151
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Slavish DC, Taylor DJ, Lichstein KL. Intraindividual variability in sleep and comorbid medical and mental health conditions. Sleep 2020; 42:5370458. [PMID: 30843059 DOI: 10.1093/sleep/zsz052] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 01/28/2019] [Indexed: 12/17/2022] Open
Abstract
STUDY OBJECTIVES Intraindividual variability (IIV) in sleep may be a risk factor for disease above the influence of mean sleep. Associations between IIV in sleep and risk for a comprehensive set of common medical and mental health conditions have not been assessed in a representative sample. METHODS This study examined mean and IIV in total sleep time (TST), sleep quality (SQ), sleep efficiency (SE), and circadian midpoint (CM) in 771 adults recruited for an epidemiological study. Participants completed 14 days of sleep diaries to assess TST, SQ, SE, and CM, after which they reported on medical conditions and mental health symptoms. Data were analyzed using logistic regression, and models controlled for gender, body mass index, age, and race. RESULTS Lower mean TST, SQ, and SE were related to increased odds of having gastrointestinal problems, depression, and anxiety. IIV in TST was related to increased odds of having neurological, breathing, and gastrointestinal problems, as well as pain and depression; all results held controlling for mean sleep and adjusting for false discovery rate. IIV in SQ and SE was not associated with odds of having any medical or mental health conditions after adjusting for false discovery rate, nor was IIV in CM or mean CM. CONCLUSIONS Confirming previous research, mean TST, SQ, and SE are related to risk for gastrointestinal problems, depression, and anxiety. IIV in TST may be a unique facet of disturbed sleep that is associated with increased risk for a diverse cluster of medical and mental health conditions.
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Affiliation(s)
| | - Daniel J Taylor
- Department of Psychology, University of North Texas, Denton, TX
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152
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Pickel L, Sung HK. Feeding Rhythms and the Circadian Regulation of Metabolism. Front Nutr 2020; 7:39. [PMID: 32363197 PMCID: PMC7182033 DOI: 10.3389/fnut.2020.00039] [Citation(s) in RCA: 122] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/20/2020] [Indexed: 12/16/2022] Open
Abstract
The molecular circadian clock regulates metabolic processes within the cell, and the alignment of these clocks between tissues is essential for the maintenance of metabolic homeostasis. The possibility of misalignment arises from the differential responsiveness of tissues to the environmental cues that synchronize the clock (zeitgebers). Although light is the dominant environmental cue for the master clock of the suprachiasmatic nucleus, many other tissues are sensitive to feeding and fasting. When rhythms of feeding behavior are altered, for example by shift work or the constant availability of highly palatable foods, strong feedback is sent to the peripheral molecular clocks. Varying degrees of phase shift can cause the systemic misalignment of metabolic processes. Moreover, when there is a misalignment between the endogenous rhythms in physiology and environmental inputs, such as feeding during the inactive phase, the body's ability to maintain homeostasis is impaired. The loss of phase coordination between the organism and environment, as well as internal misalignment between tissues, can produce cardiometabolic disease as a consequence. The aim of this review is to synthesize the work on the mechanisms and metabolic effects of circadian misalignment. The timing of food intake is highlighted as a powerful environmental cue with the potential to destroy or restore the synchrony of circadian rhythms in metabolism.
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Affiliation(s)
- Lauren Pickel
- Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada
| | - Hoon-Ki Sung
- Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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153
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Mansur RB, Lee Y, McIntyre RS, Brietzke E. What is bipolar disorder? A disease model of dysregulated energy expenditure. Neurosci Biobehav Rev 2020; 113:529-545. [PMID: 32305381 DOI: 10.1016/j.neubiorev.2020.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/30/2020] [Accepted: 04/05/2020] [Indexed: 12/24/2022]
Abstract
Advances in the understanding and management of bipolar disorder (BD) have been slow to emerge. Despite notable recent developments in neurosciences, our conceptualization of the nature of this mental disorder has not meaningfully progressed. One of the key reasons for this scenario is the continuing lack of a comprehensive disease model. Within the increasing complexity of modern research methods, there is a clear need for an overarching theoretical framework, in which findings are assimilated and predictions are generated. In this review and hypothesis article, we propose such a framework, one in which dysregulated energy expenditure is a primary, sufficient cause for BD. Our proposed model is centered on the disruption of the molecular and cellular network regulating energy production and expenditure, as well its potential secondary adaptations and compensatory mechanisms. We also focus on the putative longitudinal progression of this pathological process, considering its most likely periods for onset, such as critical periods that challenges energy homeostasis (e.g. neurodevelopment, social isolation), and the resulting short and long-term phenotypical manifestations.
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Affiliation(s)
- Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Elisa Brietzke
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Kingston General Hospital, Providence Care Hospital, Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada
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154
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Chung N, Bin YS, Cistulli PA, Chow CM. Does the Proximity of Meals to Bedtime Influence the Sleep of Young Adults? A Cross-Sectional Survey of University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082677. [PMID: 32295235 PMCID: PMC7215804 DOI: 10.3390/ijerph17082677] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/01/2020] [Accepted: 04/10/2020] [Indexed: 01/09/2023]
Abstract
Avoiding food before bedtime is a widely accepted sleep hygiene practice, yet few studies have assessed meal timing as a risk factor for disrupted sleep. This study examined the relationship between evening meal timing and sleep quality in young adults. A total of N = 793 participants (26% male) aged between 18 and 29 years responded to an online survey, which captured sociodemographic information, lifestyle variables, and sleep characteristics. Meal timing was defined as meals more than 3 h before or within 3 h of bedtime. The outcomes were as follows: one or more nocturnal awakenings, sleep onset latency of >30 min, and sleep duration of ≤6 h. Logistic regression analyses showed that eating within 3 h of bedtime was positively associated with nocturnal awakening (OR = 1.61, 95% CI = 1.15–2.27) but not long sleep onset latency (1.24; 0.89–1.73) or short sleep duration (0.79; 0.49–1.26). The relationship remained significant after adjusting for potential confounders of ethnicity and body mass index (OR = 1.43, 95% CI = 1.00–2.04). Meal timing appears to be a modifiable risk factor for nocturnal awakenings and disrupted sleep. However, this is a preliminary cross-sectional study and highlights the need for additional research on the influence of the timing of food intake on sleep.
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Affiliation(s)
- Nikola Chung
- Sydney Medical School, University of Sydney, Sydney 2006, Australia; (N.C.); (P.A.C.)
| | - Yu Sun Bin
- Sydney Medical School, University of Sydney, Sydney 2006, Australia; (N.C.); (P.A.C.)
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Sydney 2006, Australia;
- Correspondence: ; Tel.: +61-2-8627-6113
| | - Peter A. Cistulli
- Sydney Medical School, University of Sydney, Sydney 2006, Australia; (N.C.); (P.A.C.)
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Sydney 2006, Australia;
| | - Chin Moi Chow
- Sleep Research Group, Charles Perkins Centre, University of Sydney, Sydney 2006, Australia;
- Sydney School of Health Sciences, University of Sydney, Sydney 2006, Australia
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155
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Åkerstedt T, Narusyte J, Svedberg P. Night work, mortality, and the link to occupational group and sex. Scand J Work Environ Health 2020; 46:508-515. [PMID: 32270204 PMCID: PMC7737802 DOI: 10.5271/sjweh.3892] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
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.
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Affiliation(s)
- Torbjörn Åkerstedt
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden.
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156
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Loef B, van der Beek AJ, Hulsegge G, van Baarle D, Proper KI. The mediating role of sleep, physical activity, and diet in the association between shift work and respiratory infections. Scand J Work Environ Health 2020; 46:516-524. [PMID: 32255192 PMCID: PMC7737798 DOI: 10.5271/sjweh.3896] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives: Shift work may be associated with an increased incidence of respiratory infections. However, underlying mechanisms are unclear. Therefore, our aim was to examine the mediating role of sleep, physical activity, and diet in the association between shift work and respiratory infections. Methods: This prospective cohort study included 396 shift and non-shift workers employed in hospitals. At baseline, sleep duration and physical activity were measured using actigraphy and sleep/activity diaries, sleep quality was reported, and frequency of meal and snack consumption was measured using food diaries. In the following six months, participants used a smartphone application to report their influenza-like illness/acute respiratory infection (ILI/ARI) symptoms daily. Mediation analysis of sleep, physical activity, and diet as potential mediators of the effect of shift work on ILI/ARI incidence rate was performed using structural equation modeling with negative binomial and logistic regression. Results: Shift workers had a 23% [incidence rate ratio (IRR) 1.23, 95% CI 1.01–1.49] higher incidence rate of ILI/ARI than non-shift workers. After adding the potential mediators to the model, this reduced to 15% (IRR 1.15, 95% CI 0.94–1.40). The largest mediating (ie, indirect) effect was found for poor sleep quality, with shift workers having 29% more ILI/ARI episodes via the pathway of poorer sleep quality (IRR 1.29, 95% CI 1.02–1.95). Conclusions: Compared to non-shift workers, shift workers had a higher incidence rate of ILI/ARI that was partly mediated by poorer sleep quality. Therefore, it may be relevant for future research to focus on perceived sleep quality as an underlying mechanism in the relation between shift work and increased infection susceptibility.
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Affiliation(s)
- Bette Loef
- Center for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment; P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
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157
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Ding L, Xiao XH. Gut microbiota: closely tied to the regulation of circadian clock in the development of type 2 diabetes mellitus. Chin Med J (Engl) 2020; 133:817-825. [PMID: 32106122 PMCID: PMC7147650 DOI: 10.1097/cm9.0000000000000702] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Indexed: 12/20/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM), a worldwide epidemic disease, has caused tremendous economic and social burden, but the pathogenesis remains uncertain. Nowadays, the impact of unrhythmic circadian clock caused by irregular sleep and unhealthy diet on T2DM has be increasingly studied. However, the contribution of the endogenous circadian clock system to the development of T2DM has not yet been satisfactorily explored. It is now becoming clear that the gut microbiota and the circadian clock interact with each other to regulate the host metabolism. Considering all these above, we reviewed the literature related to the gut microbiota, circadian clock, and T2DM to elucidate the idea that the gut microbiota is closely tied to the regulation of the circadian clock in the development of T2DM, which provides potential for gut microbiota-directed therapies to ameliorate the effects of circadian disruptions linked to the occurrence and development of T2DM.
