Shift Work Might Lead to Type 2 Diabetes, Obesity

Dec. 28, 2011— -- While shift workers are needed to help our 24-7 world go 'round, an editorial written by Dr. Virginia Barbour, chief editor of the journal PLoS Medicine, warned that such work schedules can put a person at increased risk of obesity and type 2 diabetes. She even argued that unhealthy eating habits on the job should be considered an occupational health hazard.

"We have a long-standing interest in publishing on the diseases and risk factors that cause the highest burden of disease," Barbour told ABCNews.com.

"We would suggest that employers need to take unhealthy eating very seriously, to the extent that they consider that unhealthy foods are essentially environmental hazards and that they should consider what the implications are of exposing their employees to high levels of such hazards in the form of vending machines and fast-food restaurants."

In the editorial, Barbour cited a study that was published in the journal earlier this month that examined rotating night-shift work and risk of type 2 diabetes, a chronic disease in which blood-sugar levels are abnormally high in the body. Most people are overweight or obese at the time of diagnosis.

The study found that more than 11 percent of a participating nurse cohort reported doing shift work for more than 10 years, and the research results suggested that an extended period of rotating night-shift work was associated with a modestly increased risk of type 2 diabetes in women.

The study noted that late-night workers might be more likely to grab a fast, less-nutritious meal than those who work normal business hours. They might also get less sleep and exercise less because of the disturbed sleep schedules.

"A substantial proportion of the work force will be working in shifts and advice from governments needs to reflect that," Barbour said. "And shift workers, in turn, need to ensure they understand that shift work is not just inconvenient and anti-social, but also a substantial risk factor for poor health outcomes.

"Hence, they need to consider their shift work as their 'normal' hours' and make a positive effort to ensure they incorporate a balanced diet, and exercise into their lifestyle, despite the hours."

Shift workers make up about 15 to 20 percent of the European and U.S. working population. It is "notoriously associated" with poor eating habits and, ironically, shift work is especially associated with the health care industry.

Because obesity has reached such pandemic proportions, Barbour argues, unhealthy eating should be considered an occupational hazard at the workplace, and "governments need to legislate to improve the habits of consumers and take specific steps to ensure that it is easier and cheaper to eat healthily than not."

"Eating well in general is difficult in a modern world that considers 'junk' a food group," Dr. David Katz, director of the Yale Prevention Center, said in an email.

"That situation is compounded, of course, for nocturnal humans, (i.e. shift workers) who are left with even fewer options and food choices, the need to adopt a dietary pattern for which there is no clear guidance; and a tendency toward perennial sleep deprivation that conspires against healthful eating and weight control in a variety of ways. Of course, there is an opportunity to take matters into one's own hands."

Experts suggested that shift workers take the extra time to plan out and bring healthy meals to work.

"Once you establish a routine, it's very easy and you'll be able to eat a satisfying meal and some snacks that are better for your health, and for probably less money," said Keith Ayoob, associate professor of pediatrics at Albert Einstein College of Medicine in Bronx, N.Y.

While Ayoob acknowledged that workplaces should assist employees in staying healthy, he disagreed that government legislation should be involved in the workplace diet.

"At what point do you make a law about what people can eat and what they cannot," Ayoob said. " Focusing only on diet would be a huge mistake. ...Type 2 diabetes is often a function of lifestyle.

"The good news is that shift work does not doom you to an unhealthy lifestyle, but it does mean that there needs to be some level of self-motivation for it to happen. It would be a mistake to expect the responsibility to be solely on the employers."