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The researchers found that the risk of type 2 diabetes was actually higher than simply adding the individual risks associated with unhealthy lifestyles and shift work, indicating that combining an unhealthy lifestyle with irregular nighttime work further increased risk.
It is well established that unhealthy lifestyles, such as smoking, poor diet, low physical activity and overweight or obesity, increase the risk of type 2 diabetes. Shift work, especially work at night, has also been associated with an increased risk of type 2 diabetes.
The researchers believe however that it is the first study to examine the combined impact of an unhealthy lifestyle and alternating night work on the risk of type 2 diabetes.
They combined data from two long-term health studies of nurses – the Nurses' Health Study (NHS) and the NHS II – who recruited American nurses in 1976 and 1989.
They extracted data from 143,410 women who did not have type 2 diabetes, cardiovascular disease, or cancer, and who completed regular questionnaires about medical care, diet, and lifestyle.
Nursing is required 24 hours a day, which means that care placements include a mix of day, night and night shifts that can disrupt personal routines and biological rhythms.
For this study, night shift shift work was defined as working at least three night shifts per month, in addition to the day and evening shifts of the month.
The unhealthy lifestyle has been defined using four factors: being overweight or obese (body mass index equal to or greater than 25), having already smoked, doing less than 30 minutes a day of exercise. intensity moderate to vigorous and have a poor diet (low in fruits, vegetables), nuts and whole grains, and rich in processed meat, trans fats, sugar and salt).
During 22-24 years of follow-up, 10,915 out of 143,410 nurses reported being diagnosed with type 2 diabetes.
Every five years of alternating night work, nurses were almost three times more likely (31%) to have been diagnosed with type 2 diabetes.
Every unhealthy lifestyle factor – having ever smoked, being overweight or obese, eating poor quality food or doing little physical activity – has more than doubled (2.3 times) the risk of being diagnosed with the disease. Type 2 diabetes.
Women who had one of these four unhealthy lifestyle factors and who worked at night alternated more and more often with a higher risk of diagnosing type 2 diabetes: for each unhealthy lifestyle factor the risk was 2.83 times higher.
This risk is higher than simply adding the two individual risks to rotating shifts and a poor lifestyle, indicating that a kind of interaction of the two risk factors adds an extra risk.
The authors calculated that night shift shift work accounted for about 17% of the highest combined risk of type 2 diabetes and unhealthy lifestyle of about 71%, the remaining 11% representing an additional risk related to Interaction of the two.
"Most cases of type 2 diabetes could be prevented by adhering to a healthy lifestyle and the benefits could be greater by alternating night workers," they concluded.
However, they point out that there is an observational study and that no definitive conclusion can therefore be drawn as to the cause and effect. Because all nurses are female and mostly white, their findings may not be applicable to men and other racial or ethnic groups.
The authors suggest that the additional risk of type 2 diabetes that occurs when night workers rotate in the wake of an unhealthy lifestyle may be due to a disruption of sleep and circadian rhythms affecting hormones. , other metabolic pathways or the balance of bacteria in the intestine. But they point out that further studies are needed to confirm and explain their results.
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