Rotating shift work time is directly associated with excess body adiposity.

OBJECTIVE: To analyze the association between changes in body adiposity and length of service on a schedule of rotating shifts. METHODS: The study was a cross-sectional investigation conducted during the years 2012, 2015, and 2018, involving individuals engaged in rotating shifts at a company involved in iron ore extraction situated within the Iron Quadrangle region of Minas Gerais and the southeastern region of Pará, Brazil. Sociodemographic and behavioral data were collected along with anthropometric parameters in order to calculate body mass index (BMI) and the waist-to-height ratio (WHtR). For data analysis, a multivariate logistic regression was employed to explore potential associations between indicators of body adiposity and the duration of shift work, employing a hierarchical determination model. RESULTS: The findings showed that in the multivariate model, controlling for confounding factors, workers with 5 to 10, 10 to 15, and more than 15 years of shift work had 41 to 96% greater odds of being overweight (BMI > 25.0 kg/m2), 71 to 82% of having altered neck circumference (> 40 cm), 33 to 120% of altered WC (>102 cm), and 57 to 214% of having altered WHtR (> 0.5 cm). CONCLUSION: The findings suggest that time spent in work has a significant effect on anthropometric indicators of body adiposity, especially if the worker has a previously established comorbidity such as dyslipidemia or hypertension and is frequently exposed to night work.

Effects of minimally and ultra-processed foods on blood pressure in Brazilian adults: a two-year follow up of the CUME Project.

AIM: To assess the association of food consumption according to degree of processing with changes in systolic (SBP) and diastolic (DBP) blood pressure in adult participants of a Brazilian cohort. METHODS: Longitudinal study with 2496 adult participants of the Cohort of Universities of Minas Gerais (CUME Project). Food consumption was categorized by food groups according to degree of processing following the NOVA grading system: unprocessed/minimally processed foods/culinary ingredients (U/MPF&CI), processed foods (PFs) and ultra-processed foods (UPFs). unprocessed/minimally processed foods/culinary ingredients (U/MPF&CI), processed foods (PFs) and ultra-processed foods (UPFs). Changes in SBP and DBP were categorized (decreased, maintained, increased). Independent associations between exposure and outcomes were verified using multiple generalized ordered logistic models adjusted for potential confounders. RESULTS: After a two-year follow-up, the consumption of U/MPF&CI (% daily caloric intake) reduced the chance of increasing DBP (P for trend = 0.014), with a more evident effect among participants within the 5th quintile of this food group (odds ratio (OR) = 0.55; 95% confidence interval (CI): 0.34-0.97]. On the other hand, the consumption of UPFs (% daily caloric intake) raised the chance of increasing DBP (P for trend = 0.005) and was more evident among participants within the quintiles of higher consumption (4th quintile - OR = 1.97; 95% CI: 1.25-3.10; 5th quintile - OR = 1.79; 95% CI = 1.12-2.86). No associations were found between food consumption according to degree of processing and changes in SBP. CONCLUSION: Higher consumption of U/MPF&CI and UPFs were independently associated to lower and greater chances of increased DBP in adult participants from CUME Project.

Rotating shift workers with vitamin D deficiency have a higher risk of obstructive sleep apnea.

OBJECTIVES: The study aimed to evaluate the association between obstructive sleep apnea (OSA) and vitamin D deficiency (VDD) in shift workers. METHODS: This cross-sectional study included male rotating shift workers in an iron ore extraction company. Participants were classified as VDD when 25(OH)D < 20 ng/mL for a healthy population and 25(OH)D < 30 ng/mL for groups at risk for VDD. Risk of developing OSA was classified by Berlin questionnaire (BQ) and NoSAS score. Data were compared using chi-square analysis with Cramer's V as effect size, and Bonferroni correction. Multivariate logistic regression analysis was performed to investigate whether or not VDD was associated with OSA risk assessment. RESULTS: Among 1423 male workers, mostly younger, aged 30 to 39 years (53%), worked shifts for more than 5 years (76%). The prevalence of high risk of OSA by BQ was 16%, and 33% by NoSAS score. Additionally, 29% had VDD. In multivariate analysis, controlled for confounding factors, workers with VDD had a 52% increased chance of OSA by BQ (OR 1.52; CI95% 1.06-2.18) and a 64% increased chance of OSA by NoSAS score (OR 1.64; CI95% 1.09-2.48). After subgroup analyses, similar results were not observed in workers aged 20-29 and 30-39 years. CONCLUSION: Rotating shift workers with vitamin D deficiency are more likely to have obstructive sleep apnea, assessed by the Berlin questionnaire and NoSAS score.

Ultra-processed food consumption and dietary, lifestyle and social determinants: a path analysis in Brazilian graduates (CUME project).

OBJECTIVE: To explore the relationship between ultra-processed foods (UPF) consumption and dietary, lifestyle and social determinants using pathway analysis in the baseline of the Cohort of Universities of Minas Gerais (CUME project). DESIGN: Cross-sectional study, in which path analysis was used to estimate direct and indirect effects of dietary practices, sleep, time on the computer and professional status on UPF consumption. SETTING: Data were collected in 2016, through an online questionnaire composed of sociodemographic, anthropometric, lifestyle and dietary practices questions, and a FFQ. PARTICIPANTS: Baseline participants from the CUME Project (n 2826), adults who graduated from Universidade Federal de Viçosa or Universidade Federal de Minas Gerais, Brazil. RESULTS: Being employed (P = 0·024), the time spent on the computer (P = 0·031) and the frequency of fried food intake (P < 0·001) were positively and directly associated with UPF consumption, whereas the sleep duration (P = 0·007) and the number of meals per d (P < 0·001) were negatively and directly associated with UPF consumption. Indirect effects were observed between being employed, mediated by the sleep duration (P = 0·032) and fried food intake (P = 0·005), whereas being a student is mediated by the time on the computer (P = 0·048). CONCLUSION: The time spent on the computer, sleep duration and fried food consumption showed direct effects on UPF consumption. They also acted as mediators on the relationship between professional status and UPF consumption. Besides, the number of meals eaten each day also was directly associated with UPF consumption.

Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers.

BACKGROUND: Data on the validity of tools for sleep apnea risk detection in rotating shift workers are limited. The aim was to evaluate the Berlin questionnaire (BQ) and the Neck, Obesity, Snoring, Age, Sex (NoSAS) score for the detection of obstructive sleep apnea risk in shift workers. METHODS: This cross-sectional study included male rotating shift workers, drivers of heavy off-road machinery in an iron ore extraction company. Polysomnography was the gold standard for evaluation. Obstructive sleep apnea (OSA) was defined as an apnea-hypopnea index (AHI) of ≥ 5 events/h. The Shapiro-Wilk test verified the data distribution and comparative analysis was conducted using the chi-square analyses and U Mann-Whitney with Bonferroni correction. Receiver operating characteristic curve analysis, sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios, and accuracy were used for evaluate BQ and NoSAS with OSA diagnosis by polysomnograph. RESULTS: Among 119 male shift workers, ages 24 to 57 years, polysomnography showed that 84% had obstructive sleep apnea (AHI ≥ 5), and 46% had moderate to severe sleep apnea (AHI ≥ 15). For AHI ≥ 5, the NoSAS score had higher sensitivity and specificity than the BQ. For AHI ≥ 15 and AHI ≥ 30, the NoSAS score had a sensitivity higher than 70% while BQ was 60% and 58%, respectively. The accuracy of the NoSAS score was higher for all OSA criteria than that of BQ. CONCLUSION: In rotating shift workers, drivers of heavy off-road machinery, the NoSAS score showed higher accuracy in identifying patients at risk for sleep apnea than the BQ.

Online Food Frequency Questionnaire From the Cohort of Universities of Minas Gerais (CUME Project, Brazil): Construction, Validity, and Reproducibility.

