Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
The Netherlands Organization for Applied Scientific Research, TNO, Schipholweg 77‑89, 2316 ZL, Leiden, The Netherlands.
Int Arch Occup Environ Health. 2021 Aug;94(6):1287-1295. doi: 10.1007/s00420-021-01662-6. Epub 2021 Mar 11.
Shift work has been related to obesity and diabetes, but the potential mediating role of lifestyle is yet unknown. Our aim was to investigate this mediating role of physical activity, diet, smoking, and sleep quality in the relationships between shift work, and obesity and diabetes.
In this cross-sectional study, 3188 shift workers and 6395 non-shift workers participated between 2013 and 2018 in periodical occupational health checks. Weight and height were objectively measured to calculate obesity (BMI ≥ 30 kg/m). Diabetes status, physical activity, diet, smoking, and sleep quality were assessed using standardized questionnaires. Structural equation models adjusted for relevant confounders were used to analyze the mediating role of lifestyle in the relationships between shift work, and obesity and diabetes.
Shift workers were more often obese (OR: 1.37, 95% CI 1.16-1.61) and reported more often to have diabetes (OR:1.35, 95% CI 1.003-1.11) than non-shift workers. Shift workers had lower physical activity levels, ate fruit and vegetables less often, smoked more often, and had poorer sleep quality (p < 0.05). Mediation analysis revealed that shift workers had a higher odds of obesity (OR: 1.07, 95% CI 1.01-1.15) and diabetes (OR: 1.13, 95% CI 1.02-1.27) mediated by poorer sleep quality. Lower physical activity levels (OR: 1.11, 95% CI 1.05-1.19) and lower intake of fruit and vegetables (OR: 1.04, 95% CI 1.01-1.15) were also mediators in the relationship between shift work and obesity, but not in the relationship between shift work and diabetes (p ≥ 0.05).
These results imply that interventions targeting diet, physical activity and in particular sleep problems specifically developed for shift workers could potentially reduce the adverse health effects of shift work.
轮班工作与肥胖和糖尿病有关，但生活方式的潜在中介作用尚不清楚。我们的目的是调查体力活动、饮食、吸烟和睡眠质量在轮班工作与肥胖和糖尿病之间的关系中的这种中介作用。
在这项横断面研究中，3188 名轮班工人和 6395 名非轮班工人于 2013 年至 2018 年期间参加了定期职业健康检查。通过客观测量体重和身高来计算肥胖（BMI≥30kg/m）。糖尿病状况、体力活动、饮食、吸烟和睡眠质量使用标准化问卷进行评估。调整了相关混杂因素的结构方程模型用于分析轮班工作与肥胖和糖尿病之间的关系中生活方式的中介作用。
轮班工人更常肥胖（OR：1.37，95%CI 1.16-1.61），并且更常报告患有糖尿病（OR：1.35，95%CI 1.003-1.11）比非轮班工人。轮班工人的体力活动水平较低，吃水果和蔬菜的频率较低，吸烟较多，睡眠质量较差（p<0.05）。中介分析显示，轮班工人肥胖的几率更高（OR：1.07，95%CI 1.01-1.15）和糖尿病（OR：1.13，95%CI 1.02-1.27）由睡眠质量较差介导。较低的体力活动水平（OR：1.11，95%CI 1.05-1.19）和较低的水果和蔬菜摄入量（OR：1.04，95%CI 1.01-1.15）也是轮班工作与肥胖之间关系的中介因素，但不是轮班工作与糖尿病之间关系的中介因素（p≥0.05）。
这些结果表明，专门针对轮班工人的饮食、体力活动，特别是睡眠问题的干预措施可能会降低轮班工作对健康的不利影响。
