The acute effects of working time patterns on fatigue and sleep quality using daily measurements of 6195 observations among 223 shift workers

Objectives:This study aimed to estimate acute effects of roster characteristics on fatigue and sleep quality and investigated whether these effects differed by individual characteristics.Methods:Using an ecological measurement assessment survey, fatigue and sleep quality were daily measured among 223 shift workers for up to eight weeks. A questionnaire assessed baseline characteristics, and roster data were retrieved from the company registers to determine roster parameters. The effects between each shift parameter on fatigue and sleep quality were estimated with random- and fixed-effects models.Results:Compared to day shifts, night shifts were related to fatigue [β=0.22; 95% confidence interval (CI) 0.05–0.39] and poorer sleep quality (β =0.64; 95% CI 0.47–0.80), and more successive night shifts with more fatigue (up to β=0.68; 95% CI 0.49–0.87 for ≥2 nights). Fatigue was increased after a quick return (<11 hours) (β=1.94; 95% CI 1.57–2.31) or 11–16 hours (β=0.43; 95% CI 0.26–0.61) compared to >16 hours between shifts. Compared to forward rotation, stable (β=0.22; 95% CI 0.01–0.43) and backward rotation (β=0.49; 95% CI 0.23–0.74) were also associated with more fatigue. Workers with a morning or intermediate chronotype had poorer sleep quality after a night shift, while workers with poor health reported poor sleep quality as well as more fatigue after a night shift.Conclusions:To alleviate acute effects of shift work on fatigue, shift schedules should be optimized by ensuring more time to recover and rotate forwards.     

Night and shift work and incidence of cerebrovascular disease – a prospective cohort study of healthcare employees in Stockholm

ObjectiveThis study aimed to investigate the effects of various aspects of night and shift work regarding incident cerebrovascular disease (CeVD).MethodsThe cohort included 26 667 women and 3793 men (nurses and nursing assistants) who were employed for at least one year 2008–2016 in Region Stockholm, Sweden. Information about the cohort and working hours were obtained from a computerized employee-register and diagnoses were retrieved from national and regional registers. We used discrete time proportional hazard models to assess the risk of CeVD (2009–2017), in relation to work hour characteristics, adjusting for sex, age, country of birth, education and profession.ResultsWe observed an excess risk of CeVD (N=223) among employees who, during the preceding year, worked night shifts >30 times [hazard ratio (HR) 1.44, 95% confidence interval (CI) 1.04–1.99] or ≥3 consecutive night shifts >15 times (HR 1.69, 95% CI 1.18–2.42) or with >30 quick returns (<28 hours) from night shifts (HR 1.52, 95% CI 1.10–2.10) compared to those who did not work nights. We also observed an excess risk among employees with a long duration (>5 years) of exposure to night shift work (HR 1.87, 95% CI 1.27–2.77), all supported by a dose–response pattern.ConclusionsOur results show that the risk of CeVD among nurses and nursing assistants is associated with night shift work. The number of years with night shift work, the frequency of night shifts per year, the frequency of consecutive night shifts, and short recovery after night shifts influenced the risk. Work schedules aiming at minimizing these aspects of night shift work may reduce the risk.     

Characteristics of working hours and the risk of occupational injuries among hospital employees: a case-crossover study

Objectives:We investigated the association of working hours with occupational injuries in hospital shift work.Methods:Registry data of occupational injuries of hospital employees from 11 towns and 6 hospital districts were linked to daily payroll data to obtain working hours for 37 days preceding the first incidence of the injury (N=18 700). A case-crossover design and associated matched-pair interval analysis were used to compare working hour characteristics for three separate hazard windows among the same subjects. Conditional logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI).Results:We found an elevated risk of an occupational injury for workdays with evening shifts (OR 1.09, 95% CI 1.03–1.14) and workdays following night shifts (OR 1.33, 95% CI 1.17–1.52). After excluding commuting injuries, the risk increased during the evening shifts (OR 1.15, 95% CI 1.09–1.23) and the work days following night shifts (OR 1.44, 95% CI 1.24–1.69), but was no more significant during the morning shifts. Injury risk increased following a week of ≥5 morning shifts or ≥3 evening shifts, but did not increase according to the number of preceding night shifts or quick returns. The length of the work shift (OR 1.22, CI 1.06–1.42) – not the length of the weekly working hours – was associated with an increased risk.Conclusions:The results indicate an increased occupational injury risk during the evening shifts and during work days following night shifts, with the risk increasing according to the number of evening but not night shifts.     

