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Dietary Inflammatory Index Scores Differ by Shift Work Status: NHANES 2005 to 2010

Wirth, Michael D. MSPH, PhD; Burch, James MS, PhD; Shivappa, Nitin MBBS, MPH; Steck, Susan E. PhD, MPH, RD; Hurley, Thomas G. MSc; Vena, John E. PhD; Hébert, James R. ScD

Journal of Occupational and Environmental Medicine: February 2014 - Volume 56 - Issue 2 - p 145–148
doi: 10.1097/JOM.0000000000000088
Original Articles

Objective: Shift workers are affected by diet- and inflammation-related diseases, including cardiovascular disease, diabetes, and cancer. We examined a dietary inflammatory index (DII) in relation to shift work from the National Health and Nutrition Examination Survey data (2005 to 2010).

Methods: The DII was calculated using data from a 24-hour dietary recall. Shift work categories included day workers, evening/night shift workers, or rotating shift workers. General linear models were fit to examine the relationship between shift work and adjusted mean DII values.

Results: Among all shift workers and specifically rotating shift workers, higher (ie, more pro-inflammatory) mean DII scores (1.01 and 1.07 vs 0.86; both P ≤ 0.01) were observed compared with day workers. Women tended to express strong evening/night shift effects.

Conclusions: More proinflammatory diets observed among shift workers may partially explain increased inflammation-related chronic disease risk observed in other studies among shift workers compared with their day-working counterparts.

Supplemental Digital Content is Available in the Text.

From the Cancer Prevention and Control Program (Drs Wirth, Burch, Shivappa, Steck, and Hébert and Mr Hurley), University of South Carolina, Columbia, SC; Department of Epidemiology and Biostatistics (Drs Burch, Shivappa, Steck, and Hébert), University of South Carolina, Columbia, SC; WJB Dorn VA Medical Center (Dr Burch), Columbia, SC; and Department of Epidemiology and Biostatistics (Dr Vena), College of Public Health, University of Georgia, Athens, Ga.

Address correspondence to: Michael Wirth, MSPH, PhD, Cancer Prevention and Control Program, University of South Carolina, 915 Greene St, Suite 200, Columbia, SC 29208 (

This work was supported by the South Carolina Statewide Cancer Prevention and Control Program and by grant number 1U54 CA153461-01 (Dr Hébert (PI)) from the National Cancer Institute, Center to Reduce Cancer Health Disparities (Community Networks Program) to the South Carolina Cancer Disparities Community Network-II (SCCDCN-II). Dr Wirth's participation was supported through an ASPIRE-II Grant from the University of South Carolina Office of Research and by the South Carolina Cancer Prevention and Control Research Network funded under Cooperative Agreement Number 3U48DP001936-01 from the Centers for Disease Control and Prevention and the National Cancer Institute. Dr Hébert was supported by an Established Investigator Award in Cancer Prevention and Control from the Cancer Training Branch of the National Cancer Institute (K05 CA136975).

Authors Wirth, Burch, Shivappa, Steck, Hurley, Vena, and Hébert have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Copyright © 2014 by the American College of Occupational and Environmental Medicine