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Affiliation(s)
- Lu Ding
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Diabetes Research Center of Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
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158
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Effects of Shift Work on the Eating Behavior of Police Officers on Patrol. Nutrients 2020; 12:nu12040999. [PMID: 32260404 PMCID: PMC7230712 DOI: 10.3390/nu12040999] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/01/2020] [Accepted: 04/02/2020] [Indexed: 12/20/2022] Open
Abstract
Recent studies indicate that the timing of food intake can significantly affect metabolism and weight management. Workers operating at atypical times of the 24-h day are at risk of disturbed feeding patterns. Given the increased risk of weight gain, obesity and metabolic syndrome in shift working populations, further research is required to understand whether their eating behavior could contribute to these increased metabolic risks. The objective of this study was to characterize the dietary patterns of police officers across different types of shifts in their natural environments. Thirty-one police officers (six women; aged 32.1 ± 5.4 years, mean ± SD) from the province of Quebec, Canada, participated in a 28- to 35-day study, comprising 9- to 12-h morning, evening, and night shifts alternating with rest days. Sleep and work patterns were recorded with actigraphy and diaries. For at least 24 h during each type of work day and rest day, participants logged nutrient intake by timestamped photographs on smartphones. Macronutrient composition and caloric content were estimated by registered dieticians using the Nutrition Data System for Research database. Data were analyzed with linear mixed effects models and circular ANOVA. More calories were consumed relative to individual metabolic requirements on rest days than both evening- and night-shift days (p = 0.001), largely sourced from increased fat (p = 0.004) and carbohydrate (trend, p = 0.064) intake. Regardless, the proportions of calories from carbohydrates, fat, and protein did not differ significantly between days. More calories were consumed during the night, between 2300 h and 0600 h, on night-shift days than any other days (p < 0.001). Caloric intake occurred significantly later for night-shift days (2308 h ± 0114 h, circular mean ± SD) than for rest days (1525 h ± 0029 h; p < 0.01) and was dispersed across a longer eating window (13.9 h ± 3.1 h vs. 11.3 h ± 1.8 h, mean ± SD). As macronutrient proportions were similar and caloric intake was lower, the finding of later meals times on night-shift days versus rest days is consistent with emerging hypotheses that implicate the biological timing of food intake—rather than its quantity or composition—as the differentiating dietary factor in shift worker health.
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159
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Rivera AS, Akanbi M, O’Dwyer LC, McHugh M. Shift work and long work hours and their association with chronic health conditions: A systematic review of systematic reviews with meta-analyses. PLoS One 2020; 15:e0231037. [PMID: 32240254 PMCID: PMC7117719 DOI: 10.1371/journal.pone.0231037] [Citation(s) in RCA: 93] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 03/13/2020] [Indexed: 01/06/2023] Open
Abstract
Background Previous reviews have demonstrated that shift work and long work hours are associated with increased risk for chronic conditions. However, these reviews did not comprehensively assessed the body of evidence, and some were not conducted in a systematic manner. A better understanding of the health consequences of shift work and long work hours will aid in creating policy and practice recommendations. This review revisits the epidemiologic evidence on the association of shift work and long work hours with chronic conditions with particular emphasis on assessing the quality of the evidence. Methods and findings We conducted a systematic review of systematic reviews with meta-analyses (SR-MA) that assessed the link between shift work or long work hours and chronic conditions (PROSPERO CRD42019122084). We evaluated the risk of bias of each SR-MA using AMSTAR v2 and assessed the overall evidence for each condition using the GRADE approach. We included 48 reviews covering cancers, cardiovascular diseases, metabolic syndrome and related conditions, pregnancy complications, depression, hypertension, and injuries. On average, only 7 of 16 AMSTAR items were fulfilled. Few SR-MAs had a registered protocol and nearly all failed to conduct a comprehensive search. We found moderate grade evidence linking shift work to breast cancer and long work hours to stroke. We found low grade evidence linking both shift work and long work hours with low to moderate increase in risk for some pregnancy complications and cardiovascular diseases. Low grade evidence also link long work hours and depression. Conclusions Moderate grade evidence suggest that shift work and long work hours increase the risk of breast cancer and stroke, but the evidence is unclear on other chronic conditions. There is a need for high-quality studies to address this gap. Stakeholders should be made aware of these increased risks, and additional screening and prevention should be considered, particularly for workers susceptible to breast cancer and stroke.
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Affiliation(s)
- Adovich S. Rivera
- Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- * E-mail:
| | - Maxwell Akanbi
- Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Linda C. O’Dwyer
- Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Galter Health Sciences Library and Learning Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
| | - Megan McHugh
- Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
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160
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Bahougne T, Kretz M, Angelopoulou E, Jeandidier N, Simonneaux V. Impact of Circadian Disruption on Female Mice Reproductive Function. Endocrinology 2020; 161:5758065. [PMID: 32100021 DOI: 10.1210/endocr/bqaa028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 02/25/2020] [Indexed: 12/12/2022]
Abstract
In female mammals, cycles in reproductive function depend both on the biological clock synchronized to the light/dark cycle and on a balance between the negative and positive feedbacks of estradiol, whose concentration varies during oocyte maturation. In women, studies report that chronodisruptive environments such as shiftwork may impair fertility and gestational success. The objective of this study was to explore the effects of shifted light/dark cycles on both the robustness of the estrous cycles and the timing of the preovulatory luteinizing hormone (LH) surge in female mice. When mice were exposed to a single 10-hour phase advance or 10-hour phase delay, the occurrence and timing of the LH surge and estrous cyclicity were recovered at the third estrous cycle. By contrast, when mice were exposed to chronic shifts (successive rotations of 10-hoursour phase advances for 3 days followed by 10-hour phase delays for 4 days), they exhibited a severely impaired reproductive activity. Most mice had no preovulatory LH surge at the beginning of the chronic shifts. Furthermore, the gestational success of mice exposed to chronic shifts was reduced, because the number of pups was 2 times lower in shifted than in control mice. In conclusion, this study reports that exposure of female mice to a single phase shift has minor reproductive effects, whereas exposure to chronically disrupted light/dark cycles markedly impairs the occurrence of the preovulatory LH surge, leading to reduced fertility.
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Affiliation(s)
- Thibault Bahougne
- Institut des Neurosciences Cellulaires et Intégratives, (UPR CNRS 3212) and University of Strasbourg, Strasbourg, France
- Service d'Endocrinologie et Diabète, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Mathilda Kretz
- Institut des Neurosciences Cellulaires et Intégratives, (UPR CNRS 3212) and University of Strasbourg, Strasbourg, France
- Service d'Endocrinologie et Diabète, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Eleni Angelopoulou
- Institut des Neurosciences Cellulaires et Intégratives, (UPR CNRS 3212) and University of Strasbourg, Strasbourg, France
| | - Nathalie Jeandidier
- Service d'Endocrinologie et Diabète, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Valérie Simonneaux
- Institut des Neurosciences Cellulaires et Intégratives, (UPR CNRS 3212) and University of Strasbourg, Strasbourg, France
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161
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Bucher Della Torre S, Wild P, Dorribo V, Danuser B, Amati F. Energy, Nutrient and Food Intakes of Male Shift Workers Vary According to the Schedule Type but Not the Number of Nights Worked. Nutrients 2020; 12:nu12040919. [PMID: 32230756 PMCID: PMC7230522 DOI: 10.3390/nu12040919] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 02/06/2023] Open
Abstract
Shift work is associated with increased risk of chronic diseases due to circadian rhythm disruptions and behavioral changes such as in eating habits. Impact of type of shifts and number of night shifts on energy, nutrient and food intake is as yet unknown. Our goal was to analyze shift workers’ dietary intake, eating behavior and eating structure, with respect to frequency of nights worked in a given week and seven schedule types. Eating habits and dietary intakes of 65 male shift workers were analyzed in three steps based on 365 24-h food records: (1) according to the number of nights, (2) in a pooled analysis according to schedule type, and (3) in search of an interaction of the schedule and the timing of intake. Mean nutrient and food group intake during the study period did not depend on the number of nights worked. Amount and distribution of energy intake as well as quality of food, in terms of nutrient and food groups, differed depending on the type of schedule, split night shifts and recovery day (day after night shift) being the most impacted. Shift workers’ qualitative and quantitative dietary intakes varied between different schedules, indicating the need for tailored preventive interventions.
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Affiliation(s)
- Sophie Bucher Della Torre
- Department of Nutrition and Dietetics, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Rue des Caroubiers 25, 1227 Carouge, Switzerland
- Correspondence: ; Tel.: +41-22-388-3547
| | - Pascal Wild
- Department of Health, Work and Environment, Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1011 Lausanne, Switzerland
- Scientific Management, INRS, 54519 Vandoeuvre-lès-Nancy, France
| | - Victor Dorribo
- Department of Health, Work and Environment, Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1011 Lausanne, Switzerland
| | - Brigitta Danuser
- Department of Health, Work and Environment, Center for Primary Care and Public Health (Unisanté), University of Lausanne, 1011 Lausanne, Switzerland
| | - Francesca Amati
- Department of Physiology and Institute of Sport Sciences, University of Lausanne, 1005 Lausanne, Switzerland
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162
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Mason IC, Qian J, Adler GK, Scheer FAJL. Impact of circadian disruption on glucose metabolism: implications for type 2 diabetes. Diabetologia 2020; 63:462-472. [PMID: 31915891 PMCID: PMC7002226 DOI: 10.1007/s00125-019-05059-6] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 08/19/2019] [Indexed: 12/21/2022]
Abstract
The circadian system generates endogenous rhythms of approximately 24 h, the synchronisation of which are vital for healthy bodily function. The timing of many physiological processes, including glucose metabolism, are coordinated by the circadian system, and circadian disruptions that desynchronise or misalign these rhythms can result in adverse health outcomes. In this review, we cover the role of the circadian system and its disruption in glucose metabolism in healthy individuals and individuals with type 2 diabetes mellitus. We begin by defining circadian rhythms and circadian disruption and then we provide an overview of circadian regulation of glucose metabolism. We next discuss the impact of circadian disruptions on glucose control and type 2 diabetes. Given the concurrent high prevalence of type 2 diabetes and circadian disruption, understanding the mechanisms underlying the impact of circadian disruption on glucose metabolism may aid in improving glycaemic control.
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Affiliation(s)
- Ivy C Mason
- Brigham and Women's Hospital, Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, 221 Longwood Avenue, Boston, MA, 02115, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jingyi Qian
- Brigham and Women's Hospital, Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, 221 Longwood Avenue, Boston, MA, 02115, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Gail K Adler
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frank A J L Scheer
- Brigham and Women's Hospital, Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, 221 Longwood Avenue, Boston, MA, 02115, USA.
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA, USA.
