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Sacher PM, Fulton E, Rogers V, Wilson J, Gramatica M, Dent JE, Aarts EO, Eccleston D, Greve JW, Palm-Meinders I, Chuttani R. Impact of a Health Coach-Led, Text-Based Digital Behavior Change Intervention on Weight Loss and Psychological Well-Being in Patients Receiving a Procedureless Intragastric Balloon Program: Prospective Single-Arm Study. JMIR Form Res 2024; 8:e54723. [PMID: 39083340 PMCID: PMC11325120 DOI: 10.2196/54723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/20/2024] [Accepted: 05/29/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Digital health interventions show promise for weight management. However, few text-based behavior change interventions have been designed to support patients receiving intragastric balloons, and none have simultaneously evaluated weight loss, psychological well-being, and behavior change despite the crucial interplay of these factors in weight management. OBJECTIVE This study aims to assess whether a health coach-led, asynchronous, text-based digital behavior change coaching intervention (DBCCI) delivered to participants receiving an intragastric balloon and its aftercare program was feasible and acceptable to participants and supported improved outcomes, including weight loss, psychological well-being, and lifestyle behavior change conducive to weight loss maintenance. METHODS This 12-month, single-arm prospective study enrolled adults aged 21 to 65 years with BMI ≥27 kg/m2 receiving a procedureless intragastric balloon (PIGB) at 5 bariatric clinics in the United Kingdom and the Netherlands. Participants received the DBCCI and the clinic-led PIGB aftercare program (remotely delivered) for 6 months after PIGB placement and then no intervention for an additional 6 months. The DBCCI was an evidence-based, personalized intervention wherein health coaches supported participants via exchanged asynchronous in-app text-based messages. Over the 12-month study, we assessed percentage of total body weight loss and psychological well-being via self-administered validated questionnaires (Warwick-Edinburgh Mental Wellbeing Scale, Generalized Anxiety Disorder Scale, Impact of Weight on Quality of Life-Lite-Clinical Trials Version, Loss of Control Over Eating Scale-Brief, Weight Efficacy Lifestyle Questionnaire-Short Form, and Barriers to Being Active Quiz). Participant engagement with and acceptability of the intervention were assessed via self-reported surveys. RESULTS Overall, 107 participants (n=96, 89.7% female; mean baseline BMI 35.4, SD 5.4 kg/m2) were included in the analysis. Mean total body weight loss was 13.5% (SEM 2.3%) at the end of the DBCCI and 11.22% (SEM 2.3%) at the 12-month follow-up (P<.001). Improvements were observed for all psychological well-being measures throughout the 12 months except for the Generalized Anxiety Disorder Scale (improvement at month 1) and Barriers to Being Active Quiz (improvements at months 3 and 6). Surveys showed high levels of engagement with and acceptability of the DBCCI. CONCLUSIONS This study provides evidence that the health coach-led, asynchronous, text-based DBCCI was engaging and acceptable to participants with overweight and obesity. The DBCCI, delivered alongside the PIGB and its aftercare program, supported improved weight loss outcomes and psychological well-being versus baseline and was associated with lifestyle behavior changes known to help achieve and maintain long-term weight loss and improved health outcomes. Follow-up findings suggest a potential need for longer-term, more intense coaching to focus on weight loss maintenance and support ongoing self-coaching. This could be achieved by leveraging generative artificial intelligence to provide ongoing automated behavior change coaching support to augment human-led care. TRIAL REGISTRATION ClinicalTrials.gov NCT05884606; https://clinicaltrials.gov/study/NCT05884606.
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Affiliation(s)
- Paul M Sacher
- Allurion Technologies Inc, Natick, MA, United States
| | - Emily Fulton
- Allurion Technologies Inc, Natick, MA, United States
| | | | - Julia Wilson
- Allurion Technologies Inc, Natick, MA, United States
| | | | | | | | | | - Jan Willem Greve
- Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Huis Ter Heide, Netherlands
| | - Inge Palm-Meinders
- Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Huis Ter Heide, Netherlands
| | - Ram Chuttani
- Allurion Technologies Inc, Natick, MA, United States
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Huang X, Zhang J, Liang J, Duan Y, Xie W, Zheng F. Association of Cardiovascular Health With Risk of Incident Depression and Anxiety. Am J Geriatr Psychiatry 2024; 32:539-549. [PMID: 37968161 DOI: 10.1016/j.jagp.2023.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVE To investigate the association between cardiovascular health (CVH), defined by the American Heart Association's Life's Essential 8 (LE8) score, and incident depression and anxiety. DESIGN A prospective cohort study using data from UK Biobank. SETTING Participants were enrolled from March 2006 to October 2010. PARTICIPANTS Participants without cardiovascular diseases and common mental disorders at baseline and having complete data on metrics of LE8 were included. MEASUREMENTS CVH was assessed by LE8 score including eight components. The overall CVH was categorized as low (LE8 score <50), moderate (50≤ LE8 score <80), and high (LE8 score ≥80). RESULTS We included 115,855 participants (mean age: 55.7 years; female: 52.6%). During a median follow-up of 12.4 years, 3,194 (2.8%) and 4,005 (3.5%) participants had incident depression and anxiety, respectively. Compared with participants having low CVH, those having moderate and high CVH had 37% (HR = 0.63, 95% CI: 0.57-0.70) and 52% (HR = 0.48, 95% CI: 0.41-0.55) lower risk of incident depression. Similarly, moderate and high CVH were related to a lower risk of incident anxiety (HR = 0.81, 95% CI: 0.73-0.89 and HR = 0.68, 95% CI: 0.60-0.78). Restricted cubic spline showed that LE8 score was inversely related to incident depression and anxiety in a linear manner, and the risk of incident depression and anxiety decreased by 17% (HR = 0.83, 95% CI: 0.80-0.85) and 10% (HR = 0.90, 95% CI: 0.88-0.92) for 10-point increment in LE8 score, respectively. CONCLUSIONS Higher CVH, evaluated by LE8 score, is strongly associated with a lower risk of incident depression and anxiety, suggesting the significance of optimizing CVH by adopting LE8.
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Affiliation(s)
- Xinghe Huang
- School of Nursing (XH, JZ, JL, FZ), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junyu Zhang
- School of Nursing (XH, JZ, JL, FZ), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Liang
- School of Nursing (XH, JZ, JL, FZ), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yanping Duan
- Department of Psychological Medicine (YD), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute (WX), Peking University First Hospital, Beijing, China
| | - Fanfan Zheng
- School of Nursing (XH, JZ, JL, FZ), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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McIntyre RS. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and suicidality: what do we know and future vistas. Expert Opin Drug Saf 2024; 23:539-542. [PMID: 38520274 DOI: 10.1080/14740338.2024.2335215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Affiliation(s)
- Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, Ontario Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
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Chai L. Interplay between actual and perceived weight on mental health among Canadian Indigenous post-secondary students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38592936 DOI: 10.1080/07448481.2024.2338419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Research increasingly focuses on the mental health implications of both actual and perceived weight, particularly among post-secondary students. Considering their unique socio-cultural context and the frequent oversight in research, this study examines these implications specifically among Canadian Indigenous post-secondary students. Recent evidence indicates that students with normal weight may also experience increased mental health risks due to negative weight perceptions. Therefore, this study explores the independent and combined effects of actual and perceived weight on the mental health of this group. PARTICIPANTS AND METHODS This study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations peoples living off-reserve, Métis, and Inuit. The focus was on Canadian Indigenous post-secondary students aged 19-34 years (n = 1,518). Logistic regression models, stratified by sex, were employed to analyze the data. RESULTS Perceptions of being overweight were linked to a higher risk of mood and anxiety disorders, poor self-rated mental health, and suicidal ideation among female students. This pattern was less evident among male students. Notably, female students who were overweight and perceived themselves as such were more likely to report poor mental health across all four indicators examined. In contrast, male students exhibited a less clear pattern. Diverging from recent studies, the findings indicated less robust mental health disparities among students with normal weight who perceived themselves as overweight, potentially due to the insufficient cell size of this category among Indigenous post-secondary students. CONCLUSIONS The study highlights the complex interplay between actual and perceived weight and its impact on mental health, particularly among female Indigenous post-secondary students.
