Accelerometer-measured physical activity, Mediterranean diet and premature mortality and life expectancy among night shift workers: a UK Biobank longitudinal study

Apr 30, 2026The Journal of nutrition

Physical activity and Mediterranean diet linked to early death and life expectancy in night shift workers

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Abstract

Over a median 12.72-year follow-up, 204 premature deaths occurred among 12,044 night shift workers.

Higher levels of moderate-to-vigorous physical activity (MVPA) are associated with a lower risk of premature mortality (hazard ratio: 0.677).
Adherence to a Mediterranean-style diet is associated with a reduced risk of premature death (hazard ratio: 0.617).
Life expectancy gains differ by sex: higher MVPA is linked to a gain of 4.90 years in men, while a higher Mediterranean diet score is associated with a gain of 7.64 years in women.
The combination of medium MVPA and a high Mediterranean diet score shows the strongest protective effect against premature death (hazard ratio: 0.385).

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BACKGROUND: Night shifts work is associated with circadian disruption and elevated premature mortality risk. Although physical activity (PA) and healthy diets like the Mediterranean diet (MED) promote longevity, their combined association with mortality and life expectancy in night shift workers is unclear.

OBJECTIVE: 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 (World Health Organization) guidelines (low: <150, medium: 150-300, high: ≥300 min/week). AMED score (0-9) was derived from a 24-hour dietary recall and categorized into tertiles. Multivariable Cox regression and life table methods assessed hazard ratios (HR) for premature mortality and life expectancy.

RESULTS: Over a median 12.72-year follow-up, 204 premature deaths occurred. Higher MVPA (hazard ratios (HR): 0.677; 95% confidence intervals (CI): 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 men (gain of 4.90 years; 95% CI: 0.77-9.02), while a higher AMED score was primary in women (gain of 7.64 years; 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.

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Accelerometer-measured physical activity, Mediterranean diet and premature mortality and life expectancy among night shift workers: a UK Biobank longitudinal study

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