رابطه استرس شغلی و افزایش بیشتر وزن در درازمدت
Abstract
Introduction
Methods
Results
Discussion
References
Abstract
Purpose Occupational stress and obesity are both increasing in prevalence, but prospective findings relating these conditions are inconsistent. We investigated if baseline as well as prolonged exposure to high job demands and low decision latitude were associated with major weight gain (≥10% of baseline weight) in 3872 Swedish women and men examined three times over 20 years in the population-based Västerbotten Intervention Program.
Methods Anthropometry was measured and participants completed questionnaires on job strain, diet, and other lifestyle factors. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI), adjusting for confounders.
Results Adjusting for age, baseline low decision latitude was associated with major weight gain over 10- and 20-year OR (95% CI) 1.16 (1.00–1.33) and 1.29 (1.13–1.47), respectively (both sexes combined). After adjustment for diet quality and other confounders, the effect over 20 years remained 1.30 (1.13–1.50). Sex modified the effect of prolonged exposure to high job demands over at least 10 years (interaction p=0.02), showing that high job demands was a risk factor of major weight gain over 20 years in women [1.54 (1.14–2.07)], but not in men [0.87 (0.63–1.19)]. Neither diet nor other lifestyle factors explained these associations.
Conclusions In conclusion, low decision latitude predicted major weight gain in women and men. In women, the results suggest an additional contribution to major weight gain from high job demands.
Introduction
The population mean body mass index (BMI) has increased in recent decades and a prognosis forecasts future increases in obesity prevalence (Breda et al. 2015). While a positive energy balance, originating from excess energy intake relative to energy expenditure, is a fundamental cause for weight gain, psychosocial factors such as mental stress might be contributing factors. Effects of mental stress on weight gain could be mediated through unhealthy behaviors such as low diet quality. In addition, chronic stress could, through higher cortisol levels, impact on visceral fat accumulation and reduction in lean body mass (Kyrou and Tsigos 2009). Alongside the trend of increasing BMI, the prevalence of self-reported mental stress has also increased (Lissner et al. 2008). Work-related stress, also referred to as job strain, with high demands and low decision latitude as conceptualized by Karasek and Theorell (1990), has also been reported to be higher in later years (Malard et al. 2015; Utzet et al. 2015) as have the prevalence of other work-related stress exposures (Houdmont et al. 2012). Although changing social norms regarding the stress concept may explain some part of the increased prevalence of self-reported stress, a considerable increase in sickness absence due to psychiatric diagnoses, including the fatigue syndrome, during the last decade has been reported in Sweden, providing support for a factual increase in stress (Swedish Social Insurance Agency 2016).