Professional group differences in general and abdominal adiposity: the roles of sex and age in a retrospective cross-sectional study

Occupational environments may influence obesity risk through work routines, sedentary behaviour, and lifestyle patterns. However, differences between occupational groups may also reflect variation in sex and age. Because body mass index (BMI) alone does not adequately characterize body composition or abdominal fat distribution, this study compared indicators of general and abdominal adiposity across occupational groups while accounting for sex and age. This retrospective cross-sectional study included 2,296 adults (1,063 men and 1,233 women), aged 22–70 years, attending a sports-health club in Istanbul between 2006 and 2016. Occupations were classified as bank employees, physicians, lawyers, engineers, architects, and educators. General adiposity was assessed using BMI and body fat percentage; abdominal adiposity was assessed using waist circumference, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and trunk skinfold thickness. A multivariate model first tested the sex × occupation interaction. As this interaction was not significant, a reduced model evaluated the main effects of sex, occupation, and age. Outcome-specific analyses used HC3 heteroskedasticity-robust standard errors with Holm correction across six outcomes. The sex × occupation interaction was not significant for the combined adiposity profile (Pillai’s trace = 0.0147, p = 0.294). In the reduced model, sex (Pillai’s trace = 0.8661, p < 0.001), age (Pillai’s trace = 0.2737, p < 0.001), and occupation (Pillai’s trace = 0.0284, p < 0.001) were associated with the combined adiposity profile, although the occupational effect was small relative to sex and age. After multiple-testing correction, sex and age remained significantly associated with all adiposity indicators. BMI was the only individual outcome that differed significantly across occupations (F(5, 2288) = 3.32, Holm-adjusted p = 0.033, partial η² = 0.007). Physicians had a lower adjusted BMI than engineers (mean difference = − 0.82 kg/m², 95% CI − 1.33 to − 0.31; Holm-adjusted p = 0.023). Sex and age showed stronger associations with adiposity than occupation. Although occupation was associated with overall adiposity profile, differences were small and not consistently observed across individual measures after multiplicity correction. Occupational title alone therefore appears to have limited value for obesity risk assessment, supporting emphasis on direct adiposity measures and risk factors.