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Feeling Vigorous and the Risks of All-Cause Mortality, Ischemic Heart Disease, and Diabetes: A 20-Year Follow-up of Healthy Employees

Objective: To investigate prospectively the effects of vigor at work on the end points of mortality and the prevalence of ischemic heart disease (IHD) and diabetes. Methods: We tested the hypothesized beneficial effects of feeling vigorous at work at baseline on the risks of all-cause mortality, IHD, and diabetes during a 20-year follow-up. Participants were healthy employees (n = 968) who underwent a routine health check at baseline. We calculated the risk of all-cause mortality, IHD, and diabetes, with days as the time scale, using the Cox proportional hazard model. In our analyses, we predicted the above end points by baseline vigor, age, gender, and educational level, adjusting for the physiological risk factors of total cholesterol, glucose, and body mass index, the behavioral risk factors of smoking, alcohol intake, and physical activity, and the psychological risk factors of depressive and anxiety symptoms. Results: As hypothesized, we found that, after the above adjustments, baseline vigor decreased the risk of follow-up mortality by 26% (hazard ratio, 0.74; 95% confidence interval, 0.58–0.95) and the risk of diabetes by 17% (hazard ratio, 0.83; 95% confidence interval, 0.68–0.98). However, vigor did not have a significant effect on the risk of IHD. Conclusions: Independently of physiological, behavioral, and psychological risk factors, feeling vigorous at work protected the participants from diabetes and reduced their risk of mortality. IHD = ischemic heart disease; CHS = Clalit Health Services; BMI = body mass index; SES = socioeconomic status.