Occupational Stress, Nutritional Health, and Physical Pain Among Hong Kong Schoolteachers: A Cross-Sectional Study

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 >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-stress relationship. An integrated approach is necessary to address the direct physical, nutritional, and mental health consequences of occupational stress.