Night work,mortality, and the link to occupational group and sex

Objective:Night shifts are associated with several major diseases. Mortality has been studied only to a limited extent, and the association with night shifts remains unclear. The purpose of the present study was to investigate the association between duration of night shift exposure and mortality in a large sample from the Swedish Twin Registry (the SALT cohort).Methods:Cox proportional hazards regression models were used to analyze the data (N=42 731) over a follow-up period of 18 years, with years of night shift work as the exposure variable and adjustment for lifestyle factors and age, and stratification on gender and occupational group.Results:The hazard ratio (HR) for “ever” night shifts for total mortality was 1.07 [95% confidence interval (CI) 1.01–1.15] but 1.15 (95% CI 1.07–1.25) for longer exposure (>5 years). Also, HR for cause-specific mortality due to cardiovascular disease was significant, with higher HR for longer night shift exposure. Mortality due to cancer was significant for longer exposure only. White-collar workers showed significant HR for longer exposure. In particular, male white-collar workers showed a significant HR, with a highest value for longer exposure [HR 1.28 (95% CI 1.09–1.49)]. Heredity did not influence the results significantly.Conclusions:Long duration of exposure to night shift work is associated with increased mortality, particularly in male white-collar workers. The lack of effects of accumulated exposure suggests that the results should be interpreted with caution.     

Shift work relationships with same- and subsequent-day empty calorie food and beverage consumption

Objectives:Shift work may contribute to unhealthy eating behaviors. However, the evidence is built mainly on comparisons of eating behaviors between shift and non-shift workers. Growing research has suggested daily experiences and exposures may contribute to daily fluctuations in people’s food consumption. The purpose of this study was to examine within-person associations between shift work and same- and subsequent-day empty calorie food/beverage consumption.Methods:This was a 14-day intensive longitudinal study using ecological momentary assessment. A convenience sample of 80 hospital registered nurses working a rotating shift in Taiwan completed a 21-item food checklist assessing their empty food/beverage consumption (ie, fast/fried food, sweet and salty snacks, sugar-sweetened beverages) four times at random daily. Daily shift work (ie, day, evening, or night shift) was derived from the registry-based work schedule. Three-level mixed-effects regression models were employed for hypothesis testing.Results:A total of 77 participants with 2444 momentary assessments were included in the final analysis. The results suggested that participants on night compared to day shifts had higher likelihoods of fast/fried food intake [adjusted odds ratio (OR_adj) 1.7, 95% CI 1.2–2.6] and sugar-sweetened beverage consumption (OR_adj 1.5, 95% CI 1.0–2.1). However, there were no significant associations between shift work and subsequent-day empty calorie food/beverage consumption.Conclusions:Night shift work is associated with same-day increased empty calorie food/beverage consumption among workers. Strategies that help to prevent unhealthy eating behaviors on night shifts may help to reduce rotating shift workers’ empty calorie food/beverage consumption and ultimately improve their health.     

Changes in melatonin and sex steroid hormone production among men as a result of rotating night shift work – the HORMONIT study

