Objectives This study aims to investigate the role of lifestyle factors in relation to the presence and degree of productivity loss at work and sick leave.

Methods A cross-sectional study recruited 10 624 workers in 49 companies in the Netherlands in 2005–2009. Productivity loss at work was measured on a 10-point scale indicating how much work was actually performed on the previous workday. Sick leave was measured by asking how many days in the past 12 months workers were off work due to health problems. Logistic regression analyses were applied to study the association between obesity and lifestyle behaviours and both outcome measures.

Results Obesity was associated with the presence of sick leave (OR 1.25) and prolonged duration (OR 1.55). Insufficient physical activity (OR 1.12) and smoking (OR 1.17) were also associated with the presence of sick leave. Smoking (OR 1.45), obesity (OR 1.29) and insufficient fruit and vegetable intake (OR 1.22) were associated with the degree of productivity loss at work. The combined population attributable fractions of lifestyle factors for sick leave and the higher levels of productivity loss at work were above 10%.

Conclusions Lifestyle-related factors, especially smoking and obesity, were associated with the presence and duration of sick leave and degree of productivity loss at work. More than 10% of sick leave and the higher levels of productivity loss at work may be attributed to lifestyle behaviours and obesity. Hence, primary interventions on lifestyle may have a noticeable contribution to maintaining a productive workforce.