Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies

Tidsskriftartikel - 2012


Background: Evidence of an association between job strain and obesity is inconsistent, mostly limited to small-scale studies, and does not distinguish between categories of underweight or obesity subclasses.Objectives: To examine the association between job strain and body mass index (BMI) in a large adult population.Methods: We performed a pooled cross-sectional analysis based on individual-level data from 13 European studies resulting in a total of 161 746 participants (49% men, mean age, 43.7 years). Longitudinal analysis with a median follow-up of 4 years was possible for four cohort studies (n =42 222).Results: A total of 86 429 participants were of normal weight (BMI 18.5-24.9 kg m-2), 2149 were underweight (BMI <18.5 kg m-2), 56 572 overweight (BMI 25.0-29.9 kg m-2) and 13 523 class I (BMI 30-34.9 kg m-2) and 3073 classes II/III (BMI = 35 kg m-2) obese. In addition, 27 010 (17%) participants reported job strain. In cross-sectional analyses, we found increased odds of job strain amongst underweight [odds ratio 1.12, 95% confidence interval (CI) 1.00-1.25], obese class I (odds ratio 1.07, 95% CI 1.02-1.12) and obese classes II/III participants (odds ratio 1.14, 95% CI 1.01-1.28) as compared with participants of normal weight. In longitudinal analysis, both weight gain and weight loss were related to the onset of job strain during follow-up.Conclusions: In an analysis of European data, we found both weight gain and weight loss to be associated with the onset of job strain, consistent with a 'U'-shaped cross-sectional association between job strain and BMI. These associations were relatively modest; therefore, it is unlikely that intervention to reduce job strain would be effective in combating obesity at a population level.


Nyberg S, Heikkila K, Fransson E, Alfredsson L, De BD, Bjorner J, Bonenfant S, Borritz M, Burr FHM, Casini A, Clays E, Dragano N, Erbel R, Geuskens G, Goldberg M, Hooftman W, Houtman I, Jockel K, Kittel F, Knutsson A, Koskenvuo M, Leineweber C, Lunau T, Madsen I, Hanson L, Marmot M, Nielsen M, Nordin M, Oksanen T, Pentti J, Rugulies RE, Siegrist J, Suominen S, Vahtera J, Virtanen M, Westerholm P, Westerlund H, Zins M, Ferrie J, Theorell T, Steptoe A, Hamer M, Singh-Manoux A, Batty G, Kivimaki M. Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies. Journal of Internal Medicine 2012;272(1):65-73.
doi: 10.1111/j.1365-2796.2011.02482.x

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