1617d Shiftwork and metabolic health risks – what does the literature conclude?

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Abstract

Introduction

Although the metabolic health effects of shift work have been extensively studied, a systematic synthesis of the available research is lacking. This review aimed to systematically summarise the available evidence of longitudinal studies linking shift work with metabolic risk factors.

Methods

A systematic literature search was performed. Studies were included if (1) they had a longitudinal design; (2) shift work was studied as the exposure; and (3) the outcome involved a metabolic risk factor, including anthropometric, blood glucose, blood lipid, or blood pressure measures. Eligible studies were assessed for their methodologic quality. A best evidence synthesis consisting of three levels of evidence was used to draw conclusions per outcome: strong, moderate or insufficient evidence.

Results

Thirty-nine articles describing 22 studies were included. Strong evidence was found for a relation between shift work and increased body weight/BMI, risk for overweight, and impaired glucose tolerance. For the remaining outcomes (waist circumference, blood lipids, and blood pressure), there was insufficient evidence.

Discussion

Shift work seems to be associated with body weight gain, risk for overweight, and impaired glucose tolerance. Overall, lack of high–methodologic quality studies and inconsistency in findings led to insufficient evidence in assessing the relation between shift work and other metabolic risk factors. To strengthen the evidence, more high-quality longitudinal studies that provide more information on the shift work schedule (e.g., frequency of night shifts, duration in years) are needed. Further, research to the (mediating) role of lifestyle behaviours in the health effects of shift work is recommended, as this may offer potential for preventive strategies.

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