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Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
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Christensen K, Victor SE, Littlefield AK, Mitchell SM. A comparison of retrospectively reported and ecological momentary assessment-reported perceived social support in predicting ecological momentary assessment-reported non-suicidal self-injury. Suicide Life Threat Behav 2024; 54:184-194. [PMID: 38078550 PMCID: PMC11021162 DOI: 10.1111/sltb.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/07/2023] [Accepted: 12/01/2023] [Indexed: 04/17/2024]
Abstract
INTRODUCTION Non-suicidal self-injury (NSSI) urges and behaviors are associated with lower perceived social support and related constructs (e.g., perceived rejection). However, no studies have examined the concordance of retrospective (baseline) and ecological momentary assessment (EMA) perceived social support assessments. Retrospective and EMA reports are often only weakly to moderately correlated; measurement approaches may, therefore, impact observed associations between variables. We tested whether average EMA-reported perceived emotional social support uniquely predicts EMA-reported NSSI urges and behaviors above baseline-reported retrospective self-report of perceived emotional social support alone. METHODS 93 young adults (ages 18-34) with past-month NSSI urges or behaviors and lifetime NSSI behaviors completed a semi-structured interview, self-report surveys, and a 2-week EMA protocol. RESULTS Baseline- and EMA-reported perceived emotional social support were positively correlated (Kendall's tau-b = 0.51). Average EMA-reported social support was uniquely associated with EMA-reported NSSI urges but not NSSI behaviors. CONCLUSIONS EMA-reported perceived emotional social support captured information not represented by baseline reports alone, but improvement in model fit was modest. EMA-reported social support may further improve the estimation of EMA-reported NSSI urges if modeled as a proximal predictor of NSSI. Further work is needed to clarify temporal directions between social support and NSSI urges. Limitations are discussed.
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Affiliation(s)
- Kirsten Christensen
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Sarah E Victor
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Sean M Mitchell
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
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Gao H, Wang Y, Wang X, Gao M. Mediation of the association between screen time and suicidality by overweight/obesity and perceived overweight: results from the youth risk behavior surveillance system of the United States. Front Psychiatry 2024; 15:1287021. [PMID: 38501093 PMCID: PMC10944958 DOI: 10.3389/fpsyt.2024.1287021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/01/2024] [Indexed: 03/20/2024] Open
Abstract
Aim Adolescent suicide is a major public health concern, and modifiable risk factors associated with adolescent suicide remain poorly understood. This study aimed to assess the association between screen time and overweight/obesity and self-perceived overweigh and suicidality in adolescents. Methods Adolescents from the United States Youth Risk Behavior Surveillance System (YRBSS) between 2013 and 2019 were included in this cross-sectional study. The outcome was suicidality, including considered suicide, made a suicide plan, attempted suicide, and injurious suicide attempt. Multivariable logistic regression model was used to investigate the associations between screen time, overweight/obesity, self-perceived overweight, and suicidality, and expressed as odds ratio (OR) and 95% confidence interval (CI). Mediation analysis was used to explore the role of overweight/obesity and self-perceived overweight on the association between screen time and suicidality. Results A total of 30,731 adolescents were included, of which 6,350 (20.65%) had suicidality, including 5,361 (17.45%) with considered suicide, 4,432 (14.42%) with made a suicide plan, 2,300 (7.45%) with attempted suicide, and 677 (2.21%) with injurious suicide attempt. Adolescents with screen time ≥3h were related to higher odds of suicidality (OR=1.35, 95%CI: 1.23-1.46), overweight/obesity (OR=1.27, 95%CI: 1.19-1.38), and self-perceived overweight (OR=1.38, 95%CI: 1.30-1.48) after adjusting confounders. Adolescents with overweight/obesity (OR=1.30, 95%CI: 1.19-1.43) and self-perceived overweight (OR=1.54, 95%CI: 1.39-1.70) were associated with higher odds of suicidality. The association between screen time and suicidality was 4.67% mediated by overweight/obesity and 9.66% mediated by self-perceived overweight. Moreover, the mediating role of overweight/obesity was observed only in females, whereas there were no sex differences in the mediating effect of self-perceived overweight. Conclusion Both overweight/obesity and self-perceived overweight mediated the association between screen time and suicidality.
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Affiliation(s)
- Hong Gao
- Department of Mental Health, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yifei Wang
- Taiyuan University of Technology, Shanxi, China
| | - Xugang Wang
- Shanxi Xinyue Psychological Counseling Research Center, Taiyuan, Shanxi, China
| | - Ming Gao
- Department of Physical Education, Shanxi Medical University, Taiyuan, Shanxi, China
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Kupila SKE, Berntzen BJ, Muniandy M, Ahola AJ, Kaprio J, Rissanen A, Pietiläinen KH. Mental, physical, and social well-being and quality of life in healthy young adult twin pairs discordant and concordant for body mass index. PLoS One 2023; 18:e0294162. [PMID: 38055659 PMCID: PMC10699637 DOI: 10.1371/journal.pone.0294162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 10/13/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE The relationship between obesity and mental health is complex and is moderated by the level of obesity, age, sex, and social and genetic factors. In the current study, we used a unique co-twin control design, with twin pairs discordant for body mass index (BMI), to control for shared genetic and environmental effects between obesity and several dimensions of mental health. METHODS We studied 74 monozygotic (MZ) twin pairs, of whom 36 were BMI-discordant (intra-pair difference in BMI ≥ 3 kg/m2), and 77 dizygotic (DZ) twin pairs (46 BMI-discordant). We assessed subjective health, especially mental health and mental well-being (depression, anxiety, self-esteem, health-related quality of life, life satisfaction, and social well-being) through questionnaires. RESULTS Heavier MZ co-twins from BMI-discordant pairs had poorer general health (58.8±3.0 vs. 72.4±3.8, P = 0.001, FDR = 0.017 on a scale from 0 to 100 where higher scores indicate more positive results), physical functioning (90.3±1.1 vs. 95.5±2.2, P = 0.024, FDR = 0.122), energy levels (55.6±3.4 vs. 66.6±3.3, P = 0.013, FDR = 0.109), and emotional well-being (65.9±3.2 vs. 75.4±2.9, P = 0.031, FDR = 0.122), as well as a tendency for depressive symptoms (8.4±1.3 vs. 5.6±0.9, P = 0.071, FDR = 0.166) compared to their leaner co-twins. Heavier DZ co-twins had poorer total physical well-being (91.6±1.9 vs. 95.6±1.0, P = 0.035, FDR = 0.356) and more depressive symptoms (4.3±0.9 vs. 2.4±0.5, P = 0.016, FDR = 0.345 on a scale from 0 to 63 where lower scores indicate fewer depressive symptoms) than their leaner co-twins. Association analyses, using all twin pairs, confirmed that higher BMI within pairs linked to general health, physical functioning and depressive symptoms. No association was found between BMI and anxiety, self-esteem, life satisfaction, or social well-being. CONCLUSIONS In conclusion, this study underscores the notable association between elevated BMI and physical well-being and to a lesser extent between elevated BMI and depressive symptoms, while revealing no discernible connections with anxiety, self-esteem, life satisfaction, or social well-being.
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Affiliation(s)
- Sakris K. E. Kupila
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Bram J. Berntzen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Maheswary Muniandy
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Aila J. Ahola
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Centre, Folkhälsan Institute of Genetics, Helsinki, Finland
- Abdominal Centre Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Aila Rissanen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kirsi H. Pietiläinen
- Obesity Research Unit, Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Obesity Centre, Endocrinology, Abdominal Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Graham CE, Frisco ML. The Mental "Weight" of Discrimination: The Relationship between Perceived Interpersonal Weight Discrimination and Suicidality in the United States. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:610-625. [PMID: 37776190 PMCID: PMC10683344 DOI: 10.1177/00221465231200634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Extant research has investigated the relationship between body weight and suicidality because obesity is highly stigmatized, leading to social marginalization and discrimination, yet has produced mixed results. Scholars have speculated that factors associated with body weight, such as weight discrimination, may better predict suicidality than body weight itself. We consider this possibility among a sample of 12,057 adult participants ages 33 to 43 in Wave V of the National Longitudinal Study of Adolescent to Adult Health through investigation of the relationships between weight discrimination and two dimensions of suicidality-suicide ideation and attempts. We also examine gender as a moderator of these relationships. We find that weight discrimination is positively associated with both suicide ideation and attempts, and this relationship is similar among men and women. Our findings underscore the need to address issues of weight discrimination in our society to better promote mental well-being.
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Zhang N, Chao J, Wu X, Chen H, Bao M. The role of cognitive function in the relationship between surrogate markers of visceral fat and depressive symptoms in general middle-aged and elderly population: A nationwide population-based study. J Affect Disord 2023; 338:581-588. [PMID: 37390925 DOI: 10.1016/j.jad.2023.06.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/21/2023] [Accepted: 06/20/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND The relationship between obesity and depressive symptoms is well documented, but not visceral fat, especially among Chinese adults are scarce. We aimed to investigate the association between visceral fat and depressive symptoms and the mediation of cognitive function. METHODS A total of 19,919 and 5555 participants from the China Health and Retirement Longitudinal Study were enrolled in the cross-sectional and follow-up analyses. Depressive symptoms were measured by the Center of Epidemiological studies depression scale (CES-D). Visceral fat measured by the waist circumference triglyceride (WT) index [calculated as waist circumference (cm)* triglyceride (mmol/L)]. The relationship between the WT index and depressive symptoms was analyzed by binary logistics and Poisson regression. The mediated role of cognitive ability was examined by intermediary analysis. RESULTS In the cross-sectional study, higher visceral fat was associated with a lower risk of depressive symptoms. But in the follow-up study, individuals in quintile 2 to quintile 4 of the WT index have a reduced risk of depressive symptoms after four years. Compared with the lower index, quintile 2 of the WT index protected from difficulty concentrating (RR [95%CI]: 0.90 [0.82,0.98], p = 0.023), feeling scared (RR [95%CI]: 0.86 [0.73,0.98], p = 0.030) and feeling that life could not go on (RR [95%CI]: 0.85 [0.74,0.98], p = 0.023). Moreover, cognitive ability explained 11.52 % of the association between visceral fat and depressive symptoms. CONCLUSIONS Our findings show that moderate visceral fat was associated with a lower risk of depressive symptoms in middle-aged and older Chinese, partly mediated by cognitive function.
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Affiliation(s)
- Na Zhang
- Department of Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of public health, Southeast University, Nanjing 210009, China
| | - Jianqian Chao
- Department of Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of public health, Southeast University, Nanjing 210009, China.
| | - Xueyu Wu
- Department of Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of public health, Southeast University, Nanjing 210009, China
| | - Hongling Chen
- Department of Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of public health, Southeast University, Nanjing 210009, China
| | - Min Bao
- Department of Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of public health, Southeast University, Nanjing 210009, China
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Gillison FB, Grey EB, Baber F, Chater A, Atkinson L, Gahagan A. The systematic development of guidance for parents on talking to children of primary school age about weight. BMC Public Health 2023; 23:1704. [PMID: 37667201 PMCID: PMC10476424 DOI: 10.1186/s12889-023-16527-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 08/16/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND The prevalence of overweight and obesity in children is increasing, alongside increases in rates of children's anxiety and worry about their weight. In many countries children's weight is measured, and parents are made aware if a child has been classified as having overweight or obesity. However, many parents are concerned that raising their child's awareness of their weight, and talking to children about their weight could harm their wellbeing. The aim of this project was to develop guidance for parents on constructive ways to talk to children of primary school age about weight when they need to. METHODS The project followed a mixed-methods design: Phase 1 involved the collation of evidence including (a) two previously published systematic literature reviews to identify the associations between parent-child weight talk, and broader health discussions, and children's wellbeing, (b) interviews with children, and (c) development and refinement of narrative messaging (previously published). In Phase 2 we developed a conceptual model and mapped primary findings to techniques and content within a draft guidance document for parents on talking to children about weight. Phase 3 involved a modified Delphi process with 29 stakeholders to refine and agree a final version. RESULTS An acceptable draft guidance was agreed following two stages of feedback from Delphi participants. Key areas for debate and adaptation included: encouraging discussion about health and growth with lesser focus on weight; finding ways to reduce stigma and perceptions of blame; emphasising a whole-family approach; inclusive representation of diversity among children and families. CONCLUSIONS Consensus on the content of guidance for parents on talking to children about weight was achieved through a process of evidence review and stakeholder and expert engagement. The next steps are to measure the impact of the resource on improving the experience of parents and children in communicating about weight.
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Affiliation(s)
- Fiona B Gillison
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK.
| | - Elisabeth B Grey
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Fran Baber
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, UK
| | - Angel Chater
- Institute for Sport and Physical Activity Research (ISPAR), Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK
- Centre for Behaviour Change, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | | | - Alison Gahagan
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, SW1H 0EU, UK
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Kim B, Kim HS, Park S, Kwon JA. BMI and perceived weight on suicide attempts in Korean adolescents: findings from the Korea Youth Risk Behavior Survey (KYRBS) 2020 to 2021. BMC Public Health 2023; 23:1107. [PMID: 37291506 PMCID: PMC10249225 DOI: 10.1186/s12889-023-16058-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/06/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Suicide is a leading cause of death in South Korea (hereafter 'Korea'), and there is evidence that body weight and perceived weight affecting suicide have a significant effect on suicidal behavior in adolescence. This study investigated the association between body mass index (BMI), perceived weight, and suicide attempts in adolescents. METHODS We included nationally representative data for a total of 106,320 students in our final analysis. We calculated and stratified BMI (underweight, normal weight, overweight) to determine the correlation between BMI and suicide attempts. We stratified the participants into three groups (perceived as underweight, normal weight, and overweight) for subjective body weight perception to analyze the relationship between subjective body weight perception and suicide attempts. We further analyzed the combination of BMI and subjective body weight perception to determine the relationship between suicide attempts and distorted subjective weight perception. RESULTS Compared with perceiving oneself as having a normal weight, the odds ratios (ORs) for suicide attempts were significantly increased in the group perceiving themselves as overweight. In addition, those who perceived themselves as overweight but were underweight according to their BMI were at significantly increased risk of suicide attempts relative to those who perceived themselves as about the right weight. CONCLUSIONS There was a significant association with suicide attempts in the underweight and perceived overweight group. This shows the importance of combining BMI and perceived weight when examining the relationship between weight and suicide attempts in adolescents.
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Affiliation(s)
- Byungmi Kim
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, Republic of Korea
- National Cancer Center Graduate School of Cancer Science and Policy, Goyang, 10408, Republic of Korea
| | - Hyo-Seon Kim
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, Republic of Korea
| | - Sunhee Park
- Public Health at Graduate School, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Jeoung A Kwon
- National Cancer Control Institute, National Cancer Center, Goyang, 10408, Republic of Korea.
- Institute of Health Services Research, Yonsei University, 50 Yonsei-Ro, Seodaemun-Gu, 03722, Seoul, Republic of Korea.
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Gallagher C, Waidyatillake N, Pirkis J, Lambert K, Cassim R, Dharmage S, Erbas B. The effects of weight change from childhood to adulthood on depression and anxiety risk in adulthood: A systematic review. Obes Rev 2023:e13566. [PMID: 37062534 DOI: 10.1111/obr.13566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 03/08/2023] [Accepted: 03/16/2023] [Indexed: 04/18/2023]
Abstract
This review aimed to evaluate the effects of weight change from childhood to adulthood on depression and/or anxiety risk in adulthood. We systematically searched MEDLINE, PsychINFO, Embase, Cumulative Index to Nursing and Allied Health Literature, and Scopus for longitudinal studies assessing changes in weight status between childhood (≤18 years) and adulthood (≥19 years) in association with outcomes of depression and/or anxiety in adulthood. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale, and data were narratively synthesized. Seventeen articles met our inclusion criteria: 13 evaluated outcomes of depression, one evaluated outcomes of anxiety, and five evaluated composite measures of depression and anxiety. Evidence was most consistent regarding outcomes of depression, with most finding that persistent and/or increasing adiposity from childhood to adulthood is associated with an increased risk of depression, particularly in women. However, heterogeneity and limitations in the evidence preclude definitive conclusions and inconsistent findings were reported in the few studies that assessed anxiety and composite outcomes. Overall, it appears that early intervention to both prevent or resolve excess weight may aid in reducing the burden of depression, along with mental health support targeting adolescents with persistent and/or increasing adiposity. However, further high-quality research is needed to address the methodological limitations discussed.
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Affiliation(s)
- Claire Gallagher
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nilakshi Waidyatillake
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Medical Education, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Pirkis
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Katrina Lambert
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Raisa Cassim
- Department of Health, Tasmanian Government, Hobart, Tasmania, Australia
| | - Shyamali Dharmage
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
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13
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Liu BP, Jia CX, Li SX. The association of weight control attempts with suicidality: The role of objective weight status and weight perception among adolescents of United States. J Affect Disord 2023; 325:369-377. [PMID: 36610601 DOI: 10.1016/j.jad.2022.12.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/30/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND The evidence for the association of weight control attempts with suicidality by objective weight status, subjective weight perception, and distorted weight perception among adolescents was limited. METHODS Data were extracted from a national representative sample of Youth Risk Behavior Surveys in the United States from 2011 to 2019. Binary logistic regression models with complex sampling designs were used to explore the association of weight control attempts, objective weight status, and weight perception with suicidality. FINDINGS The adolescents attempting to lose weight had higher weighted prevalence of suicidal ideation, suicide plan, suicide attempt, and suicide attempt with medical treatment compared with other attempts of weight control. Totally, attempting to lose weight was significantly associated with increased risk of suicidal ideation (OR: 1.17, 95%CI: 1.05-1.30) and suicide attempt (OR: 1.26, 95%CI: 1.10-1.46) when adjusting objective weight status, weight perception and all other covariates. In the subgroup analyses, attempting to lose weight was significantly associated with increased risk of suicidality in the adolescents of normal weight, underweight, perceived normal weight, perceived underweight, right estimation of objective weight status. LIMITATIONS Uncertain causal relationship existed because of cross-sectional design. CONCLUSIONS The risk of suicidality associated with weight control attempts varied among different subgroups. The findings in this study suggest that not only objective weight status but also weight perception should be with consideration when performing weight control attempts.
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Affiliation(s)
- Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Center for Suicide Prevention Research, Shandong University, Jinan, Shandong, China.
| | - Shi-Xue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
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14
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Zu P, Xu SJ, Shi CY, Zhao YQ, Huang ZH, Tao FB. Perceived rather than objective weight status is associated with suicidal behaviors among Chinese adolescents: a school-based study. J Public Health (Oxf) 2023; 45:75-83. [PMID: 35226755 DOI: 10.1093/pubmed/fdac015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/22/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND We aimed to explore the relationship between body mass index (BMI) and body weight perception (BWP) with suicidal behaviors among mainland Chinese adolescents. METHODS A nationally representative sample (N = 10 110) of Chinese adolescents was assessed in this study. Suicidal behaviors (ideation, plan and attempt) were evaluated by four self-reported questions. Generalized linear mixed model was used to estimate the adjusted odds ratios (ORs) for the association between BWP/BMI with suicidal behaviors. RESULTS The prevalence of suicidal ideation, suicidal plan and suicidal attempt was 12, 5 and 2.1%, respectively. After adjusting potential covariates, perceiving oneself as obese was significantly associated with increased risks of suicidal ideation (OR: 2.4, 95% confidence intervals, CI: 1.6-4.0, P = 0.001), suicidal plan (OR: 3.1, 95% CI: 1.5-6.3, P = 0.002) and suicidal attempt (OR: 3.7, 95% CI: 1.5-9.1, P = 0.001) compared with perceiving as normal weight among male adolescents; the effect attenuated to null among female adolescents. Perceiving oneself as underweight and overweight both exhibited significant adverse effect on suicidal behaviors (only suicidal ideation and suicidal plan) compared with perceiving oneself as normal weight among male adolescents, but not among female adolescents. The actual measured BMI was not significantly associated with suicidal behaviors among neither gender. CONCLUSIONS Self-perception of their body image rather than actual measured weight may have a gender-specific adverse effect on suicidal behaviors among Chinese adolescents.
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Affiliation(s)
- Ping Zu
- Department of Economic Management, Anhui Vocational College of Press and Publishing. Hefei 230601, Anhui, China
| | - Shao-Jun Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Cheng-Ying Shi
- Department of Economic Management, Anhui Vocational College of Press and Publishing. Hefei 230601, Anhui, China
| | - Yu-Qiu Zhao
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, Anhui, China
| | - Zhao-Hui Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
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15
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Hazzard VM, Mason TB, Smith KE, Schaefer LM, Anderson LM, Dodd DR, Crosby RD, Wonderlich SA. Identifying transdiagnostically relevant risk and protective factors for internalizing psychopathology: An umbrella review of longitudinal meta-analyses. J Psychiatr Res 2023; 158:231-244. [PMID: 36603318 PMCID: PMC9898156 DOI: 10.1016/j.jpsychires.2022.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 10/16/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
Internalizing mental disorders are highly comorbid with one another, and evidence suggests that etiological processes contributing to these disorders often overlap. This systematic umbrella review aimed to synthesize meta-analytic evidence from observational longitudinal studies to provide a comprehensive overview of potentially modifiable risk and protective factors across the depressive, anxiety, and eating disorder psychopathology domains. Six databases were searched from inception to August 2022. Only meta-analyses of longitudinal studies that accounted for baseline psychopathology (either via exclusion of baseline cases or statistical adjustment for baseline symptoms) were included. Methodological quality of meta-analyses was evaluated using the AMSTAR 2, and quality of evidence for each analysis was rated using GRADE. Study selection, quality assessment, and data extraction were conducted in duplicate by independent reviewers. The protocol for this review was registered with PROSPERO (CRD42020185575). Sixty-one meta-analyses were included, corresponding to 137 meta-analytic estimates for unique risk/protective factor-psychopathology relationships. Most potential risk/protective factors, however, were examined only in relation to depressive psychopathology. Concern over mistakes and self-esteem were the only risk and protective factors, respectively, identified as statistically significant across depressive, anxiety, and eating disorder psychopathology domains. Eight risk factors and four protective factors also emerged as having transdiagnostic relevance across depressive and anxiety domains. Results suggest intervention targets that may be valuable for preventing/treating the spectrum of internalizing psychopathology and reducing comorbidity. However, few factors were identified as transdiagnostically relevant across all three internalizing domains, highlighting the need for more research investigating similar sets of potential risk/protective factors across internalizing domains.
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Affiliation(s)
- Vivienne M Hazzard
- Center for Biobehavioral Research, Sanford Research, United States; Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, United States; Division of Epidemiology & Community Health, University of Minnesota School of Public Health, United States.
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, United States
| | - Kathryn E Smith
- Department of Psychiatry and Behavioral Sciences, University of Southern California, United States
| | | | - Lisa M Anderson
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, United States
| | - Dorian R Dodd
- Center for Biobehavioral Research, Sanford Research, United States
| | - Ross D Crosby
- Center for Biobehavioral Research, Sanford Research, United States
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Tengilimoglu-Metin MM, Gumus D. Are depression, resilience and fear of COVID-19 related to eating behavior and nutrition status of university students? Nutrition 2023; 106:111884. [PMID: 36493550 PMCID: PMC9616475 DOI: 10.1016/j.nut.2022.111884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 10/04/2022] [Accepted: 10/11/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES This study was designed to examine eating behaviors and their association with fear and depression states concerning COVID-19 among students in Turkey. METHODS A total number of 499 students, 336 (67.3%) female and 163 (32.7%) male, participated in an online-based cross-sectional study. The survey collected data on the Dutch eating behavior questionnaire (DEBQ), along with measuring psychological effect by using the Fear of COVID-19 Scale, Beck Depression Inventory, and Brief Resilience Scale. In addition, 24-h dietary records were used to calculate the daily energy and macronutrient intakes in the study. RESULTS A negative correlation between brief resilience and fear of COVID-19 was found. Total and subdomain DEBQ scores were positively correlated with fear of COVID-19; conversely, there was a negative correlation with brief resilience (P < 0.05). More than half (58.9%) of students had depression, and students who had moderate and severe depression had higher total DEBQ and emotional eating scores. Students with severe depression had the highest levels of fear of COVID-19. Students having higher daily energy intake had greater fear concerning COVID-19, and the daily energy intake was negatively correlated with restrained and external eating. CONCLUSIONS During the pandemic, negative psychological effects resulted in unfavorable dietary behavioral consequences, depending on the increasing levels of stress.
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17
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Yu Z, He F, Cai G, Wang M, Fu J. Relationships between Weight Perceptions and Suicidal Behaviors in Chinese Adolescents: Results from an Ongoing School-Based Survey in Zhejiang Province. Behav Sci (Basel) 2022; 13:bs13010008. [PMID: 36661580 PMCID: PMC9854802 DOI: 10.3390/bs13010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/10/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Weight perception has been implicated in suicidal behaviors among children and adolescents, yet little is known about the relationships in China. We examined the associations of self-perceived weight status and weight misperception with suicidal behaviors among Chinese adolescents. METHODS Data used in this analysis were from the 2017 Zhejiang Youth Risk Behavior Survey, which included 17,359 middle and high school students aged 9 to 18 years. Information on perceived weight status, as well as the actual height, weight and other related traits, was extracted by a self-reported questionnaire. Multivariate logistic regression models were used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for suicidal behaviors associated with perceived weight status and weight misperception. RESULTS Overall, the mean (SD) age was 15.7 (1.6) years among the study participants. Students who perceived themselves as overweight were more likely to have increased suicidal ideation and attempts reports, with ORs of 1.22 (95% CI: 1.09-1.37) and 1.32 (1.06-1.34), compared to those who perceive themselves as having about the right weight. Overestimated weight was significantly associated with greater odds of suicidal ideation (OR: 1.15, 95% CI: 1.03-1.27) and attempts (1.35, 1.10-1.65) relative to accurate weight perception. CONCLUSIONS Controlling for potential confounders, we found that both self-perception of overweight and overestimated perception were significantly associated with suicidal ideation and attempts among Chinese adolescents.
