HSW 35 – Type 2 Diabetes and Weight Loss with Wendy Steward.

Healthy Shift Worker Podcast Episode:

As I’ve submerged myself in journal articles on all things to do with shift work health over the years, one of the things which keeps coming up in the research, is that shift workers are quite prone to developing insulin resistance, a condition where the body in unable to move glucose from the blood, and into the cells efficiently. This causes blood sugar levels to rise to unhealthy levels, which can lead to prediabetes and eventually type 2 diabetes.

Sleep deprivation alone has shown to impair the way our body responds to insulin, however when you combine it with a diet high in unhealthy fats, fructose and carbohydrates from processed and take-away foods, it can enhance our likelihood of developing diabetes even more, along with leading to a steady gain in weight.

In this episode, I invited Wendy Steward from Melbourne who after incorporating more whole foods and movement into her lifestyle, along with removing a lot of processed foods from her diet, managed to reverse her dependency on insulin, along with losing a staggering 40 kilograms!

Wendy is a real character and is authentic as they come, so was happy to share her diabetes and weight gain story which incorporated a roller coaster of emotional eating, a diagnosis of PCOS or Polycystic Ovarian Syndrome, and an ongoing struggle to have children. If any of these things resonate, then you’re going to love this episode because Wendy is one incredibly inspiring lady :-).

Wendy’s website

Wendy’s Facebook page – Wendy’s Way

Wendy’s Podcast – Wendy’s Way

Changing Habits, Changing Lives book by Cyndi O’Meara

Shift Work, Snacking and Insulin Resistance:

Why It Can Lead to Weight Gain.

Snacks.  We all love them, especially in the wee hours of night shift, when exhaustion is at an all time high and we’re needing something to satisfy our hunger, or should I say cravings, to help keep us awake!

But is this the reason for our weight gain whilst working 24/7?

Well it would definitely be a contributing factor for many shift workers, particularly if these “snacks” are made up predominantly of trans fats, refined and processed carbohydrates as they are definitely not conducive to a healthy waistline.

When we’re sleep deprived, we also tend to crave the naughty stuff, the sweets and greasy chips because sleep deprivation impairs the frontal lobe region of the brain which oversees complex decision making, whilst at the same time, increasing activity in the deeper region of the brain called the amygdala, which is involved in reward seeking behaviour.

In other words, our tired brains are geared more to eating for pleasure, as opposed to hunger and explains why we’re more likely to crave the sweet and fatty foods.  Combine this with a disruption to our hunger hormones (as a result of a lack of sleep), which leads to an increase in appetite, its inevitable that weight gain will soon follow suit.

But what has this all got to do with insulin resistance?

Well each time we eat carbohydrates, it raises our blood sugar levels triggering the pancreas to release insulin, a hormone that prompts cells to absorb this blood sugar for energy or storage.

Insulin resistance is a condition where the body in unable to move this blood sugar from the blood, and into the cells efficiently.  This causes blood sugar levels to rise to unhealthy levels, which can lead to prediabetes and eventually type 2 diabetes.

Unfortunately for shift workers, sleep deprivation alone has shown to impair the way our body responds to insulin, so we’re disadvantaged before anything has even passed through our mouth!

However when we’re discussing insulin resistance, its not just about the food that we eat.

These days we tend to spend a lot of time obsessing about what we’re eating (I’m a Nutritionist, I totally get it), but we also need to be reviewing when we’re eating, along with the frequency of our food intake.

Because in the case of insulin resistance, it comes down to both meal composition AND meal timing.

In healthy individuals, each time we eat refined carbohydrates like sugar and white bread, it spikes our insulin levels, but then drops off soon after.  However, carbohydrates are not the only macronutrient to increase insulin levels.  Both protein and fats raise insulin levels, but to a much lesser extent.

So when we eat continually 24/7, with lots of snacks in between, it leads to persistently high levels of insulin which overtime, can develop into the condition of insulin resistance along with weight gain.  Figure 1 below shows a healthy fluctuation of insulin throughout the day, based on three meals a day, with dips between meals and when we’re sleeping.

Figure 1:  Insulin release with an eating pattern of three meals, no snacks.

In contrast, Figure 2 below, shows persistently high levels of insulin as a result of continually eating and snacking throughout the day (or night).  This ongoing level of raised insulin can eventually lead to insulin resistance (and weight gain).

Figure 2:  Insulin release with an eating pattern of multiple meals and snacks

Quite simply, figure 2 is not normal (or healthy).

As human beings, we haven’t evolved to eat continually 24/7, and probably never will.

