A study conducted among nurses and paramedical staff at a large public hospital in Karachi, Pakistan, has revealed that over half of the participants had excess abdominal fat. The research indicates that poor sleep quality, older age, and years of service are stronger predictors of abdominal obesity than rotating shift schedules. The findings, published in BMC Public Health, challenge the common belief that rotating shifts are the primary reason behind health issues in healthcare workers.
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The analytical cross-sectional study, carried out from December 2024 to May 2025 by researchers from the School of Public Health and the Dow Institute of Nursing and Midwifery at Dow University of Health Sciences, included 279 healthcare workers aged 25 to 55. Participants were selected through non-probability consecutive sampling, which may not fully represent the entire hospital workforce but was deemed practical by the researchers.
Abdominal obesity, identified as the primary outcome, is linked to serious health conditions, including type 2 diabetes and cardiovascular disease. This study measured abdominal fat using waist circumference thresholds, which can reveal risks that body mass index (BMI) alone may not capture.
Researchers utilized the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality, evaluating multiple factors, including subjective sleep quality and disturbances. A total of 150 participants, representing 53.8 percent, met the criteria for abdominal obesity. Initial analysis found significant associations between abdominal obesity and factors such as being older than 30, having over five years of work experience, being female, and poor sleep quality, with the last notably raising the odds of obesity nearly fourfold.
Further analysis using multivariable logistic regression indicated that workers older than 30 were almost five times more likely to be abdominally obese compared to younger peers. Meanwhile, fixed duty schedules were not significantly associated with obesity once other factors were controlled for, suggesting that perceived risks linked to shift patterns might relate more to sleep quality than to shift arrangements themselves.
The research highlights biological links between sleep and obesity, indicating that poor sleep impacts hormone levels and metabolism in ways that can drive weight gain. While the study cannot confirm causation due to its cross-sectional nature, it suggests that poor sleep is a modifiable risk factor for abdominal obesity.
The authors recommend that healthcare facilities prioritize sleep hygiene education and consider scheduling practices that enhance sleep continuity. The study emphasizes that addressing sleep quality could play a critical role in managing obesity among healthcare workers, pointing to a broader issue of workforce health in the global healthcare system.