{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:12:39Z","timestamp":1788952359548,"version":"build-2803163510"},"reference-count":23,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007420","name":"Lee Hysan Foundation","doi-asserted-by":"publisher","award":["R-ZH4T"],"award-info":[{"award-number":["R-ZH4T"]}],"id":[{"id":"10.13039\/100007420","id-type":"DOI","asserted-by":"publisher"}]},{"award":["R-ZH4T"],"award-info":[{"award-number":["R-ZH4T"]}],"id":[{"id":"https:\/\/ror.org\/00jspma72","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Teaching is a highly stressful occupation, yet the associations between occupational stress, nutritional health, and physical pain among schoolteachers remain understudied, particularly in non-Western contexts. This study examined whether high occupational stress is associated with reduced favorable dietary behaviors, as well as with the presence and prolonged duration of physical pain among Hong Kong schoolteachers. Methods: Cross-sectional data were analyzed from 267 secondary and special schoolteachers (65.5% female, mean age 41.5 years) who completed the Occupational Stress Indicator-2 (OSI-2), a dietary behavior questionnaire, and a region-specific pain assessment. One-way analysis of variance, independent t-tests, and linear regression (adjusting for age, gender, income, school type, depression, anxiety, stress, and sleep quality) were conducted. Results: In the adjusted linear regression, moderate red meat intake was associated with lower odds of high occupational stress. Shoulder, forearm\/wrist, and hip pain were associated with high OSI-2 scores in univariable analyses. However, only pain duration of &gt;30 days and depression remained significant in fully adjusted models. No other dietary variables or pain locations showed significant associations. Conclusions: Occupational stress among Hong Kong schoolteachers is independently associated with prolonged musculoskeletal pain, with depression strongly confounding the pain\u2013stress relationship. An integrated approach is necessary to address the direct physical, nutritional, and mental health consequences of occupational stress.<\/jats:p>","DOI":"10.3390\/nu18182956","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:19:16Z","timestamp":1788949156000},"page":"2956","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Occupational Stress, Nutritional Health, and Physical Pain Among Hong Kong Schoolteachers: A Cross-Sectional Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4624-2737","authenticated-orcid":false,"given":"Kenneth K. H.","family":"Lo","sequence":"first","affiliation":[{"name":"Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"},{"name":"Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiting","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Jiali","family":"He","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4051-9133","authenticated-orcid":false,"given":"Raymond C. K.","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy W. Y.","family":"So","sequence":"additional","affiliation":[{"name":"The Hong Kong Jockey Club Centre for Suicide Research and Prevention, The University of Hong Kong, Sai Ying Pun, Hong Kong Island, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"},{"name":"Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0729-8618","authenticated-orcid":false,"given":"Man-sau","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Food Science and Nutrition, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"},{"name":"Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"given":"Hector W. H.","family":"Tsang","sequence":"additional","affiliation":[{"name":"Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"},{"name":"Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"},{"name":"Mental Health Research Centre, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Agyapong, B., Obuobi-Donkor, G., Burback, L., and Wei, Y. (2022). Stress, burnout, anxiety and depression among teachers: A scoping review. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph191710706"},{"key":"ref_2","first-page":"3","article-title":"COVID-19 pandemic-related anxiety, stress, and depression among teachers: A systematic review and meta-analysis","volume":"73","author":"Ma","year":"2022","journal-title":"Work"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Lau, S.S., Shum, E.N., Man, J.O., Cheung, E.T., Amoah, P.A., Leung, A.Y., Okan, O., and Dadaczynski, K. (2022). Teachers\u2019 well-being and associated factors during the COVID-19 pandemic: A cross-sectional study in Hong Kong, China. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph192214661"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.jpsychores.2008.03.003","article-title":"Identifying teachers at risk in Hong Kong: Psychosomatic symptoms and sources of stress","volume":"65","author":"Jin","year":"2008","journal-title":"J. Psychosom. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1177\/0017896909349255","article-title":"Occupational stress, mental health status and stress management behaviors among secondary school teachers in Hong Kong","volume":"68","author":"Leung","year":"2009","journal-title":"Health Educ. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1037\/0022-0663.99.2.274","article-title":"Job resources boost work engagement, particularly when job demands are high","volume":"99","author":"Bakker","year":"2007","journal-title":"JouJ Educ. Psychol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"36","DOI":"10.14507\/epaa.27.3699","article-title":"The trouble with teacher turnover: How teacher attrition affects students and schools","volume":"27","year":"2019","journal-title":"Educ. Policy Anal. Arch."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1037\/spq0000666","article-title":"Depression and anxiety among K\u201312 teachers in the United States: A systematic review","volume":"40","author":"Hooker","year":"2025","journal-title":"Sch. Psychol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1210\/clinem\/dgz236","article-title":"Predicting weight loss using psychological and behavioral factors: The POUNDS LOST trial","volume":"105","author":"Liu","year":"2020","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Sominsky, L., and Spencer, S.J. (2014). Eating behavior and stress: A pathway to obesity. Front. Psychol., 5.","DOI":"10.3389\/fpsyg.2014.00434"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e3040","DOI":"10.1590\/1518-8345.2567.3040","article-title":"Relationship between anxiety, depressive symptoms and compulsive overeating disorder in patients with cardiovascular diseases","volume":"26","author":"Garcia","year":"2018","journal-title":"Rev. Lat. Am. Enferm."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1177\/1559827614537789","article-title":"Mindfulness meditation to promote wellness and manage chronic disease: A systematic review and meta-analysis of mindfulness-based randomized controlled trials relevant to lifestyle medicine","volume":"9","author":"Victorson","year":"2015","journal-title":"Am. J. Lifestyle Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Erick, P.N., and Smith, D.R. (2011). A systematic review of musculoskeletal disorders among school teachers. BMC Musculoskelet. Disord., 12.","DOI":"10.1186\/1471-2474-12-260"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Yue, P., Liu, F., and Li, L. (2012). Neck\/shoulder pain and low back pain among school teachers in China, prevalence and risk factors. BMC Public Health, 12.","DOI":"10.1186\/1471-2458-12-789"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1002\/ajim.10050","article-title":"Are psychosocial factors, risk factors for symptoms and signs of the shoulder, elbow, or hand\/wrist?: A review of the epidemiological literature","volume":"41","author":"Bongers","year":"2002","journal-title":"Am. J. Ind. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/j.socscimed.2012.04.015","article-title":"Psychosocial work stressors as antecedents of musculoskeletal problems: A systematic review and meta-analysis of stability-adjusted longitudinal studies","volume":"75","author":"Lang","year":"2012","journal-title":"Soc. Sci. Med."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Zamri, E., Moy, F., and Hoe, V. (2017). Association of psychological distress and work psychosocial factors with self-reported musculoskeletal pain among secondary school teachers in Malaysia. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0172195"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2433","DOI":"10.1001\/archinte.163.20.2433","article-title":"Depression and pain comorbidity: A literature review","volume":"163","author":"Bair","year":"2003","journal-title":"Arch. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1017\/S1368980022002579","article-title":"Evaluation of perceived depression, anxiety, stress levels and emotional eating behaviours and their predictors among adults during the COVID-19 pandemic","volume":"26","author":"Kaner","year":"2023","journal-title":"Public Health Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Naknoi, S., Suamchaiyaphum, K., and Tomon, S. (2025). Psychosocial predictors of emotional eating among Thai nurses: A cross-sectional study. BMC Nurs., 24.","DOI":"10.1186\/s12912-025-04086-6"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/10803548.2023.2288779","article-title":"The relationship between workplace toxicity, stress, physical activity and emotional eating","volume":"30","author":"Tekin","year":"2024","journal-title":"Int. J. Occup. Saf. Ergon."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Ma, M., Zhang, Y., Tao, K., and Lu, Z. (2025). Neurochemical crossroads: Exploring the neurotransmitter network in chronic pain and depression comorbidity. Front. Mol. Neurosci., 18.","DOI":"10.3389\/fnmol.2025.1675814"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"9724371","DOI":"10.1155\/2017\/9724371","article-title":"The link between depression and chronic pain: Neural mechanisms in the brain","volume":"2017","author":"Sheng","year":"2017","journal-title":"Neural Plast."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/18\/2956\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:25:46Z","timestamp":1788949546000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/18\/2956"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":23,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["nu18182956"],"URL":"https:\/\/doi.org\/10.3390\/nu18182956","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]}}}