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Updated: May 2, 2026
Human Circadian Phenotyping and Diurnal Performance Testing in the Real World
Published on: April 7, 2020
Accelerometer-Measured Physical Activity, Mediterranean Diet, and Premature Mortality and Life Expectancy Among Night
Jiaxu Xu1, Zhuo Chen1, Fengru Niu1
1Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Precision Nutrition and Health, Ministry of Education, Harbin Medical University, Harbin, China; NHC Specialty Laboratory Cooperation Unit of Food Safety Risk Assessment and Standard Development, Harbin Medical University, Harbin, China.
Background:
Night shift work is associated with circadian disruption and elevated premature mortality risk. Although physical activity (PA) and healthy diets such as the Mediterranean diet (MED) promote longevity, their combined association with mortality and life expectancy in night shift workers is unclear.
Objectives:
This study investigated the individual and joint effects of accelerometer-measured moderate-to-vigorous PA (MVPA) and adherence to the alternate MED (AMED) score on these outcomes.
Methods:
This prospective cohort study included 12,044 night shift workers from the UK Biobank. MVPA was categorized per WHO guidelines (low: <150, medium: 150-300, high: ≥300 min/wk). AMED score (0-9) was derived from a 24-h dietary recall and categorized into tertiles. Multivariable Cox regression and life table methods assessed hazard ratios (HRs) for premature mortality and life expectancy.
Results:
Over a median 12.72-y follow-up, 204 premature deaths occurred. Higher MVPA [HR: 0.677; 95% confidence intervals (CIs): 0.473, 0.970] and higher AMED score (HR: 0.617; 95% CI: 0.384, 0.991) were independently associated with lower mortality risk. Life expectancy gains were sex-specific: higher MVPA was primary in males (gain of 4.90 y; 95% CI: 0.77, 9.02), whereas a higher AMED score was primary in females (gain of 7.64 y; 95% CI: 0.61, 13.56). The combination of medium MVPA and high AMED score showed the strongest protective effect (HR: 0.385; 95% CI: 0.161, 0.919).
Conclusions:
Among night shift workers, higher levels of MVPA and a Mediterranean-style diet are associated with a reduced risk of premature death, with the primary protective lifestyle factor differing by sex. An integrated strategy combining medium MVPA with high dietary quality may be optimal for reducing mortality in this high-risk group, supporting precision health interventions.