Background: The Food Frequency Questionnaire (FFQ) is usually used in epidemiological studies to assess food consumption. However, the FFQ must have good accuracy, requiring its validation and reproducibility for the target population. Thus, this study aimed to describe the construction of the online Food Frequency Questionnaire (oFFQ) used at the Cohort of Universities of Minas Gerais (CUME project, Brazil) and evaluate its validity and reproducibility. Methods: The oFFQ was answered two times in 1 year (March/August 2018-March/April 2019; n = 108 participants-reproducibility), and four 24-h dietary recalls (24hRs) were applied in two seasons of the southern hemisphere [two 24hRs in autumn (March/June 2018) and two 24hRs in winter (August/September 2018); n = 146 participants-validity]. To assess the validity and reproducibility, the intraclass correlation coefficients (ICCs) were estimated. Results: The oFFQ had 144 food items separated into eight groups (dairy products; meat and fish; cereals and legumes; fruits; vegetables; fats and oils; drinks; other foods). In assessing the validity, ICCs for energy and macronutrients were considered moderate, ranging from 0.41 (energy) to 0.59 (protein), while the ICCs for micronutrients were considered low to moderate, ranging from 0.25 (fibers) to 0.65 (vitamin B6). Regarding reproducibility assessment, ICCs for energy and all the assessed items were considered moderate to excellent, ranging from 0.60 (vegetables) to 0.91 (vitamin E and retinol). Conclusions: The self-reported oFFQ had satisfactory validity and reproducibility. So, it can be used to analyze the association between food consumption and chronic diseases in the participants of the Cohort of Universities of Minas Gerais (CUME project-Brazil).

Body fat indicators for cardiometabolic risk screening among shift workers.

BACKGROUND: In view of the costly methods currently available for the assessment of body adiposity, anthropometric obesity indicators have proven effective in predicting cardiovascular risk. OBJECTIVE: To investigate the discriminatory power of body fat indicators for cardiovascular risk screening among shift workers. METHODS: Cross-sectional study with male employees of an iron ore extraction company. The predictive power of body fat indicators relative to cardiovascular risk was analyzed based on the Framingham risk score and metabolic syndrome by means of receiver operating characteristic curves, sensitivity, specificity, positive and negative predictive values, area under the receiver operating characteristic curve and Youden's index. RESULTS: The prevalence of cardiovascular risk was 14.2% in the metabolic syndrome risk model. According to the Framingham score, 95.0%, 4.1% and 0.9% of the participants exhibited low, moderate and high risk, respectively. All the analyzed body fat indicators exhibited satisfactory discriminatory power for the tested cardiovascular risk models. CONCLUSION: Waist-height ratio exhibited the highest ability to predict cardiometabolic risk in both risk models.

Vagal Flexibility during Exercise: Impact of Training, Stress, Anthropometric Measures, and Gender.

We evaluated the effect of physical training, stress, anthropometric measures, and gender upon the reactivity and recovery of the heart rate variability (HRV) during a cardiorespiratory test. Professors (N = 54) were evaluated using the following: physical training: time, frequency, and length of physical exercise; resting heart rate (HR); maximum HR; and recovery HR; stress: stress symptoms, work stress, vital events, and perceived stress; anthropometric measures: body mass index, waist circumference (WC), waist-hip ratio (WHR), and fat percentage (FP); and HRV before, during, and after the test. The HRV decreased during and increased after the test. Increased recovery HR was associated with the decreased vagal output during the test, and decreased recovery HR was associated with the increased posttest vagal input. The higher the work control and stress symptoms of men and the higher the perceived stress for both genders, the lower the vagal output during the test. The lower stress symptom and work control of men and the lower work demand of women were associated with the posttest vagal increase. The increased WC and decreased WHR of men were associated with the lower vagal output during the test and the lower posttest vagal increase. The lower FP also was associated with the greater recovery.

Effects of vitamin D supplementation on cardiovascular risk factors in shift workers: Study protocol for randomized, double-blind, placebo-controlled clinical trial.

OBJECTIVE: The present clinical study aims to describe protocol to evaluate the effects of vitamin D3 supplementation on the cardiovascular risk factors in a population of rotating shift workers. DESIGN: A randomized, double-blind, placebo-controlled, parallel group clinical trial testing 2 oral dosages of cholecalciferol (14,000 IU and 28,000 IU per week) for 12 months. SETTING: The primary outcome for evaluation is an 18% reduction in hypertriglyceridemia (≥150 mg/dL) between pre and postintervention measurements. Baseline characteristics of the study population will be summarized separately within each randomized group, and will use tests for continuous and categorical variables. For all tests, a P < .05 will be considered significant. The analysis of primary and secondary outcomes will use an intention-to-treat population and a per-protocol population. The primary and secondary outcomes will be compared separately between each treatment group and placebo, using binary logistic regression or regressão de Poisson for proportions (for binary outcomes) and using linear regression for differences in means (for continuous endpoints), with 95% confidence intervals. PARTICIPANTS: Rotating shift workers, adults aged between 18 and 60 years, with hypovitaminosis D and alterations in at least 1 of the following parameters: fasting glucose, high-density lipoprotein cholesterol, triglycerides, low-density lipoprotein cholesterol, blood pressure, and waist circumference. CONCLUSION: This clinical trial aims to contribute to the gap in knowledge about the potential, dose, and time of vitamin D supplementation to generate beneficial effects on triglycerides in a population at increased risk for hypertriglyceridemia and vitamin D deficiency.

The overweight increases circulating inflammatory mediators commonly associated with obesity in young individuals.

Obesity is a serious and growing world healthy problem affecting developed and developing countries. The new conception of obesity as a basal inflammatory condition has opened a new window of possibilities to identify inflammatory biomarkers to be used in the diagnosis or prognosis of obesity-associated comorbidities. This present work aims the identification of the adipokines (leptin and resistin), chemokines (CCL2, CCL5, CXCL16) and the BMP-2 and their association with the clinical, biochemical (fasting glucose, hemogram, cholesterol, T3, T4 and TSH) and anthropometric (weight, height, body circumferences, skinfold thickness and percentage of body fat) parameters in young adults (18-30 years old) presenting obesity and overweight. Our data showed increasing in anthropometric parameters and in the plasma inflammatory levels in those individuals presenting overweight and obesity. We observed a higher plasma levels of CCL2, CCL5, CXCL16, leptin and resistin in those overweigh and obese individuals. In addition, the CCL2, CCL5 presented a positive correlation with the body mass index and the body fat percentage. Assuming the obesity as a systemic inflammatory process, in this current study, the overweight individuals possess a close similar pattern of circulating inflammatory mediators which might be a potential risk of the development of obesity comorbidities. Further studies are still needed to precise the role of the biomarkers CCL2, CCL5, CXCL16 and BMP-2 in the clinical prognosis related to the overweight or obese individuals.

Heart rate variability in shift workers: responses to orthostatism and relationships with anthropometry, body composition, and blood pressure.

In order to investigate the response of heart rate variability (HRV) components to postural change and their association with cardiovascular risk factors in shift workers, a cross-sectional study with 438 Brazilian males rotating shift workers was done. Anthropometric, body composition, and clinical measures were collected. Electrocardiogram was recorded for 3 minutes, in the supine and orthostatic position, and HRV components were extracted. Descriptive analyses showed that mean values of body mass index, waist circumference (WC), waist-to-height ratio, visceral fat area (VFA), and blood pressure (BP) were higher than the reference values. In the regression model, age, WC, VFA, and systolic BP showed negative association with HRV components. These findings suggest the need for determining effective strategies for the evaluation and promotion of health among shift workers focused on the altered variables.

Lifetime shift work exposure: association with anthropometry, body composition, blood pressure, glucose and heart rate variability.

OBJECTIVE: To evaluate the association between lifetime exposure to shift work and blood pressure, fasting glucose (FG), anthropometric variables, body composition and heart rate variability (HRV). METHODS: Male shift workers (N=438) were evaluated using principal component (PC) analysis. The variables used were: weight, body mass index (BMI), waist circumference (WC), neck circumference (NC), hip circumference (HC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body fat mass (BFKg), body fat percentage (BF%), visceral fat area (VFA), FG, systolic (SBP) and diastolic blood pressure (DBP), and HRV variables. ECG was performed, extracting heart rate (HR), root mean square of the successive differences (RMSSD), high frequency (HF), low frequency (LF) and the LF/HF ratio. Using linear regression models, the lifetime shift work exposure was associated with each PC. RESULTS: Five PCs were obtained, which accounted for 79.6% of the total variation of the data. PC1 (weight, BMI, WC, NC, HC, WHR, WHtR, BFKg, BF% and VFA) was designated as body obesity; PC2 (HF, RMSSD and LF) as good cardiac regulation; PC3 (SBP and DBP) as blood pressure; PC4 (LF/HF ratio and HR) as bad cardiac regulation and PC5 (WHR and FG) as insulin resistance. After age adjustment, the regression analysis showed that lifetime shift work was negatively associated with PC2 and positively associated with PC3. CONCLUSIONS: The association of lifetime shift work exposure with PC2 and PC3 suggests that shift work promotes unfavourable changes in autonomic cardiac control related to a decrease in parasympathetic modulation and an increase in blood pressure.