Background: Office-based workers are chronically exposed to a cluster of overlapping metabolic risk factors, including frequent reliance on out-of-home meals, prolonged sedentary behaviour, circadian misalignment and chronic psychological stress. These exposures act cumulatively through dose–response mechanisms rather than as isolated insults.

Objectives: This narrative review synthesises epidemiological, pathophysiological and randomised controlled trial evidence to examine the dietary, chronobiological, sedentary and stress-related determinants of metabolic health in office-based populations, and to propose an integrated workplace health promotion framework.

Methods: A structured narrative review was undertaken of studies retrieved from PubMed and major nutrition, chronobiology and exercise-physiology journals, prioritising systematic reviews, meta-analyses and landmark randomised controlled trials published up to 2025.

Results: Frequent out-of-home eating is consistently associated with higher energy, fat and sodium intakes, lower micronutrient intakes and adverse anthropometric change. Dietary patterns rich in whole grains, unsaturated fats, vegetables and high-quality protein — exemplified by the Mediterranean and DASH diets — reduce cardiovascular events and blood pressure. Indoor workers show a high prevalence of vitamin D deficiency. Dietary fibre exerts metabolic protection partly via gut-microbiota-derived short-chain fatty acids, with intakes of 25–29 g/day associated with 15–30% lower all-cause mortality. Time-restricted eating without caloric restriction improves weight, blood pressure and glycaemia, although a large recent trial found no benefit of an 8-hour window over calorie restriction alone. Interrupting sitting with brief light activity attenuates postprandial glucose by approximately 37%. Stress-related emotional eating is driven by hypothalamic–pituitary–adrenal axis and reward-circuit mechanisms and is modifiable by mindfulness-based interventions.

Conclusions: Metabolic risk in office workers reflects a closed-loop system of mutually reinforcing exposures. Effective workplace health promotion should adopt an integrated time–dose–quality framework that optimises meal composition, eating timing, sedentary-interruption dose and stress regulation concurrently, rather than targeting single nutrients or behaviours.