Unhealthy Food Choices among Healthcare Shift Workers: A Cross-Sectional Study

Round 1

Reviewer 1 Report

Thank you for the opportunity to review your manuscript titled “Shift Workers Make an Unhealthy Food Choices and Have a High Fat Intake: a Cross-Sectional Study Among Health Care Workers”. Several problems are required to revise.

 1.     Line 53-55, “Studies have shown that there is a link between shift work, especially night work as well as seniority and the occurrence of particular types of cancer, such as colorectal, endometrial and prostate cancer [8].” The authors claimed studies have shown...., and only cited one reference. Please add more citations to support your points. Or you can change “studies” to “A meta-analysis study...”

  2.     Line 98, the i.e. should be changed to “i.e.,”

  3.     Table 3, why were these numbers different colors? Do they mean something different? 

  4.      Line 319, “The studies by Filipczuk et al. [29]...” the “studies” should be changed to “study”.

  5.     Line 322, the “abouth” may be changed to “about”. 

  6.     Line 443-444, the last paragraph should be deleted.

Author Response

Dear Reviewer,

We are very excited to have been given the opportunity to resubmit the revised version of our manuscript (ID: nutrients-1977765) entitled “Unhealthy Food Choices Among Health Care Shift Workers: a Cross-Sectional Study”.

We greatly appreciate your time and efforts taken to review our manuscript. We have addressed all issues indicated in the review report and believe that the revised version can meet the journal publication requirements.

Please find our responses to the Reviewer’s comments attached. The changes in the manuscript are highlighted in blue. In addition, the manuscript has been corrected for language errors, using professional editing and proof-reading service.

Author Response File: Author Response.docx

Reviewer 2 Report

Dear authors,

thank you for presenting a very valuable research topic.

the reality of the life and work situation for care workers is pretty much related to the stressfull environment and heavy and responsibility of their duties

this reflects especcially on shift care workers

in the frame of the health standards in hospitals in Europe which have very high standards for work safety and patients safety it is crucial to provide a good working environmeent for all medical staff

you have clearly shown that the working environment takes toll on the health of care workers who care for the health of their patients while neglecting their own health becoming in the future "a problem" for future care workers

therefore I may reccommend some minor changes to the text:

in the title you may ask "Why"  , why shift workers make unhealthy food choices......(or some other term-word)

or "Unhealthy food choices among health care shift workers:  a cross-sectional study"

the introduction has adequate references, and the authors have a respectable knowledge on methodology

the authors expressed sound knowledge and use adequate scientific language

in table 3. in the collon lacto-ovo-vegetarian and meat-fats-alcohol - fish the numbers are in grey colour - it should be changed to black color

you may also in a few senteces describe the differences between the three groups,

is is evident that these three groups have tottaly different dietary pattern which also result in different fat intake

but not only fats were important here,

i.e the lacto-ovo segment uses less snacks, sugar, refined grain and breakfest cereals, and use more vegetables, fruits, legumes, nuts...

the segment sweet-salty.snack- dairy use the opposite from the lactoovo segment (much more snacks, sugar, refined) and much less (evene negative whole grains, legumes, nuts..)

the segment meat-fats-alcohol- fish exceeds the other two egment not only for fats but also for processed meats, white meat, alcohol, fish,

in the conclusion the use of fats is not only a consequence of shift work but also a consequence of chosen diet pattern,

the socioeconomic status ussually has a lot to show in statisticall significance,

if you have 40 or more % of the sample living thriftly of course it will impact their food purchaces leading to cheaper choices of food, more procesed meats and sugarly sweets,  so you may mention in conclusion that it had also some influence on diet patterns

you may also consider the larger setting of the health care system,

as a future recommendation/limitation

I do not know exactly the situation in Poland, but in Croatia we have a contant lack of care personell so the work pressures are rising and of course leaving less time for breaks during the work time, 

in practice do nurses actually have time (a break of 1/2 our or more) to take  a meal during their shift 

also the space to take the meals are limited in hospitals, some have a restaurant with cooked meals others do not,

and they are not open in the night shifts,

also during the day some hospitals have very narrow or inadequate spaces for staff taking meals or breaks.

therefore in the recomendations it should be said that some institutional limitations hindered healthy diet patterns

and healthy "vending machines" or available "healthy choices" should be provided from the health care system to have healthy care workers,

best regards

the reviewer

Author Response

Dear Reviewer,

We are very excited to have been given the opportunity to resubmit the revised version of our manuscript (ID: nutrients-1977765) entitled “Unhealthy Food Choices Among Health Care Shift Workers: a Cross-Sectional Study”.

We greatly appreciate your time and efforts taken to review our manuscript. We have addressed all issues indicated in the review report and believe that the revised version can meet the journal publication requirements.

Please find our responses to the Reviewer’s comments attached. The changes in the manuscript are highlighted in blue. In addition, the manuscript has been corrected for language errors, using professional editing and proof-reading service.

Author Response File: Author Response.docx