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McNaughton BA, Burrows K, Choquette E, Poplin T, Kuplicki R, Paulus MP, Ironside M, Stewart JL. Impaired eating behaviors but intact metabolic hormone levels in individuals with major depressive disorder and generalized anxiety disorder. J Psychiatr Res 2023; 168:193-203. [PMID: 37918032 PMCID: PMC10842703 DOI: 10.1016/j.jpsychires.2023.10.042] [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: 05/23/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) and generalized anxiety disorder (GAD) contribute significantly to global health burdens. Identifying disease markers for these comorbid disorders can increase understanding of pathogenesis and improve screening and intervention strategies. This study examined the association of physical health factors with MDD and MDD + GAD, across sexes. METHODS Two samples of participants from the Tulsa-1000 study (exploratory cohort: N = 136; confirmatory cohort: N = 185) completed body composition measurements, eating behavior (Three Factor Eating Questionnaire [TFEQ], Eating Disorder Diagnostic Scale [EDDS]), exercise questionnaires, and a blood draw. Metabolic hormone concentrations (leptin, insulin, and adiponectin) were analyzed from blood samples. Within each cohort, a two-way analysis of variance compared three groups (MDD, MDD + GAD, and healthy controls [HC]), sex, and their interaction on dependent variables. Hedges g was calculated to reflect effect size magnitude. RESULTS Medium-to-large group main effects across cohorts indicated that compared to HC: (1) MDD (g = 1.71/0.57) and MDD + GAD (g = 0.93/0.69) reported higher TFEQ Disinhibition scores; (2) MDD endorsed higher TFEQ Hunger scores (g = 0.66/0.48); and (3) MDD (g = 1.60/1.30) and MDD + GAD (g = 0.92/1.72) reported greater EDDS scores. Large sex main effects across cohorts indicated that females exhibited higher levels than males for percent body fat (g = 1.07/1.17), leptin (g = 1.27/1.12), and adiponectin (g=0.82/0.88). LIMITATIONS The power to detect group*sex interactions was limited due to a greater number of females (than males) in the study, and over half of clinical participants were taking medications. CONCLUSIONS Individuals with MDD and MDD + GAD demonstrate difficulties in regulating eating behaviors, potentially contributing to functional impairment and increased disease burden.
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Affiliation(s)
| | | | | | - Tate Poplin
- Laureate Institute of Brain Research, Tulsa, OK, USA
| | | | - Martin P Paulus
- Laureate Institute of Brain Research, Tulsa, OK, USA; The University of Tulsa, Tulsa, OK, USA
| | - Maria Ironside
- Laureate Institute of Brain Research, Tulsa, OK, USA; The University of Tulsa, Tulsa, OK, USA
| | - Jennifer L Stewart
- Laureate Institute of Brain Research, Tulsa, OK, USA; The University of Tulsa, Tulsa, OK, USA.
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Acharya S, Satpathy A, Beura R, Datta P, Das U, Mahapatra P. Assessment of clinical depression in abdominally obese subjects with periodontal disease. Indian J Dent Res 2022; 33:120-125. [PMID: 36254945 DOI: 10.4103/ijdr.ijdr_780_18] [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] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Depression is a commonly prevailing condition that goes undetected in clinical settings. Both abdominal obesity and periodontal disease have a bearing on mental health and have an impact on the quality of life. OBJECTIVE To assess the level of clinical depression in abdominally obese subjects with periodontal disease. METHODS Two hundred and ten subjects with a mean age of 37.45 ± 9.59 years (males = 117; females = 93) were grouped as per their abdominal obesity and periodontal status and assessed for their clinical depression levels (mental health) using the Centre for Epidemiologic Studies-Depression Scale (CES-D). Collected data were analysed. RESULTS The clinical depression score significantly varied in subjects with different periodontal status in both non-obese (F (2,102) = 113.66, P < 0.0001) and abdominally obese subjects (F (2,102) = 132.04, P < 0.001). Significantly higher depression score was demonstrated in healthy (P < 0.001), gingivitis (P < 0.001), and periodontitis (P < 0.001) groups in abdominally obese subjects. CONCLUSION Clinical depression is significantly associated with abdominal obesity and periodontal disease in subjects with abdominal obesity and severe periodontal disease demonstrating higher depression scores.
