title: Job strain and health-related lifestyle: findings from an individual-participant meta-analysis of 118,000 working adults.
abstract: OBJECTIVE
  We examined the associations of job strain, an indicator of work-related stress, with overall unhealthy and healthy lifestyles.
  
  
  METHODS
  We conducted a meta-analysis of individual-level data from 11 European studies (cross-sectional data: n = 118,701; longitudinal data: n = 43,971). We analyzed job strain as a set of binary (job strain vs no job strain) and categorical (high job strain, active job, passive job, and low job strain) variables. Factors used to define healthy and unhealthy lifestyles were body mass index, smoking, alcohol intake, and leisure-time physical activity.
  
  
  RESULTS
  Individuals with job strain were more likely than those with no job strain to have 4 unhealthy lifestyle factors (odds ratio [OR] = 1.25; 95% confidence interval [CI] = 1.12, 1.39) and less likely to have 4 healthy lifestyle factors (OR = 0.89; 95% CI = 0.80, 0.99). The odds of adopting a healthy lifestyle during study follow-up were lower among individuals with high job strain than among those with low job strain (OR = 0.88; 95% CI = 0.81, 0.96).
  
  
  CONCLUSIONS
  Work-related stress is associated with unhealthy lifestyles and the absence of stress is associated with healthy lifestyles, but longitudinal analyses suggest no straightforward cause-effect relationship between work-related stress and lifestyle.
authors.affiliation: Katriina Heikkilä, Solja T. Nyberg, Marianna Virtanen, and Mika Kivimäki are with the Finnish Institute of Occupational Health, Helsinki. Eleonor I. Fransson is with the School of Health Sciences, Jönköping University, Jönköping. Lars Alfredsson is with the Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. Marie Zins, Marcel Goldberg, and Archana Singh-Manoux are with the Centre for Research in Epidemiology and Population Health, Villejuif, France. Hugo Westerlund is with the Stress Research Institute, Stockholm University, Stockholm, Sweden. Peter Westerholm is with the Department of Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden. Jussi Vahtera, Paula Salo, Jaana Pentti, and Tuula Oksanen are with the Finnish Institute of Occupational Health, Turku. Sakari Suominen is with the Department of Public Health, University of Turku, Turku, Finland. Andrew Steptoe, Michael G. Marmot, and Jane E. Ferrie are with the Department of Epidemiology and Public Health, University College London, London, UK. Maria Nordin is with the Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. Thorsten Lunau and Nico Dragano are with the Department of Medical Sociology, University of Düsseldorf, Düsseldorf, Germany. Karl-Heinz Ladwig is with the German Research Center for Environmental Health, Munich. Markku Koskenvuo is with the Department of Public Health, University of Helsinki, Helsinki, Finland. Anders Knutsson is with the Department of Health Sciences, Mid Sweden University, Sundsvall. France Kittel and Annalisa Casini are with the School of Public Health, Université Libre de Bruxelles, Brussels, Belgium. Karl-Heinz Jöckel is with the Institute for Medical Informatics, Biometry, and Epidemiology, University Duisburg-Essen, Essen, Germany. Raimund Erbel is with the Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen. Dirk DeBacquer and Els Clays are with th
authors.forename: Katriina
authors.initials: K
authors.lastname: Heikkilä
authors.forename: Eleonor I
authors.initials: EI
authors.lastname: Fransson
authors.forename: Solja T
authors.initials: ST
authors.lastname: Nyberg
authors.forename: Marie
authors.initials: M
authors.lastname: Zins
authors.forename: Hugo
authors.initials: H
authors.lastname: Westerlund
authors.forename: Peter
authors.initials: P
authors.lastname: Westerholm
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
authors.forename: Sakari
authors.initials: S
authors.lastname: Suominen
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
authors.forename: Paula
authors.initials: P
authors.lastname: Salo
authors.forename: Jaana
authors.initials: J
authors.lastname: Pentti
authors.forename: Tuula
authors.initials: T
authors.lastname: Oksanen
authors.forename: Maria
authors.initials: M
authors.lastname: Nordin
authors.forename: Michael G
authors.initials: MG
authors.lastname: Marmot
authors.forename: Thorsten
authors.initials: T
authors.lastname: Lunau
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Ladwig
authors.forename: Markku
authors.initials: M
authors.lastname: Koskenvuo
authors.forename: Anders
authors.initials: A
authors.lastname: Knutsson
authors.forename: France
authors.initials: F
authors.lastname: Kittel
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.forename: Marcel
authors.initials: M
authors.lastname: Goldberg
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Nico
authors.initials: N
authors.lastname: Dragano
authors.forename: Dirk
authors.initials: D
authors.lastname: DeBacquer
authors.forename: Els
authors.initials: E
authors.lastname: Clays
authors.forename: Annalisa
authors.initials: A
authors.lastname: Casini
authors.forename: Lars
authors.initials: L
authors.lastname: Alfredsson
authors.forename: Jane E
authors.initials: JE
authors.lastname: Ferrie
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
authors.forename: G David
authors.initials: GD
authors.lastname: Batty
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000150:complications*; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications*