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The Association Between Shift Work and Unhealthy Weight: A Cross-Sectional Analysis From the Nurses and Midwives’ e-Cohort Study
Abstract
To examine the association between shift work and unhealthy weight among female nurses and midwives.
A cross-sectional study. Measurement outcomes included shift work, unhealthy weight (underweight: body mass index [BMI] < 18.5; overweight: BMI 25.0 to 29.9; obesity: BMI > 30.0), diet quality, physical-activity level, alcohol consumption, and smoking status.
Among the 2494 participants (1259 day and 1235 shift workers), only 1% of the participants were underweight, 31.8% were overweight, and 26.9% were obese. After adjusting the selected confounders, shift workers were 1.15 times more likely to be overweight/obese than day workers (P = 0.013, 95% confidence interval, 1.03 to 1.28; P = 0.02, 95% confidence interval, 1.02 to 1.30, respectively).
Shift work is associated with higher risk of being overweight/obese. Longitudinal studies are being undertaken to better understand the causal relationship between shift work and unhealthy weight.
... The results of the study among one occupation of healthcare workers coincided with the results of studies including some health professionals (e.g., from Poland [68] and Greece [69]) or incorporated nurses and midwives in one group (Poland [51], Australia [53,70], New Zealand, United Kingdom [70]). Also, the result can reflect studies of nurse populations, including nurse-midwives, in countries where midwives are also nurse practitioners. ...
... The results of the study among one occupation of healthcare workers coincided with the results of studies including some health professionals (e.g., from Poland [68] and Greece [69]) or incorporated nurses and midwives in one group (Poland [51], Australia [53,70], New Zealand, United Kingdom [70]). Also, the result can reflect studies of nurse populations, including nurse-midwives, in countries where midwives are also nurse practitioners. ...
... The methodology was designed to obtain a highly homogeneous group of participants representing one distinctive occupation (midwives) and workplace (only public hospitals in Wrocław). Therefore, the study group was not combined with other medical professionals, e.g., nurses or doctors, as was practiced in other studies [51,68,70]. These assumptions contributed to the unification of the group but limited its size. ...
The aim of this study was to assess the quality of diets among midwives working in a shift system and to analyze variations in their dietary habits according to their working hours. In a group of fifty midwives employed in four public hospitals in Wrocław, the HDI-2015, HEI-2015, AHEI-2010, and Mellen’s DASH diet index were calculated. The significance of differences in terms of the prevalence of selected dietary habits, meal frequency, average content of selected food items, and the percentage of energy obtained from them was assessed. Over half of the diets of the participants exhibited low adherence to the selected dietary indices. Only the scores on Mellen’s DASH diet index were significantly associated with other components of the diet. Diets scoring ≥ 4.5 points were characterized by significantly lower processed meat content, meal frequency, and energy value, as well as lower sugar content and lower dietary energy value, compared to diets scoring < 4.5 points. Regardless of their working hours, the diets of midwives are characterized by low quality. Therefore, it appears essential to introduce targeted educational programs and provide guidance on appropriate dietary models, such as the DASH diet.
... Multiple cross-sectional studies have reported greater BMI [25,26] and increased prevalence of overweight/ obesity [25,[27][28][29] among shift workers compared to nonshift workers. A population-based survey of 1,593 adults found that shift workers (including night shift workers, rotating shift workers, or alternative shift workers) were more than twice more likely to have a BMI ≥ 25 than traditional workers [27]. ...
... A population-based survey of 1,593 adults found that shift workers (including night shift workers, rotating shift workers, or alternative shift workers) were more than twice more likely to have a BMI ≥ 25 than traditional workers [27]. Shift work was independently associated with increased risk of both overweight and obesity in a multinational sample of nurses and midwives [28]. When considering the location of excess fat accumulation, evidence is suggestive of a more robust relation between shift work and abdominal obesity compared to general obesity [25,29]. ...
... Despite the abundance of studies examining the relation between shift work and obesity, little is known on whether such relationship varies by sex. When examining the literature, it is apparent that several studies included only male [33,38,40] or only female participants [25,28,34,35], or did not test for sex differences in their analysis [27,29,32]. However, a number of investigations addressed whether the impact of shift work on excess body weight differs by sex, yielding mixed results (Table 1). ...
Purpose of review
Shift work is prevalent among the working population and is linked to an array of adverse health outcomes. This review summarizes current evidence on the relation between shift work and risk of obesity, with a particular emphasis on potential sex differences.
Recent findings
Observational data strongly point towards an association between shift work and heightened risk of prevalent and incident obesity, and particularly abdominal obesity. Circadian misalignment and unhealthy lifestyle behaviors are the primary culprits mediating such association. As it pertains to sex differences in the impact of shift work on obesity, few studies have examined this aspect, and findings are conflicting.
Summary
Shift work is an important risk factor for obesity, with likely multiple biological and behavioral mediators. However, whether there is a sex-dependent vulnerability to the obesogenic effects of shift work is unclear. This area presents opportunities for future research.
... Moreover, the questionnaire used was developed by the researchers themselves and no information on its validation was provided. Zhao et al. analyzed diet quality and alcohol consumption in an e-cohort of 2494 nurses and midwives [12]. Diet quality was measured using Australian Recommended Food Score (ARFS), which is a 74-item validated instrument. ...
... These include diet quality and composition, and temporal distribution of foods. Five of the studies analyzed diet quality [12,[20][21][22]26] using various questionnaire tools and guidelines. A poorer diet quality among night shift nurses was found in 2 studies [21,22], while 3 others revealed no differences in the analyses by the system of work [12,20,26]. ...
... Five of the studies analyzed diet quality [12,[20][21][22]26] using various questionnaire tools and guidelines. A poorer diet quality among night shift nurses was found in 2 studies [21,22], while 3 others revealed no differences in the analyses by the system of work [12,20,26]. Few studies indicated the specific aspects of poor dietary behaviors of nurses working night shifts, such as a lower number of main meals per day [9,10,13], meals irregularity [16,25], a later hour of the last meal [9,21], and eating at night [10,23]. ...
The shift work system may affect the temporal distribution of eating and diet quality. The paper aimed at reviewing a body of research
examining the associations between night shift work and dietary habits among nurses. Data from the PubMed and Google Schoolar
databases, as well as references lists in selected papers were searched. The authors used the following keywords: nurses, shift work,
diet, nutrition. Papers published in English or Polish were selected for the review, and as many as 19 papers published in 2000−2017
were eventually identified. The studies varied greatly with respect to the study size, subjects’ age and the duration of night shift
work. The major problem was the heterogeneity of the tools used for dietary assessment. Self-administered questionnaires were used
and analyses were rarely adjusted for confounders. Alcohol consumption was the most frequently analyzed aspect (N = 8 studies),
followed by the total energy (N = 7), protein, fat (N = 6), and carbohydrate intake, coffee and fruit consumption (N = 5). The results
showed quite a consistent association of night work with higher coffee (caffeine) consumption, as well as lower alcohol, and fruit and
vegetables consumption. Few studies also reported more frequent snacks consumption, later time of the last meal, eating at night,
meals irregularity, and a poorer diet quality among night shift nurses when compared to the reference. The review showed some poor
nutritional habits among nurses working night shifts. However, the topic warrants further attention, owing to the relatively small
number of the studies performed so far, and their numerous methodological limitations. Med Pr. 2019;70(3):363–76
... Table 3 presents the characteristics of the articles. Of the total 33 studies included, 10 included only female subjects (22,(31)(32)(33)(34)(35)(36)(37)(38)(39), 13 studies included only males (6,7,11,21,(40)(41)(42)(43)(44)(45)(46)(47)(48) and 10 studies included both sexes (17,19,28,(49)(50)(51)(52)(53)(54)(55). Workers from different sectors were evaluated as follows: workers in industries and plants (N=10) (6,11,17,31,39,(41)(42)(43)(44)46), hospitals (N=10) (28, 32-38, 49, 51), transportation company workers (N=4) (7,40,47,50), and the general population (N=9) (19-22, 28, 45, 48, 52-55). ...
... On the other hand, table 5 shows studies that evaluated the intake of food groups (17,40,50,53) and eating pattern scores (5,17,31,34,35,41,(54)(55) through food frequency questionnaires (FFQ) (5,17,40,51,53,55), questionnaires about meals and food patterns (31,34,35,41,56), and 24HR (54). Of these, 12 were cross-sectional (6,17,31,34,35,37,40,41,50,(53)(54)(55), and 1 was a case-control study (34). Regarding the quality of the studies, only 5 presented scores >70% (17,40,50,54,55). ...
... Food habits were evaluated in 9 studies through diet quality scores or dietary patterns (6,17,19,22,32,36,37,54,55). In a study by Barbadoro et al (6), working in a rotating shift system was inversely associated with an increased cardiovascular risk score, whereas in 2 other studies, rotating shift work was positively associated with unhealthy eating patterns (22) and inflammatory potential (54), characterized by the consumption fatty and fried foods (tables 5 and 6). ...
Objective This systematic review aimed to evaluate the association between shift work and eating habits. Methods The protocol was registered in PROSPERO (number 42015024680). PubMed, EMBASE, Scopus, and Web of Science were searched for published reports. Of 2432 identified articles, 33 observational studies met the inclusion criteria. Their methodological approaches were assessed using the Newcastle-Ottawa Scale. Data were extracted using a standardized form. Studies were considered to have a low or a high risk of bias according to a percentage score of quality. Results The majority of the studies presented a quality score of <70% and a high risk of bias for comparability, sample selection and non-respondents. Shift workers show changes in meal patterns, skipping more meals and consuming more food at unconventional times. They also show higher consumption of unhealthy foods, such as saturated fats and soft drinks. Conclusions This review suggests that shift work can affect the quality of workers' diets, but new studies, especially longitudinal studies, which examine the time of exposure to shift work, the duration of the workday and sleep patterns, are necessary to confirm this association.
... In a study on nurses in India, the night shift workers reported to consume fewer main meals but were more likely to consume snacks during the night duty. However, Zhao et al (2011)., in their study also reported that more overweight and obese participants in their study in the shift work group. [17] In a study by Sahu et al (2011) it was observed that nurses working in shifts had lower appetite and eating satisfaction. ...
... However, Zhao et al (2011)., in their study also reported that more overweight and obese participants in their study in the shift work group. [17] In a study by Sahu et al (2011) it was observed that nurses working in shifts had lower appetite and eating satisfaction. It was also reported that nurses working in shift had lower intake as per ICMR recommended value, which is inconsistent with the findings of our study. ...
A BSTRACT
Introduction
Shift work comprises work hours other than 9 am to 5 pm. Healthcare jobs such as nursing have been associated with shift work, which can affect their overall health status. Due to excessive workload and instability in working hours, nurses are also prone to higher occupational stress.
Materials and Methods
A descriptive study, Cornell Medical Index (CMI) questionnaire, 24-h recall method, and occupational stress score (OSS) were used to assess overall health, calorie intake, and occupational stress among nurses working in a tertiary care centre in Central India.
Results
The mean age of participants in the control and study groups was 43.2 ± 6.059 years and 43.93 ± 5.20 years, respectively. Neither of the group’s participants had poor nutritional status. CMI health scores revealed poor mental health among the study group. Severe occupational stress was observed in 57% of participants, and 33% had moderate occupational stress. Among the causes of occupational stress, 92% cited unfavourable work conditions, and 88% pointed out the workload. Poor peer relations and low status were cited by 77% and 57% of participants.
Conclusion
This study highlights the harmful effects of shift work on health of nurses. These negative effects are usually linked to poor diet and stress, which can be induced by overwork, poor sleep, or both. This study found that high workload is the main cause of occupational stress. Sleep disruption, lack of exercise and excess work load are major contributors for occupational stress and unhealthy eating habits. More awareness regarding importance of good diet and stress management may aid in improving health of nurses working in shifts.
... Shift-work is necessary to deliver continuous care for patients (Ferri et al., 2016). However, rotating shiftwork exposes nurses to a wide range of difficulties leading to sleep disturbances (Costa et al., 2013;Reed, 2014), including inadequate sleep and sleep deprivation (Heath et al., 2019), and poor sleep quality (McDowall et al., 2017), high stress level (Buss, 2012;Heath et al., 2019), and nutritional problems (e.g., overweight and obesity) (Buss, 2012;Kim et al., 2013;Liu et al., 2018;Peplonska et al., 2015;Reed, 2014;Smith et al., 2013;Zhao et al., 2011). ...
... These findings are compatible with previous studies among Arabs (Almajwal, 2016). However, our findings are inconsistent with studies based in Poland and Australia (Almajwal, 2015;Peplonska et al., 2015;Zhao et al., 2011). These results could be related to sedentary lifestyle and lack of physical activity among nurses . ...
Shift-work leads to many negative health outcomes among nurses, including overweight/obesity, high stress level, and sleep disturbances. This study purposed to evaluate the influence of shift-work on perceived stress, sleep quality, and Body Mass Index (BMI) among emergency department (ED) nurses in Jordan. A descriptive correlational design was employed. A structured self-reported questionnaire was used to collect data from emergency nurses in government and private hospitals. A total of 450 emergency nurses responded to the questionnaire. Findings found that around 81.1% and 14.0% of the study participants endorsed moderate and high levels of stress, respectively. The majority of the participants (94.5%) had poor sleep quality; 35.3% had overweight and 18.7% had obesity. The study findings indicated that shift-work influenced on perceived stress (β = 0.18, p < .001) and BMI (β = 0.15, p < .001). The mixed shift-workers had lower perceived stress and higher BMI than their counterparts who were doing other shift-work categories. Hence, shift-work had a negative influence on the levels of perceived stress and BMI. Hence, this influence should be taken into consideration when planning interventions and strategies to minimize the negative effects of shift-work.
... It could lead job related stress, poor job performance, insomnia and disrupted social and family life. Furthermore, it is reported that high risk factors such as obesity, overweight, physical inactivity, and poor eating habits are associated with shift and rotational night shift works 4,5 . Many researchers associate obesity among nurses with their long working hours and overload of work. ...
... Many researchers associate obesity among nurses with their long working hours and overload of work. Zhoa I 2011 5 conducted a cross sectional study to examine association between shift work and unhealthy weight among female nurses and midwifes. Another study highlighting the association of shift work with obesity hypothesized the shift work as a risk factor for obesity in female nurses in Korea 6 . ...
OBJECTIVE: To determine the associations between long duty hours and unhealthy dietary habits among nurses at private and public sector in Karachi, Pakistan METHODOLOGY: In this cross-sectional analytical design 300 nurses were randomly selected from private and public hospitals between months of October to December 2017. The data was collected through structured questionnaire developed by Aryee PA 2013 containing two portions. The first part asks about the demographic data including age, sex, marital status and ethnicity, whereas, the second part asks about the anthropometry, job schedule, physical activity and dietary habits of the respondents. RESULTS: The mean age of 300 study subjects was 30.78±8.47 years. Among them 61% nurses were working as long duty hours. Nurses working in private sectors are more involved in the long duty hours rather than nurses working in public sectors. Body Mass Index (BMI) of nurses was significantly relevant with the long duty hours (P-value <0.05). The mean BMI of nurses with long duty hours were BMI=25.78±7.35. Long duty hours were associated with skipping meal through Mann Whitney U test, which was significant with P-value ˂ 0.05. BMI and age of participants was negatively correlated with duty hours i.e.-0.116 &-0.239 respectively. CONCLUSION: In conclusion, long duty hours are associated with the unhealthy dietary habits of the nurses. The study recommended that nurses must reflect on their dietary habits to stay healthy and prevent from non-communicable diseases. Nurse Managers should work efficiently so workload of nurses could minimize and could reduce their duty hours.
... General observation suggests that physical inactivity and weight issues may be more prevalent in the nursing profession, particularly as seniority level increases. The majority of current research on nurses' physical activities centres on its impact on obesity (Aryee, Helegbe, Baah, Sarfo-Asante, & Quist-Therson, 2014;Kim, 2013;Nam & Lee, 2016;Smith, Fritschi, Reid, & Mustard, 2013;Zapka, Lemon, Magner, & Hale, 2009;Zhao, Bogossian, Song, & Turner, 2011). None, however, has attempted to link differing work schedules with PA behaviour. ...
... Physical activity is an integral component of overall cost of energy expenditure and is therefore pertinent to energy balance and weight management considerations (World Health Organisation, 2010b). Internationally, the prevalence of unhealthy weight among nurses is known to be high, and studies conducted in America (Han, Trinkoff, Storr, & Geiger-Brown, 2011;Miller, Alpert, & Cross, 2008;Nam & Lee, 2016;Zapka et al., 2009), Australia (Zhao et al., 2011), Malaysia (Coomarasamy, Wint, Neri, & Sukumaran, 2012), and Ghana (Aryee et al., 2014) has shown that overweight ranges from 41.3% to 65%. This study revealed that the combined prevalence of pre-obese/obesity was at an alarming 62.4%. ...
Physically sedentary and overweight nurses appear to be less credible in inculcating healthy behaviour among patients. Shift-work has been shown to promote physical inactivity, whilst sedentarism strongly correlates with a high body mass index (BMI). We aim to determine the level of physical activity among hospital nurses of different work schedules, i.e. shift-work and day-work; and explore any associations between nurses’ demographic backgrounds, BMI, and work schedules with their physical activity level. This cross-sectional study design was employed. The self-administered Malaysian International Physical Activity Questionnaire – Long form (IPAQ-L) and a demographic survey sheet were provided to the eligible nurses. Bivariate and subsequent regression analyses were performed to determine their associations. A total of 1988 nurses from the University Malaya Medical Centre, Kuala Lumpur were invited to participate in this study. There were 1504 (76%) returned responses, with 77% of responding nurses working shift. Based on the IPAQ-L, 87% of the nurses were deemed highly active, while another 11% were moderately active. Upon stratifying into shift-work and day-work, statistically significant differences were observed between the groups in the domains of ‘work’ (p = 0.016), ‘domestic chores’ (p = 0.038), and in intensity-specific ‘walking’ (p = 0.046) and ‘vigorous’ activities (p = 0.034). There were no differences among groups within categories of physical activities (p = 0.355). Regression analysis showed significant difference for ‘duration of daily vehicle travel’, with the day-workers reporting a longer adjusted travel time (76.50 minutes/day, p < 0.001). Working shift does not seem to harm an individual nurse’s overall measured physical activity, as evidenced by equivalent high values of physical activity engagement between both work schedules. Any differences within domains and intensities of physical activities may be attributed to the respective cohort characteristics.
... Shift workers individuals often suffer from sleep disorders due to their sleeping and waking cycle. In addition, the main cause of insomnia in shift workers is changes in the circadian rhythm (13,14). Antunes showed that 62% of people suffer from sleep disorders and insomnia is the most common complaint of shift workers (15). ...
... This cross-sectional study was carried out on 100 male military personnel in Southern Iran in June-July 2016. The participants were divided into two groups based on their working schedule; day work (from 7 am to 4 pm; N = 50) and shift work (from 7 pm to 7 am; N = 50) (13). The two groups were similar in terms of type of work. ...
... Contributing factors to the high BMI in RNs include shift work (Buss, 2012;Zhao, Bogossian, Song, & Turner, 2011), occupational setting, and full-time work (Bogossian et al., 2012). RNs who work outside typical daytime hours (i.e., shift work) are 15% to 30% more likely to be overweight or obese than RNs working typical daytime hours (Zhao et al., 2011). ...
... Contributing factors to the high BMI in RNs include shift work (Buss, 2012;Zhao, Bogossian, Song, & Turner, 2011), occupational setting, and full-time work (Bogossian et al., 2012). RNs who work outside typical daytime hours (i.e., shift work) are 15% to 30% more likely to be overweight or obese than RNs working typical daytime hours (Zhao et al., 2011). The effects of shift work are complex because they negatively affect other factors, such as sleep quality, meal times, food and beverage consumption, food snacking habits, and physical activity time (Buss, 2012;Kyle et al., 2015;Zhao & Turner, 2008). ...
Background:
The published literature suggests that RNs are more overweight and obese than the general population. This research investigates associations between nutrition literacy, anthropometry measures, and nutritional biomarkers in an undergraduate nursing student population.
Method:
Year-one nursing students from two tertiary education institutions in New Zealand were invited to participate in an observational, convenience sample study. Data collection from participants (N = 103) included a nutrition literacy questionnaire, anthropometry measures, and blood lipid, glucose, and HbA1c concentrations.
Results:
Approximately 51% of participants were either overweight or obese, which is a similar prevalence to the New Zealand demographic-matched population. Mean body mass index was 26.7 ± 6.3 kg/m(2) and body fat was 29% ± 8.3%. The mean literacy score was 56.7% ± 13.2%. The literacy score was inversely associated with anthropometry measures and total cholesterol/high-density lipoprotein cholesterol ratio and positively associated with high-density lipoprotein cholesterol.
Conclusions:
Nutrition literacy had a statistically significant influence on anthropometry and lipid measures. [J Nurs Educ. 2017;56(1):43-48.].
... Установлено, что у медсестер, работающих неполный рабочий день значительно снижен риск распространения избыточного веса и ожирения [5]. Сменная работа (дневные и ночные смены) медицинских работников имеет корреляцию как с избыточным весом, так и с ожирением, тогда как работа в ночную смену ассоциирована с ожирением, а не с избыточным весом [71,44]. Особенности сменной работы приводят к неадекватному питанию, такому как не регулярный режим питания, избыточное потребление сахара, частые нездоровые перекусы [40,68]. ...
... Therefore, only midwives were included in the study, without combining them with other representatives of the medical profession, as in other studies [12,13,52]. In addition, only public hospitals located in Wrocław were selected, excluding those near Wrocław. ...
Objectives:
The aim of the study was to assess the nutritional status and diet of midwives working on a shift schedule in public hospitals in Wrocław, Poland, and to analyze the variation in their diet according to their working hours (day shift, night shift) and on a non-working day.
Material and methods:
In the group of 50 midwives, employed in 4 public hospitals in Wrocław weight and body composition, waist and hip circumference, waist-hip-ratio and BMI were assessed. The nutritional habits and quality of the study participants' diets were assessed by 3-days food dietary recall, including 1 day shift day, 1 night shift day, and 1 non-working day.
Results:
More than half of the subjects were assessed as having excess body weight (BMI ≥25 kg/m2). Thirty percent of participants had BMI ≥25-<30 kg/m2 and 24% BMI ≥30 kg/m2, 70% had a body fat percentage >30%. Fifty-six percent of the diets had an energy value <90% of the subject's total daily energy expenditure. Significantly higher energy value of diets on the night shift day compared to the morning shift day (1959.05±596.09 kcal vs. 1715.36±654.55 kcal, p = 0.01) were observed. The same relationship applied to cholesterol content (349.50±155.33 mg vs. 261.39±190.59 mg, p = 0.002). A high intake of phosphorus and sodium, exceeding the recommended dietary intake, was noticed.
Conclusions:
The occurrence of a night shift in the shift work schedule is an element of that model that may have a significant impact on the nutritional and health value of shift workers' diets. Therefore, it seems reasonable to implement nutritional education programs promoting healthy eating choices and habits during night work. Int J Occup Med Environ Health. 2023;36(5).
... Articles on shift workers were excluded as their eating and sleeping schedules are driven by external factors other than hunger and sleep cycles, and shift work has been shown to affect weight management. [29][30][31] As this review focused on how the distribution of energy intake across the day affects weight loss in the general population, studies that involved a period of fasting such as time restricted feeding, intermittent fasting, or Ramadan were excluded. Studies on drug or surgical interventions, such as bariatric surgery, were also excluded as these interventions may have an impact on metabolism and weight loss independently of eating patterns. ...
Consuming a greater proportion of total energy intake earlier in the day rather than in the evening is proposed to positively influence weight loss and health, potentially due to greater synchronization of human body circadian rhythms. This systematic review provides an update on existing evidence regarding earlier distributed eating patterns in weight loss interventions. Using a robust search strategy in five electronic databases, nine randomized controlled trials investigating the impact of energy intake distribution on weight loss were identified. Following critical appraisal, a random‐effects meta‐analyses found that, in the context of an energy‐reduced diet, distributing energy intake with a focus on earlier intake resulted in significantly greater weight loss (−1.23 kg; 95% CI 2.40, −0.06, p = 0.04). Improvements in HOMA‐IR, fasting glucose, and LDL cholesterol were also seen. The current study provides a timely update on the evidence linking distribution of total daily energy intake and health, showing that a focus on earlier intakes can result in greater short‐term weight loss compared with later intakes. Future studies are needed to elucidate the impact that earlier intakes may have on weight management and metabolic health.
... Eating during the biological night, e.g., for shift workers, decreases total daily energy expenditure and increases the risk of weight gain and obesity [89] 10 adults underwent a 10-day protocol with eating and sleeping in all phases Forced desynchrony protocols cause circadian misalignment and disturb postprandial glucose response typical of prediabetes [104] 2494 participants (1259 day and 1235 shift workers) Shift work is associated with higher risk of being overweight/obese [105] Late Night Eating, BMI and Metabolic Health 26,382 participants (9088 shift workers) Long-term shift work is associated with metabolic syndrome [106] 9912 male employees (8892 daytime workers and 920 rotating three-shift workers High risk of obesity among male shift workers [107] 905 shift workers Strong association between sleep deprivation and obesity in shift workers [108] 200 shift workers Night work is a risk factor for abdominal obesity, social jetlag is higher in night shift workers and it was associated with the presence of obesity. [109] 3188 shift workers and 6395 non-shift workers Shift work associated with obesity, lower physical activity, poor dietary choices [110] ...
Obesity is a chronic and relapsing public health problem with an extensive list of associated comorbidities. The worldwide prevalence of obesity has nearly tripled over the last five decades and continues to pose a serious threat to wider society and the wellbeing of future generations. The pathogenesis of obesity is complex but diet plays a key role in the onset and progression of the disease. The human diet has changed drastically across the globe, with an estimate that approximately 72% of the calories consumed today come from foods that were not part of our ancestral diets and are not compatible with our metabolism. Additionally, multiple nutrient-independent factors, e.g., cost, accessibility, behaviours, culture, education, work commitments, knowledge and societal set-up, influence our food choices and eating patterns. Much research has been focused on ‘what to eat’ or ‘how much to eat’ to reduce the obesity burden, but increasingly evidence indicates that ‘when to eat’ is fundamental to human metabolism. Aligning feeding patterns to the 24-h circadian clock that regulates a wide range of physiological and behavioural processes has multiple health-promoting effects with anti-obesity being a major part. This article explores the current understanding of the interactions between the body clocks, bioactive dietary components and the less appreciated role of meal timings in energy homeostasis and obesity.
... Our findings were comparable with research done on 9,989 female nurses in Korea, which found that obesity rates for shift workers and non-shift employees were 5.8 percent and 9.1 percent, respectively [29]. However, it contradicted a cross-sectional research from Australia, which found that nurses who worked shifts were 1.15 times more likely to be overweight or obese than day workers [30]. BMI of daytime workers was greater than that of shift workers, which might be impacted by the daytime workers' older age, as well as other potential confounding factors. ...
Background: It's been suggested that shift employment is linked to an increased risk of metabolic syndrome (MetS). It is a complex syndrome that has been linked to the development of cardiovascular disease and/or type 2 diabetes mellitus. The goal of the study was to determine the prevalence of MetS among health-care workers and to investigate the impact of rotating shift work on MetS biomarkers and inflammation. Methods: 100 current daytime workers were compared to 210 rotating shift workers in comparative analytical cross-sectional research involving 310 health care personnel. A questionnaire on socio-demographic (sex, age, marital status, job), health-related behaviors such as a physical activity) and occupational history about shift work, as well as a health examination with anthropometric and arterial blood pressure measurements, and laboratory investigations. For the diagnosis and determination of MetS, we used the Adult Treatment Protocol III National Cholesterol Education Program of America (ATPIII) indicators. SPSS version 20 was used for the statistical analysis. Results: The overall prevalence of MetS among healthcare workers was 8.4% (9.0% among Original Research Article Arafat et al.; JAMMR, 33(24): 43-59, 2021; Article no.JAMMR.79796 44 current daytime workers and 8.1% among rotating shift workers) with no significant difference between males and females, and shift category. Elevated C-reactive protein (44.5%) was the most commonly altered component among healthcare workers, followed by high triglyceride (35.5%), raised total cholesterol (24.8%), and elevated BMI>30 (20.6 %). In descending order, the following were the main risk factors for MetS in both sexes among rotating shift workers: high blood pressure (OR = 59.5; 95 percent CI, 16.4-215.8), high fasting blood sugar (OR = 43.9; 95 percent CI, 12.9-149.1), high triglyceride (OR = 42.3; 95 percent CI, 5.5-326.6), obesity (BMI >30) (OR = 11.8; 95 percent CI, 4-34.6), and low HDL cholesterol (OR = 1.6; 95 percent CI, 0.3-6.1) Conclusion: MetS was prevalent amongst Gaza Strip healthcare workers, with a consistent increase in prevalence as people were older and had a higher BMI. There was no direct relationship between shift category and the occurrence of MetS and inflammation; however, other factors such as genetics, lifestyle factors, and the work itself may have a greater impact than shift category.
... More recently, nurses discussed regularly eating unhealthy foods at work given their availability at nurses' stations or in tea rooms (Torquati et al., 2016). These behaviours are concerning as they are associated with weight gain and obesity (Zhao et al., 2011). Snacking on discretionary food may form a new behavioural pattern during the transitional year that is difficult to overcome. ...
Aims
This study explored the acceptability of a workplace health promotion intervention embedded into a transition to practice (TTP) programme to assist new graduate nurses in establishing healthy dietary and physical activity (PA) behaviours from career commencement.
Design
A sequential mixed methods design.
Methods
The Start Healthy and Stay Healthy (SH&SH) intervention, informed by the Behaviour Change Wheel, was conducted in an Australian Local Health District. It included face-to-face education sessions, the use of a fitness tracker and twice-weekly short answer messages. Participants completed three online surveys: at orientation, 6 weeks and 6 months. A sub-sample participated in semi-structured interviews to explore their experience of the intervention. Interview data were analysed thematically.
Results
The intervention was delivered from February to December 2019. A total of 99 nurses completed the baseline survey, 62 at 6 weeks and 69 at 6 months. After 6 months, health knowledge increased as participants correctly identified recommended amounts of fruits, vegetables and PA. Fruit consumption increased at 6 months with little change to vegetable intake. Takeaway consumption decreased, but consumption of some discretionary foods increased. Across the three time points, there was a low engagement in PA during leisure time. The interviews identified three themes: (1) Support of Colleagues and Peers, (2) The Work Environment and (3) Engagement with SH&SH.
Conclusion
Providing a targeted intervention for new graduate nurses embedded into a TTP programme improved their health knowledge, some dietary behaviours, and participation in PA by some participants.
Impact
Ensuring a healthy nursing workforce is critical to retaining staff. Implementing a workplace health promotion intervention that targets new graduate nurses can help them adopt and maintain healthy lifestyle behaviours to support them in their future careers.
... Shift work is associated with 15% more odds of being overweight/obese [15]. In the current study, nurses working in RS were 3.7 times and 2.9 times more likely to have excessive weight and adiposity, respectively. ...
PurposeTo compare physical, psychological, and physiological adaptations between rotating and morning shift health workers using objective and subjective approaches.Methods
Forty nurses [n = 20 morning shift (MS) group; n = 20 rotating shift (RS) group] were evaluated for anthropometry, body composition, and handgrip strength. Quality of life, depression, fatigue, daytime sleepiness, and sleep quality were assessed with SF-36, Zung Self-Rating Depression Scale (SDS), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI), respectively. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ) and triaxial accelerometers. Sleep-related data were monitored with sleep actigraphy. Salivary melatonin levels were analyzed before/after sleep, and blood lipid profiles were measured the following morning.ResultsThe RS group had higher mean BMI and total and abdominal fat and scored lower in the SF-36 (p < 0.01). All nurses showed reduced physical activity levels, which, in the RS group, were negatively correlated with FSS (p = 0.033) and SDS scores (p = 0.025). Poor sleep was revealed in 53% of nurses. The RS group had worse sleep quality by PSQI than the MS group (p = 0.045). PSQI scores were inversely related to SF-36 scores and positively correlated with FSS, BMI, waist circumference, and body fat (p < 0.05).ConclusionRS nurses showed increased body mass and total and abdominal fat along with decreased quality of life and sleep quality compared to MS counterparts. A strong relationship was found between physical, psychological, and physiological domains. Further studies should consider workplace interventions to prevent obesity, promote physical activity, and manage poor sleeping patterns in nurses.
