Obesity, food insecurity, and depression among females

Delivering the National Diabetes Prevention Program: Assessment of Retention, Physical Activity, and Weight Loss Outcomes by Participant Characteristics and Delivery Modes

Type 2 diabetes disproportionately affects older adults, persons from racial and ethnic minority groups, and persons of low socioeconomic status. It can be prevented or delayed through evidence-based interventions such as the National Diabetes Prevention Program (National DPP) lifestyle change program (LCP). This analysis is aimed at evaluating the outcomes (i.e., retention, physical activity, and weight loss) associated with participation in the National DPP LCP by participant characteristics and delivery mode (i.e., in-person, online, distance learning, and combination) using the 2012-2018 Diabetes Prevention Recognition Program (DPRP) data. Across all delivery modes, there were generally no substantial differences in retention between male and female participants, but male participants tended to have higher physical activity and weight loss (e.g., average weight loss for in-person delivery: 5.0% for males and 4.3% for females). Older participants had better retention rates than younger participants in all delivery modes and mostly higher physical activity and weight loss except for distance learning delivery (e.g., average weight loss for in-person delivery: 5.1% for those aged 65+ and 3.3% for those aged 18-34). Among the seven racial and ethnic groups studied, retention was generally highest for non-Hispanic/Latino (NH)-White participants and lowest for Hispanic/Latino participants. Physical activity varied by racial and ethnic groups and delivery mode. NH-White participants generally had the most weight loss except for distance learning delivery, and NH-Black/African American participants had the least (e.g., average weight loss for in-person delivery: 5.1% for NH-White participants, 3.3% for both NH-Black/African American and NH-American Indian/Alaska Native participants, and other racial and ethnic minority groups ranged from 3.4% to 4.9%). Monitoring and identifying disparities across demographics and delivery modes, particularly across multiple racial and ethnic groups, provides information that can be used to improve the implementation of the National DPP LCP by tailoring the intervention to reduce disparities.

Childhood migration experience and adult health: evidence from China's rural migrants

BACKGROUND

Place of residence plays an influential role in shaping individual development, and studies have established links between Childhood migration experience (CME) and health outcomes through maturity. Over the past three decades, China has undergone one of the largest rural-to-urban migrations, however, little is known about the effect of CME on rural migrants' adult health in China.

METHODS

Data from 7035 members of the 2016 and 2018 China Labor-force Dynamics Survey were analyzed. CME was measured by whether the place of residence and place of birth changed at the age of 14 years. Three measures of health (self-assessed health, BMI, and mental health scale) were obtained. Causal inferential analysis was performed, using the Probit model, the OLS model and the Propensity Score Matching (PSM) method, to explore the impact of CME on the adult health of rural migrants.

RESULTS

Overall, compared to individuals who did not migrate in childhood, the probability of reporting "very unhealthy", "rather unhealthy", and "fair" in the self-assessed health of the rural migrants with CME decreased by 0.23%, 1.55%, and 5.53%, the probability of reporting "healthy" and "very healthy" increased by 1.94% and 5.38%, the probability of BMI within the normal range was higher by 7.32%, and the mental health test scores were 0.2591 points higher significantly. Furthermore, in comparison with childhood non-migration, both cross-county and cross-city migration promoted the health status of rural migrants, but the positive effect of cross-province migration was not significant; from the gender perspective, CME could more dramatically improve rural women's adult health than men, especially in mental health.

CONCLUSION

CME can significantly improve adult health, including physical and mental health, and the positive effect is more obvious among women, helping to reduce gender differences in health. For the migration distance, attention can be focused on the long-distance migrating individuals, who should get more support.

Associations between adiposity measures and depression and well-being scores: A cross-sectional analysis of middle- to older-aged adults

BACKGROUND

Obesity and mental health are significant global health concerns. Evidence has linked increased adiposity with depression and well-being; however, there is limited documented evidence in Ireland. Research also suggests lifestyle factors and disease conditions to be related to mental health. These may modulate relationships between adiposity and depression and well-being.

METHODS

This was a cross-sectional study of 1,821 men and women aged 46-73 years, randomly selected from a large primary care centre. Depression and well-being were assessed using the 20-item Centre for Epidemiologic Studies Depression Scale (CES-D) and the World Health Organization-Five (WHO-5) Well-Being Index. Linear regression analyses were performed to examine relationships between mental health scores (dependent variable) and adiposity (independent variable) defined using body mass index (BMI) and waist-height ratio while adjusting for demographic characteristics, lifestyle factors and disease conditions.

RESULTS

BMI and waist-height ratio had a significant positive association with depression scores and a significant inverse association with well-being scores in males and females. These associations were maintained following adjustment for demographic variables and lifestyle factors. In final models where disease conditions were adjusted for, BMI (β = 0.743, p < .001) and waist-height ratio (β = 0.719, p < .001) associations with the CES-D score remained significant. In stratified analyses, relationships between measures of adiposity and depression were found to be stronger in females (BMI: β = 0.806, p = .007; waist-height ratio: β = 0.768, p = .01) than males (BMI: β = 0.573, p = .049; waist-height ratio: β = 0.593, p = .044) but no effect modification was identified.

