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10.02.2020 | Original Article Open Access

The moderating role of lifestyle, age, and years working in shifts in the relationship between shift work and being overweight

International Archives of Occupational and Environmental Health
Gerben Hulsegge, Willem van Mechelen, Heleen Paagman, Karin I. Proper, Johannes R. Anema
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The online version of this article (https://​doi.​org/​10.​1007/​s00420-020-01519-4) contains supplementary material, which is available to authorized users.

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This study aimed to investigate the relationship between the moderating role of lifestyle, age, and years working in shifts and, shift work and being overweight.


Cross-sectional data were used of 2569 shift and 4848 non-shift production workers who participated between 2013 and 2018 in an occupational health check. Overweight (BMI ≥ 25 kg/m2) was calculated using measured weight and height; lifestyle was assessed by questionnaires. Multiple-adjusted logistic regression with interaction terms between shift work and potential moderators assessed multiplicative interaction; the relative excess risk due to interaction assessed additive interaction (synergism).


Shift work was significantly related to being overweight (OR 1.53, 95% CI 1.33 1.76). The strength of this association did not differ by level of sleep quality, fruit and vegetable intake, and physical activity (p ≥ 0.05). Additive and multiplicative interaction by smoking status was present (p < 0.01), with a stronger relationship between shift work and being overweight among non-smokers compared to smokers. Older age as well as more years of exposure to shift work were, independently from each other, related to a stronger relationship between shift work and being overweight (multiplicative interaction p < 0.05).


Shift work was to a similar extent related to being overweight among those with a healthy and unhealthy lifestyle. This does, however, not imply that shift workers can behave unhealthy without any harm. Based on the evident health benefits of a healthy lifestyle, it is still recommended to get sufficient quality of sleep and to meet the recommended level of daily physical activity and, fruit and vegetable intake.

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