ObjectiveData from real world settings on circadian disruption and subsequent hormone-related changes may explain the higher risk of hormone-dependent cancers among night shift workers.The present study examines the melatonin and sex steroid hormone levels among night shift workers.MethodsWe included 44 male, rotating shift workers from a car factory in Spain, sampled both at the end of a 3-week night shift (22:00–06:00 hrs) and a 3-week early morning shift (06:00–14:00 hrs). Participants collected all urine voids over 24-hours during each shift. Urinary concentrations of sex steroid hormones (estrogens, androgens and progestogens) and 6-sulfatoxymelatonin (aMT6s, major melatonin metabolite) were determined. Individual cosinor analysis was used to derive the acrophase (peak time) and area under the curve (total production). Linear mixed models examined intraindividual associations between night shift work and log-transformed 24-hour peak time and total production of hormones compared to early morning shift work.ResultsThe acrophase was delayed during the night shift for aMT6s [geometric mean difference (GMD) 7.53 hrs, 95% confidence interval (CI) 4.46–10.60], androgens (eg, testosterone: GMD 6.83 hrs, 95% CI 0.34–13.32) and progestogens (eg, 17-hydroxyprogesterone: GMD 4.54 hrs, 95% CI 2.92–6.16) compared to the early morning shift. We found a higher production of adrenal androgen 11-oxoandrosterone/11-oxoetiocholanolone [geometric mean ratio (GMR) 1.43, 95% CI 1.12–1.81], and a lower production of adrenal progestogen 16-cysteinylprogesterone (GMR 0.79, 95% CI 0.67–0.93) during the night shift compared to the early morning shift levels.ConclusionsNight shift work was associated with melatonin and sex hormone-related changes in timing and total production, providing insight into the mechanistic path for its association with hormone-dependent cancer.     

The associations of working hour characteristics with short sickness absence among part- and full-time retail workers

Objective:This study aimed to determine the associations of working hour characteristics with short (1–3 days) sickness absence (SA) among retail workers.Methods:As part of “RetailHours-project”, 4046 employees of 338 Finnish retail stores were included. Registry-based data on working hour characteristics and short SA were utilized. A case-crossover design was used and the odds ratios (OR) were controlled for the clustering effect and working hour characteristics.Results:There were strong dose–response relationships between percent of short (<11 hours) shift intervals and short SA among part- and full-time workers, men and women, and younger and older workers. Compared to workers without short shift intervals, the risk of SA was 1.47 times [95% confidence interval (CI) 1.29–1.68] higher among workers who had short shift intervals <10% of work times, 2.39 times (95% CI 2.03–2.82) higher among workers who had 10–25% of work times, and 4.03 times (CI 2.34–6.93) higher among workers who had short shift intervals >25% of work times. Weekly working hours >40 hours were associated with SA among part-time workers [odds ratio (OR) 2.22, CI 1.65–2.98], women (OR 1.62, CI 1.27–2.07) and among workers <30 years of age (OR 1.68, CI 1.20–2.35) as well as among workers aged ≥30 years (OR 1.43, CI 1.07–1.92). Furthermore, working mainly night shifts was associated with SA among full-time workers (OR 2.41, 95% CI 0.99–5.86) and women (OR 1.72, CI 1.02–2.89).Conclusions:A short shift interval is an important risk factor for short SA. Improving intervals between shifts and shortening long weekly working hours could reduce the risk of short SA among retail workers.     

Lower Protein-to-Carbohydrate Ratio in Maternal Diet is Associated with Higher Childhood Systolic Blood Pressure up to Age Four Years

The prenatal environment can influence development of offspring blood pressure (BP), which tracks into adulthood. This prospective longitudinal study investigated whether maternal pregnancy dietary intake is associated with the development of child BP up to age four years. Data are from 129 mother-child dyads enrolled in the Women and Their Children’s Health study. Maternal diet was assessed using a validated 74-item food frequency questionnaire at 18 to 24 weeks and 36 to 40 weeks, with a reference period of the previous three months. Child systolic and diastolic BP were measured at 3, 6, 9, 12, 24, 36 and 48 months, using an automated BP monitor. Using mixed-model regression analyses adjusted for childhood growth indices, pregnancy intakes of percentage of energy (E%) polyunsaturated fat (β coefficient 0.73; 95% CI 0.003, 1.45; p = 0.045), E% omega-6 fatty acids (β coefficient 0.89; 95% CI 0.09, 1.69; p = 0.03) and protein-to-carbohydrate (P:C) ratio (β coefficient −14.14; 95% CI −27.68, −0.60; p = 0.04) were associated with child systolic BP trajectory up to 4 years. Child systolic BP was greatest at low proportions of dietary protein (<16% of energy) and high carbohydrate (>40% of energy) intakes. There may be an ideal maternal macronutrient ratio associated with optimal infant BP. Maternal diet, which is potentially modifiable, may play an important role in influencing offspring risk of future hypertension.     

