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

Nyberg, S; Heikkilä, K; Fransson, E; Alfredsson, L; De Bacquer, D; Bjorner, J; Bonenfant, S; Borritz, M; Burr, H; Casini, A; +36 more...Clays, E; Dragano, N; Erbel, R; Geuskens, G; Goldberg, M; Hooftman, W; Houtman, I; Jöckel, K; Kittel, F; Knutsson, A; Koskenvuo, M; Leineweber, C; Lunau, T; Madsen, I; Hanson, LM; Marmot, M; Nielsen, M; Nordin, M; Oksanen, T; Pentti, J; Rugulies, R; 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; Kivimäki, M; IPD-Work Consortium and (2011) Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies. Journal of internal medicine, 272 (1). pp. 65-73. ISSN 0954-6820 DOI: 10.1111/j.1365-2796.2011.02482.x
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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.


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