Cardiovascular
Workplace wellness: contributions of long working hours and poor diet to cardiometabolic outcomes and mortality in U.S. workers Xiang Li* Xiang Li Jian Li Tong Xia Onyebuchi A. Arah Liwei Chen
Both long working hours (LWH) and poor diet contribute to cardiometabolic outcomes and mortality and have been rarely investigated as combined exposures. We examined the individual and joint associations of LWH and diet with cardiometabolic risk factors and mortality using a nationally representative sample of U.S. workers. We included 18,542 workers (aged 35-74 years) free of cardiovascular disease from National Health and Nutrition Examination Surveys (NHANES, 1999-2018), linked with the National Death Index to follow up on mortality status. Working hours were classified as <35, 35-40, 41-54, and ≥55 hours/week (i.e., LWH). Dietary quality was measured using the EAT-Lancet diet score assessed by two 24-hour dietary recalls and classified as high vs. low by the median score. The associations of LWH and dietary quality with cardiometabolic outcomes were estimated using logistic regression model (for obesity, hypertension, diabetes, hypercholesterolemia, or Framingham CVD risk score>20%) or Cox proportional hazard model (for all-cause, heart disease and CVD mortality), accounting for sampling strategies and confounders. Compared to working 35-40 hours/week, LWH was associated with higher odds of obesity (OR=1.19; 95% CI: 1.06-1.34) but not for other cardiometabolic outcomes. 1.13; 95% CI: 0.47-2.71among individuals with high Framingham CVD risk scores. Poor dietary quality was associated with higher odds of all cardiometabolic outcomes and CVD mortality in this study. Compared to workers without LWH and with high dietary quality, those with LWH and low dietary quality had the greatest odds of obesity (OR=1.60, 95% CI: 1.37-1.87), hypertension (OR=1.21, 95% CI: 1.00-1.46), and highest heart disease mortality (HR=1.81, 95% CI: 1.05-3.12). If plausibly causal with additional evidence, these findings suggest improving dietary quality among U.S. workers with LWH to mitigate cardiometabolic risks and mortality.