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Affiliation(s)
- Sheetal Acharya
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Anurag Satpathy
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Rajdeep Beura
- Department of Periodontics, Hi Tech Dental College and Hospital, Bhubaneswar, Odisha, India
| | - Pratiti Datta
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Utkalika Das
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
| | - Pranab Mahapatra
- Department of Psychiatry, Kalinga Institute of Medical Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
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Effects of ear and body acupressure on labor pain and duration of labor active phase: A randomized controlled trial. Complement Ther Med 2020; 51:102413. [PMID: 32507430 DOI: 10.1016/j.ctim.2020.102413] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/02/2020] [Accepted: 04/16/2020] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES This study sought to compare the effects of multi-point ear and body acupressure on labor pain and the duration of labor active phase. DESIGN Three-armed randomized controlled trial. SETTING Kowsar Hospital, Qazvin, Iran. INTERVENTION Participants in the body acupressure group received acupressure on GB21, GB30, BL32, LI4, and SP6 points, each for two minutes, at cervical dilation of four, six, and eight centimeters. For participants in the ear acupressure group, adhesive auriculotherapy-specific Vaccaria seeds were attached to their auricles on the zero, genitalia, Shen Men, thalamic, and uterine 1 and 2 acupoints. The seeds were compressed every thirty minutes, each time for thirty seconds. Participants in the control group received routine care services. MAIN OUTCOME MEASURES Labor pain intensity was assessed using a visual analogue scale at cervical dilation of four and ten centimeters. RESULTS While there was no significant difference between mean scores of pain among three groups, mean score of labor pain in both acupressure groups was significantly less than that in the control group (P < 0.001). However, the difference between the acupressure groups was not statistically significant (P = 0.12). Moreover, the duration of labor active phase in the ear acupressure group was significantly less than those in the body acupressure and the control groups (P < 0.001). CONCLUSION Ear acupressure was significantly effective in reducing labor pain and shortening labor active phase. However, body acupressure solely reduces labor pain. Therefore, ear acupressure can be used to reduce labor pain and shorten labor active phase.
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Hadi S, Momenan M, Cheraghpour K, Hafizi N, Pourjavidi N, Malekahmadi M, Foroughi M, Alipour M. Abdominal volume index: a predictive measure in relationship between depression/anxiety and obesity. Afr Health Sci 2020; 20:257-265. [PMID: 33402914 PMCID: PMC7750042 DOI: 10.4314/ahs.v20i1.31] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Obesity is a risk factor for mood disorder (such as depression and anxiety). We aimed to assess application of A Body Shape Index (ABSI) and abdominal volume index (AVI), as new indices of obesity to evaluate the relationship between obesity and depression/anxiety. Methods This cross sectional study was conducted on 307 overweight and obese women (249 females, 58 males) 20–60 years in Iran in 2017–2018. The anthropometric measures including weight, waist circumference, hip circumference, body fat and derived values of body mass index, waist-hip ratio, AVI and ABSI were evaluated. HADS questionnaire for depression and anxiety completed. Results Prevalence of depression was 36.1% in women; men 24.1%; overweight 28.1%; obese 36.5 % and central obesity 33.7%. Anxiety was apparent in 27.1% of overweight 30.3 % obese and 29.6% central obesity. People with depression and anxiety had higher WC, BF and AVI. ABSI had no significant correlation with depression/anxiety. The odds of depression (1.06; 95% CI, 1.02–1.12) and anxiety (1.06; 95% CI, 1.01–1.11) were elevated with increase AVI. Conclusion Our results suggested that AVI as an indirect measure of abdominal obesity along with WC and BF could be useful in predicting the relationship between obesity and depression/anxiety.
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Azzolino D, Arosio B, Marzetti E, Calvani R, Cesari M. Nutritional Status as a Mediator of Fatigue and Its Underlying Mechanisms in Older People. Nutrients 2020; 12:E444. [PMID: 32050677 PMCID: PMC7071235 DOI: 10.3390/nu12020444] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/22/2022] Open
Abstract
Fatigue is an often-neglected symptom but frequently complained of by older people, leading to the inability to continue functioning at a normal level of activity. Fatigue is frequently associated with disease conditions and impacts health status and quality of life. Yet, fatigue cannot generally be completely explained as a consequence of a single disease or pathogenetic mechanism. Indeed, fatigue mirrors the exhaustion of the physiological reserves of an older individual. Despite its clinical relevance, fatigue is typically underestimated by healthcare professionals, mainly because reduced stamina is considered to be an unavoidable corollary of aging. The incomplete knowledge of pathophysiological mechanisms of fatigue and the lack of a gold standard tool for its assessment contribute to the poor appreciation of fatigue in clinical practice. Inadequate nutrition is invoked as one of the mechanisms underlying fatigue. Modifications in food intake and body composition changes seem to influence the perception of fatigue, probably through the mechanisms of inflammation and/or mitochondrial dysfunction. Here, we present an overview on the mechanisms that may mediate fatigue levels in old age, with a special focus on nutrition.
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Affiliation(s)
- Domenico Azzolino
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (B.A.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Beatrice Arosio
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (B.A.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (E.M.); (R.C.)
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, 00168 Rome, Italy; (E.M.); (R.C.)
