title: Feeling vigorous and the risks of all-cause mortality, ischemic heart disease, and diabetes: a 20-year follow-up of healthy employees.
abstract: OBJECTIVE
  To investigate prospectively the effects of vigor at work on the end points of mortality and the prevalence of ischemic heart disease (IHD) and diabetes.
  
  
  METHODS
  We tested the hypothesized beneficial effects of feeling vigorous at work at baseline on the risks of all-cause mortality, IHD, and diabetes during a 20-year follow-up. Participants were healthy employees (n = 968) who underwent a routine health check at baseline. We calculated the risk of all-cause mortality, IHD, and diabetes, with days as the time scale, using the Cox proportional hazard model. In our analyses, we predicted the above end points by baseline vigor, age, gender, and educational level, adjusting for the physiological risk factors of total cholesterol, glucose, and body mass index, the behavioral risk factors of smoking, alcohol intake, and physical activity, and the psychological risk factors of depressive and anxiety symptoms.
  
  
  RESULTS
  As hypothesized, we found that, after the above adjustments, baseline vigor decreased the risk of follow-up mortality by 26% (hazard ratio, 0.74; 95% confidence interval, 0.58-0.95) and the risk of diabetes by 17% (hazard ratio, 0.83; 95% confidence interval, 0.68-0.98). However, vigor did not have a significant effect on the risk of IHD.
  
  
  CONCLUSIONS
  Independently of physiological, behavioral, and psychological risk factors, feeling vigorous at work protected the participants from diabetes and reduced their risk of mortality.
authors: Faculty of Management, Tel Aviv University, Ramat Aviv, Tel Aviv 69978, Israel. ashirom@post.tau.ac.il
authors: Arie
authors: A
authors: Shirom
authors: Sharon
authors: S
authors: Toker
authors: Orit
authors: O
authors: Jacobson
authors: Ran D
authors: RD
authors: Balicer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002423:Cause of Death; D003920:Diabetes Mellitus / Q000401:mortality*; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality; D004644:Emotions / Q000502:physiology*; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D017202:Myocardial Ischemia / Q000401:mortality*; D016272:Occupational Health / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012923:Social Class; D011795:Surveys and Questionnaires; D014937:Work / Q000502:physiology / Q000523:psychology