Obesity and low back pain: a retrospective cohort study of Japanese males

Hashimoto, Yuko; Matsudaira, Ko; Sawada, Susumu S.; Gando, Yuko; Kawakami, Ryoko; Kinugawa, Chihiro; Okamoto, Takashi; Tsukamoto, Koji; Miyachi, Motohiko; Naito, Hisashi

doi:10.1589/jpts.29.978

Cited by 29 publications

(46 citation statements)

References 19 publications

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“…We did not find evidence of significant associations in relation to LTSA because of cancer or LSTA because of musculoskeletal disorders. Albeit with differences in the outcomes studied, this finding seems to contradict with those reported in previous studies on the association of obesity with the incidence of cancer and with the incidence of musculoskeletal disorders . One possible interpretation for such discrepancy might have been due to our definition of SA (i.e., SA ≥ 30 consecutive days).…”

Section: Discussioncontrasting

confidence: 84%

BMI and Medically Certified Long‐Term Sickness Absence Among Japanese Employees

Endo

Inoue

Kuwahara

et al. 2020

Obesity

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Objective In contrast to the association between excess weight and sickness absence (SA), the association in relation to underweight has been under‐researched. This study aimed to examine the effects of BMI at both extremes of its distribution on SA. Methods Data came from the Japan Epidemiology Collaboration on Occupational Health study of 77,760 workers aged 20 to 59 years (66,166 males, 11,594 females). Information was collected on medically certified long‐term SA (LTSA) (i.e., SA lasting ≥ 30 consecutive days) from April 2012 to March 2017. A sex‐specific Cox proportional hazards model was used to investigate the associations. Results Among males, both obesity (hazard ratio [HR] = 1.81, 95% CI: 1.50‐2.17) and underweight (HR = 1.56, 95% CI: 1.23‐1.96) were significantly associated with LTSA compared with normal weight. This U‐shaped association between BMI categories and LTSA was observed both for mental and physical disorders. Among females, an elevated risk was observed among those with overweight (HR = 1.54, 95% CI: 1.16‐2.05). Conclusions In a cohort of the Japanese working‐age population, both obesity and underweight were associated with a greater risk of LTSA in males. Future research should not overlook the excess risk of LTSA associated with underweight.

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Section: Discussioncontrasting

confidence: 84%

BMI and Medically Certified Long‐Term Sickness Absence Among Japanese Employees

Endo

Inoue

Kuwahara

et al. 2020

Obesity

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“…These 5026 articles were screened based on their title and abstract, where a further 4945 articles were excluded, leaving 81 articles that underwent full-text review. After 53 articles were excluded, 28 unique articles were included in this review [ 16 , 18 – 20 , 35 – 58 ]. Twenty-two articles reported cross-sectional data [ 16 , 18 , 20 , 35 – 53 ] and eight articles [ 16 , 19 , 35 , 54 – 58 ] provided longitudinal data (two articles reported both cross-sectional and longitudinal data [ 16 , 35 ]).…”

Section: Resultsmentioning

confidence: 99%

“…After 53 articles were excluded, 28 unique articles were included in this review [ 16 , 18 – 20 , 35 – 58 ]. Twenty-two articles reported cross-sectional data [ 16 , 18 , 20 , 35 – 53 ] and eight articles [ 16 , 19 , 35 , 54 – 58 ] provided longitudinal data (two articles reported both cross-sectional and longitudinal data [ 16 , 35 ]). Four articles used participants from the same study [ 18 – 20 , 40 ], and there were three other instances of articles using data, reporting different outcomes, from the same study [ 47 , 58 , 35 , 39 , 55 ] and [ 38 , 42 ], leaving 21 unique studies.…”

Section: Resultsmentioning

confidence: 99%

The association between body fat and musculoskeletal pain: a systematic review and meta-analysis