... In this study, the average BMI of shift nurses was higher than that of non-shift nurses. Previous studies have reported that shift workers tend to be obese [20,21]. Since nurses work longer than regular work hours, suffer work stress, and have unhealthy dietary patterns with exposures to hospital infections, they are prone to obesity [22]. ...
Background and Objective The objective of this study was to determine whether there were differences in diet and sleep quality between shift and non-shift nurses. Nurses among healthcare professionals mostly work in shifts. Therefore, they may face many health problems. Changes of their dietary pattern and sleep quality might be among underlying causes for their health risks. Methods This descriptive and cross-sectional research enrolled 298 nurses working in two hospitals who volunteered to participate in this study. The work schedule of nurses included a non-shift work and a shift-work. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using a three-factor PSQI model. Results Based on the three-factor PSQI model, scores for sleep efficiency, sleep quality, and daily disturbances were significantly (p < 0.05) higher in shift nurses than in non-shift nurses. Among individuals with good sleep quality, the diet quality of shift nurses was worse (p < 0.05) than that of non-shift nurses. Among individuals with poor sleep quality, there was no significant (p > 0.05) difference in total diet quality score according to shift status. Conclusions Shift work was significantly associated with poor sleep quality. Among nurses with good sleep quality, the diet quality of shift nurses was worse than that of non-shift nurses.
... 11,15 Nicotine dependence was high among nurses. 16,17 A comparative research for 3200 Australian nurses showed that 80% of the nurse smokers were nicotine dependent. 17 Another study documented that the level of nicotine dependence among ED nurses was the highest level compared with the nurses in other departments (15.6%). ...
Shift-work can alter the nurses' lifestyle behaviors, which negatively influence health. This study is purposed to assess the relationship between shift-work and selected lifestyle behaviors including, dietary habits, physical activity, and nicotine dependence among Jordanian nurses who work at the emergency department. A cross-sectional, descriptive correlational design was used. A total of 275 Jordanian nurses from the emergency department of Jordanian hospitals participated in the questionnaire. The results showed that 50.2% of the nurses suffered from poor dietary habits, 81.8% of them were physically inactive, and 65.1% had nicotine dependence. There was a positive correlation between shift-work, dietary habits, physical activity, and nicotine dependence. Therefore, the effects of shift-work should be considered when planning and developing interventional programs to enhance nurses’ health and promote healthy behaviors among nurses workforce during shift-work.
... An association for percent energy from evening food intake and BMI was not found after adjustment for covariates in another US study of 1802 women aged 19-50, based on the USDA Continuing Survey of Food Intakes of Individuals (CSFII), in which evening food intake was related to percentage of energy from grams of alcohol, fat, and protein [3]. Additionally, when compared to day workers, day-night rotation workers have been reported to have a higher prevalence of obesity and overweight as well as higher BMIs [53,54]. These individuals also have increased evening food intake [55]. ...
Studies of relationships between eating frequency and/or timing and energy intake have not examined associations with low-calorie sweeteners (LCS). We assessed the frequency of eating behavior related to LCS consumption emphasizing timing, calorie intake, and body mass index (BMI) among United States (US) adults aged ≥19 years. Using the National Health and Nutrition Examination Survey (NHANES) 2007–2016, we defined eating episodes as food and/or beverage intake within 15 min of one another over the first 24-h dietary recall. We coded items ingested during episodes (n = 136,938) and assessed LCS presence using US Department of Agriculture (USDA) food files. Episode analysis found intakes of foods only (27.4%), beverages only (29.5%), and foods with beverages (43.0%). LCS items were consumed without concurrent calories from other sources in fewer than 2.7% of all episodes. Within participants having normal weight (29.4%), overweight (33.6%) and obese (37.1%) BMIs, LCS consumers (35.2% overall) evidenced: more episodes/day; and fewer: calories, carbohydrates, fats, and protein per episode. Per person, those consuming LCS had lower total calories and higher fiber intake per day. LCS consumption was associated with higher BMI. Number of eating episodes/day and longer hours when eating episodes occurred were also consistently associated with higher BMI. Consuming LCS did not modify these relationships. These results did not show that LCS consumption was associated with increased caloric intake from other dietary sources.
... Sixty articles were excluded for the following reasons: participants were not exclusively shift work nurses, inappropriate outcomes (outcome variable without obesity), insufficient data (did not provide the magnitude of the association in terms of OR and their 95% CI, or sufficient data for calculation of these parameters), and other language. Of these, three publications used data based on a same population of a nurses and midwives' e-cohort study, we only included the most recent one in this metaanalysis ( Zhao et al., 2012a ), due to the same database being used in the other 2 studies ( Zhao et al., 2012 b;Zhao et al., 2011 ). Thus, a total of 11 eligible studies were included in this systematic review and meta-analysis (Supplementary Table S2). ...
Background
The association of shiftwork and the risk of obesity in nurses has been inconsistent in the literature.
Objectives
We therefore conducted a systematic review and meta-analysis to quantitatively summarize this association in nurses.
Methods
We systematically searched PubMed, Ovid MEDLINE, Cochrane Library, EMBASE and Web of Science from inception until April 2020 for studies that examined the relationship between shift work and obesity in nurses. Pooled odds ratio (OR) was calculated using a fixed- or random-effect model. The quality of each study was evaluated by using the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) tool. Two researchers independently assessed eligibility and extracted data. The whole process followed the PRISMA statement.
Results
We included 11 eligible studies with a total of 74,651 nurses in this study. All of the studies were found to be low or moderate risk of bias according to the ROBINS-I tool. The pooled estimate of the risk of obesity in shift work nurses as compared to non-shift work nurses did not achieve statistical significance (OR = 1.05, 95% CI = 0.97–1.14). However, the risk of obesity was significantly higher in the sub-analysis of night-only shift work nurses (OR = 1.12, 95% CI = 1.03–1.21). In a sub-analysis limited only to the studies of female nurses, the obesity risk was found not to be statistically significant (OR = 1.09, 95% CI = 0.84–1.35). For different regions of study population, shift work was associated with a 36% increased risk of obesity in America (OR = 1.36, 95% CI = 1.30–1.42) and 1% increased risk in Europe and Australia (OR = 1.01, 95% CI = 1.00–1.03). The BMI cut-off for obesity varied in the included studies. When using a cut-off of BMI ≥ 30 kg/m² for obesity, our subgroup analysis shows a positive relationship between obesity and nurse shift work (OR = 1.12, 95% CI = 1.03–1.20).
Conclusions
This is the first systematic review and meta-analysis confirming that shiftwork may play a significant role in the development of obesity among nurses, especially in America, Europe and Australia. This was found to be particularly true for night only shift work nurses. Implementation of health policies and a better night shift schedule are needed in the hospital's management to effectively protect nurses from obesity, and the health risks associated with it.
... Being overweight or obese has also been positively associated with advancing 3 4 -3 6 3 6 -3 8 age , female gender , middle or high 39- 41 42-45 socioeconomic status , married persons , and educational levels (positive association with 41,46 tertiary education in some Nigerian studies and 38,47 inverse relationship in others . Doctors are one of the important group of health service providers (HSPs) that may work in obesogenic work environments which are typified by long work 48,49 hours, shift work and job stress . However, reports differ on the prevalence of obesity among HSPs with some studies reporting lower obesity prevalence among health service providers [50][51][52][53] compared to the general population while others have found higher or similar rates with the 33,54 general population . ...
Background: Doctors are one of the important groups of health service providers (HSPs) that may work in stressful and obesogenic work environments (long work hours, shift work and job stress). We assessed some sociodemographic factors that may be associated cardiovascular risk factors in medical doctors in two tertiary health facilities in Southern Nigeria. Study design: Cross sectional study Methods: Data was collected using a structured self-administered questionnaire that consisted of a questionnaire component and the measurement of blood pressures (BP) and anthropometry (body mass index BMI and waist circumference WC). The questionnaire was used to collect information on the sociodemographic characteristics of the population. Results: A total of 244 medical doctors participated in the study. Most were below age 30years (40.2%), married (54.9%) and males (70.1%). Mean age was 37.4years (SD-11.3 years) and mean duration of practice was 9 years (SD-11.1 years). About a quarter of all study participants (26.6%) had blood pressure reading of 140/90mmHg while only 2 participants (0.8%) are diabetic patients. Prevalence of general obesity was 18.4% while central obesity was 44.3% Advancing age, male sex, higher years of practice and higher staff cadre were associated with most of the cardiovascular risk factors including elevated systolic BP levels, obesity and smoking (statistical difference between consultants and house officers). More proportion of male doctors than women took alcohol and smoked. Other variables that showed significant relationship with gender were aerobic exercise (males > females) and perception of stress (males >females for mild to moderate stress, females > males for severe stress). Conclusion: The high prevalence of central obesity and hypertension in medical doctors' calls for more focus on their cardiovascular health. Advancing age, male sex, higher professional cadre and years of medical practice may also be associated with increased cardiovascular disease risk in medical doctors.
... This result is in line with the results of (30) reported that all nurses for both groups had normal body mass index in their studies. Other studies result found that nurses who worked night shifts or rotating night shifts were more likely to be overweight or obese Lawsonet al., 2015 (16) ; Griep et al., 2014 (31) and Zhao et al., 2011 (32) . Also, Wang et al., 2016 (11) reported that Nurses in the shift group had a higher BMI than those in the non-shift group (P = 0.003). ...
Background: Rotating shift work may interrupt the normal function of the biological clock, so considered to be one of the factors leading to alter endocrine regulation and increased risk of menstrual cycle abnormality. Aim: to assess the impact of shift work pattern on menstrual characteristics among nurses. Methodology: Research design used for the present study was a cross-sectional comparative design with three months of monitoring. The survey conducted in three hospitals in Benha city, Egypt which affiliated to the Ministry of health. After recognizing the inclusion and exclusion criteria, the study sample was 100 (100 out of 678) active female nurse staff who were in reproductive age below 40 years and had at least one year of work experience. A convenient type of sample was used to collect the data. The researchers designed an interviewing assessment sheet, and semi-structured menstrual self-assessment tool was adopted by the researcher to collect the data. Results: The present study showed that there were statistically significant differences in educational attainment, work duration and drinking tea habit among nurses in rotating shifts compared to day shift one. Heavy menstrual bleeding and severe dysmenorrhea were significantly higher among rotating shifts group nurses (MC P=0.034* and P=0.021*, respectively). Also, inter-menstrual bleeding and short cycle length were higher among nurses in rotating shifts group but not a significant difference. Also, Irregular menstrual cycle and very severe dysmenorrhea were significantly higher among nurses with more than 12-night shifts rotation at the last twelve months of work (P=0.001* and MC P=0.005*, respectively). For short menstrual and prolonged menstrual cycle, numbers of pads used, heavy menstrual bleeding, and inter-menstrual bleeding were higher among nurses with more than 12-night shifts rotation at the last 12 months of work but not reach the significant. Rotating shifts work has a negative impact on the menstrual cycle. Rotating shift has been associated with heavy menstrual bleeding, severe dysmenorrhea as well as intermenstrual bleeding and short cycle length. Also, Increased the numbers of night shifts more than 12-night shift rotation at last 12 months associated with severe dysmenorrhea and irregular menstrual cycle. So this finding can be used to guide preventive measures to eliminate or decrease the menstrual problems among rotating shift nurses. Conclusion: The results of this study which done to assess the impact of shift work pattern on menstrual characteristics among nurse staff in Egypt are comparable with those reported in other parts of the world. It can conclude from the results of this study that rotating shifts work associated with increased risk of menstrual disturbances. Nurses working in rotating shifts had a significant heavy menstrual bleeding and severe dysmenorrhea.
... Moreover, some previous studies relied on self-reported weight and height, which might have resulted in imprecision in BMI assessment. [19][20][21] Furthermore, most of the studies investigated the relationship between night work and BMI or waist circumference (WC), and few simultaneously investigated both markers of adiposity. 2,22,23 BMI and WC are the most common anthropometric measures of body composition used in epidemiological studies because of their simplicity, low cost, and ease of measurement. ...
Background:
Night work can disturb the natural circadian rhythm, leading to disruptions in metabolic rate and subsequent overall gain weight or even more harmful abdominal adiposity. Our aims were to investigate the associations between night work frequency and markers of overall and central obesity.
Methods:
We conducted a cross-sectional analysis of data from the Brazilian National Health Survey on over 35 500 current workers. Exposure to current night work was composed of three categories: daytime work (reference category), less than one night per week, and more than two nights per week. The body mass index and waist circumference were used as adiposity markers. Logistic and multinomial regression models were used, with adjustment for demographic characteristics, work conditions, self-related health, and health-related behaviors.
Results:
After complete adjustment, individuals who worked two or more nights a week had higher odds of overweight (odds ratio [OR]: 1.20, 95% CI: 1.04-1.38), obesity (OR: 1.38, 95% CI: 1.17-1.64) and increased waist circumference (OR: 1.27, 95% CI: 1.10-1.46) than daytime workers.
Conclusions:
Night work was significantly associated with measures of adiposity. Changes in working conditions, such as controlling the numbers of nights worked per week or promoting workplaces with healthy meals and the opportunity to perform physical exercise at work, could be suggested.
... This result is in line with the results of (30) reported that all nurses for both groups had normal body mass index in their studies. Other studies result found that nurses who worked night shifts or rotating night shifts were more likely to be overweight or obese Lawsonet al., 2015 (16) ; Griep et al., 2014 (31) and Zhao et al., 2011 (32) . Also, Wang et al., 2016 (11) reported that Nurses in the shift group had a higher BMI than those in the non-shift group (P = 0.003). ...
Background: Rotating shift work may interrupt the normal function of the biological clock, so
considered to be one of the factors leading to alter endocrine regulation and increased risk of menstrual cycle
abnormality. Aim: to assess the impact of shift work pattern on menstrual characteristics among nurses.
Methodology: Research design used for the present study was a cross-sectional comparative design with three
months of monitoring. The survey conducted in three hospitals in Benha city, Egypt which affiliated to the Ministry
of health. After recognizing the inclusion and exclusion criteria, the study sample was 100 (100 out of 678) active
female nurse staff who were in reproductive age below 40 years and had at least one year of work experience. A
convenient type of sample was used to collect the data. The researchers designed an interviewing assessment sheet,
and semi-structured menstrual self-assessment tool was adopted by the researcher to collect the data. Results: The
present study showed that there were statistically significant differences in educational attainment, work duration
and drinking tea habit among nurses in rotating shifts compared to day shift one. Heavy menstrual bleeding and
severe dysmenorrhea were significantly higher among rotating shifts group nurses (MCP=0.034* and P=0.021*,
respectively). Also, inter-menstrual bleeding and short cycle length were higher among nurses in rotating shifts
group but not a significant difference. Also, Irregular menstrual cycle and very severe dysmenorrhea were
significantly higher among nurses with more than 12-night shifts rotation at the last twelve months of work
(P=0.001* and MCP=0.005*, respectively). For short menstrual and prolonged menstrual cycle, numbers of pads
used, heavy menstrual bleeding, and inter-menstrual bleeding were higher among nurses with more than 12-night
shifts rotation at the last 12 months of work but not reach the significant. Rotating shifts work has a negative impact
on the menstrual cycle. Rotating shift has been associated with heavy menstrual bleeding, severe dysmenorrhea as
well as intermenstrual bleeding and short cycle length. Also, Increased the numbers of night shifts more than 12-
night shift rotation at last 12 months associated with severe dysmenorrhea and irregular menstrual cycle. So this
finding can be used to guide preventive measures to eliminate or decrease the menstrual problems among rotating
shift nurses. Conclusion: The results of this study which done to assess the impact of shift work pattern on
menstrual characteristics among nurse staff in Egypt are comparable with those reported in other parts of the world.
It can conclude from the results of this study that rotating shifts work associated with increased risk of menstrual
disturbances. Nurses working in rotating shifts had a significant heavy menstrual bleeding and severe dysmenorrhea.