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Affiliation(s)
- Zhu Yu
- Department of Endocrinology, Children’s Hospital Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou 310051, China
- National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou 310051, China
- National Children’s Regional Medical Center, 3333 Binsheng Road, Hangzhou 310051, China
| | - Fan He
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
| | - Gaofeng Cai
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
| | - Meng Wang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou 310051, China
- Correspondence: (M.W.); (J.F.); Tel.: +86-0571-87115104 (M.W.); +86-0571-88873013 (J.F.)
| | - Junfen Fu
- Department of Endocrinology, Children’s Hospital Zhejiang University School of Medicine, 3333 Binsheng Road, Hangzhou 310051, China
- National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou 310051, China
- National Children’s Regional Medical Center, 3333 Binsheng Road, Hangzhou 310051, China
- Correspondence: (M.W.); (J.F.); Tel.: +86-0571-87115104 (M.W.); +86-0571-88873013 (J.F.)
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18
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Bouzas C, Bibiloni MDM, Garcia S, Mateos D, Martínez-González MÁ, Salas-Salvadó J, Corella D, Goday A, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, Lopez-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Serra-Majem L, Riquelme-Gallego B, Martín-Sánchez V, Pintó X, Gaforio JJ, Matía P, Vidal J, Vázquez C, Daimiel L, Ros E, Pascual-Roquet-Jalmar E, Babio N, Gonzalez-Monge I, Castañer O, Abete I, Sorto-Sánchez C, Carlos Benavente-Marín J, Torres-Collado L, Martin M, García-Ríos A, Castro-Barquero S, Fernández-García JC, Santos-Lozano JM, Fernandez-Lazaro CI, Salas-Huetos A, Guillem-Saiz P, Zomeño MD, Ángeles Zulet M, Goikoetxea-Bahon A, Gea A, Nishi SK, Schröder H, Tur JA. Desired weight loss and its association with health, health behaviors and perceptions in an adult population with weight excess: One-year follow-up. Front Nutr 2022; 9:848055. [PMID: 35938116 PMCID: PMC9355147 DOI: 10.3389/fnut.2022.848055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 06/27/2022] [Indexed: 01/10/2023] Open
Abstract
BackgroundMetabolic syndrome (MetS) worsens quality of life and increases mortality. Dissatisfaction with weight in patients with MetS may modify the effect of lifestyle interventions to achieve changes in health-related behaviors.ObjectiveTo assess 1-year changes in cardiovascular risk scores, self-perceived general health and health-related behaviors according to observed changes in desired weight loss during the first year of intervention in a large cardiovascular prevention trial.DesignProspective analysis of the PREDIMED-PLUS trial, including 5,499 adults (55–75 years old) with overweight or obesity at baseline.MethodsThe desired weight loss was the difference between ideal and measured weight. Tertiles of change in desired weight loss (1 year vs. baseline) were defined by the following cut-off points: ≥0.0 kg (T1, n = 1,638); 0.0 to −4.0 kg (T2, n = 1,903); ≤−4.0 kg (T3, n = 1,958). A food frequency questionnaire assessed diet and the Minnesota-REGICOR questionnaire assessed physical activity. The Framingham equation assessed cardiovascular risks. The changes in the severity of MetS were also assessed. The Beck Depression Inventory assessed depressive symptoms and the SF-36 assessed health-related quality of life. Data were analyzed using general linear models.ResultsBMI decreased at T2 and T3 (T1: 0.3, T2: −0.7, T3: −1.9). The most significant improvement in diet quality was observed at T3. Cardiovascular risk decreased at T2 and T3. Mean reductions in MetS severity score were: −0.02 at T1, −0.39 at T2 and −0.78 at T3. The perception of physical health increases in successive tertiles.ConclusionsIn older adults with MetS, more ambitious desired weight loss goals were associated with improvements in diet, cardiovascular health and perceived physical health during the first year of a healthy lifestyle intervention programme. Weight dissatisfaction needs to be considered by health professionals.Clinical trial registrationhttp://www.isrctn.com/ISRCTN89898870, identifier 89898870.
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Affiliation(s)
- Cristina Bouzas
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Maria del Mar Bibiloni
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Silvia Garcia
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - David Mateos
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Miguel Ángel Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Albert Goday
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - J. Alfredo Martínez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Cardiometabolics Precision Nutrition Program, Instituto Madrileño de Estudios Avanzados (IMDEA) Food, Campus Excelencia Internacional (CEI UAM + CSIC), Madrid, Spain
- Department of Nutrition, Food Sciences, and Physiology, Center for Nutrition Research, University of Navarra, Pamplona, Spain
| | - Ángel M. Alonso-Gómez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain
- Department of Medicine, University of the Basque Country, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - Jesús Vioque
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José Lopez-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
| | - Ramon Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J. Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - José Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Lluís Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Blanca Riquelme-Gallego
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Vicente Martín-Sánchez
- CIBER Diabetes y enfermedades metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, Leon, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - José J. Gaforio
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
- Department of Health Sciences, Center for Advanced Studies in Olive Grove and Olive Oils, University of Jaen, Jaen, Spain
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Fundación Para la Investigación Biomedica de El Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Josep Vidal
- Department of Endocrinology, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Clotilde Vázquez
- Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Lidia Daimiel
- Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, Campus Excelencia Internacional (CEI UAM + CSIC), Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Elena Pascual-Roquet-Jalmar
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
- Osasunbidea, Servicio Navarro de Salud, Atención Primaria, Pamplona, Spain
| | - Nancy Babio
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
| | | | - Olga Castañer
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - Itziar Abete
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
| | - Carolina Sorto-Sánchez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain
- Department of Medicine, University of the Basque Country, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Juan Carlos Benavente-Marín
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Nursing, School of Health Sciences, University of Málaga-IBIMA, Málaga, Spain
| | - Laura Torres-Collado
- Instituto de Investigación Sanitaria y Biomédica de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL-UMH), Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Marian Martin
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Antonio García-Ríos
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Córdoba, Spain
| | - Sara Castro-Barquero
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Jose C. Fernández-García
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, University of Málaga, Málaga, Spain
| | - José Manuel Santos-Lozano
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Cesar I. Fernandez-Lazaro
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
| | - Albert Salas-Huetos
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
| | - Patricia Guillem-Saiz
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - María Dolores Zomeño
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
| | - Maria Ángeles Zulet
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
| | - Amaia Goikoetxea-Bahon
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Bioaraba Health Research Institute, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain
- Department of Medicine, University of the Basque Country, Universidad del País Vasco/Euskal Herriko Unibertsitatea (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IDISNA), University of Navarra, Pamplona, Spain
| | - Stephanie K. Nishi
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Human Nutrition Unit, Biochemistry and Biotechnology Department, Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Universitat Rovira i Virgili, Tarragona, Spain
| | - Helmut Schröder
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Josep A. Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- *Correspondence: Josep A. Tur
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Changes in the association between overweight and depression across three major ethnic groups, 2005-2018. J Psychiatr Res 2022; 151:564-570. [PMID: 35636033 DOI: 10.1016/j.jpsychires.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 04/10/2022] [Accepted: 05/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The relationship between body weight and depression may have changed along with the climbing trend of obesity prevalence, but most previous studies examined the association with a single cross-sectional survey. The present study assessed the change in the association between depression and body weight, measured and perceived from 2005 to 2018, among three major racial/ethnic groups. METHODS We analyzed the data of 27,387 adults aged ≥18, collected in the National Health and Nutrition Examination Survey. Surveys from 2005 to 2010 were combined as the early period and the surveys from 2011 to 2018 as the recent period. RESULTS A switching pattern was observed among white women. In the 2005-2010 survey period, only self-perceived overweight was significantly associated with depression [Odds ratio (OR) = 3.25 (95% confidence interval = 1.33, 7.90)]. However, in the 2011-2018 survey period, self-perceived overweight was not associated with depression anymore [1.32 (0.72, 2.41)], but obesity measured directly was significantly associated with depression [2.59 (1.04, 6.48)]. Among white men, self-perceived overweight and obesity measured directly were significantly associated with depression only in 2011-2018; [2.57 (1.18, 5.58)] and [0.29 (0.10, 0.80)], respectively. Obesity directly measured consistently associated with increased odds of depression among black men. No significant associations were observed in Hispanic and black women in any survey period. CONCLUSION Significant gender and ethnic differences exist, and the associations between body weight and depression have evolved in sex-race-specific trajectories. The interventions must be consistently fine-tuned following the dynamics of the relationship between body weight and overall well-being.
