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

Solja T. Nyberg 1, * Katriina Heikkilä 1 Eleonor I. Fransson 2, 3 Lars Alfredsson 2 Dirk de Bacquer 4 Jakob B. Bjorner 5 Sébastien Bonenfant 6 Marianne Borritz 7 Hermann Burr 8 Annalisa Casini 9 Els Clays 4 Nico Dragano 10 Raimound Erbel 11 Goedele A. Geuskens 12 Marcel Goldberg 6 Wendela E. Hooftman 12 Irene L. Houtman 12 Karl-Heinz Jöckel 10 France Kittel 9 Anders Knutsson 13 Markku Koskenvuo 14 Constanze Leineweber 15 Thorsten Lunau 10 Idea Eh Madsen 5 Linda L. Magnusson Hanson 15 Michael G. Marmot 16 Martin L. Nielsen 17 Maria Nordin 18 Tuula Oksanen 1, 19 Jaana Pentti 1 Reiner Rugulies 5, 20 Johannes Siegrist 21 Sakari Suominen 22, 23 Jussi Vahtera 1, 22, 24 Mariana Virtanen 1 Peter Westerholm 25 Hugo Westerlund 15, 16, 26 Marie Zins 6 Jane E. Ferrie 16, 27 Töres Theorell 15 Andrew Steptoe 16 Mark Hamer 16 Archana Singh-Manoux 6, 16 G. David Batty 28, 16 Mika Kivimäki 1, 16, 29 
Abstract : 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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Solja T. Nyberg, Katriina Heikkilä, Eleonor I. Fransson, Lars Alfredsson, Dirk de Bacquer, et al.. Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies.. Journal of Internal Medicine, Wiley, 2012, 272 (1), pp.65-73. ⟨10.1111/j.1365-2796.2011.02482.x⟩. ⟨inserm-00677219⟩

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