Skip to main content Accessibility help

Obesity, diet quality and absenteeism in a working population

  • Sarah Fitzgerald (a1), Ann Kirby (a2), Aileen Murphy (a2) and Fiona Geaney (a1)



The relationship between workplace absenteeism and adverse lifestyle factors (smoking, physical inactivity and poor dietary patterns) remains ambiguous. Reliance on self-reported absenteeism and obesity measures may contribute to this uncertainty. Using objective absenteeism and health status measures, the present study aimed to investigate what health status outcomes and lifestyle factors influence workplace absenteeism.


Cross-sectional data were obtained from a complex workplace dietary intervention trial, the Food Choice at Work Study.


Four multinational manufacturing workplaces in Cork, Republic of Ireland.


Participants included 540 randomly selected employees from the four workplaces. Annual count absenteeism data were collected. Physical assessments included objective health status measures (BMI, midway waist circumference and blood pressure). FFQ measured diet quality from which DASH (Dietary Approaches to Stop Hypertension) scores were constructed. A zero-inflated negative binomial (zinb) regression model examined associations between health status outcomes, lifestyle characteristics and absenteeism.


The mean number of absences was 2·5 (sd 4·5) d. After controlling for sociodemographic and lifestyle characteristics, the zinb model indicated that absenteeism was positively associated with central obesity, increasing expected absence rate by 72 %. Consuming a high-quality diet and engaging in moderate levels of physical activity were negatively associated with absenteeism and reduced expected frequency by 50 % and 36 %, respectively. Being in a managerial/supervisory position also reduced expected frequency by 50 %.


To reduce absenteeism, workplace health promotion policies should incorporate recommendations designed to prevent and manage excess weight, improve diet quality and increase physical activity levels of employees.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Obesity, diet quality and absenteeism in a working population
      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Obesity, diet quality and absenteeism in a working population
      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Obesity, diet quality and absenteeism in a working population
      Available formats


