The associations of long working hours and unhealthy diet with cardiometabolic outcomes and mortality in US workers.

Abstract

To examine independent and joint associations of long working hours (LWH) and EAT-Lancet diet with cardiometabolic outcomes and mortality in US workers. This prospective cohort included US workers from the National Health and Nutrition Examination Survey, with cross-sectional baseline data from 1999 to March 2020. A subsample of participants from 1999 to 2018 was linked to the National Death Index, with mortality follow-up through December 2019. The independent and joint associations of LWH (≥ 55 vs. < 55 h/week) and EAT-Lancet diet scores (low vs. high) with cardiometabolic outcomes and mortality were estimated using multivariable logistic and Cox proportional hazards models, respectively. LWH was associated with higher odds of obesity (OR = 1.20; 95%CI = 1.07, 1.34) among all workers and higher CVD mortality among workers with high CVD risk at baseline (HR = 1.64, 95%CI = 0.79, 3.12). Low diet scores were associated with higher odds of obesity (OR = 1.34, 95%CI = 1.21, 1.42) and diabetes (OR = 1.33, 95%CI = 1.01, 1.76) among all workers. Working hours and diet scores were jointly associated with obesity and CVD mortality, indicating by the relative excess risk due to interaction greater than zero among all workers. LWH and unhealthy diet are independent risk factors and may interact to exacerbate adverse cardiometabolic health outcomes.