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Lei J, Luo Y, Xie Y, Wang X. Visceral Adiposity Index Is a Measure of the Likelihood of Developing Depression Among Adults in the United States. Front Psychol 2022; 13:772556. [PMID: 35401344 PMCID: PMC8991090 DOI: 10.3389/fpsyg.2022.772556] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background Depression is a serious mental disorder often accompanied by emotional and physiological disorders. Visceral fat index (VAI) is the current standard method in the evaluation of visceral fat deposition. In this study, we explored the association between VAI and depression in the American population using NHANES data. Methods A total of 2,577 patients were enrolled for this study. Data were collected through structured questionnaires. Subgroup analysis for the relationship between VAI and depression was evaluated using multivariate regression analysis after adjustment for potential confounding factors. Results For every 1 unit increase in VAI, the clinical depression increased by 14% (OR = 1.14, 95% CI: 1.04–1.25). High VAI scores (T3) increased the highest risk of developing depression (OR = 2.32, 95% CI: 1.2–4.47). Subgroup analysis demonstrated a strong and stable association between VAI and the development of depression. Conclusion Our study showed that depressive symptoms are associated with a high ratio of visceral adiposity index after controlling confounding factors.
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Affiliation(s)
- Jun Lei
- School of Nursing Hunan University of Chinese Medicine, Changsha, China
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yaoyue Luo
- School of Nursing Hunan University of Chinese Medicine, Changsha, China
- *Correspondence: Yaoyue Luo,
| | - Yude Xie
- School of Nursing Hunan University of Chinese Medicine, Changsha, China
| | - Xiaoju Wang
- College of Integrated Traditional Chinese and Western Medicine, Changsha, China
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21
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Zhang MZ, Tang R, Rao WM, Wang MH, Liu MW, Yu HJ, He QQ. Body mass index and the risk of suicidal ideation and suicide attempt among youth in 45 low-and middle-income countries. J Affect Disord 2022; 298:357-363. [PMID: 34774645 DOI: 10.1016/j.jad.2021.11.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 10/02/2021] [Accepted: 11/07/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Suicide has become a severe public health issue worldwide. Body weight has been put forward as a potentially modifiable element for suicide thought and behavior. However, there are discrepancies across previous studies. Furthermore, the relationships of body weight with suicidal ideation and suicide attempt among low- and middle-income countries (LMICs) remain unclear. Therefore, we addressed this issue among 104,907 adolescents of 12-15 years old in 45 LMICs. METHODS The present study used data from the Global School-based Student Health Survey (GSHS). Suicidal ideation and suicide attempt during the last year were self-reported. Participants were classified intro underweight, normal weight, overweight and obesity according to their body mass index classification. Multivariable logistic regression and meta-analyses based on country-wise estimates were conducted. RESULTS The prevalence of suicidal ideation and suicide attempt were 11.8% and 13.0%, respectively. Countrywide meta-analysis demonstrated that overweight and obesity were significantly associated with increased risks of suicidal ideation (For overweight: OR = 1.10; 95% CI = 1.01-1.20; for obesity: OR=1.17; 95%CI: 1.01-1.35) and suicide attempt (For overweight: OR = 1.12; 95% CI = 1.02-1.23; for obesity: OR=1.12; 95%CI: 1.00-1.25). Subgroup analyses showed that the associations between overweight/obesity and suicide attempt were significant for girls but not for boys. LIMITATIONS The cross-sectional design cannot explore causality; mental health factors were not assessed; suicidal behaviors were self-reported; significant heterogeneity across countries; only students attending school were included. CONCLUSIONS Overweight/obesity was significantly associated with the risk of suicidal ideation and suicide attempt among adolescents in LMICs.
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Affiliation(s)
- Min-Zhe Zhang
- School of Health Sciences, Wuhan University, Donghu Rd, No. 185, Wuhan, Hubei Province 430071, PR China
| | - Rui Tang
- School of Health Sciences, Wuhan University, Donghu Rd, No. 185, Wuhan, Hubei Province 430071, PR China
| | - Wei-Ming Rao
- School of Health Sciences, Wuhan University, Donghu Rd, No. 185, Wuhan, Hubei Province 430071, PR China
| | - Ming-Hui Wang
- School of Health Sciences, Wuhan University, Donghu Rd, No. 185, Wuhan, Hubei Province 430071, PR China
| | - Ming-Wei Liu
- School of Health Sciences, Wuhan University, Donghu Rd, No. 185, Wuhan, Hubei Province 430071, PR China
| | - Hong-Jie Yu
- School of Health Sciences, Wuhan University, Donghu Rd, No. 185, Wuhan, Hubei Province 430071, PR China
| | - Qi-Qiang He
- School of Health Sciences, Wuhan University, Donghu Rd, No. 185, Wuhan, Hubei Province 430071, PR China; Hubei Biomass-Resource Chemistry and Environmental Biotechnology Key Laboratory, Wuhan University, Wuhan, PR China.
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22
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Feng X, Wilson A. Association between community average body mass index and perception of overweight. Soc Sci Med 2022; 294:114694. [PMID: 35038633 DOI: 10.1016/j.socscimed.2021.114694] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/30/2021] [Accepted: 12/28/2021] [Indexed: 11/28/2022]
Abstract
Some evidence indicates under-perception of overweight is associated with lower levels of weight loss. This might be due to 'visual normalisation' of overweight through comparisons made in communities where average body mass index (BMI) is high, resulting in under-perception of overweight, which in turn, may protect against negative weight-related self-perceptions and/or reduce motivation to lose weight. Evidence in support of this hypothesis was found initially in a precision-weighted multilevel logistic regression analysis of 3729 overweight Australians aged >18 y, after adjusting for age, sex and area-level disadvantage. Participants whose BMI was -1 kg/m2 or less than the community mean BMI had lower odds of weight-related dissatisfaction (OR = 0.64, 95%CI = 0.51-0.80) and perceived overweight (OR = 0.56, 95%CI = 0.45-0.70), compared with peers whose BMI was within ± 1 kg/m2 of the community mean. Moreover, participants whose BMI was 1 kg/m2 or greater than the community mean BMI had higher odds of weight-related dissatisfaction (OR = 1.97, 95%CI = 1.69-2.30) and perceived overweight (OR = 2.81, 95%CI = 2.41-3.28) when compared to the same reference group. These findings were consistent for men and women; however, they were attenuated towards the null and rendered statistically insignificant after adjustment for personal BMI. Overall, these results indicate that among adults who are overweight, personal BMI, rather than the relative difference between personal and community BMI, is the stronger determinant of weight-related perception and satisfaction.
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Affiliation(s)
- Xiaoqi Feng
- School of Population Health, UNSW Sydney, Sydney, Australia; Population Wellbeing and Environment Research Lab (PowerLab), Australia; The George Institute for Global Health, University of New South Wales, Australia; Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, Australia.
| | - Andrew Wilson
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney, Australia; The Australian Prevention Partnership Centre, The Sax Institute, Sydney, Australia.
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Examining the role that weight perception and social influences have on mental health among youth in the COMPASS study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1671-1684. [PMID: 35044480 PMCID: PMC8767527 DOI: 10.1007/s00127-022-02219-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE We investigated whether social health mitigates the association between weight perception and anxiety and depression 1 year later in a large sample of Canadian youth in a prospective, gender-specific analysis. METHODS We used 2 years of linked survey data from 20,485 grade 9-11 students who participated in wave 6 (2017/18) and 7 (2018/19) of the COMPASS study. Mental health outcomes included the Generalized Anxiety Disorder-7 item (GAD-7) scale and the 10-item Centre for Epidemiological Studies Depression Scale Revised (CESD-10-R). Social health encompassed students' perceived relationships with friends, family, teachers, and within schools. Multilevel, prospective, linear models regressed mental health (at wave 7) on social health (at wave 6) and weight perception (at wave 6) while controlling for weight status, ethnicity, and grade (at wave 6). Interaction terms were used to test social health factors as moderators in the association between weight perception and mental health. RESULTS Overweight perceptions were associated with higher anxiety and depression scores among youth; this was more pronounced among females. Social health was associated with lower anxiety and depression scores. Among females only, an overweight perception had the highest predicted scores for significant depressive symptoms. Among males only, underweight perceptions were associated with higher anxiety scores. No social health factors had moderating effects in females, and only two interactions were significant among males: feeling safe at school had protective associations with anxiety scores among those with underweight perceptions while those with overweight perceptions had higher depression scores when they reported rewarding social relationships. CONCLUSION Overweight perceptions in all youth, and underweight perceptions in males, predicted anxiety and depression symptoms 1 year later. The role of social health should not be discounted as a means of preventing anxiety and depression in youth, although this study suggests it is not sufficient to protect against adverse associations with overweight perceptions for all youth, and underweight perceptions for males.
