The prevalence of central obesity among white-collar workers of different genders
According to the results, the total detection rate of central obesity in white-collar workers was 60.7%, 67.5% in males and 30.1% in females. A multicenter cross-sectional investigation on the prevalence and risk factors of Central Obesity among Adults with Normal BMI in China showed that the detection rate of central obesitywas 58.3%, 50.3% in males and 63.7% in females [26]. Another cross-sectional study of women in south-central China found that the prevalence of central obesity was 52.8% [33]. Compared with the general Chinese population, white-collar workers have a higher detection rate of central obesity. White-collar workers, who generally have not only longer sedentary time at work but can also have more freedom to make more personal decisions about when to take a break, snack, and about doing physical activity during work, might be more influenced by obesogenic work environment (environmental cues) [24]. They are the main force of current social development, and their social pressure, occupational pressure and occupational challenges are also increasingly intensified. White-collar male and female workers who spent more than three hours per day sedentary (out of work) had more than four and three times greater risk of high perceived stress, respectively, compared with those who sat for less than three hours a day [34]. However, overweight/obesity was associated with higher perceived stress levels [35]. So we suggest that white-collar workers try to reduce their sedentary time to reduce the likelihood of obesity. Occupational stress is closely related to occupational factors such as the working environment and system and can induce a series of immune-neuroendocrine system diseases, cardiovascular and cerebrovascular diseases and mental health problems [36–39]. White-collar workers are a high-risk group for central obesity. Therefore, in the research field of central obesity, they need more attention to ensure their maximum health and to reduce the global medical burden.
At the same time, the results of this study show that the detection rate of central obesity in males is higher than that in females, which is different from available evidence [40, 41]. Previous studies have shown that women are more prone to central obesity than men, which may be related to the physiological fat hoarding and different life-styles of women [26, 41]. A recent meta-analysis also revealed women are less active than men [42]. In this study, this difference may be explained by the smaller proportion of women, only 17.7%. Besides, it may be also related to the pursuit of professional image and enthusiasm for weight loss of white-collar workers [43]. In recent years, with economic development and the improvement in living standards, people's daily food has become increasingly abundant. At the same time, many people eat irregularly and overeat and participate in various social activities. In the long run, their bodies become fatter and fatter. Women, in particular, like to eat to relieve stress and express negative emotions, which is not healthy. Moreover, rapid economic growth drives the rapid growth of all types of occupations, especially with the rapid development of the social engagement industry and media industry, and women are increasingly inclined to regard thin as beautiful [43]. However, in this study, there may be some bias in the results due to the difference in sample size between men and women, and further studies are needed to verify the relevant results.
Influencing factors of central obesity among white-collar workers of different genders
In male white-collar workers, increasing age, chronic disease, higher FBG level, higher total cholesterol level, high salt intake, higher BEE, social engagement eating spicy food and animal offal are harmful factors for central obesity, while higher HDL levels, eating fish and high vegetable intake are protective factors. However, in female white-collar workers, increasing age, higher total cholesterol level, higher BEE and overeating are risk factors for central obesity, while higher HDL-C level and drinking milk are protective factors for central obesity.
In contrast, influencing factors of central obesity differ by genders. Increasing age, higher FBG level, higher total cholesterol level, higher BEE and social engagement are common risk factors affecting the occurrence of central obesity. HDL-C is a common protective factor affecting the development of central obesity.
The overweight rate of men and women tends to increase with age, which may be related to the decrease in metabolic rate and slowing down of fat metabolism [44]. Plenty of evidence suggested that WC increased throughout most of adult life. A recent 15-year longitudinal study evaluated sex-specific changes in WC in the adult population and found that an increase in WC was strongly associated with aging [45].
This could be a result of body composition changes. Age has been shown to affect body composition, with a higher proportion of adipose tissue to lean body mass in the elderly [44]. At the same time, with increasing age, the redistribution of body fat and lean tissue, abdominal fat accumulation in elderly people, and age-related spinal degenerative changes and oligomeric obesity may also be found [46].
A large number of studies have shown that abdominal obesity indicators such as WC and WHR are closely related to changes in blood lipids [47, 48], which may be affected by metabolic abnormalities. Studies have shown that obese people have a higher basal metabolic volume, which may be because obese people have a larger base weight and need more energy to support their base [49, 50]. Banquets or parties attended for business or personal reasons, usually held in the evening, are often attended by people who drink alcohol and consume ultra-processed foods. As the number of social occasions increases, so does the risk of central obesity, which is caused by an unhealthy lifestyle [51, 52].
Regarding different factors, central obesity among male white-collar workers is more influenced by diet-related factors, such as eating animal offal, spicy food, fish and daily vegetable intake. Male white-collar workers need to adjust their dietary preferences if they want to improve central obesity. Animal offal contain high cholesterol, and it is easy to accumulate cholesterol if eating animal offal frequently without complete metabolism, and the change in blood lipids has a great in-fluence on central obesity [47, 48]. However, a national study found that higher consumption of animal offal was associated with a lower risk of obesity [53]. The difference may be because the latter subjects were children. High intakes of fish and vegetables meet the requirements of the Mediterranean diet and the Mediterranean diet has been shown to be the healthiest dietary pattern for tackling obesity [54]. Fiber in vegetables can effectively promote peristalsis of the intestines and stomach, and can promote the body's metabolic function and achieve weight control. Evidence also suggested that polyphenols in vegetables may reduce the risk of obesity [55]. In addition, fish are rich in omega-3 fatty acids and high-quality protein and are easily absorbed by the body. Omega-polyunsaturated fatty acids may work to improve body composition and counteract obesity-related metabolic changes include modulating lipid metabolism; regulating adipokines, such as adiponectin and leptin; alleviating adipose tissue inflammation, which are beneficial to the improvement of central obesity [56]. Studies have shown that people who eat spicy food have a lower risk of all-cause death. Capsaicin can promote fat metabolism and energy consumption, improve blood glucose control, and reduce obesity and metabolic syndrome. Eating spicy food can reduce the occurrence of central obesity [57]. Howover, our study and other cross-sectional studies indicated that spicy food consumption increased the risk of abdominal obesity in Chinese adult population [58, 59]. The dietary tastes of where the participants lived may have contributed to the difference. Further multicentre, prospective and long-term follow-up cohort studies are needed to elucidate the mechanisms underlying this association.
The prevalence of female-centric obesity is influenced by emotional eating and milk consumption. Due to reasons such as weight loss and pursuit of a good image, women pay more attention to the health of their diet structure in daily life and seldom have bad dietary preferences. However, women like to eat to relieve pressure and express negative emotions and are prone to overeating, which has a harmful effect on the occurrence of central obesity [43]. Studies have shown that intake of milk can reduce or prevent obesity in teenagers, but according to further research, adult intake of low-fat milk is effective for the prevention of obesity [60]. This study did not evaluate the types of white-collar workers who chose milk, so the relationship between central obesity and milk consumption still needs further evaluation.
Implication of diet management of white-collar workers
For white-collar workers, dietary management may be more important than exercise for central obesity prevention and intervention. Based on the results of this study, we can conclude that female white-collar workers should reduce emotional eating, while male white-collar workers need to pay more attention to dietary changes. White-collar workers should pay attention to the balance of dietary nutrition at ordinary times according to a reasonable dietary composition index to determine what nutrition they need to supplement. In future studies, dietary interventions for white-collar workers with central obesity should be carried out first, which may achieve better obesity management effects.