- Institute of Internal Medicine and Geriatrics, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (B.A.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
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Ali S, Adamczyk L, Burgess M, Chalder T. Psychological and demographic factors associated with fatigue and social adjustment in young people with severe chronic fatigue syndrome/myalgic encephalomyelitis: a preliminary mixed-methods study. J Behav Med 2019; 42:898-910. [PMID: 30684123 DOI: 10.1007/s10865-019-00010-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 01/05/2019] [Indexed: 10/27/2022]
Abstract
This mixed-methods study investigated factors associated with fatigue, disability and school attendance in young people with severe CFS/ME. Participants' illness experiences were also explored. Questionnaires were completed at baseline (T1) and approximately 5 months later (T2). There were 51 participants aged between 12 and 25, with a mean age of 18.8 years (SD 3.4). At T1, participants reported severe fatigue and poor social adjustment. Stronger fear avoidance beliefs at T1 were associated with higher fatigue at T2, and with worse social adjustment at T1 and T2. Female gender was associated with lower work/school attendance at T1 and T2 but not with higher fatigue or worse social adjustment. Having accessed treatment was associated with reporting lower levels of work/school attendance at T1 and T2. Multivariate analyses of key outcomes identified significant associations between stronger fear avoidance beliefs and worse social adjustment at T2, and between female gender and lower work/school attendance at T2. It was clear from the qualitative data that severe CFS/ME negatively impacted on many aspects of young people's lives. Fearful beliefs about activity could be targeted using cognitive-behavioural interventions.
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Affiliation(s)
- Sheila Ali
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Lucy Adamczyk
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Mary Burgess
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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Abstract
We assessed the effect of body weight and BMI on plasma concentrations of venlafaxine (VEN), O-desmethylvenlafaxine (ODVEN), active moiety (AM=VEN+ODVEN), and dose-corrected plasma concentrations (C/D). A database containing concentrations of VEN and ODVEN including 737 of 1594 eligible patients was analyzed. Analyses included sex, body weight, and BMI as well as concentrations of VEN, ODVEN, AM, and C/D. A positive correlation was detected between body weight and daily dosage (rs=0.168, P<0.001). A negative correlation was found between body weight and AM (rs=-0.124, P=0.001) and ODVEN (rs=-0.137, P<0.001). Negative correlations were also found between body weight and C/D ratios (C/D VEN: rs=-0.134, P<0.001, C/D ODVEN: rs=-0.239, P<0.001, C/D AM: rs=-0.256, P<0.001). No correlations were detected between BMI and concentrations for VEN, ODVEN, and AM. Comparing low-BMI (<20 kg/m²), medium-BMI (20-29.9 kg/m²), and high-BMI (≥30 kg/m²) groups, higher values of some pharmacokinetic variables in the lower BMI group did not remain significant after controlling for sex. Women had higher VEN, ODVEN, AM, and C/D values for AM, VEN, and ODVEN than men (P<0.001 for all comparisons). Our results highlight the role of different pharmacokinetically relevant parameters and foremost of sex as mediators for the effect of BMI on VEN metabolism.
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Dimitrova TD, Reeves GM, Snitker S, Lapidus M, Sleemi AR, Balis TG, Manalai P, Tariq MM, Cabassa JA, Karim NN, Johnson MA, Langenberg P, Rohan KJ, Miller M, Stiller JW, Postolache TT. Prediction of outcome of bright light treatment in patients with seasonal affective disorder: Discarding the early response, confirming a higher atypical balance, and uncovering a higher body mass index at baseline as predictors of endpoint outcome. J Affect Disord 2017; 222:126-132. [PMID: 28692905 DOI: 10.1016/j.jad.2017.06.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 05/17/2017] [Accepted: 06/17/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND We tested the hypothesis that the early improvement in mood after the first hour of bright light treatment compared to control dim-red light would predict the outcome at six weeks of bright light treatment for depressed mood in patients with Seasonal Affective Disorder (SAD). We also analyzed the value of Body Mass Index (BMI) and atypical symptoms of depression at baseline in predicting treatment outcome. METHODS Seventy-eight adult participants were enrolled. The first treatment was controlled crossover, with randomized order, and included one hour of active bright light treatment and one hour of control dim-red light, with one-hour washout. Depression was measured on the Structured Interview Guide for the Hamilton Rating Scale for Depression-SAD version (SIGH-SAD). The predictive association of depression scores changes after the first session. BMI and atypical score balance with treatment outcomes at endpoint were assessed using multivariable linear and logistic regressions. RESULTS No significant prediction by changes in depression scores after the first session was found. However, higher atypical balance scores and BMI positively predicted treatment outcome. LIMITATIONS Absence of a control intervention for the six-weeks of treatment (only the first session in the laboratory was controlled). Exclusion of patients with comorbid substance abuse, suicidality and bipolar I disorder, and patients on antidepressant medications, reducing the generalizability of the study. CONCLUSION Prediction of outcome by early response to light treatment was not replicated, and the previously reported prediction of baseline atypical balance was confirmed. BMI, a parameter routinely calculated in primary care, was identified as a novel predictor, and calls for replication and then exploration of possible mediating mechanisms.
