Occupational stress is associated with major long-term weight gain in a Swedish population-based cohort

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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00420-018-1392-6) contains supplementary material, which is available to authorized users.