Mild Depressive Symptoms Among Americans in Relation to Physical Activity, Current Overweight/Obesity, and Self-Reported History of Overweight/Obesity

Racial and ethnic disparities in prevalence and correlates of depressive symptoms and suicidal ideation among adults in the United States, 2017-2020 pre-pandemic

BACKGROUND

This study aims to estimate the pre-COVID-19 pandemic prevalence of mild, major depressive symptoms, and suicide ideation among U.S. adults and evaluate their correlates and racial/ethnic disparities.

METHODS

This is a cross-sectional analysis of a nationally representative sample of adults ≥20 years from the National Health and Nutrition Examination Survey study 2017-2020 Pre-Pandemic. Overall and racial/ethnic-specific weighted prevalence and 95%CI of mild and major depressive symptoms and suicidal ideation assessed by the Patient Health Questionnaire-9 were calculated. Multivariable logistic regression modelings were used to examine overall and racial/ethnic-specific correlates.

RESULTS

Data on 7917 US adults (Weighted N = 210,200,829; 51.8 % females) were analyzed. The prevalence of mild, major depressive symptoms, and suicidal ideation was 8.5 %, 16.5 %, and 3.2 %, respectively. Overall, consistent correlates for all three conditions included smoking, short/long sleep duration, and obesity. Females, non-Hispanic Blacks, low family-poverty-income ratio, prolonged sitting time, and a history of cardiovascular disease were consistent correlates for mild and major depressive symptoms. Younger age, never married/living without a partner, physical inactivity, drinking alcohol, and a history of diabetes were related to major depressive symptoms. Never married/living without a partner and having a low family-poverty-income ratio correlate with suicide ideation. Having cancer diagnosis was only negatively associated with major depressive symptoms in non-Hispanic Blacks. Females, current smoking, short/long sleep duration, and having cardiovascular disease were correlated with suicidal ideation among Hispanics.

CONCLUSIONS

The prevalence of mild, major depressive symptoms, and suicidal ideation were high among U.S. adults. Unique correlates were identified among different racial and ethnic groups.

A Comparison between Healthy Lifestyle Behaviors and Physical Activity Levels of Elderly İndividuals Residing in the City Center and Rural, and Analyzing Their Relationship with Depression

ABSTRACT Purpose: Our study aimed to determine the differences in the levels of physical activity and healthy lifestyle behaviours in elderly individuals living in urban and rural and to examine their relationship with depression. Methods: Individuals who are over 65 and residing in the city and rural were included in the study. The Healthy Lifestyle Behaviour’s Scale-II, the Physical Activity Scale for the Elderly, and the Geriatric Depression Scale-15 were used on the participants Results: Healthy Lifestyle Behaviour’s Scale-II scores was no significant difference between the two groups (p=0.430). Physical Activity Scale for the Elderly score in rural (p= 0.001); Geriatric Depression Scale-15 score was statistically higher in the city (p= 0.01). While the relationship between the Healthy Lifestyle Behaviour’s Scale-II and Geriatric Depression Scale-15 scores was significant in both groups (p= 0.001 and p= 0.03), the relationship between the Elderly Physical Activity Scale-II and Geriatric Depression Scale-15 scores was significant only in the rural (p= 0.001). Conclusion: The elderly individuals in rural are more physically active than in city, the elderly living in city have higher depression levels. The factors affecting depression in the elderly living in cities need to be examined in detail.

Difference in the risk of depressive symptoms associated with physical activity in persons with diabetes: Across age, gender, and race/ethnicity

BACKGROUND

To investigate the link between depressive symptoms and physical activity (PA) by examining their association across genders, age, and race/ethnicity.

METHODS

Data of the cross-sectional study were from the 2011 and 2015 Behavioral Risk Factor Surveillance System. The Patient Health Questionnaire-8, a well-validated instrument to measure depressive symptoms was used. PA was categorized as active, moderately active, and inactive. A generalized linear model specified with a Poisson distribution and log link was performed to investigate the association between depressive symptoms and PA across population characteristics.

RESULTS

No significant association between PA and depressive symptoms between genders and across racial/ethnic groups was found. Persons aged 65 years or older showed a significantly lower risk of depressive symptoms than those below 45 years when physically active (Adjusted Prevalence Ratio (APR) 0.36, 95% CI = 0.16-0.82) and moderately active (APR 0.39, 95% CI = 0.16-0.98).

LIMITATIONS

The study included only leisure-time PA. Well-designed surveys that reflect a wider scope of PA are needed to strengthen the analysis.

CONCLUSIONS

Compared to younger adults, older adults may gain further health benefits in reducing the risk of depressive symptoms by being physically active. Similar health benefits may be gained from PA between genders and between racial/ethnic groups. The different association between PA and depressive symptoms provides practical implications for the effective management of depressive symptoms in persons with diabetes.

Levels of Physical Activity, Obesity and Related Factors in Young Adults Aged 18-30 during 2009-2017

The objective of this study was to analyze the temporal trend of physical activity and body mass index in young adults aged 18–30 in Spain and to ascertain their relationship with sociodemographic and psychosocial variables in the period of 2009–2017. Methods: A descriptive study with a sample of 10,061 young adults aged 18–30 years was performed. The data were obtained from the European Health Survey in Spain in 2009 and 2014 and the National Health Survey in 2011/2012 and 2017. The chi-square test was used for qualitative variables, and multiple linear regression analysis was performed for physical activity. Results: Sedentary levels had decreased in 2017 as compared to 2011/2012 (p < 0.001); smokers were more sedentary than non-smokers (p < 0.001); men were more active than women (p < 0.001); and the year with the highest physical activity was 2014. Body mass index in the total sample increased from 2009 to 2017 (p < 0.01), showing a significant increase in obesity in women (p < 0.05) and no difference in men (p ≥ 0.05). Conclusions: In the period 2011/2012–2017, the sedentary lifestyle of young adults was reduced and physical activity was increased, with men being more active than women.

The Impact of Overweight/Obesity Duration and Physical Activity on Medical Multimorbidity: Examining the WATCH Paradigm

Purpose:

The “fat-but-fit” paradigm has been evaluated. However, the duration of overweight/obesity within the “fat-but-fit” paradigm (ie, assessing body mass at more than 1 time point) has not been extensively evaluated, which was this study’s purpose.

Design:

Cross-sectional.

Setting:

National Health and Nutrition Examination Survey 2003 to 2006.

Participants:

Ages 36 to 85; N = 3621.

Measures:

Physical activity assessed via accelerometry. Medical multimorbidity was assessed via physician diagnosis of 13 chronic diseases. Height and body mass were directly measured for current body mass index (BMI), and 10-year prior BMI was calculated using current height and self-reported weight 10 years prior. Six mutually exclusive groups were created: (1) active, normal weight now and 10 years ago; (2) inactive, normal weight now and 10 years ago; (3) active, overweight/obese now but not 10 years ago; (4) active, overweight/obese now and 10 years ago; (5) inactive, overweight/obese now but not 10 years ago; and (6) inactive, overweight/obese now and 10 years ago.

Analysis:

Logistic regression.

Results:

Compared to group 1, adjusted odds ratios (ORs) were as follows: group 2: OR = 2.0 ( P = .004), group 3: OR = 1.7 ( P = .004), group 4: OR = 2.5 ( P < .001), group 5: OR = 2.9 ( P < .001), and group 6: OR = 4.8 ( P < .001).

Conclusions:

All patterns of weight change/duration and activity level altered the odds of medical multimorbidity, suggesting that the duration of overweight/obesity should also be taken into consideration when assessing the “fat-but-fit” paradigm.

Physical activity in depressed and non-depressed patients with obesity

PURPOSE

Obesity and depression have both been shown to be associated with reduced physical activity (PA). However, most studies have not applied objective measures to determine PA in patients. Moreover, to our knowledge, no studies are available comparing depressed and non-depressed patients with regard to PA.

METHODS

We investigated PA in 47 patients with both obesity and depression, 70 non-depressed patients with obesity, and 71 non-depressed and non-obese healthy control participants using the SenseWear™ Armband (SWA) with walked steps per day and metabolic equivalents (MET) as parameters for PA.

RESULTS

Depressed as well as non-depressed patients with obesity showed a significantly reduced PA as reflected by walked steps as well as reduced METs. Healthy controls walked a mean of 11,586 ± 3731 (SD) steps per day, whereas non-depressed patients with obesity accumulated 7283 ± 3547 and patients with both obesity and depression recorded only 6177 ± 3291 steps per day. However, the difference between depressed and non-depressed patients with obesity did not reach statistical significance either in terms of walked steps or with regard to METs.

CONCLUSIONS

Obesity seems to be associated with a substantial reduction of PA and energy expenditure, whereas the effect of an additional depressive disorder was comparably small. Even though depression did not have any statistically significant effect on steps and METs per day in this study with obese patients, it could be clinically relevant for an individual patient.

The Association Between Weight Status, Weight History, Physical Activity, and Cognitive Task Performance

PURPOSE

Physical activity has been shown to attenuate the association between overweight/obesity and deleterious cardiovascular health-related outcomes, with emerging work also taking the duration of overweight/obesity into consideration. No previous work, however, has explored the interrelationships between physical activity, obesity, and obesity duration in the context of cognitive task performance, which was the purpose of this study.

METHOD

Data from the 1999-2002 National Health and Nutrition Examination Survey were used (N = 2322 adults 60-85 yrs). Physical activity was assessed via self-report, with body mass index (BMI) directly measured. Participants were classified into one of eight mutually exclusive groups: (0) normal weight now and 10 years ago and active now (n = 195), (1) normal weight and 10 years ago and inactive now (n = 265), (2) normal weight now but not 10 years ago and active now (n = 46), (3) normal weight now but not 10 years ago and inactive now (n = 123), (4) overweight/obese now but not 10 years ago and active now (n = 117), (5) overweight/obese now but not 10 years ago and inactive now (n = 168), (6) overweight/obese now and 10 years ago and active now (n = 435), and (7) overweight/obese now and 10 years ago and inactive now (n = 973). The digit symbol substitution test (DSST) was employed to assess cognitive task performance.

RESULTS

After adjustments, only individuals who were inactive (groups 1, 3, 5, and 7) had significantly lower cognitive task performance.

CONCLUSION

Being inactive, regardless of weight classification and duration of overweight/obesity, was inversely associated with cognitive task performance in this national sample of older adults.

The impact of overweight/obesity duration and physical activity on telomere length: An application of the WATCH paradigm

INTRODUCTION

Physical activity may protect against health consequences associated with obesity, yet less is known on how the duration of obesity alters this association, specifically as it relates to leukocyte telomere length.

METHODS

The 1999-2002 NHANES was used to place individuals into 6 mutually exclusive groups based on physical activity status and weight status/duration.

RESULTS

All active individuals, except for those overweight/obese for longer durations, were associated with longer telomeres in comparison to sedentary individuals.

CONCLUSIONS

Physical activity may attenuate the decline in telomere length associated with obesity, but this protective effect may be negated by prolonged periods of overweight/obesity.

Health Outcomes in Relation to Physical Activity Status, Overweight/Obesity, and History of Overweight/Obesity: A Review of the WATCH Paradigm

Previous research has shown that physical activity may mitigate the association between overweight/obesity and a number of negative health outcomes; however, less is known on how the duration of overweight/obesity alters this association. Therefore, the purpose of this leading article was to synthesize recent studies from our research group examining how physical activity, overweight/obesity classification, and importantly, overweight/obesity duration impact the association with a variety of different health outcomes. Five studies were analyzed, each of which used data from the National Health and Nutrition Examination Survey to analyze six mutually exclusive groups and their respective association with cardiovascular disease risk, all-cause mortality, multi-morbidity, health-related quality of life, and mild depressive symptoms. These studies detailed that physical inactivity, overweight/obesity classification, and overweight/obesity duration were each independently associated with cardiovascular disease risk and multi-morbidity. Additionally, physical activity reduced the risk of all-cause mortality across all weight classifications/durations, and also reduced the association with depressive symptoms and poor health-related quality of life among those overweight/obese for longer durations. These results illustrate that, while physical activity may reduce the association with negative health outcomes, overweight/obesity appears to increase this association independent of physical activity level, with this further exacerbated by the duration of overweight/obesity. Therefore, the emerging studies examining the importance of physical activity among overweight/obese individuals should also consider the duration of overweight/obesity as this will likely alter the associations present.