[Mirfat, M. L. El-Kashif and Mageda, A. S. Arafat. Shift Work Pattern and Menstrual Characteristics among
Nurses in Egypt. Biomedicine and Nursing 2016;2(4): 104-115]. ISSN 2379-8211 (print); ISSN 2379-8203
(online). http://www.nbmedicine.org. 15. doi:10.7537/marsbnj020416.15.
Keywords: Nurse Staff, shift work pattern, menstrual cycle.
... en mujeres enfermeras y parteras que informaron ocho o más turnos nocturnos por mes. Otros autores como Zhao et al., (2011), Kim et al. (2014) y Morales (2014) también encontraron asociación entre el trabajo por turnos y el aumento en la prevalencia de sobrepeso y obesidad, tal es así; que, atendiendo al número de horas de sueño diarias, tanto la obesidad como el sobrepeso fueron más frecuentes entre quienes dormían menos de siete horas al día, lo cual concuerda con los resultados encontrados en la presente investigación. Además; Shlisky et al. (2012) mencionan que al restringir 4 horas de sueño por dos noches se incrementa en un 30% el apetito por comidas ricas en carbohidratos lo cual eleva los niveles de glucosa y disminuye los niveles de insulina, lo que explica que la relación ghrelina/leptina se incrementara en más del 70% comparado con el grupo de duración de sueño mayor. ...
El sobrepeso y la obesidad son uno de los principales problemas de salud pública en todo el mundo debido a su magnitud y trascendencia. Con el objetivo de determinar la prevalencia de sobrepeso/obesidad y su relación con las horas de sueño, se realizó un estudio descriptivo transversal que incluyó médicos/as y enfermeros/as residentes del departamento de clínica de la Fundación Favaloro. Se registraron: edad, sexo, peso, talla, índice de masa corporal, se aplicó el cuestionario de Pittsburgh para valorar las horas de sueño. Los principales resultados muestran que un porcentaje alto de participantes tuvieron sobrepeso/obesidad (76.2% hombres, 65.5% mujeres) y con mayor prevalencia en la edad de 35 a 44 años (100%), en comparación con los otros grupos etarios 45-54 (83.3%) y 25-34 (61.1%). El 82.0% de los participantes resultó con deuda de sueño. La proporción de sobrepeso/obesidad resultó ser mayor entre los que poseen deuda de sueño (75.6%) con respecto a los que no tienen deuda de sueño (44.4%), sin embargo; dicha diferencia no resultó estadísticamente significativa (p=0.106). Concluyendo, un patrón de sueño corto junto con la presencia de exceso de peso constituye un factor de riesgo para el desarrollo de diversas enfermedades crónicas y afecta no solo a la población en general sino también al personal de salud.
... Long shifts were a predictor of increased BMI in a cross-sectional study [33]. In an Australian cross-sectional study, it was shown that nurses working shifts had a 1.15-times greater risk of obesity and overweight, while only fixed night shifts were linked to obesity [34,35]. ...
Background: Nutrition is related to different health problems. Working in shifts has been identified as one of the factors associated with overweight and obesity. This study was performed to assess the association between food intake and dietary diversity with shift work among nurses.Methods: This cross-sectional study was conducted on 270 nurses working in hospitals under the supervision of Tehran University of Medical Sciences. A three-day 24-h food recall was used to evaluate food intake and diversity, Blood pressure (mmhg), fasting blood glucose (mg/dl), insulin (μm/ml), lipid profile (mg/d), serum levels of cobalamin (ng/l), folic acid (pg/l) and anthropometric indices were also evaluated.Results: Mean age of subjects was 35.01 ± 6.52 years. Mean dietary diversity scores (by Kant and IDDS methods) were 4.68 ± 1.18 and 5.77 ± 1.25, respectively. Among study participants the mean weight (p<0.03), waist circumference (p<0.02) and hip circumference (p<0.001) showed a significant difference across the tertiles of Kant dietary diversity score. A significant difference was seen in terms of body mass index (BMI) and WHR (p<0.03). This means that by increasing dietary diversity score, average height and weight reduces. It was also seen that by increasing the dietary diversity score, systolic blood pressure decreased and serum folic acid level increased, though these changes were statistically insignificant. In the Kant method, weight and hip circumference were increased in dietary diversity in the morning shift (p=0.05). In the FAO method, insulin and vitamin B9 (Folic acid) levels decreased by increasing dietary diversity in the morning shift. However, the serum level of vitamins B9 (Folic acid) and B12 was increased by the increment of dietary diversity in the rotating shift.Conclusion: Anthropometric factors are decreased by increasing the dietary diversity. It was also found that the mean of some anthropometric indices was higher in the morning shift. Higher dietary diversity and lower carbohydrate intake was also seen in the morning shift.
... en mujeres enfermeras y parteras que informaron ocho o más turnos nocturnos por mes. Otros autores como Zhao et al., (2011), Kim et al. (2014) y Morales (2014) también encontraron asociación entre el trabajo por turnos y el aumento en la prevalencia de sobrepeso y obesidad, tal es así; que, atendiendo al número de horas de sueño diarias, tanto la obesidad como el sobrepeso fueron más frecuentes entre quienes dormían menos de siete horas al día, lo cual concuerda con los resultados encontrados en la presente investigación. Además; Shlisky et al. (2012) mencionan que al restringir 4 horas de sueño por dos noches se incrementa en un 30% el apetito por comidas ricas en carbohidratos lo cual eleva los niveles de glucosa y disminuye los niveles de insulina, lo que explica que la relación ghrelina/leptina se incrementara en más del 70% comparado con el grupo de duración de sueño mayor. ...
El sobrepeso y la obesidad son uno de los principales problemas de salud pública en todo el mundo debido a su magnitud y trascendencia. Con el objetivo de determinar la prevalencia de sobrepeso/obesidad y su relación con las horas de sueño, se realizó un estudio descriptivo transversal que incluyó médicos/as y enfermeros/as residentes del departamento de clínica de la Fundación Favaloro. Se registraron: edad, sexo, peso, talla, índice de masa corporal, se aplicó el cuestionario de Pittsburgh para valorar las horas de sueño. Los principales resultados muestran que un porcentaje alto de participantes tuvieron sobrepeso/obesidad (76.2% hombres, 65.5% mujeres) y con mayor prevalencia en la edad de 35 a 44 años (100%), en comparación con los otros grupos etarios 45-54 (83.3%) y 25-34 (61.1%). El 82.0% de los participantes resultó con deuda de sueño. La proporción de sobrepeso/obesidad resultó ser mayor entre los que poseen deuda de sueño (75.6%) con respecto a los que no tienen deuda de sueño (44.4%), sin embargo; dicha diferencia no resultó estadísticamente significativa (p=0.106). Concluyendo, un patrón de sueño corto junto con la presencia de exceso de peso constituye un factor de riesgo para el desarrollo de diversas enfermedades crónicas y afecta no solo a la población en general sino también al personal de salud
... This result is in line with the results of (30) reported that all nurses for both groups had normal body mass index in their studies. Other studies result found that nurses who worked night shifts or rotating night shifts were more likely to be overweight or obese Lawsonet al., 2015 (16) ; Griep et al., 2014 (31) and Zhao et al., 2011 (32) . Also, Wang et al., 2016 (11) reported that Nurses in the shift group had a higher BMI than those in the non-shift group (P = 0.003). ...
Background: Rotating shift work may interrupt the normal function of the biological clock, so considered to be one of the factors leading to alter endocrine regulation and increased risk of menstrual cycle abnormality. Aim: to assess the impact of shift work pattern on menstrual characteristics among nurses. Methodology: Research design used for the present study was a cross-sectional comparative design with three months of monitoring. The survey conducted in three hospitals in Benha city, Egypt which affiliated to the Ministry of health. After recognizing the inclusion and exclusion criteria, the study sample was 100 (100 out of 678) active female nurse staff who were in reproductive age below 40 years and had at least one year of work experience. A convenient type of sample was used to collect the data. The researchers designed an interviewing assessment sheet, and semi-structured menstrual self-assessment tool was adopted by the researcher to collect the data. Results: The present study showed that there were statistically significant differences in educational attainment, work duration and drinking tea habit among nurses in rotating shifts compared to day shift one. Heavy menstrual bleeding and severe dysmenorrhea were significantly higher among rotating shifts group nurses (MC P=0.034* and P=0.021*, respectively). Also, inter-menstrual bleeding and short cycle length were higher among nurses in rotating shifts group but not a significant difference. Also, Irregular menstrual cycle and very severe dysmenorrhea were significantly higher among nurses with more than 12-night shifts rotation at the last twelve months of work (P=0.001* and MC P=0.005*, respectively). For short menstrual and prolonged menstrual cycle, numbers of pads used, heavy menstrual bleeding, and inter-menstrual bleeding were higher among nurses with more than 12-night shifts rotation at the last 12 months of work but not reach the significant. Conclusions: Rotating shifts work has a negative impact on the menstrual cycle. Rotating shift has been associated with heavy menstrual bleeding, severe dysmenorrhea as well as inter-menstrual bleeding and short cycle length. Also, Increased the numbers of night shifts more than 12-night shift rotation at last 12 months associated with severe dysmenorrhea and irregular menstrual cycle. So this finding can be used to guide preventive measures to eliminate or decrease the menstrual problems among rotating shift nurses. Conclusion: The results of this study which done to assess the impact of shift work pattern on menstrual characteristics among nurse staff in Egypt are comparable with those reported in other parts of the world. It can conclude from the results of this study that rotating shifts work associated with increased risk of menstrual disturbances. Nurses working in rotating shifts had a significant heavy menstrual bleeding and severe dysmenorrhea.
... Peplonska (27) en 2015 habló también de la relación entre el trabajo nocturno y obesidad y otros autores como Zhao (28) o Kim (29) concluyeron sin embargo, que el trabajo por turnos es el que más se relaciona con un aumento en la prevalencia de sobrepeso y obesidad. Atendiendo al número de horas de sueño diarias, la obesidad y el sobrepeso fueron más frecuentes entre quienes dormían menos de seis horas al día y entre quienes dormían más de ocho. ...
Objective:
Huntington's disease is a hereditary disease with low prevalence. The low frequency of Huntington's disease leads to its inclusion as one of the pathologies in the Registry of Rare Diseases. The Balearic Islands Population-based Registry of Rare Diseases began in 2010. Previously, there had been no prevalence or mortality data for Huntington's disease in the Balearic Islands. The aim of this study was to determine the prevalence and mortality of Huntington's disease in the Balearic Islands between 2010 and 2013.
Methods:
The data sources were the Balearic Islands Population-based Registry of Rare Diseases, from which the diagnosed cases were obtained; the Balearic Islands Mortality Register, from which the deceased cases were obtained; the Balearic Islands Health Service, from which the number of Health Cards was obtained; and the National Institute for Statistics, from which population data were obtained. Prevalence and mortality rates were calculated.
Results:
The Balearic Islands Population-based Registry of Rare Diseases registered 27 cases of Huntington's disease between 2010-2013. 63% of these were women. The period prevalence rate was 2.6 per 100,000 and the period mortality rate was 1.1 per 100,000. Menorca was the island with the highest rates, the prevalence rate was 5,9 per 100,000 and the mortality rate was 2,1 per 100,000.
Conclusions:
Prevalence and mortality of Huntington's disease in the Balearic Islands are low compared to similar areas.
... Peplonska (27) en 2015 habló también de la relación entre el trabajo nocturno y obesidad y otros autores como Zhao (28) o Kim (29) concluyeron sin embargo, que el trabajo por turnos es el que más se relaciona con un aumento en la prevalencia de sobrepeso y obesidad. Atendiendo al número de horas de sueño diarias, la obesidad y el sobrepeso fueron más frecuentes entre quienes dormían menos de seis horas al día y entre quienes dormían más de ocho. ...
Fundamentos:
La obesidad es un problema de salud pública a nivel mundial. El objetivo de este estudio fue determinar la asociación entre el tipo de jornada laboral y las horas de sueño diarias con la presencia de obesidad y sobrepeso.
Métodos:
A partir de los datos de la Encuesta Nacional de Salud del año 2012, se realizó un análisis de regresión logística multinomial y se estimaron las tasas de posibilidad de riesgo de obesidad y sobrepeso frente al normopeso según el tipo de jornada laboral y las horas de sueño.
Resultados:
La obesidad entre quienes realizaron trabajos con jornada nocturna fue del 17,50% y en quienes tenían jornadas irregulares del 17,92%. El sobrepeso entre quienes realizaron trabajos con jornada partida fue del 40,81% y en quienes tenían jornadas nocturnas del 39,17%. La obesidad y el sobrepeso entre los que durmieron menos de seis horas al día fueron del 24,42% y del 40,99%, respectivamente. El análisis de regresión logística dio una OR=1,42; IC95%:(1,15-1,75) en trabajadores con jornada irregular la y OR=1,83; IC 95% (1,59-2,11) en personas que durmieron menos de seis horas.
Conclusiones:
Existe una asociación positiva entre la jornada irregular de trabajo y personas con patrones de sueño corto y la presencia de sobrepeso y obesidad, pero la significación estadística se pierde al estimar las OR ajustadas a los factores de confusión.
... Peplonska (27) en 2015 habló también de la relación entre el trabajo nocturno y obesidad y otros autores como Zhao (28) o Kim (29) concluyeron sin embargo, que el trabajo por turnos es el que más se relaciona con un aumento en la prevalencia de sobrepeso y obesidad. Atendiendo al número de horas de sueño diarias, la obesidad y el sobrepeso fueron más frecuentes entre quienes dormían menos de seis horas al día y entre quienes dormían más de ocho. ...
La obesidad es un problema de salud p?blica a nivel mundial. El objetivo de este estudio fue determinar la asociaci?n entre el tipo de jornada laboral y las horas de sue?o diarias con la presencia de obe - sidad y sobrepeso. M?todos: A partir de los datos de la Encuesta Nacional de Salud del a?o 2012, se realiz? un an?lisis de regresi?n log?stica multinomial y se es - timaron las tasas de posibilidad de riesgo de obesidad y sobrepeso frente al normopeso seg?n el tipo de jornada laboral y las horas de sue?o. Resultados: La obesidad entre quienes realizaron trabajos con jorna- da nocturna fue del 17,50% y en quienes ten?an jornadas irregulares del 17,92%. El sobrepeso entre quienes realizaron trabajos con jornada parti - da fue del 40,81% y en quienes ten?an jornadas nocturnas del 39,17%. La obesidad y el sobrepeso entre los que durmieron menos de seis horas al d?a fueron del 24,42% y del 40,99%, respectivamente. El an?lisis de regresi?n log?stica dio una OR=1,42; IC95%:(1,15-1,75) en trabajadores con jorna - da irregular la y OR=1,83; IC 95% (1,59-2,11) en personas que durmieron menos de seis horas. Conclusiones: Existe una asociaci?n positiva entre la jornada irregular de trabajo y personas con patrones de sue?o corto y la presencia de sobre - peso y obesidad, pero la significaci?n estad?stica se pierde al estimar las OR ajustadas a los factores de confusi?n.
A significant concern in healthcare settings is extended hours' effect on nurses' health. Objective: This study aims to explore the lifestyle impacts of extended nursing shifts among nurses at tertiary care hospitals in Karachi, Pakistan. Methods: This cross-sectional study was conducted in three tertiary care hospitals in Karachi, Pakistan, among 100 nurses. Results: Study findings reveal that majority, 87%, believe it hinders decision-making, while 88% see sleep deficits and 88% note time constraints for exercise. Communication quality is a concern for 76%. 78% see knowledge transfer issues when nurses hand over responsibilities, and 58% think religious activities are impacted. Opinions vary on patient care quality (50% positive). Stress levels concern 80%, social lives are disrupted for 91%, and physical health effects concern 93%. Additional worries include inadequate diet (39%), nurses working long shifts are exhausted (91%), child care neglect (89%), altered eliminatory patterns (84%), life expectancy (32%), memory problems (69%), hormonal disruptions (76%), workplace conflicts (88%), and infection risk (88%). Finally, 76% perceive high absenteeism. Conclusions: The findings underscore significant concerns about the negative impact of long working hours on nurses' health and performance. To address these issues, it is recommended that healthcare institutions prioritize implementing structured shift rotations and providing adequate breaks to mitigate the adverse effects of extended shifts on nurses' wellbeing and patient care quality.
