Skip to main content

Changes in job strain and subsequent weight gain: a longitudinal study, based on the Danish Nurse Cohort

  • Gitte Kingo Vesterlund (a1), Amélie Cléo Keller (a1) and Berit Lilienthal Heitmann (a1) (a2) (a3)

Obesity as well as job strain is increasing, and job strain might contribute to weight gain. The objective of the current study was to examine associations between longitudinal alterations in the components of job strain and subsequent weight gain.


The study was designed as a prospective cohort study with three questionnaire surveys enabling measurement of job-strain alterations over 6 years and subsequent measurements of weight gain after further 10 years of follow-up. ANCOVA and trend analyses were conducted. Job demands were measured as job busyness and speed, and control as amount of influence.


Employed nurses in Denmark.


We included a sub-sample of 6188 female nurses from the Danish Nurse Cohort, which consisted of the nurses who participated in surveys in 1993, 1999 and 2009.


A linear trend in weight gain was seen in nurses who were often busy in 1999 between those who were rarely v. sometimes v. often busy in 1993 (P=0·03), with the largest weight gain in individuals with sustained high busyness in both years. Loss of influence between 1993 and 1999 was associated with larger subsequent weight gain than sustained high influence (P=0·003) or sustained low influence (P=0·02). For speed, no associations were found.


Busyness, speed and influence differed in their relationship to subsequent weight gain. A decrease in job influence and a sustained burden of busyness were most strongly related to subsequent weight gain. Focus on job strain reduction and healthy diet is essential for public health.

Corresponding author
* Corresponding author: Email
Hide All
1. World Health Organization (2016) Obesity and overweight. Fact sheet. (accessed December 2016).
2. Reaven, GM (2011) Insulin resistance: the link between obesity and cardiovascular disease. Med Clin North Am 95, 875892.
3. Redman, L, Johannsen, D & Ravussin, E (2000) Regulation of body weight in humans. In Endotext [J De Groot, P Beck-Peccoz, G Chrousos et al., editors]. South Dartmouth, MA:
4. Yau, YH & Potenza, MN (2013) Stress and eating behaviors. Minerva Endocrinol 38, 255267.
5. Spencer, SJ & Tilbrook, A (2011) The glucocorticoid contribution to obesity. Stress 14, 233–146.
6. Health and Safety Executive (2016) Work-related stress, anxiety and depression statistics in Great Britain 2016. (accessed November 2016).
7. The American Institute of Stress (n.d.) Workplace Stress. (accessed November 2016).
8. National Research Centre for the Working Environment (2011) Psykisk Arbejdsmiljo. (accessed November 2016).
9. Karasek, R & Theorell, T (1990) Healthy Work, Stress, Productivity, and the Reconstruction of Working Life. New York: Basic.
10. Kivimaki, M, Singh-Manoux, A, Nyberg, S et al. (2015) Job strain and risk of obesity: systematic review and meta-analysis of cohort studies. Int J Obes (Lond) 39, 15971600.
11. Lallukka, T, Sarlio-Lahteenkorva, S, Kaila-Kangas, L et al. (2008) Working conditions and weight gain: a 28-year follow-up study of industrial employees. Eur J Epidemiol 23, 303310.
12. Nyberg, ST, Heikkila, K, Fransson, EI et al. (2012) Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies. J Intern Med 272, 6573.
13. Brunner, EJ, Chandola, T & Marmot, MG (2007) Prospective effect of job strain on general and central obesity in the Whitehall II Study. Am J Epidemiol 165, 828837.
14. Hundrup, YA, Simonsen, MK, Jorgensen, T et al. (2012) Cohort profile: the Danish nurse cohort. Int J Epidemiol 41, 12411247.
15. Overgaard, D, Gamborg, M, Gyntelberg, F et al. (2004) Psychological workload is associated with weight gain between 1993 and 1999: analyses based on the Danish Nurse Cohort Study. Int J Obes Relat Metab Disord 28, 10721081.
16. Gram Quist, H, Christensen, U, Christensen, KB et al. (2013) Psychosocial work environment factors and weight change: a prospective study among Danish health care workers. BMC Public Health 13, 43.
17. Solovieva, S, Lallukka, T, Virtanen, M et al. (2013) Psychosocial factors at work, long work hours, and obesity: a systematic review. Scand J Work Environ Health 39, 241258.
18. Ishizaki, M, Nakagawa, H, Morikawa, Y et al. (2008) Influence of job strain on changes in body mass index and waist circumference – 6-year longitudinal study. Scand J Work Environ Health 34, 288296.
19. Maina, G, Palmas, A, Bovenzi, M et al. (2009) Salivary cortisol and psychosocial hazards at work. Am J Ind Med 52, 251260.
20. Shively, CA, Register, TC & Clarkson, TB (2009) Social stress, visceral obesity, and coronary artery atherosclerosis: product of a primate adaptation. Am J Primatol 71, 742751.
21. Friis, K, Ekholm, O & Hundrup, YA (2005) Comparison of lifestyle and health among Danish nurses and the Danish female population: is it possible to generalize findings from nurses to the general female population? Scand J Caring Sci 19, 361367.
22. Kivimaki, M, Head, J, Ferrie, JE et al. (2006) Work stress, weight gain and weight loss: evidence for bidirectional effects of job strain on body mass index in the Whitehall II study. Int J Obes (Lond) 30, 982987.
23. Marchand, A, Beauregard, N & Blanc, ME (2015) Work and non-work stressors, psychological distress and obesity: evidence from a 14-year study on Canadian workers. BMJ Open 5, e006285.
24. Ng, SP, Korda, R, Clements, M et al. (2011) Validity of self-reported height and weight and derived body mass index in middle-aged and elderly individuals in Australia. Aust N Z J Public Health 35, 557563.
25. Toren, K, Schioler, L, Giang, WK et al. (2014) A longitudinal general population-based study of job strain and risk for coronary heart disease and stroke in Swedish men. BMJ Open 4, e004355.
26. Nyberg, ST, Fransson, EI, Heikkila, K et al. (2014) Job strain as a risk factor for type 2 diabetes: a pooled analysis of 124,808 men and women. Diabetes Care 37, 22682275.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *