Introducción: El burnout constituye un problema creciente de salud laboral vinculado a factores psicológicos, organizativos y de estilo de vida. Evidencias recientes sugieren que los patrones dietéticos, especialmente la dieta mediterránea (DM), pueden influir en la salud mental y la respuesta al estrés. Objetivo: Analizar la asociación entre la adherencia a la dieta mediterránea y el riesgo de burnout en una gran cohorte de trabajadores españoles. Métodos: Estudio transversal con 92.470 empleados (55.918 hombres y 36.552 mujeres) evaluados en reconocimientos de salud laboral entre enero de 2021 y diciembre de 2023. La adherencia a la DM se midió mediante el cuestionario MEDAS-14 y se clasificó en baja, intermedia o alta. El burnout se evaluó con el Maslach Burnout Inventory (MBI), categorizado en bajo, moderado o alto. Se aplicaron modelos de regresión logística ajustados por edad, sexo, clase social, actividad física y tabaquismo para estimar odds ratio (OR) e intervalos de confianza del 95% (IC95%). Resultados: Una alta adherencia a la DM se asoció significativamente con menor probabilidad de burnout alto (OR 0,68; IC95%: 0,62–0,75). Los análisis estratificados mostraron asociaciones más intensas en mujeres (OR 0,64; IC95%: 0,58–0,72) y en menores de 40 años (OR 0,53; IC95%: 0,45–0,62). Los resultados fueron consistentes al tratar la DM como variable continua y en análisis de sensibilidad, incluyendo la exclusión de fumadores y de personas con alta actividad física. Conclusiones: La adherencia a la dieta mediterránea se asocia de manera inversa con el riesgo de burnout en trabajadores españoles. Estos hallazgos respaldan la necesidad de integrar estrategias dietéticas, junto con intervenciones organizativas y de hábitos de vida, en los programas de bienestar laboral.

Introducción: El trastorno por estrés postraumático (TEPT) ha sido asociado con un mayor riesgo de enfermedades cardiovasculares y metabólicas, pero la evidencia en población laboral y general española sigue siendo limitada. Este estudio analiza la relación entre la sintomatología de TEPT y el desarrollo de alteraciones cardiometabólicas en una amplia cohorte nacional. Métodos: Se realizó un estudio de cohorte prospectiva con 108 125 trabajadores evaluados mediante el PTSD Checklist for DSM-5 (PCL-5). Los desenlaces incluyeron hipertensión arterial, diabetes tipo 2, dislipemia, síndrome metabólico y eventos cardiovasculares mayores, determinados a través de controles clínicos anuales. Se aplicaron modelos de riesgos proporcionales de Cox ajustados por edad, sexo, factores laborales, conductuales y psicológicos, incluyendo depresión y ansiedad. Se exploraron mediadores conductuales (sueño, índice de masa corporal) mediante modelos de efectos naturales y análisis de sensibilidad. Resultados: Durante un seguimiento medio de cinco años, la presencia de síntomas de TEPT se asoció con un mayor riesgo de hipertensión (HR 1,23; IC95%: 1,17–1,29), diabetes tipo 2 (HR 1,18; IC95%: 1,11–1,26) y síndrome metabólico (HR 1,27; IC95%: 1,21–1,33). Estas asociaciones persistieron tras el ajuste multivariable y se observaron gradientes dosis-respuesta según la severidad del TEPT. Se identificó mediación parcial por alteraciones del sueño y obesidad, responsables de aproximadamente un 30 % del efecto total. Los resultados fueron consistentes entre sexos, aunque más pronunciados en mujeres. Conclusiones: El TEPT se asocia de manera independiente con un incremento del riesgo cardiometabólico en la población española activa. Estos hallazgos subrayan la necesidad de integrar la evaluación de salud mental en las estrategias de prevención cardiovascular y laboral, promoviendo un enfoque multidisciplinario que contemple la interacción entre los determinantes psicológicos y fisiológicos de la enfermedad crónica.

Background: Body mass index (BMI) is widely used to assess obesity-related health risks; however, the magnitude of cardiometabolic deterioration associated with incremental increases in BMI remains insufficiently quantified. This study aimed to evaluate the cardiometabolic burden associated with increasing BMI in a large cohort of Spanish workers. Methods: A cross-sectional study was conducted among 386,924 Spanish workers who underwent routine occupational health examinations between 2019 and 2024. Associations between BMI and cardiometabolic risk markers were assessed using multivariable linear and logistic regression analyses. Outcomes included systolic and diastolic blood pressure, fasting glucose, lipid profile, triglyceride-glucose (TyG) index, atherogenic dyslipidemia, and metabolic syndrome defined according to the NCEP ATP III, IDF, and JIS criteria. Receiver operating characteristic (ROC) analyses were performed to evaluate the discriminatory capacity of BMI. Results: Increasing BMI was associated with progressive deterioration in all cardiometabolic parameters. In fully adjusted models, each 1 kg/m² increase in BMI was associated with increases of 0.85 mmHg in systolic blood pressure, 0.64 mmHg in diastolic blood pressure, 0.36 mg/dL in fasting glucose, and 0.006 units in the TyG index (all p < 0.001). BMI was also independently associated with a higher likelihood of atherogenic dyslipidemia (OR: 1.031; 95% CI: 1.027–1.035) and metabolic syndrome according to ATP III (OR: 1.132; 95% CI: 1.129–1.135), IDF (OR: 1.198; 95% CI: 1.195–1.202), and JIS criteria (OR: 1.156; 95% CI: 1.153–1.159). A pronounced dose–response relationship was observed across BMI categories. BMI demonstrated good discriminatory capacity for identifying metabolic syndrome, with AUC values ranging from 0.797 to 0.843 and optimal thresholds close to 27 kg/m². Conclusions: Increasing BMI is associated with a substantial and progressive cardiometabolic burden characterized by worsening blood pressure, glucose metabolism, insulin resistance, lipid abnormalities, atherogenic dyslipidemia, and metabolic syndrome. Cardiometabolic risk increases across the entire BMI spectrum, highlighting the importance of early prevention and weight-management strategies before obesity becomes established.

Background: Lifestyle behaviors and psychosocial factors are key determinants of cardiometabolic health across the life course. Beyond traditional risk factors, emerging evidence suggests that chronic stress and burnout may influence metabolic risk through behavioral pathways such as physical inactivity and poor diet. However, their joint contribution to type 2 diabetes risk in working populations remains insufficiently understood. Objectives: Our objectives were to examine the joint contribution of lifestyle habits, sociodemographic factors, and burnout to type 2 diabetes risk, and to explore potential behavioral pathways linking psychosocial stress to metabolic risk in a large adult population. Methods: A cross-sectional study was conducted in 92,480 Spanish workers undergoing routine occupational health assessments between 2021 and 2023. Type 2 diabetes risk was assessed using validated tools (FINDRISC, QDScore, CANRISK). Lifestyle indicators included adherence to the Mediterranean diet and physical activity levels; burnout was assessed using the Burnout Assessment Tool (BAT). Multivariable logistic regression models were used to evaluate associations between determinants and diabetes risk. Mediation analyses were performed to assess the contribution of lifestyle behaviors to the association between burnout and diabetes risk, and predictive performance analyses evaluated the incremental value of burnout. Results: Burnout was independently associated with a higher probability of moderate-to-high diabetes risk across all screening tools. Exploratory cross-sectional mediation analyses indicated that lifestyle behaviors, particularly physical inactivity and low adherence to the Mediterranean diet, statistically accounted for approximately 45% of the observed association. Adding burnout to the models significantly improved discrimination and reclassification of moderate-to-high diabetes-risk classification. In addition, higher diabetes risk was consistently observed among individuals from lower socioeconomic groups and those with unhealthy lifestyle profiles. Conclusions: Lifestyle behaviors and psychosocial stress were associated with estimated diabetes risk across adulthood. Burnout was independently associated with a higher probability of moderate-to-high diabetes-risk classification, with exploratory analyses suggesting that lifestyle behaviors may statistically account for part of this association. These cross-sectional findings highlight the potential relevance of considering both behavioral and psychosocial factors when studying cardiometabolic risk in working populations, while prospective studies are needed to establish temporal and causal relationships.