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Affiliation(s)
- Tzvetelina D Dimitrova
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Gloria M Reeves
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Division of Child & Adolescent Psychiatry, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Soren Snitker
- Division of Endocrinology, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Manana Lapidus
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Aamar R Sleemi
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Theodora G Balis
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Partam Manalai
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Muhammad M Tariq
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Johanna A Cabassa
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Naila N Karim
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Mary A Johnson
- Department of Ophthalmology and Visual Science, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Patricia Langenberg
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - Kelly J Rohan
- Department of Psychological Science, University of Vermont, Burlington, VT 05405-0134, United States
| | - Michael Miller
- Center for Preventive Cardiology, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States
| | - John W Stiller
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Psychiatry Residency Training Program, St. Elizabeths Hospital, Washington, DC 20032, United States; Department of Neurology, St. Elizabeths Hospital, Washington, DC 20032, United States
| | - Teodor T Postolache
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201-1549, United States; Rocky Mountain MIRECC, Denver, CO 80220, United States; VISN 5 MIRECC, Baltimore, MD 21201 United States.
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Woo YS, Seo HJ, McIntyre RS, Bahk WM. Obesity and Its Potential Effects on Antidepressant Treatment Outcomes in Patients with Depressive Disorders: A Literature Review. Int J Mol Sci 2016; 17:ijms17010080. [PMID: 26771598 PMCID: PMC4730324 DOI: 10.3390/ijms17010080] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 01/04/2016] [Indexed: 02/07/2023] Open
Abstract
Accumulating evidence regarding clinical, neurobiological, genetic, and environmental factors suggests a bidirectional link between obesity and depressive disorders. Although a few studies have investigated the link between obesity/excess body weight and the response to antidepressants in depressive disorders, the effect of weight on treatment response remains poorly understood. In this review, we summarized recent data regarding the relationship between the response to antidepressants and obesity/excess body weight in clinical studies of patients with depressive disorders. Although several studies indicated an association between obesity/excess body weight and poor antidepressant responses, it is difficult to draw definitive conclusions due to the variability of subject composition and methodological differences among studies. Especially, differences in sex, age and menopausal status, depressive symptom subtypes, and antidepressants administered may have caused inconsistencies in the results among studies. The relationship between obesity/excess body weight and antidepressant responses should be investigated further in high-powered studies addressing the differential effects on subject characteristics and treatment. Moreover, future research should focus on the roles of mediating factors, such as inflammatory markers and neurocognitive performance, which may alter the antidepressant treatment outcome in patients with comorbid obesity and depressive disorder.
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Affiliation(s)
- Young Sup Woo
- Department of Psychiatry, College of Medicine, the Catholic University of Korea, Seoul 07345, Korea.
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada.
| | - Hye-Jin Seo
- Department of Psychiatry, College of Medicine, the Catholic University of Korea, Seoul 07345, Korea.
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5T 2S8, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 2S8, Canada.
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, the Catholic University of Korea, Seoul 07345, Korea.
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Noh JW, Kwon YD, Park J, Kim J. Body mass index and depressive symptoms in middle aged and older adults. BMC Public Health 2015; 15:310. [PMID: 25884564 PMCID: PMC4383216 DOI: 10.1186/s12889-015-1663-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 03/19/2015] [Indexed: 01/21/2023] Open
Abstract
Background The relationship between weight problems and depression has been the focus of many studies; however, results from these studies vary. The purpose of this study is to describe the association between depression and BMI using data from a national sample of middle aged and older Koreans and to examine whether gender moderates the relationship between depression and weight. Methods We used data from the Korean Longitudinal Study of Aging (KLoSA). Of the 7,920 respondents that participated in KLoSA in 2010, 7,672 adults aged between 50 and 102 years were included in the final analysis. The relationship between depression and obesity status was examined in both the full sample and in sub-samples stratified by gender. The observed U-shaped association between obesity status and CES-D score was tested by regressing CES-D score on linear and quadratic terms of BMI scores. Results The distribution of CES-D scores by respondents’ obesity status (i.e., underweight, normal weight, overweight, obese and severely obese) showed a U-shaped association. Specifically, the highest CES-D scores were found in underweight individuals; this was followed by the severely obese and obese groups in the full sample and in gender-specific subsamples. The lowest CES-D scores were found in the overweight group when considering the entire population and males alone and in the normal weight group for females. This U-shaped association between CES-D and obesity status was confirmed by a model in which CES-D scores were regressed on BMI scores and other covariates. Conclusions This study found a U-shaped association between BMI and levels of depressive symptoms among adults in Korea overall and also within each gender. Specifically, the highest level of depressive symptoms was found among the underweight, followed by the severely obese and then the obese. Slightly different patterns between male and female adults were found regarding the weight status associated with the fewest depressive symptoms.
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Affiliation(s)
- Jin-Won Noh
- Department of Healthcare Management, Eulji University, Seongnam, Korea.
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, the Catholic University of Korea, Seoul, Korea.
| | - Jumin Park
- University of Maryland School of Nursing, Baltimore, MD, USA.
| | - Jinseok Kim
- Department of Social Welfare, Seoul Women's University, Rm. #721, Insa-Kwan Bldg., 126 Kongneung 2-Dong, Nowon-Ku, Seoul, Korea.
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Wanat KA, Kovarik CL, Shuman S, Whitaker RC, Foster GD, O'Brien MJ. The association between obesity and health-related quality of life among urban Latinos. Ethn Dis 2014; 24:14-18. [PMID: 24620443 PMCID: PMC4009345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES To examine differences in health-related quality of life (HRQL) by obesity status in a community-based sample of urban Latinos. To determine if sex moderates the relationship between HRQL and obesity status in this cohort. DESIGN, SETTING AND PARTICIPANTS Cross-sectional study of 202 foreign-born Latinos with low levels of acculturation, living in an urban setting. MAIN OUTCOME MEASURE Health-related quality of life by the Medical Outcomes Study Short-Form Health Survey (SF-12). METHODS Including the entire study cohort, t-tests were used to determine the unadjusted difference between obese and non-obese participants on SF-12 physical and mental functioning scores (PCS and MCS, respectively). Linear regression was used to estimate the adjusted difference in SF-12 scores between obese and non-obese participants after adjusting for potential confounders. The association between obesity status and HRQL summary scores were then assessed separately in men and women both with and without adjustment for potential confounders. RESULTS There was a small but statistically significant unadjusted difference between obese and non-obese participants in the physical functioning domain of HRQL (-2.2, 95% CI -4.0, -.4), which was no longer significant in multivariate analysis (difference -1.5, 95% CI -3.3, .3). There were no significant differences in mental functioning scores in unadjusted or adjusted analyses. Sex did not moderate the relationship between obesity status and HRQL scores in stratified analyses. CONCLUSIONS Our results in an under-studied population suggest that obesity may have little impact on HRQL in urban Latinos. Future studies with larger and more diverse Latino populations are needed to further investigate the relationship between obesity and HRQL, and explore how acculturation impacts the association between these two factors.
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Gaskin JL, Pulver AJ, Branch K, Kabore A, James T, Zhang J. Perception or reality of body weight: which matters to the depressive symptoms. J Affect Disord 2013; 150:350-5. [PMID: 23706878 DOI: 10.1016/j.jad.2013.04.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 04/19/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Failure to control for the confounding effects from body perceptions may contribute to the inconsistency of literature on the relationship between body weight and depression. The aim was to determine if perception mediates the associations between measured weight and depression. METHODS We analyzed the data of 13,548 adults age 18 or older, collected in the National Health and Nutrition Examination Survey, 2005-2008. Depression status was ascertained using the Patient Health Questionnaire; and the BMI was calculated from measured height and weight. RESULTS Among women, adjusting for perception weakened the relationship between measured weight and depression. The odds ratios (OR) of depression for being obese and overweight were 2.26 [95% confidence interval (1.50-3.40)] and 1.92 (1.29-2.85) before being adjusted for perception and 1.72 (1.01-2.92) and 1.62 (1.01-2.60) when perception was adjusted for. Independent from measured weight, women who perceived themselves as underweight [OR=2.95(1.47-5.14)] or overweight [1.73 (1.14-2.61)] had an increased odds of depression compared with women who perceived themselves as about the right weight. Among men, measured weight, neither overweight nor underweight, was associated with depression, perceiving oneself as underweight [OR=2.80 (1.42-5.54)] was associated with depression. LIMITATION The inherent limitation of the study's cross-sectional design prevented the authors from investigating causality. CONCLUSION Perception may be more important than measured weight in the relationship with depression. Independent from measured weight either perceived under or overweight among women, or underweight among men, appear to be significantly associated with depression.
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Affiliation(s)
- Jaynie L Gaskin
- Division of Epidemiology, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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Flores S, Brown A, Adeoye S, Jason LA, Evans M. Examining the Impact of Obesity on Individuals with Chronic Fatigue Syndrome. Workplace Health Saf 2013; 61:299-307. [DOI: 10.1177/216507991306100705] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 05/06/2013] [Indexed: 11/17/2022]
Abstract
Chronic fatigue syndrome (CFS) is a complex disorder affecting multiple body systems. The most commonly used definition of CFS is 6 or more months of fatigue and the presence of at least four of eight minor symptoms. In addition, many health and psychological conditions, including severe obesity–body mass index (BMI) of 40 kg/m2 or greater–exclude individuals from a diagnosis of CFS. Obesity has been correlated with fatigue, sleep problems, and less satisfaction with general health, functioning, and vitality. The current study investigated weight trends over time in a community-based sample of individuals with CFS and healthy controls. The study further investigated the impact of comorbid weight issues on several health and disability outcomes in a subset of overweight individuals. Overweight and obese individuals with CFS demonstrated poorer functioning than controls who were similarly weighted One participant was excluded because she had gained weight at a monitoring visit and her BMI was greater than 40 kg/m2. The implications of these findings for health care workers are discussed.
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Flores S, Brown A, Adeoye S, Jason LA, Evans M. Examining the impact of obesity on individuals with chronic fatigue syndrome. Workplace Health Saf 2013. [PMID: 23799656 DOI: 10.3928/21650799-20130617-12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Chronic fatigue syndrome (CFS) is a complex disorder affecting multiple body systems. The most commonly used definition of CFS is 6 or more months of fatigue and the presence of at least four of eight minor symptoms. In addition, many health and psychological conditions, including severe obesity-body mass index (BMI) of 40 kg/m(2) or greater-exclude individuals from a diagnosis of CFS. Obesity has been correlated with fatigue, sleep problems, and less satisfaction with general health, functioning, and vitality. The current study investigated weight trends over time in a community-based sample of individuals with CFS and healthy controls. The study further investigated the impact of comorbid weight issues on several health and disability outcomes in a subset of overweight individuals. Overweight and obese individuals with CFS demonstrated poorer functioning than controls who were similarly weighted. One participant was excluded because she had gained weight at a monitoring visit and her BMI was greater than 40 kg/m(2). The implications of these findings for health care workers are discussed.
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Meza C, Moral J. Modelos Recursivos de Índice de Masa Corporal con Variables Sociodemográficas, Funciones del Yo y Alteración Alimentaria en Mujeres Mexicanas. PSYKHE 2013. [DOI: 10.7764/psykhe.22.1.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Saiga M, Watanabe T, Yoshioka SI. Physical and mental factors associated with obesity in individuals with mental disorders attending psychiatric day-care facilities. Yonago Acta Med 2013; 56:1-6. [PMID: 24031145 PMCID: PMC3760492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 12/07/2012] [Indexed: 06/02/2023]
Abstract
BACKGROUND Individuals with mental disorders have increased rates of obesity and metabolic syndrome. Here we evaluated factors influencing obesity in individuals with mental disorders who were attending psychiatric day-care facilities on an outpatient basis. METHODS The subjects (n = 108) were outpatients attending hospital-based rehabilitation programs. We assessed body fat, weight, height, waist circumference, body mass index (BMI), blood pressure, Geriatric Depression Scale-15 (GDS) scores, frequency of day-care visits, satisfaction with body shape, physical comorbidity and lifestyle habits. Lifestyle habits were evaluated using Breslow's health index based on health-related choices. RESULTS The subjects were divided into 2 groups: obese group (BMI ≥ 25 kg/m(2)) and non-obese group (BMI < 25 kg/m(2)). The physical parameters and attributes of both groups were compared, and factors related to BMI were statistically analyzed. The prevalence of obesity was 47.2% in all patients, 42.4% in males and 54.8% in females. Weight, waist circumference, body fat and systolic and diastolic blood pressure were significantly higher in the obese group than in the non-obese group. Body fat, waist circumference, systolic blood pressure and diastolic blood pressure exhibited significant positive correlations with BMI, whereas the frequency of day-care visits, satisfaction with body shape, GDS score and Breslow's health index exhibited significant negative correlations with BMI. CONCLUSION The present results showed that the prevalence of obesity was high in outpatients with mental disorders. Improvement in lifestyle choices is necessary to prevent obesity and the onset of metabolic syndrome in such patients.
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Affiliation(s)
- Michiko Saiga
- Department of Nursing Care Environment and Mental Health, School of Health Science, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
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Brandheim S, Rantakeisu U, Starrin B. BMI and psychological distress in 68,000 Swedish adults: a weak association when controlling for an age-gender combination. BMC Public Health 2013; 13:68. [PMID: 23347701 PMCID: PMC3564918 DOI: 10.1186/1471-2458-13-68] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 01/11/2013] [Indexed: 11/23/2022] Open
Abstract
Background Study results concerning associations between body mass index (BMI) and psychological distress are conflicting. The purpose of this study was to describe the shape of the association between BMI and psychological distress in a large sample of Swedish adults. Methods Data was measured with the General Health Questionnaire-12 (GHQ-12), in 68,311 adults aged 18–74. Self-reported data was derived from a merger of the 2000, 2004 and 2008 Life and Health (Liv och Hälsa) questionnaires focusing general perceived distress as well as living conditions. Logistic regression analysis was used to describe the association between BMI and psychological distress when controlled for age and gender in combination. Results Women reported an overall higher psychological distress than men. A significant pattern of decreasing psychological distress with increasing age emerged among women in all BMI categories. Trends of this same pattern showed for men. Small or no differences were seen in psychological distress between those in normal weight, overweight, and obesity I categories (among women: 20.4%, 18.4%, 20.5%; among men: 12.8%, 11.2%, 12.9%). For both genders, any notable increase in psychological distress appeared first in the obesity II category (among women: 27.2%. Among men: 17.8%). Conclusions Psychological distress decreases with increasing age regardless of BMI; a pattern more obvious for women. Being categorized with obesity II leads to a markedly higher psychological distress than being categorized with normal weight, overweight or obesity I. From this, we suggest that future obesity research focusing on psychological distress could investigate the role of stigma and norm susceptibility in relationships where people are evaluated through the eyes of the other.
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Affiliation(s)
- Susanne Brandheim
- Department of Social and Psychological Studies, Karlstad University, Karlstad, SE 651 88, Sweden.
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Waist circumference, abdominal obesity, and depression among overweight and obese U.S. adults: National Health and Nutrition Examination Survey 2005-2006. BMC Psychiatry 2011; 11:130. [PMID: 21834955 PMCID: PMC3163524 DOI: 10.1186/1471-244x-11-130] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2010] [Accepted: 08/11/2011] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Obesity is associated with an increased risk of mental illness; however, evidence linking body mass index (BMI)-a measure of overall obesity, to mental illness is inconsistent. The objective of this study was to examine the association of depressive symptoms with waist circumference or abdominal obesity among overweight and obese U.S. adults. METHODS A cross-sectional, nationally representative sample from the 2005-2006 National Health and Nutrition Examination Survey was used. We analyzed the data from 2,439 U.S. adults (1,325 men and 1,114 nonpregnant women) aged ≥ 20 years who were either overweight or obese with BMI of ≥ 25.0 kg/m2. Abdominal obesity was defined as waist circumference of > 102 cm for men and > 88 cm for women. Depressive symptoms (defined as having major depressive symptoms or moderate-to-severe depressive symptoms) were assessed by the Patient Health Questionnaire-9 diagnostic algorithm. The prevalence and the odds ratios (ORs) with 95% confidence intervals (CIs) for having major depressive symptoms and moderate-to-severe depressive symptoms were estimated using logistic regression analysis. RESULTS After multivariate adjustment for demographics and lifestyle factors, waist circumference was significantly associated with both major depressive symptoms (OR: 1.03, 95% CI: 1.01-1.05) and moderate-to-severe depressive symptoms (OR: 1.02, 95% CI: 1.01-1.04), and adults with abdominal obesity were significantly more likely to have major depressive symptoms (OR: 2.18, 95% CI: 1.35-3.59) or have moderate-to-severe depressive symptoms (OR: 2.56, 95% CI: 1.34-4.90) than those without. These relationships persisted after further adjusting for coexistence of multiple chronic conditions and persisted in participants who were overweight (BMI: 25.0-< 30.0 kg/m2) when stratified analyses were conducted by BMI status. CONCLUSION Among overweight and obese U.S. adults, waist circumference or abdominal obesity was significantly associated with increased likelihoods of having major depressive symptoms or moderate-to-severe depressive symptoms. Thus, mental health status should be monitored and evaluated in adults with abdominal obesity, particularly in those who are overweight.
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Abstract
I investigated the association between depression and percent body fat, two major global problems. Participants are 1,704 American women, ages 39-49, who responded to a detailed self-administered mailed questionnaire. My results showed a positive correlation; the adjusted OR = 1.70, 95% CI (1.20, 2.39), p = .002. Percent body fat was estimated from age, height, and weight, a cost-free method that may be useful in areas in which dual energy X-ray absorptiometry, or other procedures are too costly or unavailable. My findings may aid health and mental health care providers in the management and treatment of patients seen in settings with limited resources.
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Affiliation(s)
- Grace Wyshak
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115, USA.
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Ludman E, Simon GE, Ichikawa LE, Operskalski BH, Arterburn D, Linde JA, Jeffery RW, Rohde P, Finch EA. Does depression reduce the effectiveness of behavioral weight loss treatment? Behav Med 2010; 35:126-34. [PMID: 19933059 DOI: 10.1080/08964280903334527] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Limited evidence suggests that depression is associated with poorer outcomes in behavioral weight loss programs; however, people with major depression are typically excluded from weight loss intervention trials. This study examined the effect of depression on women's participation and weight loss in behavioral treatment. Non-treatment seeking obese women over 40 years of age with major depressive disorder (MDD, n = 65) and without MDD (n = 125) were recruited into a 26-session group intervention. Primary analyses compared participants' mean weight change from baseline to 6 and 12 months; at 6 months, women with MDD lost a mean of 3.8 kg vs 4.3 kg for women without MDD (t = 0.54, p = .59). At 12 months, women with MDD lost 3.0 kg and women without MDD lost 3.6 kg (t = 0.44, p =.66). Women who attended at least 12 treatment sessions lost more weight than women who attended fewer sessions, regardless of depression status (ie, there was no significant interaction between depression and session attendance). Results suggest that depression should not be an exclusion criterion for weight loss intervention programs.
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Affiliation(s)
- Evette Ludman
- Group Health Research Institute, Group Health Cooperative, 1730 Minor Ave, Suite 1600, Seattle, WA 98101, USA.
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Uher R, Mors O, Hauser J, Rietschel M, Maier W, Kozel D, Henigsberg N, Souery D, Placentino A, Perroud N, Dernovsek MZ, Strohmaier J, Larsen ER, Zobel A, Leszczynska-Rodziewicz A, Kalember P, Pedrini L, Linotte S, Gunasinghe C, Aitchison KJ, McGuffin P, Farmer A. Body weight as a predictor of antidepressant efficacy in the GENDEP project. J Affect Disord 2009; 118:147-54. [PMID: 19269691 DOI: 10.1016/j.jad.2009.02.013] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Revised: 02/19/2009] [Accepted: 02/19/2009] [Indexed: 11/30/2022]
Abstract
BACKGROUND Being overweight or obese may be associated with poor response to antidepressants. The present report explores the moderation of antidepressant response by body weight to establish the specificity to antidepressant mode of action, type of depressive symptoms and gender. METHODS Height and weight were measured in 797 men and women with major depression treated with escitalopram or nortriptyline for twelve weeks as part of the Genome Based Therapeutic Drugs for Depression (GENDEP) project. Body mass index (BMI) and obesity (BMI>30) were tested as predictors of change in depressive symptoms using mixed linear models. RESULTS Higher BMI and obesity predicted poor response to nortriptyline but did not significantly influence response to escitalopram. The moderation of response by body weight was due to differential improvement in neurovegetative symptoms, including sleep and appetite. The relationship between body weight and change in neurovegetative symptoms was moderated by gender with obese men responding less to nortriptyline and obese women having poorer response to both antidepressants. LIMITATIONS As no placebo arm was included, the specificity of findings to antidepressants is relative. Lack of specific measures precluded accounting for differences in body fat distribution. CONCLUSIONS Body weight should be considered in the assessment of depression as it may inform the selection of antidepressant treatment.
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Affiliation(s)
- Rudolf Uher
- Institute of Psychiatry, King's College London, United Kingdom.
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Valentine RJ, McAuley E, Vieira VJ, Baynard T, Hu L, Evans EM, Woods JA. Sex differences in the relationship between obesity, C-reactive protein, physical activity, depression, sleep quality and fatigue in older adults. Brain Behav Immun 2009; 23:643-8. [PMID: 19133324 DOI: 10.1016/j.bbi.2008.12.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2008] [Revised: 12/01/2008] [Accepted: 12/04/2008] [Indexed: 12/14/2022] Open
Abstract
Fatigue is a serious health concern in the elderly. Sex differences exist in adiposity, systemic inflammation, physical activity/fitness and fatigue; however, the relations among these variables remain inadequately characterized impeding the development of fatigue prevention strategies. Measures of adiposity, C-reactive protein, physical activity, aerobic fitness, fatigue, sleep quality and depression were obtained from 127 community-dwelling older adults. Although similar in age (70 y) and BMI (28.0kg/m(2)) women (n=80) reported 63% greater fatigue than men (p=0.04). Adiposity (r=0.44), CRP (r=0.29), physical activity (r=-0.26) and fitness (r=-0.41) were related to fatigue in women (all p<0.05), but not in men. Depression was also related to fatigue in women (r=0.37), and was the only variable related to fatigue in men (r=0.42). In women, fatigue was independently explained (all p<0.05) by CRP (6.6%), depression (6.3%), physical activity (5.8%), and adiposity (3.9%); however, in men, only depression explained variance in fatigue (12.0%). CRP was 40% higher and adiposity 12% higher in women reporting fatigue compared to those with no fatigue; no such differences existed in men. Obese women perceived a greater degree of fatigue than non-obese women, but this was not the case in men. Women report more fatigue than men which was independently associated with inflammation, depression, physical activity and adiposity, whereas in men the only independent predictor was depression. Strategies to prevent fatigue may differ in older women and men, especially with regard to inflammation, physical activity and adiposity.
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Affiliation(s)
- Rudy J Valentine
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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Boutin-Foster C, Rodriguez A. Psychosocial Correlates of Overweight or Obese Status in Latino Adults with Coronary Artery Disease. J Immigr Minor Health 2008; 11:359-65. [DOI: 10.1007/s10903-008-9167-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Accepted: 06/26/2008] [Indexed: 11/29/2022]
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