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163
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Sanya RE, Andia Biraro I, Nampijja M, Zziwa C, Nanyunja C, Nsubuga D, Kiwanuka S, Tumusiime J, Nassuuna J, Walusimbi B, Cose S, Ocama P, Grencis RK, Elliott AM, Webb EL. Contrasting impact of rural, versus urban, living on glucose metabolism and blood pressure in Uganda. Wellcome Open Res 2020; 5:39. [DOI: 10.12688/wellcomeopenres.15616.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2020] [Indexed: 11/20/2022] Open
Abstract
Background: The burden of cardiometabolic diseases, including cardiovascular diseases and diabetes, is increasing in sub-Saharan Africa and this has been linked to urbanisation. Helminths, through their immunomodulatory properties, may protect against these disorders. We hypothesised that the rural environment protects against cardiometabolic diseases and that helminths may influence rural-urban disparity of cardiometabolic disease risk. Methods: We compared metabolic parameters of individuals aged ≥10 years living in rural, high-helminth-transmission and urban, lower-helminth-transmission settings in Uganda. Cross-sectional surveys were conducted in rural Lake Victoria island communities and in urban sub-wards in Entebbe municipality. Helminth infection and outcomes, including insulin resistance (computed using the homeostatic model assessment of insulin resistance [HOMA-IR]), fasting blood glucose, fasting blood lipids, blood pressure, body mass index (BMI), waist and hip circumference, were assessed. Results: We analysed 1,898 rural and 930 urban participants. Adjusting for BMI, exercise, smoking, alcohol intake, age and sex, urban residents had lower mean fasting glucose (adjusted mean difference [95%CI] -0.13 [-0.24, -0.01] p=0.04) and HOMA-IR (-0.13 [-0.25, -0.01] p=0.04) but higher blood pressure (systolic, 4.64 [3.23, 6.06] p<0.001; diastolic, 1.89 [0.81, 2.97] p=0.001). Current helminth infection did not explain the observed differences. Conclusions: In low-income countries, rural living may protect against hypertension but impair glucose metabolism.
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164
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Abstract
Circadian rhythm misalignment due to social jet lag, shift work, early morning starts, and delayed bedtimes is becoming common in our modern society. Disturbances of sleep and the underlying circadian rhythms are related to multiple human diseases, such as obesity, diabetes, cardiovascular disorders, and cognitive impairments. Given the crucial role of microbiota in the same pathologies as are caused by sleep disturbance, how the gut microbiota is affected by sleep is of increasing interest. The results of this study indicate that the acute circadian rhythm disturbance caused by sleep-wake shifts affect the human gut microbiota, especially the functional profiles of gut microbes and interactions among them. Further experiments with a longer-time-scale intervention and larger sample size are needed to assess the effects of chronic circadian rhythm disruption on the gut microbiome and to guide possible microbial therapies for clinical intervention in the related diseases. Disturbances of sleep and the underlying circadian rhythm are related to many human diseases, such as obesity, diabetes, cardiovascular disorders, and cognitive impairments. Dysbiosis of the gut microbiome has also been reported to be associated with the pathologies of these diseases. Therefore, we proposed that disturbed sleep may regulate gut microbiota homeostasis. In this study, we mimicked the sleep-wake cycle shift, one typical type of circadian rhythm disturbances in young people, in recruited subjects. We used 16S rRNA gene amplicon sequencing to define microbial taxa from their fecal samples. Although the relative abundances of the microbes were not significantly altered, the functional-profile analysis of gut microbiota revealed functions enriched during the sleep-wake cycle shift. In addition, the microbial networks were quite distinct among baseline, shift, and recovery stages. These results suggest that an acute sleep-wake cycle shift may exert a limited influence on the gut microbiome, mainly including the functional profiles of the microbes and the microbial relationships within the microbial community. IMPORTANCE Circadian rhythm misalignment due to social jet lag, shift work, early morning starts, and delayed bedtimes is becoming common in our modern society. Disturbances of sleep and the underlying circadian rhythms are related to multiple human diseases, such as obesity, diabetes, cardiovascular disorders, and cognitive impairments. Given the crucial role of microbiota in the same pathologies as are caused by sleep disturbance, how the gut microbiota is affected by sleep is of increasing interest. The results of this study indicate that the acute circadian rhythm disturbance caused by sleep-wake shifts affect the human gut microbiota, especially the functional profiles of gut microbes and interactions among them. Further experiments with a longer-time-scale intervention and larger sample size are needed to assess the effects of chronic circadian rhythm disruption on the gut microbiome and to guide possible microbial therapies for clinical intervention in the related diseases.
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165
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Sunde E, Mrdalj J, Pedersen T, Thun E, Bjorvatn B, Grønli J, Harris A, Waage S, Pallesen S. Role of nocturnal light intensity on adaptation to three consecutive night shifts: a counterbalanced crossover study. Occup Environ Med 2020; 77:249-255. [PMID: 32019847 DOI: 10.1136/oemed-2019-106049] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 12/27/2019] [Accepted: 01/12/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate how a standard ceiling mounted light-emitting diode (LED)-based bright light intervention affected alertness and neurobehavioural performance during three consecutive simulated night shifts, and timing of circadian rhythm after the shifts. METHODS Twenty seven participants (20 females, 21.4±2.1 years; mean±SD) worked three consecutive night shifts (23:00-07:00) under a full-spectrum (4000 K) bright light (900 lx) and a standard light (90 lx) condition in a counterbalanced crossover design (separated by 4 weeks). Subjective alertness (Karolinska Sleepiness Scale) and neurobehavioural performance (Psychomotor Vigilance Task and Digit Symbol Substitution Test) were assessed five times during each shift. Salivary dim-light melatonin onset (DLMO) was assessed before and after the shifts. The simulated night shifts were conducted in a laboratory while the participants slept at home. RESULTS Subjective alertness and neurobehavioural performance deteriorated during the night shifts in both light conditions. However, bright light significantly reduced alertness and performance decrements as compared with standard light. For a subset of the participants, DLMO was delayed by a mean of 3:17±0:23 (mean±SEM) hours after three night shifts in bright light and by 2:06±0:15 hours in standard light, indicating that bright light causes larger phase delay. CONCLUSION Bright light improved performance and alertness during simulated night shifts and improved adaptation to night work. Bright light administered by ceiling mounted LED luminaires has the potential to improve adaptation to night work and reduce the risk of accidents and injuries among night workers. TRIAL REGISTRATION NUMBER NCT03203538.
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Affiliation(s)
- Erlend Sunde
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Jelena Mrdalj
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Torhild Pedersen
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Eirunn Thun
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Janne Grønli
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Siri Waage
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
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166
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Greater social jetlag associates with higher HbA1c in adults with type 2 diabetes: a cross sectional study. Sleep Med 2020; 66:1-9. [DOI: 10.1016/j.sleep.2019.07.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 07/02/2019] [Accepted: 07/12/2019] [Indexed: 11/21/2022]
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167
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Sleep quality and health related problems of shift work among resident physicians: a cross-sectional study. Sleep Med 2020; 66:201-206. [DOI: 10.1016/j.sleep.2019.11.1258] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 11/04/2019] [Accepted: 11/27/2019] [Indexed: 02/06/2023]
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168
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Dashti HS, Vetter C, Lane JM, Smith MC, Wood AR, Weedon MN, Rutter MK, Garaulet M, Scheer FAJL, Saxena R. Assessment of MTNR1B Type 2 Diabetes Genetic Risk Modification by Shift Work and Morningness-Eveningness Preference in the UK Biobank. Diabetes 2020; 69:259-266. [PMID: 31757795 PMCID: PMC6971490 DOI: 10.2337/db19-0606] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 11/18/2019] [Indexed: 02/01/2023]
Abstract
Night shift work, behavioral rhythms, and the common MTNR1B risk single nucleotide polymorphism (SNP), rs10830963, associate with type 2 diabetes; however, whether they exert joint effects to exacerbate type 2 diabetes risk is unknown. Among employed participants of European ancestry in the UK Biobank (N = 189,488), we aimed to test the cross-sectional independent associations and joint interaction effects of these risk factors on odds of type 2 diabetes (n = 5,042 cases) and HbA1c levels (n = 175,156). Current shift work, definite morning or evening preference, and MTNR1B rs10830963 risk allele associated with type 2 diabetes and HbA1c levels. The effect of rs10830963 was not modified by shift work schedules. While marginal evidence of interaction between self-reported morningness-eveningness preference and rs10830963 on risk of type 2 diabetes was seen, this interaction did not persist when analysis was expanded to include all participants regardless of employment status and when accelerometer-derived sleep midpoint was used as an objective measure of morningness-eveningness preference. Our findings suggest that MTNR1B risk allele carriers who carry out shift work or have more extreme morningness-eveningness preference may not have enhanced risk of type 2 diabetes.
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Affiliation(s)
- Hassan S Dashti
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- The Eli and Edythe L. Broad Institute of MIT and Harvard, Cambridge, MA
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Céline Vetter
- The Eli and Edythe L. Broad Institute of MIT and Harvard, Cambridge, MA
- Department of Integrative Physiology, University of Colorado at Boulder, Boulder, CO
| | - Jacqueline M Lane
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- The Eli and Edythe L. Broad Institute of MIT and Harvard, Cambridge, MA
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Matt C Smith
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, U.K
| | - Andrew R Wood
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, U.K
| | - Michael N Weedon
- Genetics of Complex Traits, University of Exeter Medical School, Exeter, U.K
| | - Martin K Rutter
- Division of Endocrinology, Diabetes and Gastroenterology, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester, U.K
- Manchester Diabetes Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, U.K
| | - Marta Garaulet
- Department of Physiology, University of Murcia, Murcia, Spain
- Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Frank A J L Scheer
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- The Eli and Edythe L. Broad Institute of MIT and Harvard, Cambridge, MA
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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169
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Vetter C. Circadian disruption: What do we actually mean? Eur J Neurosci 2020; 51:531-550. [PMID: 30402904 PMCID: PMC6504624 DOI: 10.1111/ejn.14255] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 10/23/2018] [Accepted: 10/23/2018] [Indexed: 12/14/2022]
Abstract
The circadian system regulates physiology and behavior. Acute challenges to the system, such as those experienced when traveling across time zones, will eventually result in re-synchronization to local environmental time cues, but this re-synchronization is oftentimes accompanied by adverse short-term consequences. When such challenges are experienced chronically, adaptation may not be achieved, as for example in the case of rotating night shift workers. The transient and chronic disturbance of the circadian system is most frequently referred to as "circadian disruption", but many other terms have been proposed and used to refer to similar situations. It is now beyond doubt that the circadian system contributes to health and disease, emphasizing the need for clear terminology when describing challenges to the circadian system and their consequences. The goal of this review is to provide an overview of the terms used to describe disruption of the circadian system, discuss proposed quantifications of disruption in experimental and observational settings with a focus on human research, and highlight limitations and challenges of currently available tools. For circadian research to advance as a translational science, clear, operationalizable, and scalable quantifications of circadian disruption are key, as they will enable improved assessment and reproducibility of results, ideally ranging from mechanistic settings, including animal research, to large-scale randomized clinical trials.
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Affiliation(s)
- Céline Vetter
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
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170
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Park H, Lee SJ. Factor Analysis of the Insomnia Severity Index and Epworth Sleepiness Scale in Shift Workers. J Korean Med Sci 2019; 34:e317. [PMID: 31880414 PMCID: PMC6935560 DOI: 10.3346/jkms.2019.34.e317] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 10/28/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Over one million Korean night shift workers undergo clinical assessment of sleep using the Insomnia Severity Index (ISI) and Epworth Sleepiness Scale (ESS) by occupational medical examination each year. Therefore, this study was conducted to evaluate the reliability and validity of the ISI and ESS using occupational medical examination data. METHODS The study subjects included 12,056 shift workers at an electronics company who underwent an occupational health examination about shift work in 2018. The evaluation of the ISI and ESS was performed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). RESULTS According to the results of the EFA, the ISI had a single-factor structure, while the ESS had a two-factor structure, which was inconsistent with the findings of previous studies. The results of the EFA of 15 items from the combined ISI and ESS suggested a three-factor structure, with one factor for ISI items and two factors for ESS items, while the results of the CFA suggested sufficient validity of the combination of the ISI and ESS for sleep evaluation. CONCLUSION The results suggest that the ISI and ESS have sufficient reliability and validity to be used for occupational health examinations about shift work.
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Affiliation(s)
- Hwanjin Park
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, Korea
- Department of Medicine, Graduate School, Hanyang University, Seoul, Korea
| | - Soo Jin Lee
- Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seoul, Korea.
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171
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Zhong LX, Li XN, Yang GY, Zhang X, Li WX, Zhang QQ, Pan HX, Zhang HH, Zhou MY, Wang YD, Zhang WW, Hu QS, Zhu W, Zhang B. Circadian misalignment alters insulin sensitivity during the light phase and shifts glucose tolerance rhythms in female mice. PLoS One 2019; 14:e0225813. [PMID: 31851682 PMCID: PMC6919582 DOI: 10.1371/journal.pone.0225813] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/13/2019] [Indexed: 12/18/2022] Open
Abstract
Shift work and jet lag, characterized by circadian misalignment, can disrupt several physiological activities, but whether they affect the rhythm of glucose uptake and insulin sensitivity remain unclear. In the present study, female C57BL/6J mice were maintained for four weeks under the condition of 8-hour phase advance and delay every 3–4 days to mimic shift work. Intraperitoneal glucose tolerance test (IPGTT) and intraperitoneal insulin tolerance test (IPITT) were performed repeatedly at Zeitgeber time (ZT) 0, ZT6, ZT12, and ZT18. Glucose-stimulated insulin secretion (GSIS) test was performed at ZT6. We found that the average level of daily glucose tolerance did not decrease but the phase of glucose tolerance advanced by 2.27 hours and the amplitude attenuated by 20.4% in shift work mice. At ZT6, IPITT showed blood glucose at 30 min after insulin injection decreased faster in shift work mice (−3.50±0.74mmol/L, −61.58±7.89%) than that in control mice (−2.11±1.10mmol/L, −33.72±17.24%), but IPGTT and GSIS test showed no significant difference between the two groups. Food intake monitor showed that the feeding time of shift work mice continued to advance. Restricting feed to a fixed 12-hour period alleviated the increase of insulin sensitivity induced by shift-work. We also observed that an increase of blood glucose and liver glycogen at ZT0, as well as a phase advance of liver clock genes and some glucose metabolism-related genes such as forkhead box O1 (Foxo1) and peroxisome proliferator activated receptor alpha (Pparα) in shift work mice. Our results showed that light change-simulated shift work altered insulin sensitivity during the light phase and shifted glucose tolerance rhythms in female mice, suggesting a causal association between long-term shift work and type 2 diabetes.
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Affiliation(s)
- Li-Xin Zhong
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.,Department of Toxicology, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China.,Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao-Na Li
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Guang-Yu Yang
- Department of Toxicology, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Xia Zhang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.,Department of Toxicology, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Wen-Xue Li
- Department of Toxicology, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Qian-Qian Zhang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Huan-Xin Pan
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.,Department of Toxicology, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Hui-Hong Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Meng-Ya Zhou
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yi-Ding Wang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei-Wei Zhang
- Department of Toxicology, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Qian-Sheng Hu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Wei Zhu
- Department of Toxicology, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Bo Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
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172
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Abstract
The immune system potentially plays an important mechanistic role in the relation between shift work and adverse health effects. To better understand the immunological effects of shift work, we compared numbers and functionality of immune cells between night-shift and non-shift workers. Blood samples were collected from 254 night-shift and 57 non-shift workers employed in hospitals. Absolute numbers of monocytes, granulocytes, lymphocytes, and T cell subsets were assessed. As read out of immune function, monocyte cytokine production and proliferative capacity of CD4 and CD8 T cells in response to various stimuli were analysed. The mean number of monocytes was 1.15 (95%-CI = 1.05–1.26) times higher in night-shift than in non-shift workers. Furthermore, night-shift workers who worked night shifts in the past three days had a higher mean number of lymphocytes (B = 1.12 (95%-CI = 1.01–1.26)), T cells (B = 1.16 (95%-CI = 1.03–1.31)), and CD8 T cells (B = 1.23 (95%-CI = 1.05–1.45)) compared to non-shift workers. No differences in functional parameters of monocytes and lymphocytes were observed. The differences in numbers of monocytes and T cells suggest that chronic exposure to night-shift work as well as recent night-shift work may influence the immune status of healthcare workers. This knowledge could be relevant for preventive initiatives in night-shift workers, such as timing of vaccination.
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173
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Zhang J, Gong Y, Zhao Y, Jiang N, Wang J, Yin X. Post-stroke medication adherence and persistence rates: a meta-analysis of observational studies. J Neurol 2019; 268:2090-2098. [PMID: 31792672 DOI: 10.1007/s00415-019-09660-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Following a doctor's prescribed medication regimen is the key to prevent recurrent stroke and adverse outcomes. Many studies have investigated post-stroke drug adherence and persistence in patients. However, a comprehensive analysis of the data is lacking. OBJECTIVES A meta-analysis of published literature was conducted to summarize the ratio of medication adherence and persistence in patients after stroke. METHODS Relevant studies were identified by conducting a literature search using PubMed, EMBASE and Web of Science up to April 2019. We also reviewed the reference list of the retrieved articles to identify additional studies. We included observational studies that reported data on patients' medication adherence or persistence status, or the rate of medication adherence or persistence among patients with stroke could be calculated based on the information provided. RESULTS The overall high medication adherence rate of patients with stroke was 64.1% (95% CI: 57.4%-70.8%), and the persistence rate of patients with stroke was 72.2% (95% CI: 69.1%-75.3%). The highest persistence rate was observed in cohort studies which was 80.1% (95% CI: 76.7%-83.4%). The medication adherence rate was the highest in cases where the rates were assessed through interviews or self-reports (77.7% (95% CI: 71.3%-84.1%)). CONCLUSIONS Medication adherence and persistence rates are low in patients after suffering a stroke. Patient medication adherence or persistence and their influencing factors should be considered for the treatment of stroke patients. More detailed disease prevention and management strategies need to be developed for stroke patients with different comorbidities.
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Affiliation(s)
- Jia Zhang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Yanhong Gong
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Yuxin Zhao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Nan Jiang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Jing Wang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China
| | - Xiaoxv Yin
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
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174
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Inolopú J, Hilario-Huapaya N, Tantaleán-Del-Águila MA, Hurtado-Roca Y, Ugarte-Gil C. Interventions for the prevention of risk factors and incidence of type 2 diabetes in the work environment: a systematic review. Rev Saude Publica 2019; 53:101. [PMID: 31800912 PMCID: PMC6863112 DOI: 10.11606/s1518-8787.2019053001084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Accepted: 03/17/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of interventions aimed at the prevention of risk factors and incidence of type 2 diabetes in the workers population. METHODS Systematic review of interventions aimed at adult workers at risk of type 2 diabetes published in Medline, Embase, Web of Science, Central Cochrane Registry of Controlled Trials, and Lilacs. Randomized trials, quasi-experimental research and cohort studies were selected; in English, Spanish and Portuguese; published from 2000 to 2017. Intervention effectiveness was evaluated concerning the incidence of type 2 diabetes and a significant reduction in body weight, or another anthropometric or metabolic parameter. RESULTS 3,024 articles were generated, of which 2,825 that did not answer the research question were eliminated, as well as 130 that did not evaluate original interventions, 57 carried out outside the workplace and two reviews; so that 10 selected items remained. Interventions based on structured programs previously evaluated and integrated into the workplace had a favorable impact on the reduction of body weight and other risk factors. CONCLUSIONS The effectiveness of lifestyle interventions for the prevention of type 2 diabetes should be based on structured programs with proven effectiveness and adapted to the workplace, with employer participation in the provision of schedules and work environments.
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Affiliation(s)
- Jorge Inolopú
- Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, Perú.,Universidad Peruana Cayetano Heredia. Facultad de Salud Pública. Lima, Perú
| | - Nélida Hilario-Huapaya
- Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, Perú.,Universidad Peruana Cayetano Heredia. Facultad de Salud Pública. Lima, Perú
| | | | - Yamilee Hurtado-Roca
- EsSalud. Instituto de Evaluación de Tecnologías en Salud e Investigación. Lima, Perú
| | - Cesar Ugarte-Gil
- Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, Perú.,Universidad Peruana Cayetano Heredia. Facultad de Medicina. Lima, Perú
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175
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Gowda RH, Sukumar GM, Gowda SH. Association between metabolic risk, oxidative stress and rotating shift work in a tertiary health care facility. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2019.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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176
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Leung GKW, Huggins CE, Ware RS, Bonham MP. Time of day difference in postprandial glucose and insulin responses: Systematic review and meta-analysis of acute postprandial studies. Chronobiol Int 2019; 37:311-326. [DOI: 10.1080/07420528.2019.1683856] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Gloria K. W. Leung
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - Catherine E. Huggins
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
| | - Robert S. Ware
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Maxine P. Bonham
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, Victoria, Australia
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177
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Park H, Suh B. Association between sleep quality and physical activity according to gender and shift work. J Sleep Res 2019; 29:e12924. [PMID: 31782219 DOI: 10.1111/jsr.12924] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 08/22/2019] [Accepted: 09/03/2019] [Indexed: 12/14/2022]
Abstract
Shift work directly causes circadian disruption and reduces sleep quality. Physical activity is also associated with sleep quality. However, no study has reported the relationship between a specific level of physical activity and sleep quality. This study aimed to investigate the relationship between sleep quality and the amount of physical activity by stratifying subjects into gender and shift-work subgroups. Among those who participated in the Kangbuk Samsung Health Study in 2016-2017, data from 185,958 full-time workers were analysed. We evaluated their physical activity by metabolic equivalents (METs-min/week), sleep quality and shift work. A chi-squared test, a t test and logistic regression analysis were performed. An increase in sleep quality was found for the group with physical activity of 600-9,000 METs-min/week compared to that in the sedentary group among all subjects. In female day workers, the sleep quality of the group with 600-6,000 METs-min/week was significantly higher (odds ratio [OR], 0.760; 95% confidence interval [CI], 0.673-857) than that in the sedentary group. In male day workers, sleep quality increased when physical activity was increased up to 6,000-9,000 METs-min/week (OR, 0.760; 95% CI, 0.673-857). In female shift workers, there was no significant difference in sleep quality according to physical activity level. In male shift workers, sleep quality was better in the group with physical activity of 1,800-3,000 METs-min/week (OR, 0.826; 95% CI, 0.692-0.986) or 3,000-6,000 METs-min/week (OR, 0.771; 95% CI, 0.642-0.926). Optimal physical activity is good for sleep quality. The sleep quality of females is significantly worse than that of males in both day and shift workers.
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Affiliation(s)
- Hwanjin Park
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byungseong Suh
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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178
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Circadian misalignment imposed by nocturnal feeding tends to increase fat deposition in pigs. Br J Nutr 2019; 123:529-536. [PMID: 31771673 DOI: 10.1017/s0007114519003052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AbstractMisalignment of day/night and feeding rhythms has been shown to increase fat deposition and the risk for metabolic disorders in humans and rodents. In most studies, however, food intake and intake patterns are not controlled. We studied the effects of circadian misalignment on energy expenditure in pigs while controlling for food intake as well as intake patterns. Twelve groups of five male pigs were housed in respiration chambers and fed either during the day (10.00–18.00 hours; DF) or night (22.00–06.00 hours; NF), bihourly the same sequential meals, representing 15, 10, 25, 30 and 20 % of the daily allowance. Paired feeding was applied to ensure equal gross energy intake between treatments. Apparent total tract digestibility, energy balances and heat partitioning were measured and analysed using a mixed linear model. Apparent total tract energy and DM digestibility tended to be lower for NF-pigs than DF-pigs (P < 0·10). Heat production was 3 % lower for NF-pigs than DF-pigs (P < 0·026), increasing fat retention by 7 % in NF-pigs (P = 0·050). NF-pigs were less active than DF-pigs during the feeding period, but more active during the fasting period. RMR was greater for DF-pigs than NF-pigs during the fasting period. Methane production was 30 % greater in NF-pigs than DF-pigs (P < 0·001). In conclusion, circadian misalignment has little effect on nutrient digestion, but alters nutrient partitioning, ultimately increasing fat deposition. The causality of the association between circadian misalignment and methane production rates remains to be investigated.
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179
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Chege BM, Waweru MP, Frederick B, Nyaga NM. The freeze-dried extracts of Rotheca myricoides (Hochst.) Steane & Mabb possess hypoglycemic, hypolipidemic and hypoinsulinemic on type 2 diabetes rat model. JOURNAL OF ETHNOPHARMACOLOGY 2019; 244:112077. [PMID: 31369832 DOI: 10.1016/j.jep.2019.112077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/06/2019] [Accepted: 07/08/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Rotheca myricoides (Hochst.) Steane & Mabb is a plant species used in traditional medicine for the management of diabetes in the lower eastern part of Kenya (Kitui, Machakos and Makueni Counties, Kenya) that is mainly inhabited by the Kamba community. AIM This study investigated the antihyperglycaemic, antidyslipidemic and antihyperinsulinemic activity of the freeze-dried extracts of Rotheca myricoides (Hochst.) Steane & Mabb (RME) in an animal model of type 2 diabetes mellitus. METHODS Type 2 diabetes was induced by dietary manipulation for 56 days via (high fat- high fructose diet) and intraperitoneal administration of streptozocin (30 mg/kg). Forty freshly-weaned Sprague Dawley rats were randomly assigned into the negative control (high fat/high fructose diet), low dose test (50mg/kg RME, high dose test (100mg/kg RME and positive control (Pioglitazone, 20mg/kg) groups. Fasting blood glucose and body weight were measured at weekly intervals. Oral glucose tolerance tests were performed on days 28 and 56. Lipid profile, hepatic triglycerides, fasting serum insulin levels and serum uric acid were determined on day 56. RESULTS The RME possessed significant antihyperglycemic [FBG: 6.5 ± 0.11 mmol/l (negative control) vs. 4.62 ± 0.13 mmol/l (low dose test) vs. 5.25 ± 0.15 mmol/l in (high dose test) vs. 4.33 ± 0.09 mmol/l (positive control): p < 0.0001] and antihyperinsulinemic effects [1.84 ± 0.19 (negative control) vs. (0.69 ± 0.13 (low dose test) vs. (0.83 ± 0.17 (high dose test) vs. (0.69 ± 0.10 (positive control): F (3, 36) = 0.6421: p < 0.0001. The extracts also possessed significant antidyslipidemic effects [LDL levels: 3.52 ± 0.19 mmol/l (negative control) vs. 0.33 ± 0.14 mmol/l (low dose test) vs. 0.34 ± 0.20 mmol/l (high dose test) vs. 0.33 ± 0.01 mmol/l (positive control): p < 0.0001].RME significantly lowered plasma uric acid levels, as well as hepatic triglycerides and hepatic weights. Network pharmacology analysis indicated that the observed pharmacological effects are mediated via the modulation of Peroxisome proliferator-activated gamma receptor. CONCLUSIONS The freeze dried extracts of Rotheca myricoides possessed significant antihyperglycemic and antidyslidemic effects. In addition it lowered serum uric levels, as well as hepatic triglycerides and hepatic weight. These results appear to validate the traditional use of this plant species in the management of diabetes mellitus.
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Affiliation(s)
- Boniface Mwangi Chege
- Department of Medical Physiology, School of Medicine, University of Nairobi, GPO 30197-00100, Kenya.
| | - Mwangi Peter Waweru
- Department of Medical Physiology, School of Medicine, University of Nairobi, GPO 30197-00100, Kenya.
| | - Bukachi Frederick
- Department of Medical Physiology, School of Medicine, University of Nairobi, GPO 30197-00100, Kenya.
| | - Nelly Murugi Nyaga
- Department of Medical Physiology, School of Medicine, University of Nairobi, GPO 30197-00100, Kenya.
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180
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Sex differences in the circadian misalignment effects on energy regulation. Proc Natl Acad Sci U S A 2019; 116:23806-23812. [PMID: 31685618 DOI: 10.1073/pnas.1914003116] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Shift work causes circadian misalignment and is a risk factor for obesity. While some characteristics of the human circadian system and energy metabolism differ between males and females, little is known about whether sex modulates circadian misalignment effects on energy homeostasis. Here we show-using a randomized cross-over design with two 8-d laboratory protocols in 14 young healthy adults (6 females)-that circadian misalignment has sex-specific influences on energy homeostasis independent of behavioral/environmental factors. First, circadian misalignment affected 24-h average levels of the satiety hormone leptin sex-dependently (P < 0.0001), with a ∼7% decrease in females (P < 0.05) and an ∼11% increase in males (P < 0.0001). Consistently, circadian misalignment also increased the hunger hormone ghrelin by ∼8% during wake periods in females (P < 0.05) without significant effect in males. Females reported reduced fullness, consistent with their appetite hormone changes. However, males reported a rise in cravings for energy-dense and savory foods not consistent with their homeostatic hormonal changes, suggesting involvement of hedonic appetite pathways in males. Moreover, there were significant sex-dependent effects of circadian misalignment on respiratory quotient (P < 0.01), with significantly reduced values (P < 0.01) in females when misaligned, and again no significant effects in males, without sex-dependent effects on energy expenditure. Changes in sleep, thermoregulation, behavioral activity, lipids, and catecholamine levels were also assessed. These findings demonstrate that sex modulates the effects of circadian misalignment on energy metabolism, indicating possible sex-specific mechanisms and countermeasures for obesity in male and female shift workers.
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181
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Gao Y, Gan T, Jiang L, Yu L, Tang D, Wang Y, Li X, Ding G. Association between shift work and risk of type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of observational studies. Chronobiol Int 2019; 37:29-46. [DOI: 10.1080/07420528.2019.1683570] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Yinyan Gao
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
| | - Ting Gan
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Gansu, China
| | - Lili Jiang
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
| | - Li Yu
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
| | - Daimao Tang
- Institute of Occupational and Environmental Health, School of Public Health, Lanzhou University, Gansu, China
| | - Yihui Wang
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
| | - Xiuxia Li
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Gansu, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Gansu, China
| | - Guowu Ding
- Institute of Social Medicine and Health Administration, School of Public Health, Lanzhou University, Gansu, China
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182
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Simak M, Lu HHS, Yang JM. Boolean function network analysis of time course liver transcriptome data to reveal novel circadian transcriptional regulators in mammals. J Chin Med Assoc 2019; 82:872-880. [PMID: 31469689 DOI: 10.1097/jcma.0000000000000180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Many biological processes in mammals are subject to circadian control at the molecular level. Disruption of circadian rhythms has been demonstrated to be associated with a wide range of diseases, such as diabetes mellitus, mental disorders, and cancer. Although the core circadian genes are well established, there are multiple reports of novel peripheral circadian regulators. The goal of this study was to provide a comprehensive computational analysis to identify novel potential circadian transcriptional regulators. METHODS To fulfill the aforementioned goal, we applied a Boolean function network method to analyze the microarray time course mouse and rat liver datasets available in the literature. The inferred direct pairwise relations were further investigated using the functional annotation tool. This approach generated a list of transcription factors (TFs) and cofactors, which were associated with significantly enriched circadian gene ontology (GO) categories. RESULTS As a result, we identified 93 transcriptional circadian regulators in mouse and 95 transcriptional circadian regulators in rat. Of these, 19 regulators in mouse and 21 regulators in rat were known, whereas the rest were novel. Furthermore, we validated novel circadian TFs with bioinformatics databases, previous large-scale circadian studies, and related small-scale studies. Moreover, according to predictions inferred from ChIP-Seq experiments reported in the database, 40 of our candidate circadian regulators were confirmed to have circadian genes as direct regulatory targets. In addition, we annotated candidate circadian regulators with disorders that were often associated with disruptions of circadian rhythm in the literature. CONCLUSION In summary, our computational analysis, which was followed by an extensive verification by means of a literature review, can contribute to translational study from endocrinology to cancer research and provide insights for future investigation.
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Affiliation(s)
- Maria Simak
- Bioinformatics Program, Taiwan International Graduate Program, Institute of Information Science, Academia Sinica, Taipei, Taiwan, ROC
- Institute of Statistics, National Chiao Tung University, Hsinchu, Taiwan, ROC
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan, ROC
| | | | - Jinn-Moon Yang
- Institute of Bioinformatics and Systems Biology, National Chiao Tung University, Hsinchu, Taiwan, ROC
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183
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Policy brief: Nurse fatigue, sleep, and health, and ensuring patient and public safety. Nurs Outlook 2019; 67:615-619. [PMID: 31582105 DOI: 10.1016/j.outlook.2019.08.004] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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184
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Buchvold HV, Pallesen S, Waage S, Moen BE, Bjorvatn B. Shift Work and Lifestyle Factors: A 6-Year Follow-Up Study Among Nurses. Front Public Health 2019; 7:281. [PMID: 31750282 PMCID: PMC6843055 DOI: 10.3389/fpubh.2019.00281] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/18/2019] [Indexed: 02/01/2023] Open
Abstract
Objectives: To evaluate different work schedules, short rest time between shifts (quick returns), and night shift exposure for their possible adverse effects on different lifestyle factors in a 6-year follow-up study. Methods: Data stemmed from “The Survey of Shiftwork, Sleep and Health,” a cohort study of Norwegian nurses started in 2008/9. The data analyzed in this sub-cohort of SUSSH were from 2008/9 to 2015 and consisted of 1,371 nurses. The lifestyle factors were: Exercise (≥1 h/week, <1 h/week), caffeine consumption (units/day), smoking (prevalence and cigarettes/day), and alcohol consumption (AUDIT-C score). We divided the nurses into four groups: (1) day workers, (2) night workers, (3) nurses who changed toward, and (4) nurses who changed away from a schedule containing night shifts. Furthermore, average number of yearly night shifts (NN), and average number of quick returns (QR) were calculated. Paired t-tests, McNemar tests, and logistic regression analyses were used in the analyses. Results: We found a significant increase in caffeine consumption across all work schedule groups and a decline in smoking prevalence for day workers and night workers at follow-up. Analyses did not show any significant differences between groups when analyzing (1) different work schedules, (2) different exposures to QR, (3) different exposures to NN on the respective lifestyle factor trajectories. Conclusion: We found no significant differences between the different work schedule groups or concerning different exposures to QR or NN when evaluating these lifestyle factor trajectories. This challenges the notion that shift work has an adverse impact on lifestyle factors.
