Does increasing physical activity reduce the excess risk of work disability among overweight individuals? 1

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1 1 Does incresing physicl ctivity reduce the excess risk of work disbility mong overweight individuls? 1 by Jenni Ervsti, PhD, 2 Jkko Airksinen, PhD, Jn Pentti, MSc, Jussi Vhter, MD, PhD, Skri Suominen, PhD, Mrinn Virtnen, PhD, Mik Kivimäki, FMedSci 1. Supplementry mteril 2. Correspondence to: Jenni Ervsti, PO Box 18, FI TYÖTERVEYSLAITOS, Finlnd. [E-mil: jenni.ervsti@ttl.fi]

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3 3 Supplementry Tble S1. Assocition between overweight, physicl ctivity nd work disbility in HeSSup nd FPS cohorts. HR=hzrd rtio; CI=confidence intervl. Long-term sickness Disbility pension bsence HeSSup Cses (%) HR (95% CI) HR (95% CI) HR b (95% CI) Cses (%) HR (95% CI) HR (95% CI) HR b (95% CI) Norml weight 895 (12) (4) Overweight 770 (17) 1.61 ( ) 1.33 ( ) 1.32 ( ) 332 (7) 2.17 ( ) 1.48 ( ) 1.45 ( ) Physiclly ctive 1255 (13) 1 1 n/ 438 (5) 1 1 n/ Physiclly inctive 410 (16) 1.31 ( ) 1.11 ( ) n/ 177 (7) 1.62 ( ) 1.22 ( ) n/ MET hours ( ) 0.99 (0.97- n/ 615 (5) 0.91 ( (0.93- n/ per week c (14) 1.01) 0.94) 1.00) FPS Norml weight 2033 (13) (5) Overweight 2295 (19) 1.65 ( ) 1.43 ( ) 1.39 ( ) 1071 (9) 1.82 ( ) 1.43 ( ) 1.36 ( ) Physiclly n/ 1341 (6) 1 1 ctive (14) Physiclly ( (1.29- n/ 582 (11) 1.98 ( (1.43- n/ inctive (21) 1.71) 1.48) 2.18) 1.75) MET hours per week 4328 (16) 0.93 ( ) 0.96 ( ) n/ 1923 (7) 0.87 ( ) 0.92 ( ) n/ Adjusted for sex, ge, socioeconomic sttus, smoking, nd lcohol consumption b Adjusted s Model, nd for physicl ctivity. c Metbolic tsk hours per week. HR per 10-unit increse. n/ = not pplicble

4 Supplementry Tble S2. Counterfctul medition nlysis on ssocition between overweight nd long-term ( 90 dys) sickness bsence, with physicl inctivity s meditor. FPS HR 95% CI P for interction Proportion medited (%) Exposure-meditor interction not llowed Controlled direct effect Nturl direct effect Nturl indirect Totl effect % Exposure-meditor interction llowed 0.48 Controlled direct effect Nturl direct effect Nturl indirect Totl effect % HeSSup Exposure-meditor interction not llowed Controlled direct effect Nturl direct effect Nturl indirect Totl effect % Exposure-meditor interction llowed 0.03 Controlled direct effect Nturl direct effect Nturl indirect Totl effect % *Adjusted for sex, ge, nd occuptionl position (FPS) or eduction (HeSSup), smoking, nd lcohol consumption. 4

5 5 Supplementry Tble S3. Counterfctul medition nlysis on ssocition between overweight nd disbility pension, with physicl inctivity s meditor. FPS HR* 95% CI P for interction Exposure-meditor interction not llowed Controlled direct effect Nturl direct effect Nturl indirect Totl effect Exposure-meditor interction llowed Controlled direct effect Nturl direct effect Nturl indirect Totl effect HeSSup Exposure-meditor interction not llowed Controlled direct effect Nturl direct effect Nturl indirect Totl effect Exposure-meditor interction llowed Controlled direct effect Nturl direct effect Nturl indirect Totl effect Proportion medited (%) 15% 13% *Adjusted for sex, ge, nd occuptionl position (FPS) or eduction (HeSSup), smoking, nd lcohol use. 4% 7%

6 6 Supplementry Tble S4. Counterfctul medition nlysis on ssocition between overweight nd work disbility, with physicl inctivity s meditor (dichotomy). Those with incident bronchil sthm, myocrdil infrction, ngin pectoris, cerebrovsculr diseses, rthritis, scitic, migrine, depression, or dibetes between the two mesurement points were omitted (n=34813). HR=hzrd rtio; CI=confidence intervl. HR 95% CI I 2 P >90 dys sickness bsence Disbility pension Controlled direct effect Nturl direct effect Nturl indirect effect Totl effect Controlled direct effect Nturl direct effect Nturl indirect effect FPS HeSSup Pooled % 0.47 FPS HeSSup Pooled % 0.63 FPS HeSSup Pooled % 0.37 FPS HeSSup Pooled % 0.38 FPS HeSSup Pooled % 0.53 FPS HeSSup Pooled % 0.68 FPS HeSSup Pooled % 0.85 Totl effect FPS HeSSup Pooled % 0.57 Adjusted for ge, sex, socioeconomic sttus, lcohol use nd smoking.

7 7 Supplementry Tble S5. Hzrd rtio for the ssocition between physicl ctivity t T2 nd work disbility mong prticipnts who were physiclly inctive t T1 nd with overweight t T1 nd T2. Physicl inctivity is mesured s dichotomy. Those with incident bronchil sthm, myocrdil infrction, ngin pectoris, cerebrovsculr diseses, rthritis, scitic, migrine, depression, or dibetes between the two mesurement points were omitted (n=3097). HR=hzrd rtio; CI=confidence intervl. HR 95% CI I 2 P >90 dys sickness bsence FPS HeSSup Pooled % 0.40 Disbility pension FPS HeSSup Pooled % 0.25 Adjusted for ge, sex, socioeconomic sttus, lcohol use nd smoking. Supplementry Tble S6. Hzrd rtio for the ssocition between physicl ctivity t T2 nd work disbility. Included re prticipnts who were physiclly inctive t T1 nd with BMI 25 with no more thn 5% chnge in BMI between T1 nd T2. Physicl ctivity t T2 is mesured s dichotomy. HR=hzrd rtio; CI=confidence intervl. PERSISTENT OVERWEIGHT (BMI 25, chnge ± 5%) events/ cses HR 95% CI I 2 P >90 dys sickness bsence FPS 328/ HeSSup 85/ Pooled % 0.37 Disbility pension FPS 164/ HeSSup 36/ Pooled % 0.65 Adjusted for ge, sex, socioeconomic sttus, lcohol use nd smoking.

8 8 Supplementry Tble S7. Hzrd rtio for the ssocition between physicl ctivity t T2 nd work disbility. Included re prticipnts who were physiclly inctive t T1 nd with BMI 30 t both times. Physicl ctivity t T2 is mesured s dichotomy. HR=hzrd rtio; CI=confidence intervl. PERSISTENT OBESITY (BMI 30) events/ cses HR 95% CI I 2 P >90 dys sickness bsence FPS 213/ HeSSup 57/ Pooled % 0.49 Disbility pension FPS 112/ HeSSup 29/ Pooled % 0.57 Adjusted for ge, sex, socioeconomic sttus, lcohol use nd smoking.