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The roles of weight stigma, emotion dysregulation, and eating pathology in suicide risk. Body Image 2021; 38:162-170. [PMID: 33892440 DOI: 10.1016/j.bodyim.2021.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 04/10/2021] [Accepted: 04/11/2021] [Indexed: 11/24/2022]
Abstract
Using an interpersonal theory of suicide and affect regulation framework, we investigated the relationships between perceived burdensomeness, thwarted belongingness, weight stigmatization, emotion dysregulation, eating pathology, and suicide risk. Three main hypotheses were investigated. First, we predicted a positive linear relationship between weight stigmatization and risk. Second, an indirect effect of weight stigmatization on risk via perceived burdensomeness and thwarted belongingness was posited. Third, we hypothesized that weight stigmatization would indirectly affect suicide risk via emotion dysregulation and eating pathology. Undergraduates (N = 156) completed online surveys. Linear regressions and indirect effect analyses were performed. Weight stigmatization was directly, positively associated with increased suicide risk. Weight stigmatization indirectly affected suicide risk via perceived burdensomeness but not thwarted belongingness. Higher stigmatization was associated with higher levels of perceived burdensomeness, which was associated with higher risk. An indirect effect of weight stigmatization on suicide risk through emotional dysregulation emerged. Higher weight stigmatization was associated with higher emotional dysregulation, which was associated with higher suicide risk. When all models were combined, only an indirect effect via perceived burdensomeness remained. Our findings may have clinical and public health implications for suicide prevention among people with weight stigma-related risk factors.
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Do weight perception and bullying victimization account for links between weight status and mental health among adolescents? BMC Public Health 2021; 21:1062. [PMID: 34088278 PMCID: PMC8177253 DOI: 10.1186/s12889-021-11037-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/11/2021] [Indexed: 12/16/2022] Open
Abstract
Background The purpose of this study was to explore whether the way youth perceive their weight and their experiences of bullying victimization account for the increased risk of depression and anxiety symptoms, and poor psychosocial well-being, associated with overweight/obesity in a large sample of Canadian secondary school students. We also explored if associations differed by gender. Methods We used cross-sectional survey data from year 7 (2018–19) of the COMPASS study. The sample included 57,059 students in grades 9–12 (Secondary III-V in Quebec) at 134 Canadian secondary schools (Alberta, British Columbia, Ontario, Quebec). First, multiple regression models tested associations between body mass index (BMI) classification and mental health outcomes (anxiety [GAD-7] and depression [CESD-10] symptoms, and psychosocial well-being [Diener’s Flourishing Scale]). Second, weight perception and bullying victimization were added to the models. Models were stratified by gender and controlled for sociodemographic covariates and school clustering. Results When weight perception and bullying victimization were added to the models, obesity BMI status no longer predicted internalizing symptoms and flourishing scores relative to normal-weight BMIs. Students with ‘overweight’ or ‘underweight’ perceptions, and experiences of bullying victimization in the past month, reported higher anxiety and depressive symptomatology, and lower flourishing levels, in comparison to students with ‘about right’ weight perceptions and without experiences of bullying victimization, respectively, controlling for BMI status. Results were largely consistent across boys and girls. Conclusions Results suggest perceptions of weight and experiences of bullying independently contribute to differences in mental health outcomes by weight status among youth. Continued efforts targeting weight-based bullying and weight bias, and the promotion of body size acceptance and positive body image, may help reduce the risk of mental illness and poor mental health among adolescents.
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Wu R, Zhu B, Chen R, Chen L, Chen R, Zhu D. Weight Perception Measured by Verbal Descriptions and Visual Descriptions: Which Measurement Correlates with Weight Loss Intentions among Female Nursing Students? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105200. [PMID: 34068383 PMCID: PMC8153562 DOI: 10.3390/ijerph18105200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 12/02/2022]
Abstract
Background: Young females tend to overestimate their weight status, which might induce unhealthy weight loss intentions and behaviours. This study aimed to examine weight perception measured by visual and verbal descriptions and its correlation with weight loss intentions among female nursing students. Methods: A cross-sectional survey was conducted among 600 female nursing students from four medical colleges in Shanghai, China. The participants rated perceptions of their weight by selecting a silhouette from the female Photographic Figure Rating Scale (PFRS) and one of the following verbal descriptions: “very underweight”, “slightly underweight”, “normal”, “overweight” or “obese”. Weight loss intentions were measured using the question “How often do you want to lose weight?”. Body mass index (BMI) was calculated from self-reported height and weight. Data were analysed using univariate and ordinal logistic regression analyses. Results: The accuracy of weight perceptions measured by verbal descriptions and visual descriptions was 44.50% and 55%, respectively. In females with underweight BMI (n = 135), 88.15% and 49.63% accurately classified their weight using visual descriptions and verbal descriptions, respectively. These females were more likely to overestimate (53.83% vs. 14.50%) and less likely to underestimate (1.67% vs. 30.50%) their weight when using verbal descriptions than when using visual descriptions. For verbal descriptions, weight overestimation was associated with weight loss intentions (odds ratio, 1.80; 95% confidence interval, 1.25–2.60). However, for visual descriptions, the two variables were not associated. Conclusions: A mismatch occurred between weight perceptions measured by the two methods and BMI status among female nursing students. Compared with verbal descriptions, visual descriptions had higher weight perception accuracy. However, weight overestimation measured by verbal descriptions was more likely to be associated with stronger intentions to lose weight than that of visual descriptions. These findings suggest that methodological discrepancies should be taken into account when measuring weight perception in future studies.
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Affiliation(s)
- Ruxing Wu
- Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China; (R.W.); (B.Z.)
| | - Bingqian Zhu
- Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China; (R.W.); (B.Z.)
| | - Rongfeng Chen
- School of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China;
| | - Liqun Chen
- School of Nursing, Fudan University, Shanghai 200032, China;
| | - Runan Chen
- School of Nursing, The Second Military Medical University, Shanghai 200433, China;
| | - Daqiao Zhu
- Shanghai Jiao Tong University School of Nursing, Shanghai 200025, China; (R.W.); (B.Z.)
- School of Nursing, The Second Military Medical University, Shanghai 200433, China;
- Correspondence: ; Tel.: +86-1391-807-8680
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Ma W, Yan Z, Wu W, Li D, Zheng S, Lyu J. Dose-Response Association of Waist-to-Height Ratio Plus BMI and Risk of Depression: Evidence from the NHANES 05-16. Int J Gen Med 2021; 14:1283-1291. [PMID: 33883926 PMCID: PMC8055360 DOI: 10.2147/ijgm.s304706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 03/23/2021] [Indexed: 11/25/2022] Open
Abstract
Background Obesity or underweight has been found to be associated with depression, but the relationship remains to be determined so that more precise prevention strategies can be implemented. Body mass index (BMI) and waist–height ratio (WHR) were used as indicators to study the dose–response relationship between depression and obesity or underweight. Methods We obtained basic information and disease-related data for 13,975 adults from the National Health and Nutrition Examination Survey (NHANES) 2005–2016 dataset. The depressive status was determined based on the PHQ-9 scale (>4). Logistic regression was used to analyze the association and risk of BMI, WHTR and depressive status. Based on the results of logistic regression, the dose–response relationship between BMI, WHTR and depressive state was analyzed using restricted cubic splines (RCS). Results The adjusted model showed that compared with the fourth quartile (Q4) of BMI, the odds ratios (ORs) of depression for Q1, Q2 and Q3 were 0.63 (0.56–0.71), 0.61 (0.54–0.68) and 0.74 (0.66–0.82), and compared with the fourth quartile (Q4) of WHtR, the odds ratios (ORs) of depression for Q1, Q2 and Q3 were 0.55 (0.49–0.62), 0.57 (0.51–0.64) and 0.64 (0.57–0.71), respectively. The restricted cubic spline regression depicted a U-shaped dose–response relationship between continuous changes of obesity indicators and the risk of depression (P1, P2 < 0.001). When the participants’ BMI reached approximately 25kg/m2 with the reference value of BMI was 18.5kg/m2, the risk of depression was minimized (OR=0.68, 95% Cl=0.56–0.83). When the WHtR reached approximately 0.52 with the reference value of WHtR was 0.40, the risk of depression was minimized (OR=0.69, 95% Cl=0.54–0.88). Conclusion We found a significant U-shape correlation between BMI, WHtR and depression. People with slight overweight have the lowest risk of depression. However, according to the International Obesity standards, the population at these levels of weight may have an obesity-chronic disease risk, and this is not recommended.