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Affiliation(s)
- Hogne Vikanes Buchvold
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Siri Waage
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Bente E Moen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
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185
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Feasibility and Preliminary Efficacy of an m-Health Intervention Targeting Physical Activity, Diet, and Sleep Quality in Shift-Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203810. [PMID: 31658624 PMCID: PMC6843501 DOI: 10.3390/ijerph16203810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 09/23/2019] [Accepted: 10/04/2019] [Indexed: 12/27/2022]
Abstract
Poor health behaviors are prevalent in shift-workers, but few multiple health-behavior interventions consider their unique needs. This study aimed to (1) evaluate the feasibility and acceptability of an existing app-based intervention to improve physical activity, diet, and sleep quality in a shift-worker population, (2) estimate intervention effect in a four-week pilot randomized controlled trial (RCT) (ACTRN12618001785291). Shift-workers (18–65 years old) were randomized to intervention (n = 20) or wait-list (n = 20) groups. Outcomes included recruitment, engagement, attrition, usefulness ratings, System Usability Scale (SUS), qualitative interviews, and estimation of treatment effect (minutes of physical activity, diet quality, and sleep quality) using mixed model analysis. Recruitment took one week. App-use at week four was 55% (11/20), 85% (34/40) completed the four-week follow-up questionnaire, and 20% (4/20) of the intervention group completed the qualitative interview. The intervention was rated as slightly to moderately useful by 76.9% (10/13) of participants on a five-point scale. The SUS score was 62.7 (12.7) out of 100. Diet quality improved for the intervention (4.5 points; 95% confidence interval (CI) = 0.1, 8.9; p = 0.047) vs. the wait-list group, but not physical activity or sleep quality. Qualitative interviews found that a more tailored intervention, more accessible information, and interactive features were desired. The intervention was feasible in terms of recruitment, but modifications to increase engagement are needed.
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186
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Effect of night shift work on the control of hypertension and diabetes in workers taking medication. Ann Occup Environ Med 2019; 31:e27. [PMID: 31737282 PMCID: PMC6850788 DOI: 10.35371/aoem.2019.31.e27] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 09/25/2019] [Indexed: 11/25/2022] Open
Abstract
Background Night shift work induces physiological and psychological stress by altering sleep and biological rhythms and is associated with hypertension, diabetes, obesity, and cardiovascular diseases. Few studies have been conducted on the control of hypertension and diabetes. This study aimed to examine the effect of night shift work on the control rate of hypertension and diabetes. Methods Subjects comprised workers aged 20–65 years who underwent specific health examination at a single facility in seven different affiliated examination centers from 1 January to 31 December 2016. Workers were categorised into day workers and night shift workers. Demographic and medical history were taken, and physical examination was done. Blood pressure (BP) and fasting glucose were measured. The control rate of each disease was evaluated based on treatment goals presented in the treatment guidelines of the Korean Society of Hypertension and the Korean Diabetes Association (systolic BP < 140 mmHg and diastolic BP < 90 mmHg; fasting glucose ≤ 130 mg/dL). Results Among 631,418 subjects, 11.2% (70,450) were night shift workers. Of whom 6.1% (4,319) were taking antihypertensive medication and 2.5% (1,775) were taking diabetes medication. Among patients taking antihypertensive medications, the proportion of those whose BP was controlled to suit treatment goals was 81.7% (26,635) of day workers and 77.4% (3,343) of night shift workers, which was significantly different (p < 0.001). Among patients taking diabetes medications, the proportion of those whose blood glucose was controlled to suit treatment goals was 37.4% (4,489) of day workers and 36.5% (647) of night shift workers, but the difference was not significant. The control rates for patients taking antihypertensive medications (odds ratio [OR]: 0.74, 95% confidence interval [CI]: 0.68–0.80) were lower among night shift workers than day workers with adjustment for age, sex, smoking history, alcohol consumption, exercise, and obesity. However, there were no differences in control rates for patients taking diabetes medications (OR: 0.99, 95% CI: 0.87–1.10) between day workers and night shift workers. Conclusions Night shift work can have an effect on the uncontrolled BP in workers taking antihypertensive medications. Therefore, additional efforts for disease control are necessary for night shift workers with hypertension.
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187
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Price LLA, Udovičić L, Behrens T, van Drongelen A, Garde AH, Hogenelst K, Jensen MA, Khazova M, Nowak K, Rabstein S, Romanus E, Wolska A. Linking the non-visual effects of light exposure with occupational health. Int J Epidemiol 2019; 48:1393-1397. [PMID: 31257447 PMCID: PMC6857759 DOI: 10.1093/ije/dyz131] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2019] [Indexed: 11/12/2022] Open
Affiliation(s)
- Luke L A Price
- Radiation Dosimetry Department, Public Health England (PHE), Centre for Radiation, Chemical and Environmental Hazards, Didcot, UK
| | - Ljiljana Udovičić
- Physical Agents Unit, Federal Institute for Occupational Safety and Health (BAuA), Dortmund, Germany
| | - Thomas Behrens
- Center of Epidemiology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - Alwin van Drongelen
- Healthy Living Unit, The Netherlands Organisation for Applied Scientific Research (TNO), The Hague, The Netherlands
| | - Anne Helene Garde
- Department of Psychosocial Work Environment, National Research Centre for the Working Environment (NFA), Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Koen Hogenelst
- Healthy Living Unit, The Netherlands Organisation for Applied Scientific Research (TNO), The Hague, The Netherlands
| | - Marie Aarrebo Jensen
- Department of Psychosocial Work Environment, National Research Centre for the Working Environment (NFA), Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marina Khazova
- Radiation Dosimetry Department, Public Health England (PHE), Centre for Radiation, Chemical and Environmental Hazards, Didcot, UK
| | - Kamila Nowak
- Central Institute for Labour Protection - National Research Institute (CIOP-PIB), Warszawa, Poland
| | - Sylvia Rabstein
- Center of Epidemiology, Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Institute of the Ruhr-Universität Bochum, Bochum, Germany
| | - Erik Romanus
- Physical Agents Unit, Federal Institute for Occupational Safety and Health (BAuA), Dortmund, Germany
| | - Agnieszka Wolska
- Central Institute for Labour Protection - National Research Institute (CIOP-PIB), Warszawa, Poland
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188
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A meta-analysis of cohort studies including dose-response relationship between shift work and the risk of diabetes mellitus. Eur J Epidemiol 2019; 34:1013-1024. [DOI: 10.1007/s10654-019-00561-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 09/04/2019] [Indexed: 12/24/2022]
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189
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Facco FL, Parker CB, Hunter S, Reid KJ, Zee PP, Silver RM, Pien G, Chung JH, Louis JM, Haas DM, Nhan-Chang CL, Simhan HN, Parry S, Wapner RJ, Saade GR, Mercer BM, Bickus M, Reddy UM, Grobman WA. Later sleep timing is associated with an increased risk of preterm birth in nulliparous women. Am J Obstet Gynecol MFM 2019; 1:100040. [PMID: 33345835 DOI: 10.1016/j.ajogmf.2019.100040] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/06/2019] [Accepted: 08/26/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Although uterine contractions have a diurnal periodicity and increase in frequency during hours of darkness, data on the relationship between sleep duration and sleep timing patterns and preterm birth are limited. OBJECTIVE We sought to examine the relationship of self-reported sleep duration and timing in pregnancy with preterm birth. STUDY DESIGN In the prospective Nulliparous Pregnancy Outcome Study: Monitoring Mothers-to-be cohort, women completed a survey of sleep patterns at 6-13 weeks gestation (visit 1) and again at 22-29 weeks gestation (visit 3). Additionally, at 16-21 weeks gestation (visit 2), a subgroup completed a weeklong actigraphy recording of their sleep. Weekly averages of self-reported sleep duration and sleep midpoint were calculated. A priori, sleep duration of <7 hours was defined as "short," and sleep midpoint after 5 am was defined as "late." The relationships among these sleep characteristics and all preterm birth and spontaneous preterm birth at <37 weeks gestation were examined in univariate analyses. Multivariable logistic regressions that controlled for age and body mass index alone (model 1) and with additional covariates (race, smoking, insurance, and employment schedule) following a backward elimination process (model 2) were performed. RESULTS Of the 10,038 women who were enrolled, sleep survey data were available on 7524 women at visit 1 and 7668 women at visit 3. The rate of short sleep duration was 17.1% at visit 1 and 20.7% at visit 3. The proportion with a late sleep midpoint was 11.6% at visit 1 and 12.2% at visit 3. There was no significant relationship between self-reported short sleep and preterm birth across all visits. However, self-reported late sleep midpoint (>5 am) was associated with preterm birth . Women with a late sleep midpoint (>5 am) in early pregnancy had a preterm birth rate of 9.5%, compared with 6.9% for women with sleep midpoint ≤5 am (P=.005). Similarly, women with a late sleep midpoint had a higher rate of spontaneous preterm birth (6.2% vs 4.4%; P=.019). Comparable results were observed for women with a late sleep midpoint at visit 3 (all preterm birth 8.9% vs 6.6%; P=.009; spontaneous preterm birth 5.9% vs 4.3%; P=.023). All adjusted analyses on self-reported sleep midpoint (models 1 and 2) maintained statistical significance (P<.05), except for visit 1, model 2 for spontaneous preterm birth (P=.07). The visit 2 objective data from the smaller subgroup (n=782) demonstrated similar trends in preterm birth rates by sleep midpoint status. CONCLUSION Self-reported late sleep midpoint in both early and late pregnancy, but not short sleep duration, is associated with an increased rate of preterm birth.
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Affiliation(s)
- Francesca L Facco
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA.
| | | | | | - Kathryn J Reid
- Department of Neurology, Northwestern University, Chicago, IL
| | - Phyllis P Zee
- Department of Neurology, Northwestern University, Chicago, IL
| | - Robert M Silver
- Department of Obstetrics and Gynecology, University of Utah and Intermountain Healthcare, Salt Lake City, UT
| | - Grace Pien
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD
| | - Judith H Chung
- Department of Obstetrics and Gynecology, University of California, Irvine, Irvine, CA
| | - Judette M Louis
- University of South Florida Morsani College of Medicine, Tampa FL
| | - David M Haas
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN
| | | | - Hyagriv N Simhan
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA
| | - Ronald J Wapner
- Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN
| | - George R Saade
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, University of Texas, Galveston, TX
| | - Brian M Mercer
- Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH
| | - Melissa Bickus
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Uma M Reddy
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - William A Grobman
- Department of Obstetrics, Gynecology-Maternal Fetal Medicine & Preventive Medicine, Northwestern University, Chicago, IL
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Lo K, Keung V, Cheung C, Tam W, Lee A. Associations between Sleep Pattern and Quality and Cardiovascular Risk Factors among Macao School Students. Child Obes 2019; 15:387-396. [PMID: 31140858 DOI: 10.1089/chi.2018.0319] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Despite accumulating evidence showing that sleep duration and cardiometabolic health are correlated, the association of sleep regularity and quality with cardiovascular risk factors in children and adolescents remains inconclusive. Therefore, we examined the relationship between sleep regularity/quality and cardiovascular risk factors in children and adolescents in Macao, China. Methods: We conducted a cross-sectional study among primary and secondary school students (age range: 9-18 years) in Macao, China. Body weight, height, waist circumference (WC), and serum lipid levels were measured. Sleep regularity and sleep quality were assessed by using the Pittsburgh Sleep Quality Index. Multivariable logistic regression was conducted to examine the relationship of sleep variables with the increased likelihood of body mass index (BMI)-classified overweight/obesity, WC-classified obesity, and dyslipidemia. Results: A total of 1078 school students were included in the analysis. Differences of >2 hours between weekday and weekend bedtimes were associated with the increased risk of BMI-classified overweight/obesity (odds ratio = 2.58, 95% confidence interval = 1.55-4.31, p < 0.01) after being adjusted for sleep variables and lifestyle factors. No statistically significant association was found between poor sleep quality and any other outcome. Conclusions: Irregular bedtime was associated with elevated body weight regardless of sleep amount and quality. Thus, regular bedtimes are recommended as a simple but practical strategy for preventing obesity.
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Affiliation(s)
- Kenneth Lo
- 1Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guang Zhou, China.,2Department of Epidemiology, Center for Global Cardiometabolic Health, Brown University, Providence, RI.,3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Vera Keung
- 3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong.,4Center for Health Education and Health Promotion, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Calvin Cheung
- 3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong.,4Center for Health Education and Health Promotion, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Wilson Tam
- 5Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Albert Lee
- 3JC School of Public Health and Primary Care, Faculty of Medicine, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong.,4Center for Health Education and Health Promotion, Shatin, the Chinese University of Hong Kong, Hong Kong, Hong Kong
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191
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Floessner TSE, Boekelman FE, Druiven SJM, de Jong M, Rigter PMF, Beersma DGM, Hut RA. Lifespan is unaffected by size and direction of daily phase shifts in Nasonia, a hymenopteran insect with strong circadian light resetting. JOURNAL OF INSECT PHYSIOLOGY 2019; 117:103896. [PMID: 31194973 DOI: 10.1016/j.jinsphys.2019.103896] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 06/07/2019] [Accepted: 06/08/2019] [Indexed: 06/09/2023]
Abstract
Most organisms have an endogenous circadian clock with a period length of approximately 24 h that enables adaptation, synchronization and anticipation to environmental cycles. The circadian system (circa = about or around, diem = a day) may provide evolutionary benefits when entrained to the 24-h light-dark cycle. The more the internal circadian period (τ) deviates from the external light-dark cycle, the larger the daily phase shifts need to be to synchronize to the environment. In some species, large daily phase shifts reduce survival rate. Here we tested this 'resonance fitness hypothesis' on the diurnal wasp Nasonia vitripennis, which exhibits a large latitudinal cline in free-running period with longer circadian period lengths in the north than in the south. Longevity was measured in northern and southern wasps placed into light-dark cycles (T-cycles) with periods ranging from 20 h to 28 h. Further, locomotor activity was recorded to estimate range and phase angle of entrainment under these various T-cycles. A light pulse induced phase response curve (PRC) was measured in both lines to understand entrainment results. We expected a concave survival curve with highest longevity at T = τ and a reduction in longevity the further τ deviates from T (τ/T<>1). Our results do not support this resonance fitness hypothesis. We did not observe a reduction in longevity when τ deviates from T. Our results may be understood by the strong circadian light resetting mechanism (type 0 PRC) to single light pulses that we measured in Nasonia, resulting in: (1) the broad range of entrainment, (2) the wide natural variation in circadian free-running period, and (3) the lack of reduced survival when τ/T ratio's deviates from 1. Together this indicates that circadian adaption to latitude may lead to changes in circadian period and light response, without negative influences on survival.
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Affiliation(s)
- Theresa S E Floessner
- Chronobiology Unit, Neurobiology Expertise Group, Groningen Institute for Evolutionary Life Sciences, University of Groningen, the Netherlands
| | - Floor E Boekelman
- Chronobiology Unit, Neurobiology Expertise Group, Groningen Institute for Evolutionary Life Sciences, University of Groningen, the Netherlands
| | - Stella J M Druiven
- Chronobiology Unit, Neurobiology Expertise Group, Groningen Institute for Evolutionary Life Sciences, University of Groningen, the Netherlands
| | - Maartje de Jong
- Chronobiology Unit, Neurobiology Expertise Group, Groningen Institute for Evolutionary Life Sciences, University of Groningen, the Netherlands
| | - Pomme M F Rigter
- Chronobiology Unit, Neurobiology Expertise Group, Groningen Institute for Evolutionary Life Sciences, University of Groningen, the Netherlands
| | - Domien G M Beersma
- Chronobiology Unit, Neurobiology Expertise Group, Groningen Institute for Evolutionary Life Sciences, University of Groningen, the Netherlands
| | - Roelof A Hut
- Chronobiology Unit, Neurobiology Expertise Group, Groningen Institute for Evolutionary Life Sciences, University of Groningen, the Netherlands.
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192
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The relationship between anthropometric measures and cardiometabolic health in shift work: findings from the Atlantic PATH Cohort Study. Int Arch Occup Environ Health 2019; 93:67-76. [PMID: 31346709 DOI: 10.1007/s00420-019-01459-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/19/2019] [Indexed: 01/11/2023]
Abstract
PURPOSE To evaluate the relationship between anthropometric measures and cardiometabolic health in shift workers compared to non-shift workers. METHODS A population health study was conducted with 4155 shift workers and 8258 non-shift workers from the Atlantic Partnership for Tomorrow's Health (PATH) cohort. Linear and logistic regression models were used to assess the differences in anthropometric measures (body adiposity) and self-reported cardiometabolic disease outcomes (obesity, diabetes, and cardiovascular disease) between shift workers and non-shift workers. RESULTS There was a significant increased risk of cardiovascular disease, obesity, and diabetes among shift workers compared to matched controls despite higher levels of physical activity and lower levels of sedentary behaviour. Shift workers were 17% more likely to be obese (95% CI 7-27) and 27% more likely to have diabetes (95% CI 8-51). The strength of this association was demonstrated by also controlling for body mass index and fat mass index. CONCLUSIONS Shift work is associated with obesity, cardiovascular disease, and diabetes despite higher levels of physical activity and lower levels of sedentary behaviour. The association between shift work and cardiometabolic health was independent of body mass index for cardiovascular disease and diabetes, and independent of fat mass index for diabetes.
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193
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Razavi P, Devore EE, Bajaj A, Lockley SW, Figueiro MG, Ricchiuti V, Gauderman WJ, Hankinson SE, Willett WC, Schernhammer ES. Shift Work, Chronotype, and Melatonin Rhythm in Nurses. Cancer Epidemiol Biomarkers Prev 2019; 28:1177-1186. [PMID: 31142495 PMCID: PMC6750706 DOI: 10.1158/1055-9965.epi-18-1018] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 01/12/2019] [Accepted: 04/18/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Previous studies associated night-shift work with melatonin disruption, with mixed evidence regarding the modulating effects of chronotype (i.e., diurnal preference). METHODS One hundred and thirty active nurses (84 rotating-shift and 46 day-shift workers) in the Nurses' Health Study II wore a head-mounted light meter and collected spontaneous urine voids over 3 days. 6-Sulfatoxymelatonin (aMT6s), the major urinary metabolite of melatonin, was assessed. RESULTS Rotating-shift workers on night shifts had more light exposure and lower urinary melatonin levels during the night, and urinary melatonin rhythms with smaller peaks [11.81 ng/mg-creatinine/h, 95% confidence interval (CI), 9.49-14.71 vs. 14.83 ng/mg-creatinine/h, 95% CI, 11.72-18.75] and later peak onset (5.71 hours, 95% CI, 4.76-6.85 vs. 4.10 hours, 95% CI, 3.37-4.99), compared with day-shift workers. Furthermore, evening chronotypes' melatonin rhythms had later peak onset compared with morning types (4.90 hours, 95% CI, 3.94-6.09 vs. 3.64 hours, 95% CI, 2.99-4.43). However, among day-shift workers, morning chronotypes had melatonin rhythms with greater mean levels, larger peaks, and earlier peak onset compared with evening chronotypes; patterns were similar comparing evening versus morning chronotypes among rotating-shift workers on night shifts. The interaction of rotating-shift work and chronotype was significant across all parameters (P < 0.05). CONCLUSIONS As expected, rotating-shift workers on night shifts had greater light exposure and lower urinary melatonin levels during the night compared with day-shift workers. Intriguingly, melatonin rhythms were dependent on both chronotype and rotating-shift work type, and better alignment of rotating-shift work and chronotype appeared to produce less disrupted melatonin rhythms. IMPACT The joint effects of shift-work type and chronotype require attention in future studies.
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Affiliation(s)
- Pedram Razavi
- Department of Medicine and Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elizabeth E Devore
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Archna Bajaj
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Steven W Lockley
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Mariana G Figueiro
- Lighting Research Center, Rensselaer Polytechnic Institute, Troy, New York
| | | | - W James Gauderman
- Division of Biostatistics, Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Susan E Hankinson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
| | - Walter C Willett
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts
| | - Eva S Schernhammer
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
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194
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Silva-Costa A, Rotenberg L, Baltar VT, Coeli CM, Fonseca MDJMD, Melo ECP, Griep RH. Structural equation modeling of associations between night work and glycemic levels. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:487-494. [PMID: 31271576 PMCID: PMC10522263 DOI: 10.20945/2359-3997000000147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 04/08/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Different pathways may lead from night work to metabolic diseases, including type 2 diabetes. This study aimed to explore the direct and indirect pathways from night work to glycemic levels, considering the role of physical activity, waist circumference and snacking using data from ELSA-Brasil. MATERIALS AND METHODS A structural equation model was used to confirm the pathways from night work to glycemic levels. The latent variable, "glycemic levels", included fasting glucose, glycated hemoglobin and 2-hour plasma glucose. RESULTS A total of 10.396 participants were included in the analyses. The final model showed that among women, night work was associated with increased glycemic levels. A statistical significant association between night work and glycemic levels mediated by waist circumference was observed among women and men. CONCLUSIONS The association between night shift and glycemic levels can be interpreted as an important step toward understanding the pathways that could explain night work as a risk factor for diabetes using epidemiological data.
