Work stress, dietary patterns and metabolic syndrome among military personnel in Ghana: a cross-sectional study

Objective The purpose of this research was to assess the association between work stress and dietary patterns on metabolic syndrome (MetS) among Ghanaian military personnel. Design A cross-sectional survey. Setting 37 Military Hospital, Accra. Population 390 military personnel were recruited for this study. Main outcome measures Lipid profiles, fasting blood sugar, waist circumference, frequency of food intake, work stress and clinical profiles. MetS was defined according to the International Diabetes Federation criteria. Univariate and multivariate logistic regression models were applied to determine the associations. Results The prevalence of MetS was 13.3%, with elevated blood pressure (69.7%) and abdominal obesity (43.8%) being the most common. Low work stress was reported by 62.8% (Effort-Reward Imbalance) and 63.6% (Job Content Questionnaire; JCQ) of participants. The JCQ model was associated with MetS (OR 6.472, 95% CI 1.535 to 27.292, p=0.011). About 61.0% of participants reported high physical activity levels. Two dietary patterns were identified, namely sugary and energy-dense and high protein and vegetables. Moderate consumers of the sugary and energy-dense dietary pattern were less likely to have MetS (Tertile 2: OR 0.368, 95% CI 0.168 to 0.805, p=0.012). Similarly, this pattern was also associated with lower odds of low high-density lipoprotein cholesterol (Tertile 2: OR 0.408, 95% CI 0.191 to 0.873, p=0.021) and reduced the odds of abdominal obesity (Tertile 3: OR 0.605, 95% CI 0.369 to 0.991, p=0.046). High triglyceride levels were also significantly lower across both Tertile 2 and Tertile 3 of this pattern (OR 0.331, 95% CI 0.116 to 0.949, p=0.040; OR 0.129, 95% CI 0.029 to 0.582, p=0.008), respectively. Further, the protein and vegetable dietary pattern was associated with increased odds of high blood pressure (Tertile 3: OR 2.132, 95% CI 1.231 to 3.693, p=0.007). Conclusion Moderate consumption of the sugary and energy-dense dietary pattern was surprisingly associated with reduced odds of MetS and several of its components, while the protein and vegetable-based pattern was linked to higher odds of elevated blood pressure. Further, work stress was significantly associated with increased odds of MetS. The findings of this research highlight the need to address psychosocial stressors in cardiometabolic risk prevention.