Insufficient Fruit and Vegetable Intake and Low Potassium Intake Aggravate Early Renal Damage in Children: A Longitudinal Study

Insufficient fruit and vegetable intake (FVI) and low potassium intake are associated with many non-communicable diseases, but the association with early renal damage in children is uncertain. We aimed to identify the associations of early renal damage with insufficient FVI and daily potassium intake in a general pediatric population. We conducted four waves of urine assays based on our child cohort (PROC) study from October 2018 to November 2019 in Beijing, China. We investigated FVI and other lifestyle status via questionnaire surveys and measured urinary potassium, β₂-microglobulin (β₂-MG), and microalbumin (MA) excretion to assess daily potassium intake and renal damage among 1914 primary school children. The prevalence of insufficient FVI (<4/d) was 48.6% (95% CI: 46.4%, 50.9%) and the estimated potassium intake at baseline was 1.63 ± 0.48 g/d. Short sleep duration, long screen time, lower estimated potassium intake, higher β₂-MG and MA excretion were significantly more frequent in the insufficient FVI group. We generated linear mixed effects models and observed the bivariate associations of urinary β₂-MG and MA excretion with insufficient FVI (β = 0.012, 95% CI: 0.005, 0.020; β = 0.717, 95% CI: 0.075, 1.359), and estimated potassium intake (β = −0.042, 95% CI: −0.052, −0.033; β = −1.778, 95% CI: −2.600, −0.956), respectively; after adjusting for age, sex, BMI, SBP, sleep duration, screen time and physical activity. In multivariate models, we observed that urinary β₂-MG excretion increased with insufficient FVI (β = 0.011, 95% CI: 0.004, 0.018) and insufficient potassium intake (<1.5 g/d) (β = 0.031, 95% CI: 0.023, 0.038); and urinary MA excretion increased with insufficient FVI (β = 0.658, 95% CI: 0.017, 1.299) and insufficient potassium intake (β = 1.185, 95% CI: 0.492, 1.878). We visualized different quartiles of potassium intake showing different renal damage with insufficient FVI for interpretation and validation of the findings. Insufficient FVI and low potassium intake aggravate early renal damage in children and underscores that healthy lifestyles, especially adequate FVI, should be advocated.     

Association between Protein Intake and Skeletal Muscle Mass among Community-Dwelling Older Japanese: Results from the DOSANCO Health Study: A Cross-Sectional Study

Whether the source of dietary protein intake is related to appendicular skeletal muscle mass (AMM) and muscle mass (MM) remains unclear. We conducted this cross-sectional study of 277 residents (115 men, 162 women) aged ≥65 years in Japan to examine the association of the amount of dietary protein intake with AMM and MM. We measured dietary protein intake using a brief self-administered diet history questionnaire. AMM and MM were assessed based on bioelectrical impedance. Multivariable linear regression analyses were used to estimate β coefficients that were adjusted for potential confounders. Among Japanese women aged ≥75 years, but not among women aged 65–74 years, dietary animal protein intake was significantly associated with AMM (β (95% confidence interval (CI)): 0.25 (0.10, 0.40)) and MM (β (95% CI): 0.40 (0.16, 0.64)). However, dietary vegetable protein intake was not associated with AMM (β (95% CI): −0.17 (−0.74, 0.41)) and MM (β (95% CI): −0.30 (−1.23, 0.63)). Furthermore, in men aged ≥65 years, dietary protein intake was not associated with AMM or MM. In conclusion, dietary animal protein intake, but not vegetable protein intake, were positively associated with AMM and MM among this population of Japanese women aged ≥75 years.     