Walsh

Arnold

Evans

et al. 2018

BMC Musculoskelet Disord

126

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BackgroundObesity and musculoskeletal pain are strongly related, but there is emerging evidence that body fat, not body weight, may be a better indicator of risk. There is, therefore, a need to determine if body fat is associated with musculoskeletal pain as it may improve management strategies. The aim of this systematic review was to investigate the association between body fat and musculoskeletal pain.MethodsSeven electronic databases were searched from inception to 8th January 2018. Cross-sectional and longitudinal studies investigating the association between measures of body fat and musculoskeletal pain were included. All included articles were assessed for methodological rigour using the Epidemiology Appraisal Instrument. Standardised mean differences (SMDs) and effect estimates were pooled for meta-analysis.ResultsA total of 10,221 citations were identified through the database searching, which after abstract and full-text review, yielded 28 unique articles. Fourteen studies were included in the meta-analyses, which found significant cross-sectional associations between total body fat mass and widespread pain (SMD 0.49, 95% CI 0.37–0.61, p < 0.001). Individuals with low-back pain and knee pain had a higher body fat percentage than asymptomatic controls (SMD 0.34, 95% CI 0.17–0.52, p < 0.001 and SMD 0.18, 95% CI 0.05–0.32, p = 0.009, respectively). Fat mass index was significantly, albeit weakly, associated with foot pain (SMD 0.05, 95% CI 0.03–0.06, p < 0.001). Longitudinal studies (n = 8) were unsuitable for meta-analysis, but were largely indicative of elevated body fat increasing the risk of incident and worsening joint pain. There was conflicting evidence for an association between body fat percentage and incident low-back pain (3 studies, follow-up 4–20 years). Increasing knee pain (1 study) and incident foot pain (2 studies) were positively associated with body fat percentage and fat mass index. The percentage of items in the EAI graded as ‘yes’ for each study ranged from 23 to 85%, indicating variable methodological quality of the included studies.ConclusionsThis systematic review and meta-analysis identified positive cross-sectional associations between increased body fat and widespread and single-site joint pain in the low-back, knee and foot. Longitudinal studies suggest elevated body fat may infer increased risk of incident and worsening joint pain, although further high-quality studies are required.Electronic supplementary materialThe online version of this article (10.1186/s12891-018-2137-0) contains supplementary material, which is available to authorized users.

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“…LBP is often a recurrent condition, 10,11 but evidence of the role of workload 12,13 or health-related factors in recurrent LBP is inconsistent. For example, obesity may increase the probability of recurrent LBP, 14 but this has not been supported by all studies. 15 Likewise, no clear associations have been reported for smoking 12,14 and leisure-time physical activity.…”

Section: Introduction (2700/2700)mentioning

confidence: 92%

“…For example, obesity may increase the probability of recurrent LBP, 14 but this has not been supported by all studies. 15 Likewise, no clear associations have been reported for smoking 12,14 and leisure-time physical activity. 12 Depressive symptoms may also be a prognostic factor for LBP.…”

Section: Introduction (2700/2700)mentioning

confidence: 92%

Risk and Prognostic Factors of Low Back Pain

Halonen

Shiri

Hanson

et al. 2019

Spine

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Study Design Prospective longitudinal cohort study. Objective To determine the associations ofr workload and health-related factors with incident and recurrent low back pain (LBP), and to determine the mediating role of healthrelated factors in associations between physical workload factors and incident LBP. Summary of Background Data It is not known whether the risk factors for the development of LBP are also prognostic factors for recurrence of LBP and whether the associations between physical workload and incident LBP are mediated by health-related factors. We used data from the Swedish Longitudinal Occupational Survey of Health (SLOSH) study. Those responding to any two subsequent surveys in 2010-2016 were included for the main analyses (N=17,962). Information on occupational lifting, working in twisted positions, weight/height, smoking, physical activity, depressive symptoms, and sleep problems were self-reported. Incident LBP was defined as pain limiting daily activities in the preceding three months in participants free from LBP at baseline. Recurrent LBP was defined as having LBP both at baseline and follow-up. For the mediation analyses, those responding to three subsequent surveys were included (N=3,516). Methods Main associations were determined using generalized estimating equation models for repeated measures data. Mediation was examined with counterfactual mediation analysis. Results All risk factors at baseline but smoking and physical activity were associated with incident LBP after adjustment for confounders. The strongest associations were observed for working in twisted positions (risk ratio (RR)=1.52, 95% CI 1.37, 1.70) and occupational lifting (RR=1.52, 95% CI 1.32, 1.74). These associations were not mediated by health-related factors. The studied factors did not have meaningful effects on recurrent LBP.

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Obesity and low back pain: a retrospective cohort study of Japanese males

Cited by 29 publications

References 19 publications

BMI and Medically Certified Long‐Term Sickness Absence Among Japanese Employees

BMI and Medically Certified Long‐Term Sickness Absence Among Japanese Employees

The association between body fat and musculoskeletal pain: a systematic review and meta-analysis

Risk and Prognostic Factors of Low Back Pain

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