Gerben Hulsegge

Musculoskeletal Complaints Among 11-Year-Old Children and Associated Factors The PIAMA Birth Cohort Study

Musculoskeletal complaints (MSC) are common among children, often persist into adolescence, and increase the risk of MSC in adulthood. Knowledge regarding determinants of MSC among children is limited. The aim of this study was to determine the prevalence of MSC at age 11 years and to examine associations with sociodemographic factors, growth and development factors, mental health, tiredness, and lifestyle. Data from a Netherlands birth cohort study, the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) Study (n = 2,638), were used (1996-2009). MSC were defined as complaints about the back, an upper extremity, a lower extremity, or any of these sites. Logistic regression analyses using a forward stepwise procedure were performed on multiply imputed data. The 1-year period prevalences of back, upper extremity, and lower extremity complaints that lasted at least 1 month were 2.8%, 4.8%, and 10.9%, respectively. Only poorer mental health was consistently associated with all 3 types of complaints. Poorer mental health, daytime tiredness, early pubertal development, being physically active at age 11 years, and weight-for-height z score were associated with having any MSC. This study showed that MSC, especially lower extremity complaints, are common among 11-year old-children and that only poorer mental health status is associated with MSC at all anatomic sites.

Shift workers have a similar diet quality but higher energy intake than day workers

OBJECTIVE Shift work is associated with adverse health outcomes, and an unhealthy diet may be a contributing factor. We compared diet quantity and quality between day and shift workers, and studied exposure-response relationships regarding frequency of night shifts and years of shift work. METHODS Cross-sectional general population data from the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) cohort was used. Dietary intake was assessed in 1993-1997 among adults aged 20-70 years using a food frequency questionnaire. We calculated energy intake, the Mediterranean Diet Score (MDS) and WHO-based Healthy Diet Indicator (HDI). In 2011-2014, we retrospectively identified 683 shift workers and 7173 day workers in 1993-1997. Using multivariable-adjusted linear regression analysis, we estimated regression coefficients (β) and 95% confidence intervals (95% CI) of the differences in dietary intake between day and shift workers. RESULTS Shift workers had a higher energy intake than day workers (β:56 kcal/d, 95% CI 10-101), and a higher consumption of grains, dairy products, meat and fish (P<0.05). The difference in energy intake was largest for shift workers with ≥5 night shifts/month. They consumed 103 kcal/d (95% CI 29-176) more than day workers. No associations were found with MDS and HDI. CONCLUSION Shift workers and particularly those with a high frequency of night shifts had a higher energy intake than day workers. Regardless of number of night shifts and years of shift work, shift workers had similar diet quality as day workers. This suggests that increased energy intake among shift workers may contribute to shift work-induced adverse health outcomes.

Fundamental movement skills, physical fitness and physical activity among Australian children with juvenile idiopathic arthritis

To describe fundamental movement skills (FMS), physical fitness and level of physical activity among Australian children with juvenile idiopathic arthritis (JIA) and compare this with healthy peers.

Shift workers have similar leisure-time physical activity levels as day workers but are more sedentary at work

Objective Physical inactivity has been hypothesized as an underlying factor for the association between shift work and adverse health outcomes. We compared leisure-time and occupational physical activity and sedentary behavior between day, night, and non-night shift workers. Methods We identified 612 day workers, 139 night shift workers and 61 non-night shift workers aged 18-65 years (54% men) in two Danish studies: the New method for Objective Measurements of physical Activity in Daily living (NOMAD) and the Danish Physical ACTivity cohort with Objective measurements (DPhacto) between 2011-2013. Sedentary behavior, light, and moderate-to-vigorous physical activity were measured using an accelerometer. Physical activity was expressed as percentage of leisure and work time spent in each activity. Linear regression analyses were used to test differences in physical activity and sedentary behavior between day, night, and non-night shift workers. Results No differences in leisure-time sedentary behavior and physical activity were observed between day and shift workers (P>0.05). Non-night shift workers spent 7.2% [95% confidence interval (95% CI) 2.3-12.1) more time in occupational sedentary behavior than day workers and 5.9% (95% CI -10.1- -1.7) and 1.9% (95% CI -3.7- -0.2) less time in occupational light and moderate-to-vigorous physical activity, respectively. Compared to day workers, night shift workers spent 4.3% (95% CI 2.4-6.1) more time at work in uninterrupted sedentary periods of ≥30 minutes. Conclusions Shift workers had similar leisure-time physical activity patterns as day workers, but were more sedentary at work. Future research should elucidate whether occupational physical inactivity and sedentary behavior contributes to shift work-related adverse health effects.

Non-occupational physical activity levels of shift workers compared with non-shift workers

Objectives Lack of physical activity (PA) has been hypothesised as an underlying mechanism in the adverse health effects of shift work. Therefore, our aim was to compare non-occupational PA levels between shift workers and non-shift workers. Furthermore, exposure–response relationships for frequency of night shifts and years of shift work regarding non-occupational PA levels were studied. Methods Data of 5980 non-shift workers and 532 shift workers from the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) were used in these cross-sectional analyses. Time spent (hours/week) in different PA types (walking/cycling/exercise/chores) and intensities (moderate/vigorous) were calculated based on self-reported PA. Furthermore, sports were operationalised as: playing sports (no/yes), individual versus non-individual sports, and non-vigorous-intensity versus vigorous-intensity sports. PA levels were compared between shift workers and non-shift workers using Generalized Estimating Equations and logistic regression. Results Shift workers reported spending more time walking than non-shift workers (B=2.3 (95% CI 1.2 to 3.4)), but shift work was not associated with other PA types and any of the sports activities. Shift workers who worked 1–4 night shifts/month (B=2.4 (95% CI 0.6 to 4.3)) and ≥5 night shifts/month (B=3.7 (95% CI 1.8 to 5.6)) spent more time walking than non-shift workers. No exposure–response relationships were found between years of shift work and PA levels. Conclusions Shift workers spent more time walking than non-shift workers, but we observed no differences in other non-occupational PA levels. To better understand if and how PA plays a role in the negative health consequences of shift work, our findings need to be confirmed in future studies.

Body mass index in adolescence may influence the risk of cardiovascular disease later in life

Commentary on: Twig G, Yaniv G, Levine H, et al. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med 2016;374:2430–40. The prevention and treatment of cardiovascular disease (CVD) has improved over recent decades. As a consequence, age-standardised mortality rates of CVD in high-income countries have steadily been decreasing since the 1970s.1 At the same time, however, prevalence of obesity has reached epidemic proportions and seems to be one of the main public health threats the younger generations face today.2 Insight into adverse effects of obesity among …

Shift work, chronotype and the risk of cardiometabolic risk factors

Background The relation between shift work and a large variety of cardiometabolic risk factors is unclear. Also, the role of chronotype is understudied. We examined relations between shift work and cardiometabolic risk factors, and explored these relations in different chronotypes. Methods Cardiometabolic risk factors (anthropometry, blood pressure, lipids, diabetes, γ-glutamyltransferase, C-reactive protein, uric acid and estimated glomerular filtration rate) were assessed among 1334 adults in 1987-91, with repeated measurements every 5 years. Using shift work history data collected in 2013-15, we identified shift work status 1 year prior to all six waves. Linear mixed models and logistic generalized estimating equations were used to estimate the longitudinal relations between shift work and risk factors 1 year later. Results Shift work was not significantly related with cardiometabolic risk factors (P ≥ 0.05), except for overweight/body mass index. Shift workers had more often overweight (OR: 1.44, 95% CI 1.06-1.95) and a higher body mass index (BMI) (β: 0.56 kg m-2, 95% CI 0.10-1.03) than day workers. A significant difference in BMI between day and shift workers was observed among evening chronotypes (β: 0.97 kg m-2, 95% CI 0.21-1.73), but not among morning chronotypes (β: 0.04 kg m-2, 95% CI -0.85 to 0.93). No differences by frequency of night shifts and duration of shift work were observed. Conclusion Shift workers did not have an increased risk of cardiometabolic risk factors compared with day workers, but, in particular shift working evening chronotypes, had an increased risk of overweight. More research is needed to verify our results, and establish whether tailored interventions by chronotype are wanted.

Characterizing Adult Sleep Behavior Over 20 Years-The Population-Based Doetinchem Cohort Study.

Abstract Study Objectives: To describe sleep duration patterns of adults over a 20-year period; to compare sociodemographic, lifestyle, and health characteristics across these patterns; and to relate the patterns to sleep quality. Methods: The study population consisted of 3695 adults aged 20 to 59 years at baseline. Five measurements of self-reported sleep duration were used to compose seven patterns from 1987 to 2012: persistent short (≤6 hours), moderate (7–8 hours), or long (≥9 hours) sleep duration and several changing patterns (varying and became short, moderate, or long sleepers). Multinomial logistic regression analyses were used to compare characteristics across sleep duration patterns. Results: About 56% of the adults had persistent moderate sleep duration over 20 years. This group had a better sleep quality than the other groups. Of the adults who changed in their sleep duration (40%), 43% became a short sleeper. Sleep duration patterns that deviate from persistent moderate sleep duration were associated with physical inactivity during leisure time (odds ratios [ORs] and 95% confidence intervals [95% CIs] varied between 1.26 [1.04–1.53] and 1.58 [1.06–2.37]) and with poor self-rated health (ORs [95% CIs] varied between 1.50 [1.20–1.87] and 2.15 [1.48–3.12]). Conclusions: Nearly half of the adults did not have persistent moderate sleep duration over a 20-year period and more than one-sixth became short sleeper. This is reason for concern considering the adverse health status associated with short and long sleep duration. Leisure-time physical activity is a potential important target to prevent unfavorable changes in sleep duration over the life course.