Background
Several studies have reported the prevalence of overweight and obesity in various countries but the global prevalence of nurses with overweight and obesity remains unclear. A consolidation of figures globally can help stakeholders worldwide improve workforce development and healthcare service delivery.
Objective
To investigate the global prevalence of overweight and obesity among nurses.
Design
Systematic review with meta‐analysis.
Setting
29 different countries across the WHO‐classified geographical region.
Participants
Nurses.
Methods
Eight electronic databases were searched for articles published from inception to January 2023. Two independent reviewers performed the article screening, methodological appraisal and data extraction. Methodological appraisal was conducted using Newcastle‐Ottawa Scale (NOS). Inter‐rater agreement was measured using Cohen's Kappa. Meta‐analyses were conducted to pool the effect sizes on overweight, obesity and waist circumference using random effects model and adjusted using generalised linear mixed models and Hartung–Knapp method. Logit transformation was employed to stabilise the prevalence variance. Subgroup analyses were performed based on methodological quality and geographical regions. Heterogeneity was assessed using the I ² statistic.
Results
Among 10,587 studies, 83 studies representing 158,775 nurses across 29 countries were included. Based on BMI, the global prevalence of overweight and obesity were 31.2% ( n = 55, 95% CI: 29%–33.5%; p < .01) and 16.3% ( n = 76, 95% CI: 13.7%–19.3%, p < .01), respectively. Subgroup analyses indicated that the highest prevalence of overweight was in Eastern Mediterranean ( n = 9, 37.2%, 95% CI: 33.1%–41.4%) and that of obesity was in South‐East Asia ( n = 5, 26.4%, 95% CI: 5.3%–69.9%). NOS classification, NOS scores, sample size and the year of data collected were not significant moderators.
Conclusions
This review indicated the global prevalence of overweight and obesity among nurses along with the differences between regions. Healthcare organisations and policymakers should appreciate this increased risk and improve working conditions and environments for nurses to better maintain their metabolic health.
Patient or Public Contribution
Not applicable as this is a systematic review.
Registration
PROSPERO (ref: CRD42023403785) https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=403785 .
Tweetable Abstract
High prevalence of overweight and obesity among nurses worldwide.
Introduction:
The present study aimed at all the benefits induced by taking the Mediterranean or Japanese diet among nurses and whether any beneficial differences in intakes between the two diets were considered.
Methods:
The author searched PubMed and Embase databases for medical subheadings terms and free full text referring to "Diet," "Mediterranean," "Japanese," and "Nurses" before 31st December 2022.
Results:
A total of 14 studies were included in this scoping review, which better underlined all the benefits implicated in the Mediterranean or Japanese diets assumption and also if there were any differences between the two diets. These eating behaviors were exclusively investigated among nurses.
Conclusion:
The nursing profession has always been considered the most stressful healthcare activity. However, some important concerns in the regular lifestyle, such as eating and physical activity, might help to live better.
Disorders of blood lipids (Dislipidemia) are one of the most important risk factors for cardiovascular
disease. Due to the high prevalence of impaired blood lipids, it is important to identify the factors that affect this
health issue. Some researchers believe that shifting the cholesterol in the industrial sector has a role to play. The
purpose of this study was to investigate the relationship between shifting and high cholesterol in employees of
Mobarakeh Steel Company in Isfahan (Iran)
Background: Shift work is associated with several health problems, possibly due to an impairment of biological rhythms. Some studies reported that changes in blood pressure regulation among shift workers could lead to chronic hypertension. So this study aimed to determine and compare the level of and risk factors for hypertension among shift and day time workers. Methods: A comparative cross-sectional study of 830 current factory workers (413 shift workers and 417 day time workers) who have worked for at least five years was conducted in Wonji Shoa sugary factory, Ethiopia. Data were collected using a pretested structured questionnaire, and blood pressure was measured using standardized instruments by trained clinical nurses. Hypertension was defined as having Systolic BP ≥140 mmHG or Diastolic BP≥ 90mmHG or reported use of regular anti-hypertensive medications prescribed by professionals for raised BP. Multiple logistic regressions were fitted and Odds ratios with 95% confidence intervals were calculated to identify independently associated factors. Results: shift work, older age, higher income quintile, and family history of hypertension were found to be independently associated with Hypertension. The prevalence of hypertension was significantly higher among shift workers compared to daytime workers (42.9% versus 30.0%; p-value<0.05)). Multivariate analysis revealed the odds of being hypertensive among shift workers persists even after controlling for potential confounders including age, income, and family history of hypertension. [AOR (95% CI) = 1.48 (1.02, 2.14)]. Shift workers were also significantly more likely to be smokers compared to daytime workers (6.5 % versus 13.1 %; p-value<0.001). Conclusions: shift work, older age, higher income quintile, and family history of hypertension were found to be independently associated with Hypertension. The finding calls for institutionalization of efficient health screening and regular checkups as well as interventions promoting healthy lifestyles among shift workers.
Objetivo.
Analizar los aportes de investigaciones en el entorno laboral y sus repercusiones en el estado de salud nutricional del personal de enfermería en las áreas hospitalarias.
Metodología.
Metaanálisis a través de la aplicación de la declaración PRISMA (Preferred Reporting Items for Sistematycal Reviews and Meta-Analyses) para una revisión sistemática e integradora de las investigaciones seleccionadas. Se realizó una búsqueda en las principales bases de datos de Medicina y Ciencias de la Salud como: PubMed, Medline, SCOPUS, Wed of Science (Wos), Cinahl y Cochrane, con la cual se identificaron los artículos con pertinencia al ambiente laboral hospitalario, calidad nutricional, personal de enfermería. Se fundamentó la búsqueda con las preguntas Pico: ¿Cuál es la relación entre un entorno laboral y la nutrición del personal de enfermería del área hospitalaria? Cómo afecta el estrés y la fatiga laboral a la nutrición del personal de enfermería que se desempeña en el área hospitalaria P: Personal de enfermería del área hospitalaria; I: Entorno laboral; C: Estado nutricional. Se incluyeron en esta revisión 17 artículos. Se identificaron siete temas: sobrepeso y obesidad, actividad física, horarios de trabajo por turnos rotativos y nocturnos, hábitos y estilos de vida, conductas alimentarias, angustia mental y estrés laboral.
Conclusión.
Los factores negativos del ambiente laboral afectan la nutrición y conlleva al deterioro de la salud del personal de enfermería que trabaja en el área hospitalaria.
Aim
To evaluate differences between insomnia condition and flexibility attitude to eating in Italian nurses directly involved in the care of patients affected by Covid-19 according to sex, Body Mass Index, shift working condition and incidence of new Covid-19 cases in the region of participants. Moreover, any correlations between the insomnia condition and the flexible attitude to eat have been investigated.
Methods
An online questionnaire was administered in October 2020, including the socio-demographic section, the insomnia condition assessment, and the behavioral flexibility evaluation to develop an eating disorder.
Results
341 Italian nurses answered the questionnaire. Regarding the insomnia condition levels, nurses belonging to regions with a higher incidence rate of the Covid-19 pandemic recorded higher levels of insomnia than others (p=.004). Females and nurses belonging to areas with lower Covid-19 incidence rate recorded a significantly higher total eating flexibility attitude (p=.003; p<.001), also, in the Food and Exercise flexibility (p=.007; p<.001). As regards the flexible attitude for weight and shape, significant differences were recorded among nurses according to their BMI values (p<.001) and to their incidence rate of the belonging region (p<.001). The insomnia condition levels significantly correlated with the eat flexibility attitude both in its total score (p=.010), in the general score (p=.010), and the weight and shape score (p<.001). All correlations between the insomnia conditions and the flexibility to eat were significantly inverse except for the food and exercise dimension. All the eat flexibility sub-dimensions significantly correlated among them (p<.001).
Conclusion
There was a direct correlation among socio-demographic factors, BMI values, insomnia, and behavioral flexibility scores in Italian nurses. So, it could be assumed that the nursing profession is at risk of developing a metabolic syndrome condition. Therefore, it could be considered a psychoendocrinological employment disease during the Covid-19 outbreak.
Overweight or obesity combined with hypercholesterolemia can cause significant cardiovascular effects. Study objective was to highlight the medical professions profile in terms of prevalence of these specific cardiovascular risk factors. Body mass index (BMI) and total blood cholesterol (TC) of 300 employees (doctors, nurses, nursing assistants, janitors and auxiliary staff) of an academic emergency hospital were analyzed. Mean age of participants was 43.9 years old, 79.3% of subjects were female, 21% were doctors, 51.3% nurses, 21.7% nursing assistants and janitors; 6% auxiliary staff. 59.3% of study subjects had BMI ≥ 25, 50.6% had TC ≥ 200mg/dl, 71.4% of physicians and 49.3% of nurses were overweight or obese, 57.4% of doctors and 43.5% of nurses had hypercholesterolemia. Overweight and hypercholesterolemia were significantly associated with increased neuropsychological overload wards. The profile of the Romanian healthcare worker is: middle-aged female, overweight or obese, with a total blood cholesterol level of over200 mg/dl.
The workers and employees in various institutions are subjected to different shifts and work schedules. The employees work not only at daytime but also during odd hours at night. The biological clock of an individual is often altered during night shifts. This affects the psychosocial well-being and circadian nutritional intake of the worker. Disturbance in circadian rhythm results in the development of metabolic disorders such as hypertension, dyslipidemia, dysglycemia, and abdominal obesity. In the present review, we discuss the nature of shift work, sleep/wake cycle of an individual, chrononutrition, dietary habits, and meal changes with regard to timing and frequency, related to shift work. We also discuss the relationship between nutritional intake and psychosocial well-being among shift workers. The review may be beneficial for prevention of metabolic disorders and maintaining sound psychological condition in shift workers.
Inadequate sleep and sleep disturbances have recently emerged as important contributors to obesity and cancer risk. This chapter describes the emergence of cross-disciplinary research on sleep, energetics, and cancer risk. It describes the challenges that were encountered, how these were addressed, and the added value this integration has brought, in terms of research questions and approaches and scientific findings.
Nurses play significant roles in health promotion and health education about healthy lifestyle practices and are considered role models of healthy lifestyle behaviours. It is unclear if their knowledge of healthy lifestyle choices translate to practice. This study assessed the lifestyle behaviours of primary healthcare professional nurses in the Eastern Cape Province, South Africa. This descriptive, cross-sectional study involved 203 purposively selected primary healthcare nurses in Eastern Cape Province, South Africa. We utilised the WHO STEPwise questionnaire to assess the lifestyle behaviour (smoking, alcohol use and physical activity) of the nurses. Descriptive and inferential statistics were carried out at a significance level of p<0.05. The participants’ mean age was 45.17 (Standard Deviation±11.26) years. Of all the participants, 27% had ever taken alcohol, and 18% currently use alcohol. Only 8% had ever smoked and of these, 3% currently smoke. Of all the participants, 33% do not engage in physical activities, and only 29% of them met the WHO recommendation for being active. Most of them were aware of the benefits of physical activities. Majority of the participants cited lack of time (74%) and lack of commitment (63%) as barriers to physical activity and few of them cited health challenges (3.9%). Among the primary health care professional nurses in this setting, we found a high prevalence of alcohol use and low prevalence of smoking and physical activity among primary health care nurses in this setting. There is a need to implement effective workplace strategies and wellness programmes that will foster healthy lifestyle practices among the nurses.
Background: Rotating shift work may interrupt the normal function of the biological clock, so considered to be one of the factors leading to alter endocrine regulation and increased risk of menstrual cycle abnormality. Aim: to assess the impact of shift work pattern on menstrual characteristics among nurses. Methodology: Research design used for the present study was a cross-sectional comparative design with three months of monitoring. The survey conducted in three hospitals in Benha city, Egypt which affiliated to the Ministry of health. After recognizing the inclusion and exclusion criteria, the study sample was 100 (100 out of 678) active female nurse staff who were in reproductive age below 40 years and had at least one year of work experience. A convenient type of sample was used to collect the data. The researchers designed an interviewing assessment sheet, and semi-structured menstrual self-assessment tool was adopted by the researcher to collect the data. Results: The present study showed that there were statistically significant differences in educational attainment, work duration and drinking tea habit among nurses in rotating shifts compared to day shift one. Heavy menstrual bleeding and severe dysmenorrhea were significantly higher among rotating shifts group nurses (MC P=0.034* and P=0.021*, respectively). Also, inter-menstrual bleeding and short cycle length were higher among nurses in rotating shifts group but not a significant difference. Also, Irregular menstrual cycle and very severe dysmenorrhea were significantly higher among nurses with more than 12-night shifts rotation at the last twelve months of work (P=0.001* and MC P=0.005*, respectively). For short menstrual and prolonged menstrual cycle, numbers of pads used, heavy menstrual bleeding, and inter-menstrual bleeding were higher among nurses with more than 12-night shifts rotation at the last 12 months of work but not reach the significant. Conclusions: Rotating shifts work has a negative impact on the menstrual cycle. Rotating shift has been associated with heavy menstrual bleeding, severe dysmenorrhea as well as intermenstrual bleeding and short cycle length. Also, Increased the numbers of night shifts more than 12-night shift rotation at last 12 months associated with severe dysmenorrhea and irregular menstrual cycle. So this finding can be used to guide preventive measures to eliminate or decrease the menstrual problems among rotating shift nurses. Conclusion: The results of this study which done to assess the impact of shift work pattern on menstrual characteristics among nurse staff in Egypt are comparable with those reported in other parts of the world. It can conclude from the results of this study that rotating shifts work associated with increased risk of menstrual disturbances. Nurses working in rotating shifts had a significant heavy menstrual bleeding and severe dysmenorrhea.
Background: Shift work has been associated with increased body mass index (BMI), metabolic disruption and increased chronic disease risk. Typically, these reports compare individuals who work the day shift to those who work the night shift. Because shift assignment is not random, differences may reflect other, unmeasured characteristics that account for outcome differences.
Objective: To compare dietary intake on days on which the participant worked the night shift to days on which she worked the day shift in a population of female nurses who work rotating shifts at a hospital.
Methods: This cross-sectional study recruited 132 female registered nurses who work rotating shifts in surgical or internal medicine departments. Dietary intake was ascertained using food diaries and analyzed on Tzameret Nutrition Analysis Software (Israel Ministry of Health). Demographic and anthropometric variables were also recorded.
Results: Compared to dietary intake on a day the nurse worked the day shift, intake of the following nutrients increased significantly on the day she worked the night shift: energy; protein; carbohydrates; total fat; saturated fat; and calcium.
Discussion: A significant increase in calorie, macronutrient and calcium intake on days the night shift was worked compared to days the day shift was worked among female nurses who work rotating shifts was demonstrated. These findings could be extended to other professionals who work rotating shifts, including physicians and allied healthcare personnel. It appears that the difference detected may be influenced by the food supplied by the hospital as well as by increased food intake in general.
Le travail posté, et en particulier le travail de nuit, engendre des perturbations au niveau des rythmes biologiques de salariés exposés pouvant être à l’origine de troubles du sommeil, digestifs et de troubles nutritionnels avec apparition d’un surpoids. L’objectif de cette étude est double : Évaluer la prévalence des troubles nutritionnels (surpoids, obésité et troubles du comportement alimentaire [TCA]) au sein du personnel de nuit du CHU-Hôpitaux de Rouen, et repérer les facteurs associés à la présence d’un TCA afin de proposer une prise en charge spécifique et adaptée au sein de l’établissement. Un questionnaire anonyme a été distribué à l’ensemble des agents de nuit. Plusieurs critères ont été pris en compte : des critères sociodémographiques (âge, sexe, fonction) des critères nutritionnels (indice de masse corporel [IMC], activité physique, existence d’un grignotage, d’une hyperphagie, variation de poids avec la durée du travail de nuit et dépistage des risques de TCA avec le questionnaire validé de SCOFF-F), des critères concernant les risques d’hypersomnolence (avec le questionnaire validé EPWORTH) et le statut tabagique. Résultats : Au total, 419 agents de nuit ont répondu au questionnaire soit un taux de réponse de 57.4%. Plus de 9 agents sur 10 (92.2%) étaient de sexe féminin et près de la moitié des agents étaient des infirmières (47%). Nos résultats retrouvent une prévalence de la surcharge pondérale de 36.6% (n=146) et une prévalence des TCA (SCOFF ≥2) de 15.8% (n=66). Un agent sur 5 (16.9%, n = 70) présentait un score d’EPWORTH évocateur de syndrome d’apnée du sommeil. Après analyse par régression logistique multivariée, les facteurs associés significativement à un risque de TCA étaient d’avoir un score d’EPWORTH élevé (ORa=3.94, 95% CI [1.91, 8.13]; p <0.001), une prise de poids au cours de la carrière professionnelle de nuit (Ora= 3.40 ; 95% CI [1.60, 7.21]; p = 0.001), d’effectuer un régime amaigrissant (ORa= 3.38 ; IC 95% [1.74 ; 6.55] ; p<0.001), et d’avoir développé une hyperphagie (ORa= 3.74 ; IC95% [1.55 ; 9.00] ; p=0.003). En revanche l’activité professionnelle d’infirmière apparait comme un facteur protecteur contre le risque de TCA (ORa= 0.29 ; IC95% [0.14 ; 0.57] p<0.001). Au moins un tiers des agents interrogés ont exprimé un intérêt pour la mise en place d’une aide diététique (38,2 % ; n=155). Conclusion : Ce travail retrouve une prévalence du surpoids comparable aux données de la littérature. La prévalence des personnes à risque de TCA a été étudiée pour la première fois et s’élève à plus de 15%. Ce risque est particulièrement augmenté en cas de prise de poids pendant la carrière de nuit, de régime en cours, d’hyperphagie et de risque d’hypersomnolence. Sur les bases de ce travail, la mise en place d’une consultation diététique spécialisée pour les agents de nuit paraît opportune et est en cours d’expérimentation.
