Lifestyle Counseling to Reduce Body Weight and Cardiometabolic Risk Factors among Truck and Bus Drivers - a Randomized Controlled Trial

By Puhkala, Jatta; Kukkonen-Harjula, Katriina et al. | Scandinavian Journal of Work, Environment & Health, January 1, 2015 | Go to article overview

Lifestyle Counseling to Reduce Body Weight and Cardiometabolic Risk Factors among Truck and Bus Drivers - a Randomized Controlled Trial


Puhkala, Jatta, Kukkonen-Harjula, Katriina, Mansikkamäki, Kirsi, Aittasalo, Minna, Hublin, Christer, Kärmeniemi, Paula, Olkkonen, Seppo, Partinen, Markku, Sallinen, Mikael, Tokola, Kari, Fogelholm, Mikael, Scandinavian Journal of Work, Environment & Health


The work of long-distance truck and bus drivers typically consists of long and irregular hours or shift work, and lengthy sitting periods (1, 2). Busy schedules and lack of healthy food choices and opportunity for exercise while on the road may predispose drivers to an unhealthy lifestyle (1, 3,4). Irregular eating and snacking is common (3). Shift work and night shifts in general have been found to be associated with unhealthy eating habits as well as with weight gain (5-7). Prolonged sitting at work is an independent risk factor for atherosclerosis and diabetes (8). There are also socioeconomic aspects behind drivers' lifestyles. Truck drivers are often sedentary in their leisure time, and they consume less fruit and vegetables and more sausages and milk fat than recommended (9-11). Most professional drivers are males, who tend to be sedentary more often and have poorer diet than women (12).

Long and irregular work hours predispose drivers to sleep deprivation, which is associated with obesity and other cardiometabolic risk factors (13, 14), as well as increased risk of road accidents (15, 16). Based on studies about actual sleeping time, truck drivers often suffer from sleep deprivation up to several hours per 24 hours compared to recommendations of 7-8 hours of sleeping time (17-19). Among professional drivers, obesity is associated with increased risk of being fatigued and involved in road traffic accident (15, 20). Among the underlying pathological processes, the central ones are breathing disorders during sleep that are induced by obesity (21).

Obesity is one of the most important health risk factors among professional drivers (15, 22, 23). Worldwide around 57%-87% of truck and bus drivers are overweight or obese (23-26), and obesity comorbidities such as hypertension, dyslipidemia, and type 2 diabetes are common to this profession (23). Overweight and obese truck drivers have substantially greater direct medical costs when compared to drivers of normal weight (23). In a Danish study, hospitalization for obesity or diabetes was more common among truck drivers than among other working populations (22). Additionally, in Europe. obese persons have a 50% higher risk for disability pension when compared to persons who are not overweight (27).

Although unhealthy lifestyle and cardiometabolic risk factors are frequent among professional drivers (22, 28-30), few health education interventions have been targeted at this group. To our knowledge, the only previous randomized trial to prevent obesity was conducted among 1061 overweight transit workers, mostly metropolitan bus drivers, lasting 18 months (25). Participants in the experimental group were encouraged to make healthy food choices and increase physical activity by being offered sports activities and healthy and affordable options in snack vending machines. Dietary habits improved but the modest body weight reduction did not differ from the control group. A Chinese randomized intervention delivered diabetes-related information by mobile messages, which led to a decreased risk of developing diabetes among 104 professional drivers with pre-diabetes symptoms (31).

According to previous studies, the most important factor preventing professional drivers from adopting a lifestyle change is irregular working schedule (3, 25, 32), which disrupt healthy eating habits, as well as sleep, exercise and social life (1). In a US study, almost half of 542 motor freight workers, most of whom were truck drivers, reported that they would not have time to eat right because of their work, although 86% thought it would be especially important to eat right (11). In addition, there are few intervention studies focusing on male workers with the same socioeconomic status as drivers, such as construction and manufacturing industrial workers, with or without shift work. These intervention studies have resulted in clinically meaningful decreases in body weight and cardiovascular risk factors (33, 34). …

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