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Affiliation(s)
- Aline Silva-Costa
- Departamento de Saúde Coletiva , Universidade Federal do Triângulo Mineiro (UFTM), Uberaba , MG , Brasil
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde , Escola Nacional de Saúde Pública (ENSP- Fiocruz ), Rio de Janeiro , RJ , Brasil
| | - Lúcia Rotenberg
- Laboratório de Educação em Ambiente e Saúde , Fiocruz , Rio de Janeiro , RJ , Brasil
| | - Valéria Troncoso Baltar
- Departamento de Epidemiologia e Bioestatística , Instituto de Saúde Coletiva , Universidade Federal Fluminense (UFF), Niterói , RJ , Brasil
| | - Claudia Medina Coeli
- Instituto de Estudos em Saúde Coletiva , Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro , RJ , Brasil
| | - Maria de Jesus Mendes da Fonseca
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde , Escola Nacional de Saúde Pública (ENSP- Fiocruz ), Rio de Janeiro , RJ , Brasil
| | - Enirtes Caetano Prates Melo
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde , Escola Nacional de Saúde Pública (ENSP- Fiocruz ), Rio de Janeiro , RJ , Brasil
| | - Rosane Härter Griep
- Laboratório de Educação em Ambiente e Saúde , Fiocruz , Rio de Janeiro , RJ , Brasil
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195
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Schernhammer ES. Larks, owls, and breast cancer. BMJ 2019; 365:l4267. [PMID: 31242993 DOI: 10.1136/bmj.l4267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Eva S Schernhammer
- Department of Epidemiology, Centre for Public Health, Medical University of Vienna, Vienna, Austria
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196
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Abstract
Synchrony of circadian rhythms between tissues/organs appears critical for health. A new study reports that meal timing, a modifiable temporal cue for the circadian system, can selectively uncouple circadian rhythms in metabolic physiology from the central circadian clock in humans.
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Affiliation(s)
- Celine Vetter
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA; Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA.
| | - Frank A J L Scheer
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115, USA; Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA 02115, USA
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197
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Time-restricted feeding improves adaptation to chronically alternating light-dark cycles. Sci Rep 2019; 9:7874. [PMID: 31133707 PMCID: PMC6536683 DOI: 10.1038/s41598-019-44398-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 05/02/2019] [Indexed: 12/19/2022] Open
Abstract
Disturbance of the circadian clock has been associated with increased risk of cardio-metabolic disorders. Previous studies showed that optimal timing of food intake can improve metabolic health. We hypothesized that time-restricted feeding could be a strategy to minimize long term adverse metabolic health effects of shift work and jetlag. In this study, we exposed female FVB mice to weekly alternating light-dark cycles (i.e. 12 h shifts) combined with ad libitum feeding, dark phase feeding or feeding at a fixed clock time, in the original dark phase. In contrast to our expectations, long-term disturbance of the circadian clock had only modest effects on metabolic parameters. Mice fed at a fixed time showed a delayed adaptation compared to ad libitum fed animals, in terms of the similarity in 24 h rhythm of core body temperature, in weeks when food was only available in the light phase. This was accompanied by increased plasma triglyceride levels and decreased energy expenditure, indicating a less favorable metabolic state. On the other hand, dark phase feeding accelerated adaptation of core body temperature and activity rhythms, however, did not improve the metabolic state of animals compared to ad libitum feeding. Taken together, restricting food intake to the active dark phase enhanced adaptation to shifts in the light-dark schedule, without significantly affecting metabolic parameters.
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198
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Pallesen S, Jacobsen DP, Nielsen MB, Gjerstad J. The 5-HTTLPR rs25531 L AL A-genotype increases the risk of insomnia symptoms among shift workers. Sleep Med 2019; 60:224-229. [PMID: 31213395 DOI: 10.1016/j.sleep.2019.04.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Previous studies indicate that shift work tolerance may be associated with individual factors including genetic variability in the gene encoding the serotonin transporter 5-HTT (SLC6A4). The present study aimed to explore the interaction between work schedule (shift work versus non-shift work), genetic variability in SLC6A4 and insomnia symptoms. METHODS The study was based on a national probability sample survey of 987 Norwegian employees drawn from The Norwegian Central Employee Register by Statistics Norway. Insomnia symptoms were assessed by three items reflecting problems with sleep onset, sleep maintenance, and early morning awakenings. Genotyping concerning SLC6A4 (the 5-HTTLPR S versus L and the SNP rs25531 A versus G) was carried out using a combination of gel-electrophoresis and TaqMan assay. RESULTS Using the LALA genotype as a reference a main effect of the SS genotype (B = 0.179; 95% CI = 0.027-0.330) was found. In addition, a main effect of work schedule (0 = non shift, 1 = shift work) was found (B = 0.504; 95% CI = 0.185-0.823). The genotype x work schedule interaction was significant for all genotypes; SLA (B = -0.590; 95% CI = -0.954-0.216), LALG (B = -0.879; 95% CI = -1.342-0.415), SLG (B = -0.705; 95% CI = -1.293-0.117) and SS (B = -0.773; 95% CI = -1.177-0.369) indicating higher insomnia symptom scores among LALA-participants compared to participants with other genotypes when working shifts. CONCLUSIONS The ability to cope with shift work is associated with the combination of the SLC6A4 variants 5-HTTLPR and SNP rs25531. Our findings demonstrated that the LALA-genotype increases the risk of insomnia symptoms among shift workers.
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Affiliation(s)
- Ståle Pallesen
- Department for Psychosocial Science, University of Bergen, Norway; Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Norway.
| | | | - Morten B Nielsen
- Department for Psychosocial Science, University of Bergen, Norway; National Institute of Occupational Health, Oslo, Norway
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199
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MORENO CR, MARQUEZE EC, SARGENT C, WRIGHT KP, FERGUSON SA, TUCKER P. Working Time Society consensus statements: Evidence-based effects of shift work on physical and mental health. INDUSTRIAL HEALTH 2019; 57:139-157. [PMID: 30700667 PMCID: PMC6449637 DOI: 10.2486/indhealth.sw-1] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 09/21/2018] [Indexed: 05/26/2023]
Abstract
Potential effects of shift work on health are probably related to the misalignment between the light-dark cycle and the human activity-rest cycle. Light exposure at night mediates these effects, including social misalignment and leads to an inversion of activity and rest, which, in turn, is linked to changes in behaviours. This article reviews the epidemiological evidence on the association between shift work and health, and possible mechanisms underlying this association. First, evidence from findings of the meta-analyses and systematic reviews published in the last 10 yr is presented. In addition, it reports the larger single-occupation studies and recent large population-based studies of the general workforce. Koch's postulates were used to evaluate the evidence related to the development of disease as a result of exposure to shift work. Finally, we discussed limitations of the multiple pathways that link shift work with specific disorders and the methodological challenges facing shift work research. We concluded that the clearest indications of shift work being the cause of a disease are given when there is a substantial body of evidence from high quality field studies showing an association and there is good evidence from laboratory studies supporting a causal explanation of the link.
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Affiliation(s)
- Claudia R.C. MORENO
- School of Public Health, University of São Paulo,
Brazil
- Stress Research Institute, Stockholm University, Sweden
| | | | - Charli SARGENT
- Appleton Institute for Behavioural Science, School of Health,
Medical, and Applied Sciences, CQUniversity, Australia
| | - Kenneth P. WRIGHT
- Department of Integrative Physiology, University of Colorado
Boulder, USA
| | - Sally A. FERGUSON
- Appleton Institute for Behavioural Science, School of Health,
Medical, and Applied Sciences, CQUniversity, Australia
| | - Philip TUCKER
- Stress Research Institute, Stockholm University, Sweden
- Department of Psychology, Swansea University, UK
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200
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Buckingham SA, Williams AJ, Morrissey K, Price L, Harrison J. Mobile health interventions to promote physical activity and reduce sedentary behaviour in the workplace: A systematic review. Digit Health 2019; 5:2055207619839883. [PMID: 30944728 PMCID: PMC6437332 DOI: 10.1177/2055207619839883] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 02/27/2019] [Indexed: 02/06/2023] Open
Abstract
Objective This systematic review aimed to assess the effectiveness, feasibility and acceptability of mobile health (mHealth) technology (including wearable activity monitors and smartphone applications) for promoting physical activity (PA) and reducing sedentary behaviour (SB) in workplace settings. Methods Systematic searches were conducted in seven electronic databases (MEDLINE, SPORTDiscus, Scopus, EMBASE, PsycINFO, Web of Science and the Cochrane library). Studies were included if mHealth was a major intervention component, PA/SB was a primary outcome, and participants were recruited and/or the intervention was delivered in the workplace. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) tool. Interventions were coded for behaviour change techniques (BCTs) using the Coventry, Aberdeen and London - Refined (CALO-RE) taxonomy. Results Twenty-five experimental and quasi-experimental studies were included. Studies were highly heterogeneous and only one was rated as 'strong' methodological quality. Common BCTs included self-monitoring, feedback, goal-setting and social comparison. A total of 14/25 (56%) studies reported a significant increase in PA, and 4/10 (40%) reported a significant reduction in sedentary time; 11/16 (69%) studies reported a significant impact on secondary outcomes including reductions in weight, systolic blood pressure and total cholesterol. While overall acceptability was high, a large decline in technology use and engagement was observed over time. Conclusions While methodological quality was generally weak, there is reasonable evidence for mHealth in a workplace context as a feasible, acceptable and effective tool to promote PA. The impact in the longer term and on SB is less clear. Higher quality, mixed methods studies are needed to explore the reasons for decline in engagement with time and the longer-term potential of mHealth in workplace interventions.Protocol registration: The review protocol was registered with PROSPERO: CRD42017058856.
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Affiliation(s)
- Sarah Ann Buckingham
- European Centre for Environment and Human Health, Knowledge Spa, Royal Cornwall Hospitals NHS Trust, University of Exeter Medical School, Truro, UK
| | - Andrew James Williams
- European Centre for Environment and Human Health, Knowledge Spa, Royal Cornwall Hospitals NHS Trust, University of Exeter Medical School, Truro, UK
| | - Karyn Morrissey
- European Centre for Environment and Human Health, Knowledge Spa, Royal Cornwall Hospitals NHS Trust, University of Exeter Medical School, Truro, UK
| | - Lisa Price
- Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - John Harrison
- Occupational Health Support Unit, Devon and Cornwall Police, Middlemoor, Exeter, UK
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