Changes in Dietary Intake Patterns and Weight Status during the COVID-19 Lockdown: A Cross-Sectional Study Focusing on Young Adults in Malaysia

Introduction: The coronavirus disease 2019 (COVID-19) isolation has altered individuals’ food purchasing behaviour and dietary intake patterns. Therefore, this study aims to investigate the changes in dietary intake patterns and their impacts on the weight status of young adults in Malaysia during the COVID-19 lockdown. Methods: This cross-sectional study involved 1045 young adults in Malaysia. The changes in dietary intake patterns were assessed using the Dietary Diversity Questionnaire with slight modifications, while anthropometric measurements including body height, body weight before the pandemic and current body weight were self-reported. Results: Overall, nearly half of the respondents (48.8%) gained weight during the confinement, with an average increment of 4.06 ± 3.23 kg. Of 1045, 45.3% reported consuming more fruits and 60.2% had higher plain water intake during the pandemic. It is observed that 41.0% to 66.8% of the young adults changed their dietary intake patterns during the pandemic. Increased consumption in cereals and grains (β = 0.084, p = 0.015, 95% CI = 0.017–0.160), as well as oils and fats (β = 0.123, p = 0.001, 95% CI = 0.059–0.241), was positively associated with weight gain during the pandemic. On the contrary, an increased plain water intake was negatively associated with weight gain during the lockdown (β = −0.100, p = 0.003, 95% CI = −0.171–−0.034). Findings in the current study also suggested that cutting back cereals and grains (β = 0.156, p < 0.001, 95% CI = 0.122–0.288), as well as oils and fats (β = 0.091, p = 0.012, 95% CI = 0.022–0.183), contributed significantly to weight loss during the pandemic confinement. Conclusion: In conclusion, the enforcement of the Movement Control Order (MCO) drove up the prevalence of overweight/obesity among young adults in Malaysia. Increased consumption of cereals and grains and oils and fats contributed to weight gain in the pandemic lockdown. Nonetheless, a noticeable proportion of young adults in Malaysia shifted to a healthier food choice by increasing the consumption of fruits and vegetables.     

Effects of Dietary Fat and Saturated Fat Content on Liver Fat and Markers of Oxidative Stress in Overweight/Obese Men and Women under Weight-Stable Conditions

Dietary fat and oxidative stress are hypothesized to contribute to non-alcoholic fatty liver disease and progression to steatohepatitis. To determine the effects of dietary fat content on hepatic triglyceride, body fat distribution and markers of inflammation and oxidative stress, overweight/obese subjects with normal glucose tolerance consumed a control diet (CONT: 35% fat/12% saturated fat/47% carbohydrate) for ten days, followed by four weeks on a low fat (LFD (n = 10): 20% fat/8% saturated fat/62% carbohydrate) or high fat diet (HFD (n = 10): 55% fat/25% saturated fat/27% carbohydrate). Hepatic triglyceride content was quantified by MRS and abdominal fat distribution by MRI. Fasting biomarkers of inflammation (plasma hsCRP, IL-6, IL-12, TNFα, IFN-γ) and oxidative stress (urinary F2-α isoprostanes) were measured. Body weight remained stable. Compared to the CONT, hepatic triglyceride decreased on the LFD (mean (95% CI): change −2.13% (−3.74%, −0.52%)), but did not change on the HFD and there was no significant difference between the LFD and HFD. Intra-abdominal fat did not change significantly on either diet, but subcutaneous abdominal fat increased on the HFD. There were no significant changes in fasting metabolic markers, inflammatory markers and urinary F2-α isoprostanes. We conclude that in otherwise healthy overweight/obese adults under weight-neutral conditions, a diet low in fat and saturated fat has modest effects to decrease liver fat and may be beneficial. On the other hand, a diet very high in fat and saturated fat had no effect on hepatic triglyceride or markers of metabolism, inflammation and oxidative stress.     

Association of Carbohydrate and Fat Intake with Prevalence of Metabolic Syndrome Can Be Modified by Physical Activity and Physical Environment in Ecuadorian Adults: The ENSANUT-ECU Study

The associations of lifestyle and environment with metabolic syndrome (MetS) and cardiovascular disease have recently resulted in increased attention in research. This study aimed to examine interactive associations among carbohydrate and fat intake, physical environment (i.e., elevation and humidity), lifestyle, and MetS among Ecuadorian adults. We used data from the Ecuador National Health and Nutrition Survey 2012 (ENSANUT-ECU), with a total of 6023 participants aged 20 to 60 years included in this study. Logistic regression was used to determine the association of status of carbohydrate and fat intake, low-carbohydrate high-fat diet (LCHF) and medium-carbohydrate and fat (MCF) diet with MetS, where the high-carbohydrate low-fat (HCLF) diet was used as a reference. Women with LCHF and MCF diets showed lower prevalence of increased blood pressure (OR = 0.34, 95% CI: 0.19–0.59; OR = 0.50, 95% CI: 0.32–0.79, respectively). Women with MCF diet also showed lower prevalence of elevated fasting glucose (OR = 0.58, 95% CI: 0.37–0.91). Moreover, there were negative associations between MetS and reduced HDL cholesterol in women with MCF diet residing in low relative humidity (OR = 0.66, 95% CI: 0.45–0.98) and in women with LCHF diet residing at a high elevation (OR = 0.37, 95% CI: 0.16–0.86). Additionally, higher prevalence of increased waist circumference was observed in men with both MFC and LCHF diets who were physically inactive (OR = 1.89, 95% CI: 1.12–3.20; OR = 2.34, 95% CI: 1.19–4.60, respectively) and residing in high relative humidity (OR = 1.90, 95% CI: 1.08–2.89; OR = 2.63, 95% CI: 1.32–5.28, respectively). Our findings suggest that LCHF intake is associated with lower blood pressure, while MCF intake is associated with lower blood pressure and fasting glucose in Ecuadorian women. Furthermore, the associations of carbohydrate and fat intake with prevalence of MetS can be modified by physical activity, relative humidity, and elevation. The obtained outcomes may provide useful information for health programs focusing on dietary intake and lifestyle according to physical environment of the population to promote health and prevent metabolic diseases.     

Time-Related Eating Patterns Are Associated with the Total Daily Intake of Calories and Macronutrients in Day and Night Shift Workers

The aim of the study was to investigate whether time-related eating patterns are associated with the daily intake of calories and macronutrients in Brazilian male military police officers (n = 81; 29-day and 52-night workers; mean age: 36.4 ± 0.9 and 38.5 ± 0.7 years, respectively). Energy and macronutrient intake were determined by a non-consecutive 3-day food recall. Time-related eating patterns, such as the time of the first and the last meals, eating duration, and caloric midpoint, were evaluated. Individuals were classified as “early” or “late” eaters according to the median caloric midpoint. Night shift workers showed a later eating time for the last meal (p < 0.001), longer eating duration (p < 0.001), and later caloric midpoint (p = 0.037) than day workers. Late eaters from both workgroups consumed more 24 h energy (p = 0.028), fat in calories (p = 0.006) and protein (calories: p < 0.001; percentage of total calories: p = 0.042), and less carbohydrates in calories (p = 0.010) intake than early eaters. The time of the first meal was negatively correlated with 24 h energy (p = 0.024) and carbohydrate (p = 0.031) intake only in day workers. The time of the last meal was positively correlated with 24 h energy (day workers: β = 0.352; p = 0.044; night workers: β = 0.424; p = 0.002) and protein (day workers: β = 0.451; p = 0.013; night workers: β = 0.536; p < 0.001) intake for both shift workers, and with carbohydrate (β = 0.346; p = 0.016) and fat (β = 0.286; p = 0.042) intake only in night workers. Eating duration was positively correlated with energy (day workers: β = 0.473; p = 0.004; night workers: β = 0.320; p = 0.023) and carbohydrate (day workers: β = 0.418; p = 0.011; night workers: β = 0.364; p = 0.010) intake in both groups. Thus, time-related eating patterns indicative of intake later at night are associated with increased daily energy and macronutrient intake.     

Macronutrients Intake and Risk of Stomach Cancer: Findings from Case-Control Study

Studies on the association between gastric cancer (GC) and the intake of nutrients in Jordan are very limited, while findings from other reports on the intake of energy and macronutrients are controversial. This study aimed to examine the associations between intake of energy and macronutrients and the risk of GC in a Jordanian population. A case-control study was carried out between March 2015 and August 2018 in four major hospitals, including an oncology center in Jordan. Study participants were 173 cases with incident and histologically confirmed GC and 314 frequency-matched controls. Interview-based questionnaires were used to obtain the study’s information. Data on nutrient intake were collected using a validated Arabic food-frequency questionnaire (FFQ). Odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were calculated through multinomial logistic regression and adjusted for potential confounders, including age, marital status, education, body mass index (BMI), smoking, period of smoking, family history of gastric cancer, history of gastric ulcer, and physical activity. Intakes of total fat, saturated fat, monounsaturated fat, polyunsaturated fat, cholesterol, trans-fat, and omega-6 fatty acids were significantly associated with increased risk of GC. The ORs for the highest versus the lowest tertiles were 6.47 (95% Cl: 3.29–12.77), 2.97 (95% CI: 1.58–5.58), 6.84 (95% CI: 3.46–13.52), 6.19 (95% CI: 3.15–12.17), 3.05 (95% CI: 1.58–5.88), 8.11 (95% CI: 4.20–15.69), and 2.74 (95% CI: 1.47–5.09), respectively. No significant association was found for energy, protein, carbohydrate, sugar, fibers, and omega-3 fatty acids. The findings of this study suggest that high intake of selected types of fats was associated with an increased risk of GC.     

Effect of long work hours and shift work on high-sensitivity C-reactive protein levels among Korean workers

Objective:We aimed to investigate the association between low-grade inflammation as indicated by high-­sensitivity C-reactive protein (hsCRP) level and organizational factors, such as work hours and shift work.Methods:We evaluated 7470 young and middle-aged workers who participated in the Korea National Health and Nutrition Examination Surveys from 2015–2018. Work hours were determined from self-reported questionnaires. Shift work was defined as a non-daytime fixed work schedule. An interaction effect between shift work and long work hours on the hsCRP level was estimated using relative excess risk due to interaction (RERI) and attributable proportion (AP) with 95% confidence intervals (CI).Results:Increased hsCRP levels were prevalent in 25.2% of the study population. There was a significant association between long work hours and increased hsCRP, especially among middle-aged men [odds ratio (OR) 1.50 (95% CI 1.20–1.87) for moderately increased hsCRP and OR 1.62 (95% CI 1.14–2.30) for highly increased hsCRP]. There was a significant interaction effect between long work hours and shift work on increased hsCRP among middle-aged workers. The RERI were 0.03 (95% CI 0.02–0.04) and 0.56 (95% CI 0.45–0.68) among middle-aged men and women, respectively. The AP were 0.02 (95% CI 0.01–0.03) and 0.36 (95% CI 0.31–0.40) among middle-aged men and women, respectively.Conclusions:There was no significant association between shift work and the level of hsCRP. Long work hours were related to low-grade inflammatory processes, but only in middle-aged workers. There was an interaction effect between long work hours and shift work for increased hsCRP, especially in middle-aged women.     

Dietary Intake of Vitamin E and Fats Associated with Sarcopenia in Community-Dwelling Older Japanese People: A Cross-Sectional Study from the Fifth Survey of the ROAD Study

Dietary habits are of considerable interest as a modifiable factor for the maintenance of muscle health, especially sarcopenia. The present study aimed to investigate the association between dietary intake and sarcopenia prevalence in community-dwelling Japanese subjects. This cross-sectional study was conducted using data from the fifth survey of the Research on Osteoarthritis/Osteoporosis against Disability (ROAD) study, and 1345 participants (437 men and 908 women) aged ≥60 years were included in the analysis. Sarcopenia was determined by the definition of the Asian Working Group for Sarcopenia established in 2014, and dietary intake was assessed with the brief-type self-administered diet history questionnaire. Overall, 77 subjects (5.7%) were identified as having sarcopenia, 5.0% of men and 6.1% of women. Multiple logistic regression analysis showed that the odds ratios of sarcopenia for the dietary intake of vitamin E (α-tocopherol, 0.14 (CI 0.04–0.49), β-tocopherol (0.24, CI 0.07–0.78), γ-tocopherol (0.28, CI 0.09–0.87), and fats (fat 0.27, CI 0.08–0.96; monounsaturated fatty acids, 0.22, CI 0.07–0.72, polyunsaturated fatty acids, 0.28, CI 0.09–0.89) at the highest quantile were significantly lower compared with those at the lowest quantile. Therefore, higher dietary intakes of vitamin E and fats would be associated with a lower prevalence of sarcopenia.     