This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

* Corresponding author: Email


Hide All
1. Signal, LN, Walton, MD, Ni Mhurchu, C et al. (2013) Tackling ‘wicked’ health promotion problems: a New Zealand case study. Health Promot Int 28, 8494.
2. World Health Organization (2000) Obesity: Preventing and Managing the Global Epidemic. Report of a WHO Consultation. WHO Technical Report Series no. 894. Geneva: WHO.
3. Trogdon, JG, Finkelstein, EA, Hylands, T et al. (2008) Indirect costs of obesity: a review of the current literature. Obes Rev 9, 489500.
4. Irish Business and Employers Confederation (2011) Employee Absenteeism: A Guide to Managing Absence. Dublin: IBEC.
5. Dee, A, Callnan, A, Doherty, E et al. (2015) Overweight and obesity on the island of Ireland: an estimation of costs. BMJ Open 5, e006189.
6. World Health Organization (2008) 2008–2013 Action Plan for the Global Strategy for the Prevention and Control of Noncommunicable Diseases. Geneva: WHO.
7. Capacci, S, Mazzocchi, M, Shankar, B et al. (2012) Policies to promote healthy eating in Europe: a structured review of policies and their effectiveness. Nutr Rev 70, 188200.
8. Chu, C, Breucker, G, Harris, N et al. (2000) Health-promoting workplaces – international settings development. Health Promot Int 15, 155167.
9. Healthy Ireland (2013) Healthy Ireland – a framework for improved health and wellbeing 2013–2025. (accessed October 2015).
10. Jensen, S & McIntosh, J (2007) Absenteeism in the workplace: results from Danish sample survey data. Empir Econ 32, 125139.
11. Alavinia, SM, van den Berg, TI, van Duivenbooden, C et al. (2009) Impact of work-related factors, lifestyle, and work ability on sickness absence among Dutch construction workers. Scand J Work Environ Health 35, 325333.
12. Robroek, SJ, van den Ber, TI, Plat, JF et al. (2011) The role of obesity and lifestyle behaviours in a productive workforce. Occup Environ Med 68, 134139.
13. Moreau, M, Valente, F, Mak, R et al. (2004) Obesity, body fat distribution and incidence of sick leave in the Belgian workforce: the Belstress study. Int J Obes Relat Metab Disord 28, 574582.
14. Finkelstein, EA, DiBonaventura, Md, Burgess, SM et al. (2010) The costs of obesity in the workplace. J Occup Environ Med 52, 971976.
15. van Duijvenbode, DC, Hoozemans, MJ, van Poppel, MN et al. (2009) The relationship between overweight and obesity, and sick leave: a systematic review. Int J Obes (Lond) 33, 807816.
16. Millar, SR, Perry, IJ, Van den Broeck, J et al. (2015) Optimal central obesity measurement site for assessing cardiometabolic and type 2 diabetes risk in middle-aged adults. PLoS One 10, e0129088.
17. Lahti, J, Laaksonen, M, Lahelma, E et al. (2010) The impact of physical activity on sickness absence. Scand J Med Sci Sports 20, 191199.
18. Bunn, WB 3rd, Stave, GM, Downs, KE et al. (2006) Effect of smoking status on productivity loss. J Occup Environ Med 48, 10991108.
19. Sindelar, JL, Duchovny, N, Falba, TA et al. (2005) If smoking increases absences, does quitting reduce them? Tob Control 14, 99105.
20. Rabacow, FM, Levy, RB, Menezes, PR et al. (2014) The influence of lifestyle and gender on sickness absence in Brazilian workers. BMC Public Health 14, 317.
21. Bacharach, SB, Bamberger, P & Biron, M (2010) Alcohol consumption and workplace absenteeism: the moderating effect of social support. J Appl Psychol 95, 334348.
22. Frone, MR (2008) Employee alcohol and illicit drug use: scope, causes, and organizational consequences. In The SAGE Handbook Organizational Behavior. vol. 1: Micro Perspectives, pp. 519540 [J Barling and CL Cooper, editors]. London: SAGE Publications Ltd.
23. Proper, K & van Mechelen, W (2008) Effectiveness and economic impact of worksite interventions to promote physical activity and healthy diet. Background paper prepared for the WHO/WEF Joint Event on Preventing Noncommunicable Diseases in the Workplace (Dalian/China, September 2007). (accessed October 2015).
24. Pelletier, B, Boles, M & Lynch, W (2004) Change in health risks and work productivity over time. J Occup Environ Med 46, 746754.
25. Darnton-Hill, I, Nishida, C & James, WP (2004) A life course approach to diet, nutrition and the prevention of chronic diseases. Public Health Nutr 7, 101121.
26. Fuhrer, R, Shipley, MJ, Chastang, JF et al. (2002) Socioeconomic position, health, and possible explanations: a tale of two cohorts. Am J Public Health 92, 12901294.
27. Ala-Mursula, L, Vahtera, J, Kivimake, M et al. (2002) Employee control over working times: associations with subjective health and sickness absences. J Epidemiol Community Health 56, 272278.
28. Schulte, PA, Wagner, GR, Ostry, A et al. (2007) Work, obesity, and occupational safety and health. Am J Public Health 97, 428436.
29. Geaney, F, Scotto Di Marrazzo, J, Kelly, C et al. (2013) The food choice at work study: effectiveness of complex workplace dietary interventions on dietary behaviours and diet-related disease risk – study protocol for a clustered controlled trial. Trials 14, 370.
30. Geaney, F, Scotto Di Marrazzo, J, Kelly, C et al. (2013) Food Choice at Work SOP. Cork: Department of Epidemiology and Public Health, University College Cork.
31. World Health Organization (2008) Waist Circumference and Waist–Hip Ratio: Report of a WHO Expert Consultation. Geneva: WHO.
32. Pickering, TG, Hall, JE, Appel, LJ et al. (2005) Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Circulation 111, 697716.
33. Harrington, JP, Lutomski, J, Morgan, K et al. (2008) SLÁN 2007: Survey of Lifestyle, Attitudes & Nutrition in Ireland: Dietary Habits of the Irish Population. Dublin: Department of Health and Children.
34. Friel, S, Kelleher, CC, Nolan, G et al. (2003) Social diversity of Irish adults nutritional intake. Eur J Clin Nutr 57, 865875.
35. Fung, TT, Chiuve, SE, McCullough, ML et al. (2008) Adherence to a DASH-style diet and risk of coronary heart disease and stroke in women. Arch Intern Med 168, 713720.
36. Food Safety Authority of Ireland (2005) Salt and Health: Review of the Scientific Evidence and Recommendations for the Public Policy in Ireland. Dublin: FSAI; available at
37. Parmenter, K & Wardle, J (1999) Development of a general nutrition knowledge questionnaire for adults. Eur J Clin Nutr 53, 298308.
38. Asfaw, AG, Chang, CC & Ray, TK (2014) Workplace mistreatment and sickness absenteeism from work: results from the 2010 National Health Interview survey. Am J Ind Med 57, 202213.
39. Taimela, S, Laara, E, Malmivaara, A et al. (2007) Self-reported health problems and sickness absence in different age groups predominantly engaged in physical work. Occup Environ Med 64, 739746.
40. Long, JS & Freese, J (2001) Regression Models for Categorical Dependent Variables Using Stata. College Station, TX: Stata Press.
41. Jones, AM, Rice, N, d’Uva, TB et al. (2007) Applied Health Economics. New York: Routledge.
42. Small Firms Association (2015) Absenteeism Report 2014. Dublin: SFA; available at
43. Central Statistics Office (2014) Quarterly National Household Survey (QNHS) Special Modules. Cork: CSO; available at
44. Central Statistics Office (2015) Statistical Yearbook of Ireland 2015. Cork: CSO; available at
45. Trogdon, J, Finkelstein, EA, Reyes, M et al. (2009) A return-on-investment simulation model of workplace obesity interventions. J Occup Environ Med 51, 751758.
46. van der Klink, JJ, Blonk, RW, Schene, AH et al. (2001) The benefits of interventions for work-related stress. Am J Public Health 91, 270276.
47. Kouvonen, A, Kivimaki, M, Cox, SJ et al. (2005) Relationship between work stress and body mass index among 45,810 female and male employees. Psychosom Med 67, 577583.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed