• S T Nyberg, K Heikkilä, E I Fransson, L Alfredsson, D De Bacquer, J B Bjorner, S Bonenfant, M Borritz, H Burr, A Casini, E Clays, N Dragano, R Erbel, G A Geuskens, M Goldberg, W E Hooftman, I L Houtman, K-H Jöckel, F Kittel, A Knutsson, M Koskenvuo, C Leineweber, T Lunau, I E H Madsen, L L Magnusson Hanson, M G Marmot, M L Nielsen, M Nordin, T Oksanen, J Pentti, R Rugulies, J Siegrist, S Suominen, J Vahtera, M Virtanen, P Westerholm, H Westerlund, M Zins, J E Ferrie, T Theorell, A Steptoe, M Hamer, A Singh-Manoux, G D Batty, M Kivimäki, and IPD-Work Consortium.
• Finnish Institute of Occupational Health, Helsinki, Finland.solja.nyberg@ttl.fi
• J. Intern. Med. 2012 Jul 1; 272 (1): 657365-73.

BackgroundEvidence 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.ObjectivesTo examine the association between job strain and body mass index (BMI) in a large adult population.MethodsWe 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).ResultsA 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.ConclusionsIn 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.© 2011 The Association for the Publication of the Journal of Internal Medicine.

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