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Affiliation(s)
- Wen Ma
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Zhengwei Yan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Wentao Wu
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Daning Li
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China
| | - Shuai Zheng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, People's Republic of China.,Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, People's Republic of China
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Frequency and Correlates of Weight-Based Discrimination among Adolescents in China. Int J Behav Med 2021; 28:523-527. [PMID: 33791993 DOI: 10.1007/s12529-021-09982-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Unfair treatment on the basis of body weight is common in the West and associated with lower well-being, starting at least as early as adolescence. We examine whether the frequency and predictors and correlates of weight discrimination seen in the West extend to adolescents in China. METHODS Participants (N = 1539) were adolescents in China who took part in a longitudinal study of mental health and academic burnout in high school. At Wave 1, participants reported on their personality and well-being and completed a school health check that included measured height and weight. At Wave 2 approximately 6 months later, participants reported on experiences with unfair treatment and completed the same measures of well-being. RESULTS Of 10 attributions for unfair treatment, weight was most common at 18%. Female gender and body mass index were associated with greater risk of reporting weight discrimination. Emotional stability, conscientiousness, and state happiness measured at Wave 1 were associated with lower risk of weight discrimination at Wave 2. Concurrently, weight discrimination was associated with lower happiness, less life satisfaction, and more distress. CONCLUSIONS Adolescents in China report weight discrimination, and the patterns of association between weight discrimination and psychological function are similar to what is seen in the West.
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Kim JS, Seo Y. Associations Between Weight Perception, Unhealthy Weight Control Behavior, and Suicidal Ideation and Planning Among Korean Adolescents: A National Cross-Sectional Secondary Analysis. J Pediatr Nurs 2021; 56:e62-e69. [PMID: 32798004 DOI: 10.1016/j.pedn.2020.07.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 07/21/2020] [Accepted: 07/30/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE This study aimed to investigate the associations between weight perception, unhealthy weight control behavior, and suicidal ideation and planning and identify the role of unhealthy weight control behavior as a mediator in these associations among Korean adolescents. DESIGN AND METHODS This national cross-sectional secondary study used data from the 2015-2017 Korea Youth Risk Behavior Web-Based Surveys, with a final sample of 96,285 adolescents who tried to manage their weight in the 30 days prior to the surveys. A multivariate logistic regression was conducted. RESULTS Both adolescent groups who perceived themselves to be underweight or overweight were significantly linked to a greater likelihood of suicidal ideation and planning (COR, 95% CI = 1.249, 1.141-1.367; COR, 95% CI = 1.339, 1.282-1.399) respectively. While adolescents with perceptions of being underweight are associated with suicidal ideation and planning through the suppression effect of unhealthy weight control behavior (Pathway A: OR, 95% CI = 0.628, 0.587-0.671), adolescents with perceptions of being overweight are linked with the same through the mediation effect (Pathway A: OR, 95% CI = 1.195, 1.141-1.251). CONCLUSIONS Adolescents with perceptions of being overweight are highly likely to have unhealthy weight control behavior that can be linked to the possibility of suicidal ideation and planning, while adolescents with perceptions of being underweight are comparatively less likely to engage in such behavior. PRACTICE IMPLICATIONS It is necessary to identify the status of weight perception among adolescents and closely monitor the unhealthy weight control behavior to prevent suicidal ideation and planning.
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Affiliation(s)
- Ji-Su Kim
- Associate professor, Department of Nursing, Chung-Ang University, Republic of Korea.
| | - Yeji Seo
- Doctoral student, Department of Nursing, Graduate School, Chung-Ang University, Republic of Korea.
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Zhou Y, Yang G, Peng W, Zhang H, Peng Z, Ding N, Guo T, Cai Y, Deng Q, Chai X. Relationship between Depression Symptoms and Different Types of Measures of Obesity (BMI, SAD) in US Women. Behav Neurol 2020; 2020:9624106. [PMID: 33299495 PMCID: PMC7705436 DOI: 10.1155/2020/9624106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 10/18/2020] [Accepted: 10/30/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To estimate the relationship between obesity (defined by both BMI and SAD) and various levels of depressive symptoms in women in the United States. METHODS This is a cross-sectional design. All data were collected from NHANES 2011-2012 and 2013-2014. The Patient Health Questionnaire (PHQ-9) was the primary variable used to index depressive symptoms. SAD was assessed using an abdominal caliper. We stratified participates into three groups according to SAD (trisection): T1: low (11.8-18.4 cm), T2: middle (18.5-22.8 cm), and T3: high (22.9-40.1 cm). Other data were collected following the NHANES protocols. We aimed to investigate the effects of obesity on the depression in the NHANES populations. RESULTS A total of 4477 women were enrolled in the final study population. Participants with a high SAD had the highest risk of clinical depression symptoms (OR = 1.2, 95% CI: 1.1-1.4), which was, in particular, the case for moderate-severe depression (OR = 1.4, 95% CI: 1.1-1.7) and severe depression (OR = 1.4, 95% CI: 1.0-1.9). We also found a significant relationship between SAD and BMI (r = 0.836). We did, however, not find a significant relationship between BMI and severe depression. CONCLUSIONS SAD had a better correlation with clinical depression symptoms than BMI, especially regarding severe depression symptoms.
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Affiliation(s)
- Yang Zhou
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Guifang Yang
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Wen Peng
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Hongliang Zhang
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhenyu Peng
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Ning Ding
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Tao Guo
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuzhong Cai
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Qijian Deng
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiangping Chai
- Department of Emergency Medicine, Second Xiangya Hospital, Central South University, Changsha, China
- Emergency Medicine and Difficult Diseases Institute, Second Xiangya Hospital, Central South University, Changsha, China
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Perceived overweight and suicidality among US adolescents from 1999 to 2017. Int J Obes (Lond) 2020; 44:2075-2079. [PMID: 32546863 DOI: 10.1038/s41366-020-0620-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/06/2020] [Accepted: 05/22/2020] [Indexed: 12/28/2022]
Abstract
Identifying oneself as overweight is a risk factor for poor mental health and suicidality independent from objective weight status. The stigma associated with heavier body weight has risen in recent decades and this may have exacerbated the detrimental mental health effects of perceived overweight. In this study, we examined the association between perceived overweight and suicidality in a nationally representative sample (N = 115,180) of US adolescents assessed from 1999 to 2017. We drew on data from the Youth Risk Behavior survey, a biennial population-based survey of students in grades 9-12. Suicidality was gauged by participant reports of past-year suicidal ideation, suicide plans, or suicide attempts. Across all waves, perceived overweight (vs. perceived "normal" weight) predicted a 7.7 percentage point (p < 0.001) increased risk of suicidality after adjustment for age, sex, ethnicity, and BMI. The risk of suicidality associated with perceived overweight increased from 5.7 percentage points in 1999-2001 to 10.1 points in 2015-2017, a difference of 4.4 points (p = 0.001). This growth was most evident after 2009 and was apparent across suicidality measures. Among US adolescents, perceiving one's body as overweight increases risk of suicidality and this risk appears to have grown substantially from 2009 to 2017.
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Robinson E, Daly M, Sutin A. Association of parental identification of child overweight and mental health problems during childhood. Int J Obes (Lond) 2020; 44:1928-1935. [PMID: 32398752 DOI: 10.1038/s41366-020-0587-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Public health policies attempt to increase parental identification of child overweight and obesity. The objective of the present research was to determine the cross-sectional, prospective and longitudinal associations between parental identification of child overweight and child mental health problems. METHODS We made use of two cohort studies of Australian (Longitudinal Study of Australian Children, LSAC) and Irish children (Growing up in Ireland Study, GUI) that measured parental identification of child overweight and child mental health problems. Participant included 6502 (LSAC) and 7503 (GUI) children (49% female) and their parents. Child mental health problems were measured using child, parent and teacher-reported Strengths and Difficulties Questionnaires (SDQ) at ages 9/10 years old to 12/13 years old. In all analyses we controlled for child Z-BMI. RESULTS In LSAC children whose parents identified them as being overweight at age 10 experienced worse mental health at age 10 (β = 0.21, SE = 0.04) and age 12 (β = 0.13, SE = 0.04) than children whose parents failed to identify them as overweight. In GUI children whose parents identified them as being overweight at age 9 experienced worse mental health at age 9 (β = 0.20, SE = 0.04) and age 13 (β = 0.22, SE = 0.04). In LSAC parental identification of child overweight at age 10 did not significantly predict changes in mental health problems from age 10 to 12 (β = -0.02, SE = 0.03). In GUI parental identification of child overweight was predictive of increases in mental health problems from age 9 to 13 (β = 0.08, SE = 0.03). CONCLUSIONS Parental identification of child overweight and obesity is associated with worse child mental health, independent of child body weight. Parents should be aware of the potential stigma and mental health difficulties associated with labelling a child as overweight.
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Affiliation(s)
- Eric Robinson
- Institute of Psychology, Health & Society, University of Liverpool, Liverpool, UK.
| | - Michael Daly
- Behavioural Science Centre, Stirling Management School, University of Stirling, Stirling, UK.,UCD Geary Institute, University College Dublin, Dublin, Ireland.,Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Angelina Sutin
- Florida State University College of Medicine, Tallahassee, FL, USA
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