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Guo X, Gong S, Chen Y, Hou X, Sun T, Wen J, Wang Z, He J, Sun X, Wang S, Feng X, Tian X. Lifestyle behaviors and stress are risk factors for overweight and obesity in healthcare workers: a cross-sectional survey. BMC Public Health 2023; 23:1791. [PMID: 37710220 PMCID: PMC10503083 DOI: 10.1186/s12889-023-16673-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Overweight and obesity have become major public health concerns worldwide. Persistent stress can activate the human hypothalamic‒pituitary‒adrenal axis (HPA) and increase the intake of "self-rewarding food", thereby raising the incidence of obesity. Health care workers (HCWs) experience higher workloads and mental stress than workers in many other industries, which may put them at increased risk for overweight/obesity. However, few studies have been carried out on overweight and obesity among HCWs in China, and the overall scenario and behind-the-scenes factors of their overweight and obesity are unknown. The aim of this study is to understand the epidemic of overweight and obesity and risk factors among Chinese HCWs. METHODS Based on a cross-sectional web survey design, 23,234 HCWs from 100 health institutions in 5 provinces/autonomous regions/municipalities across China were sampled to answer a self-administered questionnaire that was purposely developed using a multi-staged clustered random-sampling method. Chi-square test and ANOVA were performed to compare variables between two or more groups. Univariate analyses were conducted to identify the influence of self-reported persistent stress and/or recurrent anxiety/depressed mood on lifestyle behaviors. A multivariate binary logistic regression model was used to analyse the risk factors of overweight/obesity. RESULTS Among the respondents, 34.26% were overweight, and 11.22% were obese. Most of the respondents had regular exercise habits (68.17%), had habitually stayed-up late (65.06%) and had been affected by persistent stress and/or recurrent anxiety/depressed mood (62.04%). A higher proportion of those with persistent stress and/or recurrent anxiety/depressed mood than those without habitually staying-up late (76.18%); consumed take-out food (54.92%), fried food (49.93%), snacks or desserts (50.51%); drank sugary drinks (46.57%); smoked (14.27%); and drank alcohol (23.34%). Gender (Female) (OR: 0.314, 95%CI: 0.292-0.336), age (OR: 1.742-2.334, 95%CI: 1.544-2.858), education (OR: 0.620-0.728, 95%CI: 0.445-0.973), living and working area (OR: 1.271, 95%CI: 1.192-1.355), breakfast (OR: 0.898, 95%CI: 0.839-0.960), fried food (OR: 1.133, 95%CI: 1.048-1.224), and alcohol consumption (OR: 1.111, 95%CI: 1.017-1.214) were factors for overweight/obesity. All of the aforementioned results were significant (P < 0.05). CONCLUSIONS The overweight/obesity rate of Chinese HCWs is rather high, which might be directly associated with lifestyle behaviors. However, these behaviors fundamentally originated from persistent stress and/or recurrent anxiety/depression, mediated by lifestyle behaviors. Substantial measures should be taken for stress reduction and mental health promotion for overweight/obesity prevention and control among HCWs.
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Affiliation(s)
- Xinyue Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Anhui, 230031, China
| | | | - Ying Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Anhui, 230031, China
| | - Xiaohui Hou
- Chinese Center for Health Education, Beijing, 100011, China
| | - Tong Sun
- Shandong Center for Disease Control and Prevention, Shandong, 250013, China
| | - Jianqiang Wen
- Gansu Province Traditional Chinese Medicine Development Center, Gansu, 741021, China
| | - Zhiyao Wang
- Health Promotion and Education Center of Xinjiang Uygur Autonomous Region, Xinjiang Uygur Autonomous Region, 843199, Xinjang, China
| | - Jingyang He
- Health Education Institute of Henan Center for Disease Control, Henan, 450004, China
| | - Xuezhu Sun
- Center for Lifestyle Medicine, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, China
| | - Sufang Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Anhui, 230031, China
| | - Xue Feng
- Center for Lifestyle Medicine, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, China.
| | - Xiangyang Tian
- Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Anhui, 230031, China.
- Chinese Center for Health Education, Beijing, 100011, China.
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