Gupta Charlotte C, Duncan Mitch J, Ferguson Sally A, Rebar Amanda, Vandelanotte Corneel, Sprajcer Madeline, Khalesi Saman, Booker Lauren A, Rampling Caroline, Rigney Gabrielle, Vincent Grace E
Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Adelaide, South Australia, Australia.
School of Medicine & Public Health, Faculty of Health and Medicine, The University of Newcastle, University Drive, Callaghan, NSW, Australia.
J Act Sedentary Sleep Behav. 2023 Dec 2;2(1):26. doi: 10.1186/s44167-023-00035-3.
Chronic disease is the leading cause of death globally. Sleep, diet, and physical activity are modifiable health behaviours that are key for reducing the burden of chronic disease. These health behaviours are collectively termed 'The 3 Pillars of Health' and are critical for populations who are at risk of poor health. Shiftworkers are one such at-risk population. To target behavioural change it is critical to first understand which of these health behaviours Australians currently prioritise. Therefore, this study aimed to investigate how Australians (including shift workers) prioritise sleep, physical activity, and diet, and examine the associations with correlates of health behaviours.
Two cohorts of Australian adults were sampled. A cohort of 1151 Australian adults (54% female, aged 18-65 years) including employed (in any work schedule), unemployed, studying, and retired completed a phone interview. A cohort of 533 Australian shiftwork-only adults (76% female, 18-72) completed an online survey. All participants were asked which health behaviour (sleep, physical activity, or diet) they prioritised in their own life. Behavioural correlates of sleep, diet, and physical activity (sleep duration, frequency of moderate to physical activity, healthy dietary behaviour), and years of shiftwork experience were also collected. Multinomial logistic regressions were used to investigate the association between the highest prioritised pillar of health and the behavioural correlates.
Diet was prioritised by the Australian adults (49%), whereas sleep was prioritised by the shiftwork-only sample (68%). Australian adults who prioritised diet were significantly more likely to report diets with less fast-food consumption (p < 0.002) and more fruit consumption (p < 0.002) compared to those that prioritised sleep. For the shiftwork-only sample, those with 16-30 years of shiftwork experience were significantly more likely to prioritise sleep compared to diet (p < 0.05). However, prioritising sleep was not associated with meeting the sleep duration recommendations in the shiftwork-only sample.
Across two cohorts of Australians, prioritisation of health behaviour was only associated with actual behaviour for diet. This may reflect different motivations for prioritising different health behaviours, in addition to different capabilities to change different health behaviours. Future research should include longitudinal methodologies to understand how behaviour prioritisation changes over work- and life-span, and any associations with actual health behaviour.
慢性病是全球主要的死亡原因。睡眠、饮食和身体活动是可改变的健康行为，是减轻慢性病负担的关键。这些健康行为统称为“健康三大支柱”，对健康状况不佳风险人群至关重要。轮班工作者就是这样一个风险人群。为了实现行为改变，首先了解澳大利亚人目前优先考虑这些健康行为中的哪一种至关重要。因此，本研究旨在调查澳大利亚人（包括轮班工作者）如何对睡眠、身体活动和饮食进行优先排序，并研究与健康行为相关因素的关联。
对两组澳大利亚成年人进行抽样。一组1151名澳大利亚成年人（54%为女性，年龄在18 - 65岁之间），包括就业者（任何工作时间表）、失业者、学生和退休人员，完成了电话访谈。一组533名仅从事轮班工作的澳大利亚成年人（76%为女性，年龄在18 - 72岁之间）完成了在线调查。所有参与者都被问及他们在自己生活中优先考虑哪种健康行为（睡眠、身体活动或饮食）。还收集了睡眠、饮食和身体活动的行为相关因素（睡眠时间、中度至剧烈身体活动频率、健康饮食行为）以及轮班工作年限。使用多项逻辑回归来研究最高优先考虑的健康支柱与行为相关因素之间的关联。
澳大利亚成年人中，饮食被优先考虑的占49%，而仅从事轮班工作的样本中，睡眠被优先考虑的占68%。与优先考虑睡眠的澳大利亚成年人相比，优先考虑饮食的成年人更有可能报告较少食用快餐（p < 0.002）和较多食用水果（p < 0.002）。对于仅从事轮班工作的样本，有16 - 30年轮班工作经验的人比优先考虑饮食的人更有可能优先考虑睡眠（p < 0.05）。然而，在仅从事轮班工作的样本中，优先考虑睡眠与达到睡眠时间建议无关。
在两组澳大利亚人中，健康行为的优先排序仅与饮食的实际行为相关。这可能反映了优先考虑不同健康行为的不同动机，以及改变不同健康行为的不同能力。未来的研究应包括纵向研究方法，以了解行为优先排序如何在工作和生活期间发生变化，以及与实际健康行为的任何关联。
