Determining the relationship between nutritional status, dietary inflammatory index, SLEEP quality and depression in shift workers

This study was conducted to evaluate nutritional status and to determine the relationship between nutritional status and dietary inflammatory index (DII), sleep quality and anxiety and depression status. A total of 170 male rotating shift workers of an industrial organization operating in iron, steel and pipe sector participated in this study. A questionnaire was administered to determine individuals' socio-demographic characteristics, lifestyle habits, nutritional habits and physical activity status. Anthropometric measurements and some biochemical findings of individuals were evaluated. A three-day food consumption record during night shift was obtained to evaluate their daily energy and nutrient intake and DII scores. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), while anxiety and depression were estimated through Hospital Anxiety and Depression Scale (HADS) questionnaire. The average age of participants was 40.1 ± 6.87 years. According to the body mass index (BMI) classification, 44.7% of individuals were pre-obese, and 35.3% were obese. The individuals participating in the study were examined by dividing them into four quartiles according to their DII scores. The first quartile (Q1) represents the anti-inflammatory diet, and the fourth quartile (Q4) represents the pro-inflammatory diet. It was determined that the DII values of the individuals ranged between -4.14 and 4.26, and the mean DII value was 0.76±1.52. A significant difference was found between individuals' C-reactive protein (CRP) levels according to the dietary inflammatory index quartiles (p<0.05). CRP levels of individuals' in Q4 was significantly higher than in Q2; and CRP levels of individuals' Q3 and Q4 was significantly higher than in Q1 (p<0.05). According to the dietary inflammatory index quartiles, when Q1 is defined as reference; the likelihood of abdominal obesity was found to be lower in Q3 (OR 0.305, %95 OR=0.124-0.749) and Q4 (OR 0.355, %95 OR=0.146-0.863); the likelihood of obesity was found to be lower in Q2 (OR 0.284, %95 OR=0.114-0.709) and Q3(OR 0.225, %95 OR=0.087-0.586) (p<0.05). According to the PSQI classification, 38.8% of individuals were found to have poor sleep quality. As BMI increased, the percentages of poor sleep quality increased (p<0.05). There were positive correlations between PSQI score and WC (r=0.157), WHtR (r=0.159) and body fat mass (r=0.152), and a negative correlation between total body water (r=-0.152), which were found to be statistically significant (p<0.05). A significant correlation was found between diet inflammatory index and poor sleep quality (p<0.05). According to the dietary inflammatory index quartiles, when Q1 is defined as reference; the likelihood of poor sleep quality was found to lower in Q2 (OR 0.313, % 95 OR=0.125-1.780) (p<0.05). According to the HAD scale classification of the individuals, it was determined that 7.6% of them had anxiety risk and 25.9% of them had depression risk. There was no significant relationship between diet inflammatory index and anxiety and depression status (p>0.05). In conclusion, considering that inflammation plays a role in the development of many chronic diseases associated with shift work, it would be useful to plan an anti-inflammatory nutrition program targeting behavioral changes that threaten the health of shift workers.