren't able to with the time that we've got .

Speaker 2 1:22:20

I just want to say , if you've got anything out of that podcast , please if you could give the podcast a rating and

Support for Shift Workers

Speaker 2 1:22:27

or review and also just share it with your colleagues so that more people get more education around this type of research to help shift workers and to optimize shift workers in our shift working world . Remember , it's all about us learning to thrive and not just survive in our shift working life . Thanks for joining and I will catch you on the next one . Thank you for listening . If you enjoyed this episode , be sure to subscribe so you get notified whenever a new episode is released . It would also be ever so helpful if you could leave a rating and review on the app you're currently listening on . If you want to know more about me or work with me , you can go to ahealthyshiftcom . I'll catch you on the next one .