Associations of night shift work with weight gain among female nurses in The Netherlands: results of a prospective cohort study

Objective This study aimed to prospectively investigate associations of working night shifts with weight gain in the Nightingale Study, a large cohort of female nurses. Methods This study included 36 273 registered nurses, who completed questionnaires in 2011 and 2017. Cumulative number of nights, mean number of nights/month and consecutive number of nights/month in 2007-2011 were assessed. We used Poisson regression to estimate multivariable-adjusted incidence rate ratios (IRR) of >5% weight gain from 2011 to 2017 among all participants and assess risk of development of overweight/obesity (BMI >= 25 kg/m(2)) among women with healthy baseline body mass index. The reference group consisted of women who never worked nights. Results Overall, working night shifts in 2007-2011 was associated with >5% weight gain [IRR 1.07, 95% confidence interval (CI) 1.01-1.13]. Associations differed by menopausal status in 2011, with an increased risk of gaining >5% weight limited to postmenopausal women who worked nights (IRR 1.23, 95% CI 1.10-1.38). Postmenopausal women had an increased risk of >5% weight gain when they worked on average >= 4 nights/month (4-5: IRR 1.29, 95% CI 1.09-1.52, >= 6: IRR 1.27, 95% CI 1.11-1.47) or >= 4 consecutive nights/month (IRR 1.37, 95% CI 1.19-1.58), compared to postmenopausal women who never worked nights. For postmenopausal women with healthy weight at baseline, night shift work was associated with an increased risk of overweight/obesity at follow-up (IRR 1.24, 95% CI 1.03-1.50). Conclusions Working night shifts was associated with a slightly increased risk of weight gain and overweight/ obesity development among women who were postmenopausal at study inclusion. Our findings emphasize the importance of health promotion to maintain a healthy weight among (postmenopausal) night workers.