Metabolic syndrome incidence in an aging workforce: Occupational differences and the role of health behaviors

Abstract Background Although the incidence of metabolic syndrome (MetS) strongly varies based on individuals’ socioeconomic position (SEP), as yet no studies have examined the SEP-MetS remission relationship. Our aim is to longitudinally assess the associations between SEP measures education, income and occupational prestige, and MetS remission, and whether these associations are mediated by health behaviors, including physical activity, smoking, alcohol intake and diet quality. Methods A subsample (n = 16,818) of the adult Lifelines Cohort Study with MetS at baseline was used. MetS remission was measured upon second assessment (median follow-up time 3.8 years), defined according to NCEP-ATPIII criteria. To estimate direct associations between SEP, health behaviors and MetS remission multivariable logistic regression analyses were used. To estimate the mediating percentages of health behaviors that explain the SEP-MetS remission relationship the Karlson-Holm-Breen method was used. Analyses were adjusted for age, sex, the other SEP measures and follow-up time. Results At the second assessment, 42.7% of the participants experienced MetS remission. Education and income were positively associated with MetS remission, but occupational prestige was not. The association between education and MetS remission could partly (11.9%) be explained by health behaviors, but not the association between income and MetS remission. Conclusions Individuals with higher education more often experienced remission from MetS, mainly because individuals with higher education were more likely to have healthier behaviors. However, individuals with higher income more often experienced MetS remissions, regardless of their health behaviors. The occupational prestige of individuals was not associated with MetS remission.

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Occupational Differences in Metabolic Syndrome Incidence Among Older Workers

Innovation in Aging ◽

10.1093/geroni/igab046.198 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 52-52

Author(s):

Katharina Runge ◽

Sander K R van Zon ◽

Ute Bültmann ◽

Kène Henkens

Keyword(s):

Metabolic Syndrome ◽

Health Behaviors ◽

Older Workers ◽

White Collar ◽

Occupational Group ◽

Blue Collar ◽

Occupational Groups ◽

Blue Collar Workers ◽

Physical Measurements ◽

Occupational Differences

Abstract This study investigates whether the incidence of metabolic syndrome (MetS), and its components, differs by occupational group among older workers (45-65 years) and whether health behaviors (smoking, leisure-time physical activity, diet quality) can explain these differences. We analyzed data from older workers (N=23 051) from two comprehensive measurement waves of the Lifelines Cohort Study and Biobank. MetS components were determined by physical measurements, blood markers, medication use, and self-reports. Occupational group and health behaviors were assessed by questionnaires. The association between occupational groups and MetS incidence was examined using Cox regression analysis. Health behaviors were subsequently added to the model to examine whether they can explain differences in MetS incidence between occupational groups. Low skilled white-collar (HR: 1.25, 95% CI: 1.13, 1.39) and low skilled blue-collar (HR: 1.45, 95% CI: 1.25, 1.69) workers had a significantly higher MetS incidence risk during 3.65 years follow-up than high skilled white-collar workers. Health behaviors reduced the strength of the association between occupational group and MetS incidence most among low skilled blue-collar workers (i.e. 10.3% reduction) as unhealthy behaviors were more prevalent in this occupational group. Similar occupational differences were observed on MetS component level. To conclude, MetS incidence in older workers differs between occupational groups and health behaviors only explain a small part of these differences. Health promotion tailored to occupational groups may be beneficial specifically among older low skilled blue-collar workers. Research into other factors that contribute to occupational differences is needed, as well as studies spanning the entire working life course.

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Socioeconomic differences in metabolic syndrome remission in adults: mediation of health behaviors

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.920 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L A Hoveling ◽

A C Liefbroer ◽

U Bültmann ◽

N Smidt

Keyword(s):

Metabolic Syndrome ◽

Health Behaviors ◽

Social Resources ◽

Occupational Prestige ◽

Socioeconomic Differences ◽

Regression Analyses ◽

Cultural Economic ◽

Shed Light

Abstract Introduction Metabolic syndrome (MetS) incidence strongly varies by socioeconomic status (SES). Each SES measure comprises different resources of an individual, including cultural, economic and social resources. To date, no studies have examined the SES - MetS remission relationship. Understanding the role of each SES measure for MetS remission could shed light on resources needed to reverse adverse health conditions. The aim is to longitudinally assess the associations between the SES measures years of education, household equivalent income and occupational prestige and remitted MetS and whether these associations are mediated by health behaviors, including physical activity, smoking, alcohol drinking and diet quality. Methods A subsample of the adult Lifelines Cohort Study, including 16,818 participants with MetS at baseline was used. MetS remission was measured at the second assessment (follow-up time 3.8 years) defined according to the NCEP-ATPIII criteria. Direct associations between SES, health behaviors and remitted MetS were estimated using multivariable logistic regression analyses. The mediating percentages of health behaviors explaining the associations between SES and remitted MetS were estimated using the Karlson-Holm-Breen method. Analyses were independent of age, sex, the other SES measures and follow-up time. Results At the second assessment MetS remitted for 42.7% of the participants. Education (OR 1.04, 99% CI: 1.02-1.06) and income (OR 1.01, 99% CI: 1.00-1.02) were associated with MetS remission, occupational prestige was not. Health behaviors (11.9%) only explained the association between education and MetS remission. For the explanation of the association between income and MetS remission, health behaviors played no role. Conclusions More education years increase MetS remission, mainly because higher educated are more likely to have healthier behaviors. Higher income increases MetS remission, regardless of the health behaviors. Key messages Education and income are positively associated with MetS remission. Health behaviors explain a relatively small part of the SES – MetS remission pathway.

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