Background and Objectives: Shift work could threaten health in the long term. The present research aimed to assess the association between shift work and body mass index (BMI) using the multilevel (hierarchical) model during a particular period of time.
Methods: The data of this longitudinal study were collected from a sample of Esfahan’s Mobarakeh steel and Polyacryl companies personnel during 2008 to 2011. Shift work schedule included day work and rotational shift work. The multilevel regression model was utilized for analysing the data and assessing the effect of shift work on BMI by controlling confounding variables including marital status, work expectation, age, company, and educational level.
Results: In this study, of 1368 workers, 42.3% (n=578) and 57.7% (n=790) were day workers and rotating shift workers, respectively. The mean (±SD) age of the day workers and rotating shift workers was 33.07 (±8.66) years and 33.31 (±8.70) years, respectively. After adjusting for confounding variables in a two-level hierarchical model, the association between shift work and BMI was not statistically significant (P=0.837). About 90% of total variation was related to personnel.
Conclusion: According to the results of the present study, no statistically significant relationship was found between shift work schedule and BMI. Thus, other similar studies with a longer follow up period (more than four years) and controlling more confounder factors are necessary to evaluate the relationship between shift work and BMI more accurately.
Background and Objectives: shift work as a pervasive phenomenon in various sectors of industry is one of the most stressful factors in workplace. Regarding contradictory studies about the relationship between shift work and hypertension, the main goal of the present study was to investigate the relationship between these two variables among petrochemical industry staff of Mahshahr, Iran.
Methods: In this longitudinal study, 3254 petrochemical staff was investigated during 2008-2011. According to work schedule, shift workers were divided into two groups shift work and day work (1872 day workers and 1382 shift workers). The aim of this research was to assess the effects of shift work on hypertension by adjusting confounding variables such as gender, age, body mass index, and smoking. The data were analyzed using a random-effects logistic regression model.
Results: Among 3254 (3142 males and 112 females) subjects, 37.85% (860 subject) were hypertensive. Fitting the random effects model, by controlling covariates, no significant relationship was found between shift work and presence of hypertension (OR=1.04, 95% CI= (0.98, 1.10). Also, the variance of the random effects was significant.
Conclusion: Generally, according to obtained results in this study, shift work was not a significant risk factor for hypertension.
Background:
The large increase in epidemiological studies on night shift work is due to the important effects of night shift work on workers' health and psychophysical wellbeing. The short-term effects-insomnia, difficulties in managing work and private life, lower work performance, and more work and extra-work accidents-are easily studied. However, there are several long-term effects that are difficult to study because of the need for detailed exposure assessment and the long latency periods of these diseases.
Objective:
The aim was to collect epidemiologic evidence of diseases in night shift workers, describing their biological pathways and a set of dietary guidelines.
Method:
This is a review on diet and health effects in night shift workers.
Results:
Significant increases in the rate ratios and hazard ratios of different diseases were associated with modified eating behaviours and poor eating habits among night shift workers. Night shift work is a risk factor for disruption of the circadian rhythms and for some genetic deregulation because it produces the inversion of the sleep/wake cycle and modifies the alternation between activity and rest.
Conclusion:
A healthy diet and improved dietary practices, together with other factors, can reduce shift workers' chronic disease risk. The literature showed the importance of eating behaviour in order to prevent diseases in these workers; therefore, educational programmes are necessary to encourage several important lifestyle changes. The target of our future research will be the role of food components in some dietetic habits for the prevention of disease in night shift workers.
Purpose
The purpose of this paper was to investigate the effect of shift work on diet and lifestyle in nurses working in the accident and emergency department in a general hospital in Malta.
Design/methodology/approach
This study was a cross-sectional, quantitative survey, whereby data were collected by the use of anonymous questionnaires consisting of a demographic and anthropometric questionnaire, a lifestyle questionnaire and a food frequency questionnaire to assess dietary intakes. In total, 110 nurses completed the study and were divided into three groups: day nurses, rotating-shift nurses and night-shift nurses.
Findings
Shift working nurses consumed significantly more energy compared to day nurses (night-shift nurses 1,963 ± 506 kcal; rotating-shift nurses 2,065 ± 655 kcal; day nurses 1,722 ± 486 kcal; p = 0.04). Shift working nurses also consumed more protein ( p = 0.04), fat ( p = 0.047) and fibre ( p = 0.005) compared to day nurses; however, day nurses were the most likely to smoke ( p = 0.009).
Practical implications
Shift work does influence the diet of nurses in Malta. It is recommended that access to healthy food, and time and facilities for physical activity are made available across all working hours and that nurses aim to exercise regularly, eat healthily, quit smoking if necessary and get good-quality sleep where possible.
Originality/value
In total, 22 per cent of workers in Malta work shifts, and Malta currently has one of the highest rates of obesity in Europe. This study considers the impact of shift work on diet.
The World Health Organisation (WHO) recommends the development of comparable national physical activity surveillance systems to assess trends within and amongst countries as the Global Strategy for Diet and Physical Activity is implemented. To date, the lack of well-standardised measurement instruments has impeded such efforts, but new methodologies are being developed for this purpose. This paper describes the usefulness of the International Physical Activity Questionnaire (IPAQ) in population samples. The Special Eurobarometer Wave 58.2 2002 covered physical activity and provided a good vehicle for assessment of health-enhancing physical activity (HEPA) in the European Union. Data from around 1,000 individuals in each of the 15 member states were collected after careful translation of the questionnaire. IPAQ scoring protocol version 2 was used for definition of activity categories. Data on the prevalence of sufficient total activity, sedentariness, frequent walking and sitting, in total and by gender across European Union (EU) countries showed consistent patterns. The prevalence of sufficient physical activity for health across the member countries was 29%. It ranged from 44% in the Netherlands to 23% in Sweden. The prevalence of sedentariness across countries was in general the mirror image. Regular walking was most prevalent in Spain. Gender was related to physical activity in that men were 1.6 times more likely than women to be sufficiently active, less likely to be sedentary and slightly more likely to sit for at least 6 hours daily. The findings suggest that two thirds of the adult populations of the European countries are insufficiently active for optimal health benefits. As the IPAQ measurement provides information about the patterns of total physical activity and inactivity, the findings indicate possibilities for targeted health promotion efforts.
Physical activity is recommended by physicians to patients with non-insulin-dependent diabetes mellitus (NIDDM), because it increases sensitivity to insulin. Whether physical activity is effective in preventing this disease is not known.
We used questionnaires to examine patterns of physical activity and other personal characteristics in relation to the subsequent development of NIDDM in 5990 male alumni of the University of Pennsylvania. The disease developed in a total of 202 men during 98,524 man-years of follow-up from 1962 to 1976.
Leisure-time physical activity, expressed in kilocalories expended per week in walking, stair climbing, and sports, was inversely related to the development of NIDDM: The incidence rates declined as energy expenditure increased from less than 500 kcal to 3500 kcal. For each 500-kcal increment in energy expenditure, the age-adjusted risk of NIDDM was reduced by 6 percent (relative risk, 0.94; 95 percent confidence interval, 0.90 to 0.98). This association remained the same when the data were adjusted for obesity, hypertension, and a parental history of diabetes. The association was weaker when we considered weight gain between the time of college attendance and 1962 (relative risk, 0.95; 95 percent confidence interval, 0.90 to 1.00). The protective effect of physical activity was strongest in persons at highest risk for NIDDM, defined as those with a high body-mass index, a history of hypertension, or a parental history of diabetes. These factors, in addition to weight gain since college, were also independent predictors of the disease.
Increased physical activity is effective in preventing NIDDM, and the protective benefit is especially pronounced in persons at the highest risk for the disease.
To determine the relation of body mass index (weight/height2) with the risk of clinical non-insulin-dependent diabetes, the authors analyzed data from a cohort of 113,861 US women aged 30-55 years in 1976. During 8 years of follow-up (826,010 person-years), 873 definite cases were identified among women initially free from diagnosed diabetes. Among women of average body mass index, 23-23.9 kg/m2, the relative risk was 3.6 times that of women having a body mass index less than 22 kg/m2. The risk continued to increase above this level of body mass index. The authors observed a much weaker positive association with weight at age 18, and this association was eliminated after adjustment for current body mass index. Thus, weight gain after age 18 was a major determinant of risk. For an increase of 20-35 kg, the relative risk was 11.3, and for an increase of more than 35 kg, the relative risk was 17.3. Adjusting for family history did not appreciably alter the strong relation observed among women at average levels of body mass index. These data indicate that, at even average weight, women are at increased risk of clinical non-insulin-dependent diabetes and that the relation between body mass index and risk of diabetes is continuous.
To investigate the characteristics of a food frequency questionnaire (FFQ) in measuring dietary intake in an adult insulin-dependent diabetes mellitus (IDDM) population. FFQs have been widely used in developed countries to assess usual dietary intake; however, information regarding the application of the method to individuals advised to follow a specific dietary regimen (such as people with IDDM) is scarce.
The measurement of energy and macronutrients by an interviewer-administered FFQ was assessed in 84 adults, who were representative of adults with IDDM in Tasmania, Australia, by comparing it with 2 days of weighed dietary records. Mean daily energy and macronutrient intakes by each method were compared, and Pearson correlation coefficients were calculated for both unadjusted and energy-adjusted macronutrient intakes.
The ratio of within-person to between-person variance in dietary estimates from weighed records was 0.53 for energy, 0.70 for fat, 2.55 for protein, 0.50 for carbohydrate, 0.78 for saturated fat, and 3.56 for dietary cholesterol. The correlation coefficient between the FFQ and a 2-day weighed dietary record for the same nutrients ranged from 0.38 for protein intake to 0.60 for saturated fat intake. The correlation coefficient between the FFQ and true usual dietary intake was estimated to be 0.60 for energy-adjusted fat intake, 0.36 for energy-adjusted protein intake, 0.72 for energy-adjusted carbohydrate intake, 0.55 for energy-adjusted saturated fat intake, and 0.77 for energy-adjusted cholesterol intake.
People with IDDM had a low ratio of within-person to between-person variance in daily energy, fat, carbohydrate, saturate fat, and cholesterol intake. The performance of the FFQ in the IDDM population is consistent with similar questionnaires in nondiabetic populations; however, there was a significant decrease in the dietary energy estimate upon readministration of the questionnaire. Validation studies such as this are important to provide information to guide the design and analysis of investigations that use dietary questionnaires.
The risk of coronary heart disease (CHD) in shift work and the possible pathways for CHD in industrial workers were studied along with the importance of shift work as an occupational class gradient of CHD risk.
Data from a psychosocial questionnaire and on life-style factors, blood pressure, and serum lipid levels were used for a follow-up study of a cohort of 1806 workers. CHD was determined from official Finnish registers. Cox's proportional hazards models were used with different covariates to evaluate the relative risks associated with shift work.
All the blue-collar workers smoked more and a had higher systolic blood pressure than the white-collar workers. Three-shift workers scored low for job-decision latitude on the Karasek job stress scales. There were no differences in the total cholesterol or high-density lipoprotein cholesterol levels. When all the shift workers were compared with all the day workers, the relative risk of CHD was 1.5 [95% confidence interval (95% CI) 1.1-2.1] when only age was adjusted for and 1.4 (95% CI 1.0-1.9) when life-style factors, blood pressure, and serum lipids were also adjusted for. The blue-collar day workers and 2-shift and 3-shift workers had relative risks of 1.3 (95% CI 0.8-2.0), 1.9 (95% CI 1.1-3.4), and 1.7 (95% CI 1.1-2.7), respectively, when compared with the white-collar day workers.
Shift work is an important part of the occupational gradient in CHD risk among industrial workers; some evidence was found for the hypothesis that a direct stress-related mechanism explains part of the increased CHD risk.
To explore how metabolic risk factors for cardiovascular disease (CVD) differ between shift workers and day workers in a defined population. Shift work has been associated with an increased risk of CVD. Risk factors and causal pathways for this association are only partly known.
A working population of 27,485 people from the Västerbotten intervention program (VIP) has been analysed. Cross sectional data, including blood sampling and questionnaires were collected in a health survey.
Obesity was more prevalent among shift workers in all age strata of women, but only in two out of four age groups in men. Increased triglycerides (>1.7 mmol/l) were more common among two age groups of shift working women but not among men. Low concentrations of high density lipoprotein (HDL) cholesterol (men<0.9 and women<1.0 mmol/l) were present in the youngest age group of shift workers in both men and women. Impaired glucose tolerance was more often found among 60 year old women shift workers. Obesity and high triglycerides persisted as risk factors in shift working men and women after adjusting for age and socioeconomic factors, with an OR of 1.4 for obesity and 1.1 for high triglyceride concentrations. The relative risks for women working shifts versus days with one, two, and three metabolic variables were 1.06, 1.20, and 1.71, respectively. The corresponding relative risks for men were 0.99, 1.30, and 1.63, respectively.
In this study, obesity, high triglycerides, and low concentrations of HDL cholesterol seem to cluster together more often in shift workers than in day workers, which might indicate an association between shift work and the metabolic syndrome.
This study investigated shift pattern (day shifts versus day-night rotation) and its interactions with age, and with years of shiftwork exposure, as predictors of body mass index (BMI).
Survey data were collected from offshore personnel working day shifts (N=787) or day-night shifts (N=787); information was obtained about shift pattern and years of shiftwork exposure, height, weight, demographic factors, and smoking habits. Hierarchical multiple regression was used to test a model in which BMI was predicted by additive and interactive effects of shift pattern, age, and exposure years with control for confounding variables.
In a multivariate analysis (controlling for job type, education and smoking), BMI was predicted by the main effects of age and years of shiftwork exposure. Shift pattern was not significant as a main effect, but it interacted significantly with the curvilinear age term and with the linear and curvilinear components of shiftwork exposure. In the day shift group, age but not exposure predicted BMI; the opposite was true of the day-night shift group. The increase in BMI with an increase in age and exposure years was steeper for the day-night shift group than for the day shift group.
The significant interaction effects found in this study were consistent with the view that continued exposure to day-night shift work gives rise to increases in BMI, over and above the normative effects of ageing on BMI shown by day-shift workers.
Obesity and arterial hypertension are important public health problems. Both overweight and hypertension predispose to cardiovascular diseases, such as myocardial infarction, stroke and renal failure. Moreover, overweight clearly predisposes to hypertension, and thus to an increased prevalence of cardiovascular diseases. This in turn favors inactivity and further weight gain, leading to an exacerbation of cardiovascular disorders. Obesity, hypertension and cardiovascular diseases thus contribute to three corners of a vicious triangle. It is within this conceptual framework that this paper reviews the pathogenesis of obesity-related hypertension, which is highly complex. Many factors act together to promote vasoconstriction and sodium retention. Leptin, free fatty acids and insulin, whose levels are increased in obesity, may act synergistically to stimulate sympathetic activity and vasoconstriction. In addition, obesity-induced insulin resistance and endothelial dysfunction may operate as amplifiers of the vasoconstrictor response. Finally, increased renal tubular reabsorption of sodium may also occur, caused by an increased renal sympathetic nerve activity, the direct effect of insulin, hyperactivity of the renin-angiotensin system and possibly by an alteration of intrarenal physical forces. All together, these factors will lead to sustained hypertension. Because the prevalence of obesity was steadily increasing in the last decades, leading to an increased prevalence of hypertension and cardiovascular disorders, obesity and hypertension will most likely become the health challenges of the twenty-first century.
To measure the prevalence of obesity in Australian adults and to examine the associations of obesity with socioeconomic and lifestyle factors.
AusDiab, a cross-sectional study conducted between May 1999 and December 2000, involved participants from 42 randomly selected districts throughout Australia.
Of 20,347 eligible people aged > or = 25 years who completed a household interview, 11,247 attended the physical examination at local survey sites (response rate, 55%).
Overweight and obesity defined by body mass index (BMI; kg/m(2)) and waist circumference (cm); sociodemographic factors (including smoking, physical activity and television viewing time).
The prevalence of overweight and obesity (BMI > or = 25.0 kg/m(2); waist circumference > 80.0 cm [women] or > or = 94.0 cm [men]) in both sexes was almost 60%, defined by either BMI or waist circumference. The prevalence of obesity was 2.5 times higher than in 1980. Using waist circumference, the prevalence of obesity was higher in women than men (34.1% v 26.8%; P < 0.01). Lower educational status, higher television viewing time and lower physical activity time were each strongly associated with obesity, with television viewing time showing a stronger relationship than physical activity time.
The prevalence of obesity in Australia has more than doubled in the past 20 years. Strong positive associations between obesity and each of television viewing time and lower physical activity time confirm the influence of sedentary lifestyles on obesity, and underline the potential benefits of reducing sedentary behaviour, as well as increasing physical activity, to curb the obesity epidemic.
Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity.
Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity.
Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode.
The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.
The International Physical Activity Questionnaire (IPAQ) was developed to measure health-related physical activity (PA) in populations. The short version of the IPAQ has been tested extensively and is now used in many international studies. The present study aimed to explore the validity characteristics of the long-version IPAQ.
Forty-six voluntary healthy male and female subjects (age, mean +/- standard deviation: 40.7 +/- 10.3 years) participated in the study. PA indicators derived from the long, self-administered IPAQ were compared with data from an activity monitor and a PA log book for concurrent validity, and with aerobic fitness, body mass index (BMI) and percentage body fat for construct validity.
Strong positive relationships were observed between the activity monitor data and the IPAQ data for total PA (rho = 0.55, P < 0.001) and vigorous PA (rho = 0.71, P < 0.001), but a weaker relationship for moderate PA (rho = 0.21, P = 0.051). Calculated MET-h day(-1) from the PA log book was significantly correlated with MET-h day(-1) from the IPAQ (rho = 0.67, P < 0.001). A weak correlation was observed between IPAQ data for total PA and both aerobic fitness (rho = 0.21, P = 0.051) and BMI (rho = 0.25, P = 0.009). No significant correlation was observed between percentage body fat and IPAQ variables. Bland-Altman analysis suggested that the inability of activity monitors to detect certain types of activities might introduce a source of error in criterion validation studies.
The long, self-administered IPAQ questionnaire has acceptable validity when assessing levels and patterns of PA in healthy adults.
Shift work has been found to be associated with an increased rate of errors and accidents among healthcare workers (HCWs), but the effect of shift work on accidental blood and body fluid exposure sustained by HCWs has not been well characterized.
To determine the duration of time on shift before accidental blood and body fluid exposure in housestaff, nurses, and technicians and the proportion of housestaff who sustain a blood and body fluid exposure after 12 hours on duty.
This retrospective, descriptive study was conducted during a 24-month period at a large urban teaching hospital. Participants were HCWs who sustained an accidental blood and body fluid exposure.
Housestaff were on duty significantly longer than both nursing staff (P=.02) and technicians (P<.0001) before accidental blood and body fluid exposure. Half of the blood and body fluid exposures sustained by housestaff occurred after being on duty 8 hours or more, and 24% were sustained after being on duty 12 hours or more. Of all HCWs, 3% reported an accidental blood and body fluid exposure, with specific rates of 7.9% among nurses, 9.4% among housestaff, and 3% among phlebotomists.
Housestaff were significantly more likely to have longer duration of time on shift before blood and body fluid exposure than were the other groups. Almost one-quarter of accidental blood and body fluid exposures to housestaff were incurred after they had been on duty for 12 hours or more. Housestaff sustained a higher rate of accidental blood and body fluid exposures than did nursing staff and technicians.
Nurses and midwives comprise the largest professional group in most national health systems, so shortfalls in numbers can have a substantial impact on health care delivery. A scarcity of human resources in health has been internationally recognized and has led the International Council of Nurses to launch the Global Workforce Project in 2004, and the World Health Organization to announce the Health Workforce Decade 2006–15 in 2006.1,2 Efforts to address workforce needs through coherent workforce planning and policy setting are hampered by the complexity of predicting the supply of and demand for nurses and midwives, and the challenges associated with understanding drivers of workforce retention.3 Available workforce descriptors among regulatory authorities vary considerably; and collections are mostly cross-sectional, frequently incomplete and typically limited to administrative databases. In Australia and New Zealand, workforce issues include the migration of staff between states and countries, and critical personnel shortages in rural and . . . [Full Text of this Article]
Our aim was to critically evaluate the relations among smoking, body weight, body fat distribution, and insulin resistance as reported in the literature. In the short term, nicotine increases energy expenditure and could reduce appetite, which may explain why smokers tend to have lower body weight than do nonsmokers and why smoking cessation is frequently followed by weight gain. In contrast, heavy smokers tend to have greater body weight than do light smokers or nonsmokers, which likely reflects a clustering of risky behaviors (eg, low degree of physical activity, poor diet, and smoking) that is conducive to weight gain. Other factors, such as weight cycling, could also be involved. In addition, smoking increases insulin resistance and is associated with central fat accumulation. As a result, smoking increases the risk of metabolic syndrome and diabetes, and these factors increase risk of cardiovascular disease. In the context of the worldwide obesity epidemic and a high prevalence of smoking, the greater risk of (central) obesity and insulin resistance among smokers is a matter of major concern.
To develop a diet quality score reflecting adherence to national dietary recommendations for the Australian Longitudinal Study on Women's Health (ALSWH) and to compare this against energy standardized nutrient intakes and indices of health.
Cross-sectional survey in a nationally representative sample of mid-aged women participating in a cohort study.
Data from 9,895 women aged 50-55 who participated in the 2001 survey and had four or less missing values on their food frequency questionnaires were used to calculate the Australian Recommended Food Score (ARFS) based on adherence to Australian Dietary Guidelines. MEASURE OF OUTCOME: Correlates of ARFS were investigated including, mean nutrient intakes and indices of self-rated health and health service use. Associations were examined using ANOVA for continuous variables and Chi-squared tests for categorical variables. Area of residence and educational attainment were used as covariates in all modeling, to adjust for sampling frame and socioeconomic status.
The maximum ARFS was 74, with a mean of 33.0 +/- 9.0 and 21% achieving a score > 40. Higher ARFS was associated with indicators of higher socio-economic status, better self-rated health and lower health service use, p<0.0001, higher intakes of micronutrients and lower percentage of energy as total or saturated fat, p<0.0001.
The Australian Recommended Food Score can be used to rank mid-aged women in terms of diet quality and nutrient intake and is associated with indices of self-rated health and health service use. The ARFS can be used to measure future associations with health outcomes and mortality.
Background
Our study aims to compare the short and full-length International Physical Activity Questionnaires (IPAQ).
Methods
Both versions were completed by 186 subjects >14 y living in southern Brazil. Half answered the short and then the long version; the remaining subjects followed the reverse order. Physical inactivity (PI) was defined as <150 min/wk spent in moderate or vigorous activities. The Bland and Altman method and the kappa statistic were used to assess agreement between the continuous and categorical outcomes, respectively.
Results
The prevalence of PI was 50% higher with the short IPAQ (42% vs. 28%). The kappa value was 53.7%. Although the correlation coefficient was moderately high (r=0.61), agreement between methods was low.
Conclusions
Both analyses used show that the short and full-length IPAQ versions have poor agreement. Utilization of inappropriate statistics would lead to misinterpretation. Researchers should exercise care before comparing studies using different IPAQ versions.
The validity of a quantitative self-administered food frequency questionnaire (FFQ) was tested by comparison with 7-d weighed food records (7DWR). Subjects for the study were 24 females between 20 and 43 years of age (mean = 24 years). The main aim of the FFQ was to classify subjects according to their total fat intake.
The mean nutrient intakes estimated by the FFQ were consistently and significantly higher than the estimates by the 7DWR. Rank correlations showed that the FFQ was able to rank subjects similarly for total energy intake, fat, alcohol and fibre intake as well as for the percentage contribution of macronutrients to energy intake. Intra-class correlations showed that the two methods did not agree at the individual level for energy and macronutrient intake except alcohol. These results suggest that the FFQ was suitable for ranking the subjects according to their total fat intake but was not suitable for estimating the individual nutrient intake or average nutrient intake of this relatively small group.
Background:
Nursing and midwifery are demanding professions. Efforts to understand the health consequences and workforce needs of these professions are urgently needed. Using a novel electronic approach, the Nurses and Midwives e-cohort Study (NMeS) aims to investigate longitudinally Australian and New Zealand nurses' and midwives' work/life balance and health. This paper describes NMeS participation; provides key baseline demographic, workforce and health indicators; compares these baseline descriptions with external norms; and assesses the feasibility of the electronic approach.
Methods:
From 1 April 2006 to 31 March 2008, nurses in Australia and New Zealand, and midwives in Australia were invited to participate. Potential participants were directed to a purpose-built NMeS Internet site, where study information was provided and consent sought. Once obtained, a range of standardized tools combined into one comprehensive electronic questionnaire was elicited.
Results:
Overall, 7633 (2.3%) eligible nurses and midwives participated (6308 from Australia and 1325 from New Zealand) from a total pool of 334,400. Age, gender, occupational and health profiles were similar between countries and to national figures. However, some differences were noted; for instance, Queensland participants were over-represented, while Victorian and South Australian participants were under-represented, and 28.2% of Australians were in high strain positions compared with 18.8% of New Zealanders.
Conclusions:
Using an internationally novel web-based approach, a large cohort, which appears generally similar to population norms, has been established. Provided participant retention is adequate, the NMeS will provide insight into understanding the drivers of nurses' and midwives' workforce retention and work-related factors associated with their health.
Epidemiologic evidence on the relation between nutrition and renal cell cancer is reviewed. Kidney cancer, comprising 1.7 percent of all malignant diseases diagnosed worldwide, shows about a 20-fold international variation in the incidence in men and 10-fold in women. This substantial variation indicates an important causal role of environmental factors. Renal cell (parenchymal) cancer (RCC) accounts for about 80 percent of all kidney cancers. While the etiology of RCC is incompletely understood, analytic epidemiologic studies provide consistent support for a positive association of obesity with risk of RCC; the dose-response observed supports a causal relationship. Only a few prospective studies, all of them limited in size, have been published, while ecologic and case-control studies suggest that diet may be important in the etiology of RCC. However, contradictory results and methodologic limitations in some casecontrol studies prevent definite conclusions concerning diet and RCC. A positive association of protein and fat intake, as well as their main food sources (meat, milk, fats), with risk of RCC-as suggested by ecologic studies—has no clear support in analytic epidemiologic studies. A protective effect of vegetables and fruits has been observed in most casecontrol studies, while the majority do not show an association between alcohol, coffee, and risk of RCC. Recent reports indicated an increased risk of RCC associated with consumption of fried/sauted meat and low intakes of magnesium or vitamin E. An apparent positive association with total energy intake, perhaps due to bias, needs further investigation.
One aspect of the quality of a measurement is its repeatability. This study addresses the repeatability of estimates of nutrient and energy intake derived from a quantitative food frequency questionnaire. One hundred individuals who, as controls in case-control studies of breast disease, had completed food questionnaires relating to usual intake, completed a second such questionnaire on re-contact approximately one year later. While, in general, the estimates of nutrient and energy intake derived from the repeat questionnaires were lower than the earlier (original) estimates, the two estimates were moderately correlated, indicating some stability over a one year period in the ranking of individuals within a population with respect to dietary intake. When the repeat estimates, categorized into three levels, were compared with the original estimates, the minority of individuals who were not classified similarly on the two occasions were as likely to have repeat estimate higher as they were to have one lower than their original estimate, indicative of non-systematic misclassification. The results indicate that the food frequency questionnaire represents a convenient technique for the measurement of dietary intake in epidemiological studies.
Objective: To review the published scientific literature for studies analysing the association between shift work and people's daily health habits (as measured by diet, exercise, smoking or alcohol consumption) and adverse health outcomes such as obesity. Methods: The following selection criteria were used to systematically search the literature: the studies were to be primary observational or analytical in design; targeted populations were working adults engaged in shift work; and outcome measures were the association between shift work and either diet, exercise, BMI, smoking or alcohol consumption. Data extraction and quality assessment were performed independently by the two authors using a standardised procedure. Synthesis of data is presented in text and tabular format. Meta-analysis was not possible due to the heterogenic nature of the studies reviewed. Results: This review retrieved seventeen studies that met all inclusion criteria. The majority of the studies found that shift workers had more adverse lifestyle behaviours. Compared to non-shift workers, the nutritional intake of shift workers is less healthy and they are more likely to smoke when compared to non-shift workers. Shift workers also tend to be overweight. The impact of shift work on exercise patterns and alcohol consumption could not be ascertained because of the paucity of high quality studies. Conclusions: Shift work impacts negatively on daily health habits and can lead to adverse health outcomes, such as poor dietary intake, smoking, and becoming overweight. The majority of Australian health care workers, and in particular nurses, work rotating shifts. It is important to have a greater understanding of the impact of shift work on our health care workforce.
We examined the incidence of nonfatal and fatal coronary heart disease in relation to obesity in a prospective cohort study of 115,886 U.S. women who were 30 to 55 years of age in 1976 and free of diagnosed coronary disease, stroke, and cancer. During eight years of follow-up (775,430 person-years), we identified 605 first coronary events, including 306 nonfatal myocardial infarctions, 83 deaths due to coronary heart disease, and 216 cases of confirmed angina pectoris. A higher Quetelet index (weight in kilograms divided by the square of the height in meters) was positively associated with the occurrence of each category of coronary heart disease. For increasing levels of current Quetelet index (less than 21, 21 to less than 23, 23 to less than 25, 25 to less than 29, and greater than or equal to 29), the relative risks of nonfatal myocardial infarction and fatal coronary heart disease combined, as adjusted for age and cigarette smoking, were 1.0, 1.3, 1.3, 1.8, and 3.3 (Mantel-extension chi for trend = 7.29; P less than 0.00001). As expected, control for a history of hypertension, diabetes mellitus, and hypercholesterolemia--conditions known to be biologic effects of obesity--attenuated the strength of the association. The current Quetelet index was a more important determinant of coronary risk than that at the age of 18; an intervening weight gain increased risk substantially. These prospective data emphasize the importance of obesity as a determinant of coronary heart disease in women. After control for cigarette smoking, which is essential to assess the true effects of obesity, even mild-to-moderate overweight increased the risk of coronary disease in middle-aged women.
504 papermill workers were followed up for 15 years and the incidence of ischaemic heart disease (IHD) in shift workers was compared with that in day workers. The relative risk (RR) of IHD rose with increasing duration of reported exposure to shift work. A significant risk of IHD was associated with an exposure of 11 - 15 years (RR = 2.2, p less than 0.04) and of 16 to 20 years (RR = 2.8, p less than 0.03. The association was independent of age and smoking history. The RR of IHD fell sharply after 20 years of shift work. This was ascribed to the pronounced positive selection that had taken place in this group.
The aim of this study was to evaluate the reproducibility and validity of a 61-item semiquantitative food frequency questionnaire used in a large prospective study among women. This form was administered twice to 173 participants at an interval of approximately one year (1980-1981), and four one-week diet records for each subject were collected during that period. Intraclass correlation coefficients for nutrient intakes estimated by the one-week diet records (range = 0.41 for total vitamin A without supplements to 0.79 for vitamin B6 with supplements) were similar to those computed from the questionnaire (range = 0.49 for total vitamin A without supplements to 0.71 for sucrose), indicating that these methods were generally comparable with respect to reproducibility. With the exception of sucrose and total carbohydrate, nutrient intakes from the diet records tended to correlate more strongly with those computed from the questionnaire after adjustment for total caloric intake. Correlation coefficients between the mean calorie-adjusted intakes from the four one-week diet records and those from the questionnaire completed after the diet records ranged from 0.36 for vitamin A without supplements to 0.75 for vitamin C with supplements. Overall, 48% of subjects in the lowest quintile of calorie-adjusted intake computed from the diet records were also in the lowest questionnaire quintile, and 74% were in the lowest one of two questionnaire quintiles. Similarly, 49% of those in the highest diet record quintile were also in the highest questionnaire quintile, and 77% were in the highest one or two questionnaire quintiles. These data indicate that a simple self-administered dietary questionnaire can provide useful information about individual nutrient intakes over a one-year period.
To investigate the relation between exposure to night work and prevalence of overweight and weight gain.
Longitudinal observational study.
469 nurses (age: 21-58 y).
Body Mass Index, exposure to night work, age, parity, smoking and sports activities in 1980, 1985 and 1990.
Prevalence of overweight was associated with exposure to night work in 1980 and weight gains (especially those exceeding 7 kg) were more frequent among nurses on night work than on daytime work between 1985 and 1990.
Exposure to night work can lead to weight gain and overweight.
This study aims to describe the prevalence of smoking, snuff use, and exposure to environmental tobacco smoke (ETS) in relation to occupation among common female and male workers in Sweden. The associations between shift work, job strain, and tobacco use and exposure to ETS are assessed. The results are based on questionnaire data of 2,584 men and 2,836 women randomly selected from 63 occupations in two counties in Sweden. The prevalence of smoking ranges from 10% (95% CI 4.5-16%, police officers) to 42% (95% CI 29-55%, packing workers) in men, and between 8% (95% CI 2-14%, dentists) and 51% (95% CI 37-65%, packing workers) in women. Snuff use is more common among men (range 11-44% in different occupations) than among women (range 0-7%). The prevalence of exposure to passive smoking in this study ranges from 0.9% to 26% in men and from 0% to 30% in women. Shiftwork is significantly associated with current smoking, and job strain is significantly related to exposure to ETS. Ages between 18 and 29 years experienced an increased risk of exposure to ETS compared to older age groups. In conclusion, this study shows that tobacco use and exposure to ETS is still a major problem in the Swedish workplace.
To determine the risk of death from coronary heart disease, stroke, all cardiovascular disease and all-cause mortality associated with systolic blood pressure and in particular with isolated systolic hypertension among the middle-aged population.
A prospective 15-year cohort study of two independent cross-sectional random samples of subjects participating in baseline surveys in 1972 and 1977. Each survey included a self-administered questionnaire, measurements of height, weight and blood pressure and the determination of the serum cholesterol concentration.
North Karelia and Kuopio provinces in eastern Finland. Mortality follow-up complete with the personal identification number.
Participants were 10,333 men and 11,160 women aged 25-64 years without histories of myocardial infarction and stroke incidence at the time of the baseline survey. Isolated systolic hypertension in these analyses was defined as systolic blood pressure > or = 160 mmHg and diastolic blood pressure < 95 mmHg. Subjects with blood pressure < 160/90 mmHg were considered normotensive.
Coronary heart disease, stroke, cardiovascular disease and all-cause mortality among men and women aged 45-64 years increased with the increasing systolic blood pressure. Among women aged 45-64 years, isolated systolic hypertension increased the relative risk of these fatal events. Among men aged 45-64 years, only coronary heart disease mortality was significantly associated with isolated systolic hypertension.
Isolated systolic hypertension is an important predictor of death from coronary heart disease, stroke, cardiovascular disease and all causes for women. For men aged 45-64 years, the risk of death from coronary heart disease was associated with isolated systolic hypertension, but the risk of stroke, cardiovascular disease and all-cause mortality associated with increasing systolic blood pressure was evident already at the systolic blood pressure levels < 160 mmHg, independently of the level of diastolic blood pressure.
In conclusion, obesity has been associated with increased risk for a number of different types of cancer. The evidence has been most consistent for endometrial cancer, breast cancer in postmenopausal women, and renal cell cancer. More variable results have been reported for colorectal, prostate and pancreatic cancer.
Possible mechanisms by which obesity may influence cancer risk include alteration in hormonal patterns, including sex hormones and insulin, and factors such as the distribution of body fat and changes in adiposity at different ages. The increasing prevalence of obesity in many parts of the world emphasizes the importance of learning more about the relationship between obesity and cancer and the mechanisms involved in their interaction.
The principal risk factors of osteoarthritis of the knee are: age, obesity and gender. It is hypothesized that long-duration walking (e. g. 20 min) in the elderly obese will lead to quadriceps fatigue. Changes in the gait pattern due to fatigue will lead to altered knee kinematics at heelstrike and consequently decreased shock absorption. This scenario will result in an increased rate of loading and possibly an increase in the overall magnitude of peak ground reaction forces, both of which could cause articular cartilage degeneration. Obese females are at an overall higher risk of developing osteoarthritis than males. This gender discrepancy may be explained by the fact that females have a higher percentage of body fat content (lower proportion of lean mass) that may increase the rate of quadriceps fatigue. These biomechanical hypotheses can be examined by studying continuous periods of walking in which ground reaction forces, knee kinematics and electromyography data are recorded.
Based on a 4-day questionnaire survey for all meals and snacks consumed by female workers in a computer factory in Japan, consisting of 44 daytime workers and 93 weekly-rotating shift workers (of whom 47 and 46 were engaged in, respectively, early-shift work and late-shift work during the survey week), the present study aimed to clarify the effects of shift work on their nutrient intakes in association with food consumption patterns. Their dietary intakes for 3 working days and an off day were assessed by self-registered food consumption records with the aid of a photographic method, and intakes of energy, protein, fat, carbohydrate, calcium and iron were estimated. The inter-group differences were prominent in the working days. The shift workers, particularly the late-shift workers, took smaller amounts of energy and nutrients than the daytime workers, implying that the former group's nutritional status has been worsened, judged from the recommended dietary allowance for Japanese. Their inadequate nutrient intake was due to lower meal frequency and poor meal quality, both of which were conditioned by shift work.
Osteoarthritis (OA) appears to be a mechanically driven but chemically mediated disease process in which there is attempted (or aberrant) repair. Well established risk factors for OA include aging, obesity, gender, and, in selected subgroups, congenital anomalies. This review addresses less well established risk factors for OA that can impact joints through their effect on systemic metabolism rather than their contribution to local joint geometry and structure. These systemic risk factors include obesity; bone and bone density; nutrients, particularly those that function as antioxidants; and genetic factors. There is great opportunity for new prevention and intervention strategies as we expand our understanding of the role of these systemic risk factors.
Relative risk is usually the parameter of interest in epidemiologic and medical studies. In this paper, the author proposes a modified Poisson regression approach (i.e., Poisson regression with a robust error variance) to estimate this effect measure directly. A simple 2-by-2 table is used to justify the validity of this approach. Results from a limited simulation study indicate that this approach is very reliable even with total sample sizes as small as 100. The method is illustrated with two data sets.
Although previous studies have linked obesity to diabetes, the risks associated with weight gain or changes in body fat distribution have not been fully elucidated. The authors therefore prospectively examined the relations between changes in body weight and body fat distribution (1986-1996) and the subsequent risk of diabetes (1996-2000) among 22,171 men in the Health Professionals Follow-up Study. Weight gain was monotonically related to risk, and for every kilogram of weight gained, risk increased by 7.3%. A gain in abdominal fat was positively associated with risk, independent of the risk associated with weight change. Compared with men who had a stable waist, men who increased waist circumference by 14.6 cm or more had 1.7 (95% confidence interval: 1.0, 2.8) times the risk of diabetes after controlling for weight gain. In contrast, men who lost more than 4.1 cm in hip girth had 1.5 (95% confidence interval: 1.0, 2.3) times the risk of diabetes compared with men with stable hip circumference. Fifty-six percent of the cases of diabetes in this cohort could be attributed to weight gain greater than 7 kg, and 20 percent of the cases could be attributed to a waist gain exceeding 2.5 cm. Our findings underscore the critical importance of maintaining weight and waist to reduce the risk of diabetes.
Factors related to overweight were examined in a cross-sectional survey that included 1612 women workers from 10 large electronics assembly factories in Peninsular Malaysia. Respondents were Malaysian citizens, direct production workers below the supervisory level, and had worked at least a year in the factory where they were presently employed. Heights and weights were taken to calculate the body mass index (BMI). Weights and BMI increased with increasing age. After adjusting for age, odds ratios for overweight were significantly raised for married women in relation to not married women (OR 1.5, 95% CI=1.15-2.02), lower secondary education in relation to higher than upper secondary education (OR 1.8, 95% CI=1.06-3.14), monthly income RM800-999 (OR 1.7, 95% CI=1.21-2.45) and >/=RM1,000 (OR 1.8, 95% CI=1.23-2.72) in relation to <RM600, working in rotating shifts that included nightshifts (OR 1.6, 95% CI=1.28-2.06), and not staying in hostel (OR 1.4, 95% CI=1.02-1.88). In a logistic regression model with all variables included as covariates, the factors significantly associated with overweight were age, marital status, education, income, and working in rotating shifts. The overall prevalence of overweight was 37.4%; the overall mean BMI was 24.2+/-5.4 kg/m(2). Prevalence of overweight and mean BMI for younger age groups were similar to Malay women in the country-wide representative National Health and Morbidity Survey II, but the older age groups in this study had higher overweight prevalence and mean BMI than the national sample. Electronics women workers face a higher risk of overweight, and is an important group for nutrition intervention.
This article is the second in a series of four that present data about physical activity in the 15 member states of the European Union collected by the Eurobarometer 58.2. The focus of this article is on days of vigorous and moderate physical activity, days of walking, and metabolic equivalence estimates (METs) for total physical activity from 15 member states of the European Union using the International Physical Activity Questionnaire (IPAQ).
Data were collected in 2002 as part of the Eurobarometer by face-to-face interviews. A total of 16,230 respondents age 15 years and older were interviewed. Sample sizes ranged about 1000 respondents in most nations. Physical activity was assessed with the last 7-days short version of the IPAQ.
Median METs estimates in hours per week were the highest in The Netherlands (39.43 MET-hours/week), Germany (34.65 MET-hours/week in the eastern part, 33.90 MET-hours/week in the western part), and Luxembourg (31.55 MET-hours/week). The lowest METs estimates were reported in Northern Ireland (11.55 MET-hours/week), Sweden (18.65 MET-hours/week) and France (19.55 MET-hours/week).
A comparison of the results with existing data on physical activity prevalence in the member states indicate some inconsistencies between studies which may be related to measurement problems, as well as to conceptual differences in the assessment of physical activity.
Obesity is an escalating pandemic in the United States, and its association with coronary heart disease is well understood. Several studies have found positive associations between body mass index (BMI) and stroke in men, but the association with stroke and its subtypes is less clear in women.
This was a prospective cohort study among 39 053 women participating in the Women's Health Study. BMI was measured as self-reported weight (in kilograms) divided by height (in meters) squared. Incident stroke was self-reported and confirmed by medical record review. We used the Cox proportional hazards model to evaluate the association between BMI and stroke. After a mean follow-up of 10 years, a total of 432 strokes (347 ischemic, 81 hemorrhagic, and 4 undefined) occurred. We found a statistically significant trend for increased risk of total and ischemic stroke across 7 BMI categories. With World Health Organization criteria, women who were obese (BMI > or =30 kg/m2) had hazard ratios of 1.50 (95% CI 1.16 to 1.94) for total stroke, 1.72 (95% CI 1.30 to 2.28) for ischemic stroke, and 0.82 (95% CI 0.43 to 1.58) for hemorrhagic stroke compared with women with BMI <25 kg/m2. Additional control for history of hypertension, diabetes, and elevated cholesterol substantially attenuated the hazard ratios for total and ischemic stroke. There was no effect modification for age, exercise, or smoking.
In this large prospective cohort study among women, BMI was a strong risk factor for total and ischemic stroke but not for hemorrhagic stroke. The association was highly mediated by hypertension, diabetes, and elevated cholesterol.
This study was conducted to criterion-validate the short format of International Physical Activity Questionnaire (IPAQ) against health-related fitness.
Participants included 951 men, aged 21-43 yr. VO2max by ergometer was used to measure cardiorespiratory fitness. Muscular fitness tests included the number of sit-ups, push-ups, and squats performed during 60 s. Physical activity was assessed from IPAQ by categories for health (health-enhancing physical activity (HEPA)) and by calculating total and vigorous MET-hours per week. The participants were classified in five groups of almost equal size by the IPAQ outcomes. Moreover, the frequency of vigorous activity was assessed by one precoded question (single-item question on leisure-time vigorous physical activity (SIVAQ)).
The mean fitness improved from the first through the fourth IPAQ group. VO2max in the most active IPAQ group, however, was lower than in the fourth group (P < 0.05), both with HEPA categories and vigorous METs as the outcome. In contrast, the weekly frequency of vigorous physical activity showed a positive association with fitness through all six categories. The 65 sedentary (according to SIVAQ) and unfit individuals who belonged to the highest 20% (by IPAQ total METs) were older (30.6 +/- 5.1 vs 28.9 +/- 3.8, P = 0.02), more obese (waist 93 +/- 12 vs 89 +/- 10 cm), more often current smokers (59.4 vs 42.0%; P = 0.03), and less educated (<12 yr of education 70.8 vs 52.0%; P = 0.02), compared with the others in the highest IPAQ group.
Almost 10% of young men had poor fitness and apparently low physical activity, but they reported very high physical activity by IPAQ. An evident need therefore exists to develop IPAQ further to solve the apparent overreporting by a considerable proportion of sedentary individuals.
Obesity has a high and rising prevalence and represents a major public health problem. Obstructive sleep apnea (OSA) is also common, affecting an estimated 15 million Americans, with a prevalence that is probably also rising as a consequence of increasing obesity. Epidemiologic data support a link between obesity and hypertension as well as between OSA and hypertension. For example, untreated OSA predisposes to an increased risk of new hypertension, and treatment of OSA lowers blood pressure, even during the daytime. Possible mechanisms whereby OSA may contribute to hypertension in obese individuals include sympathetic activation, hyperleptinemia, insulin resistance, elevated angiotensin II and aldosterone levels, oxidative and inflammatory stress, endothelial dysfunction, impaired baroreflex function, and perhaps by effects on renal function. The coexistence of OSA and obesity may have more widespread implications for cardiovascular control and dysfunction in obese individuals and may contribute to some of the clustering of abnormalities broadly defined as the metabolic syndrome. From the clinical and therapeutic perspectives, the presence of resistant hypertension and the absence of a nocturnal decrease in blood pressure in obese individuals should prompt the clinician to consider the diagnosis of OSA, especially if clinical symptoms suggestive of OSA (such as poor sleep quality, witnessed apnea, excessive daytime somnolence, and so forth) are also present.
The Health of New Zealand: Total Population
- Ministry
Ministry of Health. The Health of New Zealand: Total Population. Wellington, New Zealand: Ministry of Health; 2004.
IARC Working Group on the evaluation of cancerpreventive strategies
- Iarc Working
IARC Working Group. IARC Working Group on the evaluation of cancerpreventive strategies. In: Vanio H, Bianchini F, eds. IARC Handbooks of Cancer Prevention, Vol. 6. Weight Control and Physical Activity. Lyon, France: IARC Press; 2002.
The Australian diabetes, obesity and lifestyle survey Tracking the Accelerating Epidemic: Its Causes and Outcomes
- Elm Barr
- Dj Magliano
- Zimmet
- Pz
Barr ELM, Magliano DJ, Zimmet PZ, et al. The Australian diabetes, obesity and lifestyle survey. Tracking the Accelerating Epidemic: Its Causes and Outcomes. Melbourne, Victoria, Australia: International Diabetes Institute; 2006:43-48.