So it’s time to pull back on the snacking – no matter what it is (remember all foods spike our insulin levels to some degree), so yes, this means even limiting consumption of those ‘healthy’ raw desserts too.

Now you may be asking, Audra, how am I going to keep my energy levels going whilst running on little sleep, if you won’t let me snack?

Here’s my top 3 tips for maintaining energy levels throughout our shifts:

  1. Increase protein and healthy fats into your diet – in other words, you want to get more bang for your buck, each time you eat!  I’m sure we can all agree that we don’t always know when our next meal break is going to be, so its best to make the most of each one that comes along.  Foods rich in protein (such as grass-fed beef, organic chicken, free range eggs, lentils, Greek yoghurt) along with healthy fats (such as avocados, butter, coconut oil, nuts and seeds), all help to increase our satiety, or keep us feeling fuller for longer, so we’re less likely to want to snack continually throughout the day.
  2. Include some moderate intensity exercise – studies on sleep deprived individuals have shown 10 minutes of walking up stairs to be more energising than consuming 50mg of caffeine (which is equivalent to a standard cup of coffee).
  3. Increasing water intake – dehydration leads to fatigue, so maintaining hydration levels throughout the shift is an important strategy to assist in reducing the compounding effects of sleep deprivation.

Audra x

 

References:

Fung, J 2016, The Obesity Code:  Unlocking the Secrets of Weight Loss, Scribe Publications, Brunswick.

Greer, S, Goldstein, A & Walker, M 2013, ‘The impact of sleep deprivation on food desire in the human brain’, Nature Communications, vol. 4, no. 2259, pp. 1-19.

Harvard School of Public Health 2017, ‘Carbohydrates and Blood Sugar’.

Randolph, D & O’Connor, P 2017, ‘Stair walking is more energizing than low dose caffeine in sleep deprived young women’, Physiology & Behavior, vol. 174, pp. 128-135.

School of Medicine and Public Health 2013, ‘How the tired brain directs junk-food binges’, University of Wisconsin-Madison.

Shift Work, Insulin Resistance and Type II Diabetes:

Are You At Risk?

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Over the last week or so I’ve been immersing myself in online library data bases, scrolling through randomised clinical trials and observational studies, trying to find a link between shift work, insulin resistance and type 2 diabetes mellitus or T2DM.

Why would I do such a thing you may ask?  Well I may be a little crazy, but it begins with the letter ‘L’ , which stands for Literature Review, and in my case, I have a 2000 word Literature Review due this weekend.  Fortunately for me, I was able to choose a topic which I’m quite passionate about – that being shift work health.

However I have to say, what I’ve found in the depths of those data bases wasn’t exactly pretty.

So let’s talk firstly about working the night or evening shift.  Studies have shown an increased risk of diabetes in nurses who worked nights or evening shifts, which can be explained by a variety of different mechanisms.

  1. Exposure to light at night leads to a decrease in the pineal release of melatonin, a strong antioxidant which plays a key role in the synthesis, secretion and action of insulin.  A reduction in melatonin has been associated with an increase in insulin resistance which over time, can lead to Type 2 Diabetes Mellitus or T2DM.
  2. Persistent circadian stress as a result of disruption to the normal sleep/wake cycle, is common in night shift workers which may cause excessive secretion of cortisol (a stress hormone) and interleukins (proteins which are involved in the immune response).  These two things combined, along with an increase in insulin concentrations can lead to the build up of abdominal fat, lipid disorders and insulin resistance.
  3. Working nights are often accompanied by changes in lifestyle, such as changing mealtimes which alters the timing of insulin response.

OK, now let’s talk about rotating shifts(more…)

Weight Loss In Shift Work:

Why Is It So Hard To Achieve?

Lose weight concept with person on a scale measuring kilograms

When it comes to New Year’s Resolutions, weight loss would have to top the charts hands down – every single year, every single time.

But when you’re a shift worker – achieving this goal can become even harder to reach.

In fact you probably go to bed at night (or the day, depending on your shift), wondering if you’re ever going to get back to that svelt figure that you once had when you were 16 years of age.

OK, if that’s what you’re aiming for then we may need to readjust your goals a little!

However if you’re trying to lose weight around working crazy and irregular hours, it can often feel as though it’s one step forward, two steps back.

Sounding familiar?

Have you ever wondered why it’s so hard?

Well there are a number of reasons why but in a nutshell, whenever we’re sleep deprived our body essentially becomes biologically stressed (*).

Yep that’s right.

Our body is stressed even before we’ve walked through the front door and started our shift! (more…)