ArticleBMJ (Clinical research ed.)2018
Rotating night shift work and adherence to unhealthy lifestyle in predicting risk of type 2 diabetes: results from two large US cohorts of female nurses.
Article in BMJ (Clinical research ed.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 159 papers, 8 of them syntheses that pooled it.
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Who cites it
159 citing papers in PubMed, 8 syntheses or guidelines pooled it, 300 citations in OpenAlex.
- Healthcare staff perceptions of the hospital food environment: a narrative systematic review.Public health nutrition · 2025Pooled it
- Association between night shift work and the risk of type 2 diabetes mellitus: a cohort-based meta-analysis.BMC endocrine disorders · 2024Pooled it
- The Best Exercise Modality and Dose to Reduce Glycosylated Hemoglobin in Patients with Type 2 Diabetes: A Systematic Review with Pairwise, Network, and Dose-Response Meta-Analyses.Sports medicine (Auckland, N.Z.) · 2024Pooled it
- An update on the role and potential mechanisms of clock genes regulating spermatogenesis: A systematic review of human and animal experimental studies.Reviews in endocrine & metabolic disorders · 2023Pooled it
- Shift work and the risk for metabolic syndrome among healthcare workers: A systematic review and meta-analysis.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2022Pooled it
- The relationship between the level of exercise and hemoglobin AEndocrine · 2021Pooled it
- Pooled it
- A meta-analysis of cohort studies including dose-response relationship between shift work and the risk of diabetes mellitus.European journal of epidemiology · 2019Pooled it
- High-Intensity Training Reduces CVD Risk Factors among Rotating Shift Workers: An Eight-Week Intervention in Industry.International journal of environmental research and public health · 2020Trial
- Time matters: circadian genetics and the molecular logic of human health and disease.Nature reviews. Genetics · 2026Review
- Discovery of circadian clock activators with anti-obesity efficacy via suppression of adipocyte development and hypertrophy.Molecular therapy : the journal of the American Society of Gene Therapy · 2026Article
- Observational
- Insomnia as an Independent Behavioral Correlate of Estimated Type 2 Diabetes Risk: Evidence from Three Validated Risk Assessment Scales.Rambam Maimonides medical journal · 2026Article
- Relationship between remission rate of type 2 diabetes and skeletal muscle after laparoscopic sleeve gastrectomy.Biomedical reports · 2026Article
- Quercetin and Fisetin activate circadian clock via RORα and inhibit adipocyte growth.bioRxiv : the preprint server for biology · 2026Article
- A newly developed circadian imbalance index (CII) and risk of cardiovascular-kidney-metabolic disease in the UK biobank.European journal of epidemiology · 2026Article
- Impact of Lactobacillus johnsonii on glycemic control and lipid metabolism in type 2 diabetes with circadian disruption.Scientific reports · 2026Article
- Shift work and the risk of incident hospital-treated infections: quantifying the role of lifestyle factors.BMC infectious diseases · 2026Article
- Biochemical mechanism of the mammalian circadian clock.FEBS letters · 2026Review
- Novel circadian clock activators display anti-obesity efficacy via suppression of adipocyte development and hypertrophy.bioRxiv : the preprint server for biology · 2026Article
99 more citing papers are in PubMed but not listed here.
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Authors and funding
10 authors at 2 institutions in 3 countries.
Funding
Abstract
objectivesTo prospectively evaluate the joint association of duration of rotating night shift work and lifestyle factors with risk of type 2 diabetes risk, and to quantitatively decompose this joint association to rotating night shift work only, to lifestyle only, and to their interaction.
designProspective cohort study.
settingNurses' Health Study (1988-2012) and Nurses' Health Study II (1991-2013).
participants143 410 women without type 2 diabetes, cardiovascular disease, or cancer at baseline. EXPOSURES: Rotating night shift work was defined as at least three night shifts per month in addition to day and evening shifts in that month. Unhealthy lifestyles included current smoking, physical activity levels below 30 minutes per day at moderate to vigorous intensity, diet in the bottom three fifths of the Alternate Healthy Eating Index score, and body mass index of 25 or above.
main outcome measuresIncident cases of type 2 diabetes were identified through self report and validated by a supplementary questionnaire.
resultsDuring 22-24 years of follow-up, 10 915 cases of incident type 2 diabetes occurred. The multivariable adjusted hazard ratios for type 2 diabetes were 1.31 (95% confidence interval 1.19 to 1.44) per five year increment of duration of rotating night shift work and 2.30 (1.88 to 2.83) per unhealthy lifestyle factor (ever smoking, low diet quality, low physical activity, and overweight or obesity). For the joint association of per five year increment rotating night shift work and per unhealthy lifestyle factor with type 2 diabetes, the hazard ratio was 2.83 (2.15 to 3.73) with a significant additive interaction (P for interaction <0.001). The proportions of the joint association were 17.1% (14.0% to 20.8%) for rotating night shift work alone, 71.2% (66.9% to 75.8%) for unhealthy lifestyle alone, and 11.3% (7.3% to 17.3%) for their additive interaction.
conclusionsAmong female nurses, both rotating night shift work and unhealthy lifestyle were associated with a higher risk of type 2 diabetes. The excess risk of rotating night shift work combined with unhealthy lifestyle was higher than the addition of risk associated with each individual factor. These findings suggest that most cases of type 2 diabetes could be prevented by adhering to a healthy lifestyle, and the benefits could be greater in rotating night shift workers.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.