Impact of physical activity, diet quality and stress on cardiometabolic health in school employees

Authors: SCHULTZ, NICOLE - Tufts University; CHUI, KENNETH - Tufts University; ECONOMOS, CHRISTINA - Tufts University; LICHTENSTEIN, ALICE - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; VOLPE, STELLA - Drexel University; SACHECK, JENNIFER - George Washington University

Submitted to: Preventive Medicine Reports
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/1/2020
Publication Date: 11/6/2020
Citation: Schultz, N.S., Chui, K.K., Economos, C.D., Lichtenstein, A.H., Volpe, S.L., Sacheck, J.M. 2020. Impact of physical activity, diet quality and stress on cardiometabolic health in school employees. Preventive Medicine Reports. 20:101243. https://doi.org/10.1016/j.pmedr.2020.101243.
DOI: https://doi.org/10.1016/j.pmedr.2020.101243

Interpretive Summary: Among school employees, poor physical and mental health, as well as high stress and large workloads, have resulted in high absenteeism and low retention. This is of concern because the consequences of unhealthy behaviors may extend to students. The objective of this work was to examine the impact of school employees' physical activity (PA), diet quality and perceived occupational stress on cardiometabolic health. In this cross-sectional study, employees from lower-income Massachusetts schools participated in Wellness Assessments (2015-2016), including measured height, weight, and lipids [total (TC), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C) cholesterol]. Self-administered surveys were used to collect demographic, stress, PA and 24-hour food intake data. Observed were high rates of overweight and obesity, and LDL-C concentrations were observed in the cohort. They reported engaging in low levels of moderate-to-vigorous PA. Higher levels of moderate-to-vigorous PA, but not diet quality, were positively associated with measures of cardiometabolic health. The relation of moderate-to-vigorous PA with BMI was weakened by high perceived stress. In summary, higher levels of moderate-to-vigorous PA were associated with more favorable cardiometabolic health, with increasing levels of stress minimizing the beneficial effect on BMI.

Technical Abstract: Among school employees, it has been reported that poor physical and mental health, as well as high stress and large workloads, have resulted in high absenteeism and low retention. The consequences of unhealthy behaviors and stress can extend to students, impacting academic achievement and school costs. Our objective was to examine the impact of school employees' physical activity (PA), diet quality and perceived occupational stress on cardiometabolic health, and explore how stress may influence the impact of PA and diet on health. In this cross-sectional study, employees from lower-income Massachusetts schools participated in Wellness Assessments (2015-2016), including measured height, weight, and lipids [total (TC), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C)]. Self-administered surveys were used to collect demographic, stress, PA and 24-hour food intake data. Linear regression models were used to examine the relationship among health behaviors (PA and diet), stress and cardiometabolic health. An interaction between stress and health behaviors was also explored. Seventy-four employees (66% teachers) participated. Overweight/obesity (mean BMI: 25.6 kg/m2), high TC and LDL-C were observed in 47%, 4%, and 34%, respectively, and moderate-to-vigorous PA (MVPA) was low (median: 17 min/day). Positive associations were identified between MVPA and cardiometabolic health, but not diet. The effect of MVPA on BMI was modified by stress (p-for-interaction=0.001), with higher levels of stress associated with a diminished protective association between MVPA and BMI. Higher levels of PA were associated with more favorable cardiometabolic health, with increasing levels of stress minimizing the beneficial effect of PA on BMI.