Total Fat and Fatty Acid Intake among 1–7-Year-Old Children from 33 Countries: Comparison with International Recommendations

This work reviews available data on dietary intakes of total fat, saturated fatty acids (SFA) and individual polyunsaturated fatty acids (PUFA) in children in different countries worldwide and for the first time, compares them with recent international recommendations. Studies published before June 2021 reporting total fat, total SFA and individual PUFA intakes in children aged 1–7 y were included. Observed intakes were evaluated against FAO/WHO and EFSA recommendations. 65 studies from 33 countries were included. Fat intake was too low in 88% of studies in young children (1–3 y). SFA intake was >10%E in 69–73% of children, especially in Europe. Linoleic acid intake was <3%E in 24% of studies in 1–2 y olds and within FAO/WHO recommendations among all other ages. Alpha-linolenic acid intake was <0.5%E in almost half of studies. Docosahexaenoic acid (DHA) or eicosapentaenoic acid + DHA intakes were below recommendations in most studies. In summary, while total fat intake was too low among younger children, SFA intake was above, especially in Europe and n-3 PUFA intake, especially DHA, were below recommendations for all ages. Intake of n-3 PUFA, especially DHA, is generally suboptimal. More data, particularly from developing countries, are required to refine these findings and guide implementation of adapted nutrition policies.     

Changes in Sugar Sweetened Beverage Intake Are Associated with Changes in Body Composition in Mexican Adolescents: Findings from the ELEMENT Cohort

Changes in consumption of sugar sweetened beverage (SSBs) have been associated with increased body mass index (BMI), but little work has evaluated the effect on waist circumference (WC) and body fat percentage during adolescence, a period characterized by rapid growth and change in dietary behaviors. We examined the relationship of changes in SSB intake and changes in adiposity over two years in 464 Mexican adolescents. Food frequency questionnaires were used to sum intake of regular soda, coffee with sugar, tea with sugar, sweetened water with fruit, chocolate milk, corn atole, and a sweetened probiotic milk beverage. Linear regression models were used to estimate the associations of changes in SSBs with changes in BMI, body fat percentage, and WC, adjusting for sex, socioeconomic status, screen time, physical activity, age, and change in age. Adolescents who increased their daily SSB intake by >2 serving had a −2.72% higher body fat percentage (95% CI: 0.61, 4.82); a 1–2 serving increase was associated with a 2.49 cm increase (95% CI: 0.21, 4.76) in WC compared with those with no change in intake. Within an adolescent sample, changes in SSB intake were related to concomitant changes in body fat percentage and WC, but not BMI.     

A longitudinal study on the association between quick returns and occupational accidents

Objective:This study aimed to investigate how change in the number of quick returns [(QR) <11 hours between consecutive shifts] longitudinally is associated with risk of occupational accidents among nurses.Methods:Two-year follow-up data from 1692 nurses participating in the Survey of Shiftwork, Sleep and Health among Norwegian nurses (SUSSH) (mean age 40.2, standard deviation 8.3 years, 91% female) were used. Negative binomial regression analyses were conducted to investigate the association between changes in the number of QR after two years and occupational accidents, controlling for demographics, work factors, and occupational accidents at baseline.Results:An increase from having no or a moderate number of QR (1–34 per year) from baseline to the two-year follow-up assessment was associated with an increased risk of occupational accidents, compared to experiencing no change in the number of QR. Those with a moderate number of QR at baseline who experienced an increase after two years had an increased risk of causing harm to patients/others [incident rate ratio (IRR) 8.49, 95% confidence interval (CI) 2.79–25.87] and equipment at work (IRR 2.89, 95% CI 1.13–7.42). Those who had many QR (>34 per year) at baseline but experienced a reduction after two years had a reduced risk of causing harm to themselves (IRR 0.35, 95% CI 0.16–0.73) and patients/others (IRR 0.27, 95% CI 0.12–0.59).Conclusion:A fairly consistent pattern was demonstrated in which changes in the number of QR over the two-year follow-up period was associated with a corresponding change in the risk of occupational accidents.