Optimization of Chrononutrition to Reduce the Risk of Disease in Shift Workers

Inclusion Criteria:

• Age: 18-70 years

• BMI ≥ 25 kg/m2

• Own a smartphone (Apple iOS or Android OS)

• Baseline eating window ≥ 14 h/day

• Night shift nurses and nursing assistants who are working a 12-hour night shift atleast 3 days/week.

• Have been doing night shift work for at least 3 months.

• Patients on cardiovascular medications (HMG CoA reductase inhibitors (statins),metformin, lipid-modifying drugs (including over-the-counter drugs such as red yeastrice and fish oil), anti-hypertensive, drugs), are allowed

• If patients have Type 2 Diabetes, they will be included in the study if A1c is lessthan 9 and they are not on insulin.

Exclusion Criteria:

• Insufficient dietary logging on the mCC app is defined as less than 7 of 14 days ofbaseline of dietary logging with a minimum of 2 items a day, at least 5 hours apart.

• Type 1 Diabetes or Insulin-dependent Type 2 Diabetes.

• Use of sulfonylurea or insulin within the last 3 months (due to unknown safety withTRE)

• Use of medications that are known to cause weight loss such as SGLT2 inhibitors andGLP1 receptor agonists)

• BMI > 50 kg/m2

• Change in medications that could impact study outcomes within the past 3 months

• Change in weight of >4kg in the past 3 months

• Women who are pregnant, breastfeeding, or are trying to become pregnant during thestudy period. If a participant becomes pregnant during the study, they will beexcluded from continuing the study.

• Systolic BP greater than 160 mmHg and/or diastolic BP greater than 110 mmHg at rest

• Fasting LDL cholesterol greater than 250 mg/dL

• Fasting triglycerides greater than 500g/dL

• Active tobacco abuse or illicit drug use or history of treatment for alcohol abusein the past 5 years.

• Frequent (more than 4) travel involving a time zone change of more than 3 hours overthe 1-year study period

• Prolonged leave from work (a continuous month or longer) during the study

• Active treatment for inflammatory and/or rheumatologic disease

• History of a major adverse cardiovascular event within the past year (acute coronarysyndrome, percutaneous coronary intervention, coronary artery bypass graft surgery,hospitalization for congestive heart failure, stroke/transient ischemic attack)

• Uncontrolled arrhythmia (i.e. rate-controlled atrial fibrillation/atrial flutter areacceptable)

• History of thyroid disease requiring dose titration of thyroid replacementmedication(s) within the past 3 months (hypothyroidism on a stable dose of thyroidreplacement therapy is allowed).

• History of adrenal disease in the past 5 years

• History of malignancy undergoing active treatment, except non-melanoma skin cancer,in the past 5 years

• History of an eating disorder in the past 5 years

• History of cirrhosis in the past 5 years

• History of stage 4 or 5 chronic kidney disease or dialysis in the past 5 years

• History of HIV/AIDs

• Currently enrolled in weight-loss or weight-management program

• Any history of surgical intervention for weight management

• Uncontrolled psychiatric disorder including prior hospitalization