CONCLUSIONS

These findings suggest that increased adiposity is significantly associated with poorer mental health, independent of lifestyle factors and disease conditions. Targeted interventions for reducing depression should include better population-level weight management measures.

Exploring the Relationship between Mood Disorders and Coexisting Health Conditions: The Focus on Nutraceuticals

Major depressive disorder and bipolar disorder are the leading causes of global disability. Approximately 50% of patients fail to attain remission, prompting a pronounced focus on the significance of dietary patterns and specific nutrients within the pathophysiology of mood disorders. The connection between chronic diseases and mood disorders follows a bidirectional pattern: physical ailments are interrelated with affective disorders, and, concurrently, mood symptoms often precede chronic diseases and have the potential to worsen their prognosis. Nutraceuticals affect factors that could potentially impact the onset of mood disorders: monoamines and brain-derived neurotrophic factor (BDNF) concentrations, neuroinflammation, oxidative stress, and sleep quality. Furthermore, mood disorders rarely manifest in isolation. Typically, such patients concurrently experience other mental disorders or somatic comorbidities: obesity, hypertension, diabetes, polycystic ovary syndrome (PCOS), etc., where providing nutritional support is also pertinent. To optimize the therapeutic approach for individuals with mood disorders, incorporating nutritional support may not solely ameliorate symptoms stemming directly from the mental condition, but also indirectly through interventions targeting comorbidities.

Obesity in Adolescents: Understanding the Combined Role of Food Security and Emotional and Behavioral Disorders

PURPOSE

To examine the associations and interactions between levels of food security and emotional and behavioral disorders with obesity in adolescents.

METHODS

Multiple logistic regression modeling was used to analyze the association of adolescent obesity with levels of food security and emotional and behavior disorders in children aged 12-17 years using data from National Health Interview Survey 2016-2018 combined years. Presence of emotional and behavioral disorders within food security categories was added to logistic regression modeling to examine interactions.

RESULTS

When added individually to multiple logistic regression models, marginal and low food security, Attention Deficit Hyperactivity Disorder (ADHD) and anxiety were associated with increased odds of obesity, but very low food security and depression were not. Within the group of adolescents with very low food security, those with anxiety, depression, or ADHD had a nearly two to three-fold increase in odds of obesity compared to adolescents with very low food security and no emotional and behavioral disorders. A similar increase in the odds of obesity with the presence of anxiety, depression, or ADHD was not seen in the adolescents with high food security.

DISCUSSION

This study finds a significant interaction between food security level and emotional and behavioral disorders. The distinction that very low food security in adolescents is only associated with obesity when either anxiety, depression or ADHD are present, but not independently, is an important contribution to understanding complex interactions contributing to obesity.

Association of Dietary Inflammatory Index With Depression and Suicidal Ideation in Older Adult: Results From the National Health and Nutrition Examination Surveys 2005-2018

BACKGROUND

The relationship between diet and psychological disorders in older adults has attracted considerable attention as the global trend of aging. This study examines the relationship between Dietary inflammatory index (DII) and the risk of depression and suicide in older adults using the National Health and Nutrition Examination Survey (NHANES) as a large cross-sectional study.

METHODS

The data were extracted from NHANES from 2005 to 2018, and cross-sectional studies were conducted on older adults (age ≥ 60 years). According to their median DII, participants were classified into High-DII (DII ≥ 1.23) and Low-DII (DII < 1.23) groups. Depression was the primary outcome, and suicidal ideation was a secondary outcome. Utilizing multi-factor logistic regression to correlate DII with outcomes.

RESULTS

There were 10,956 elderly participants included in the analysis. In comparison to Low-DII group, High-DII group exhibited a higher rate of depression (8.9% vs. 6.7%; P < 0.001) and higher ideation to commit suicide (3.7% vs. 3.0%; P = 0.039). Moreover, in terms of gender ratio, men accounted for 44% of the High-DII group, which was significantly lower than 56.2% of the Low-DII group (P < 0.001). Furthermore, logistic regression revealed that High-DII group had a higher risk of depression in the previous 2 weeks (OR = 1.358, 95% CI: 1.180-1.564; P < 0.001) and a higher risk of suicidal ideation (OR = 1.244, 95% CI: 1.010-1.532; P = 0.040). Additionally, after adjusting for demographic covariates such as age, gender and race, High-DII group still had a higher risk of depression (OR = 1.293, 95% CI: 1.121-1.493; P < 0.001) and suicidal ideation (OR = 1.261, 95% CI: 1.021-1.55; P = 0.031). Furthermore, after adjusting for various covariates like demographic, social factors, and comorbidities, the High-DII group remained at higher risk for depression (OR = 1.178, 95% CI: 1.019-1.363; P = 0.027), and the risk of comorbid suicidal ideation remained high (OR = 1.136, 95% CI: 0.917-1.408), but the difference was not significant (P = 0.243).

CONCLUSION

In older adults, high levels of DII are associated with depression and suicidal ideation. Multiple factors affect the mental health of older adults, and it is unknown to what extent a pro-inflammatory diet contributes to depression and suicidal thoughts in older adults. Nonetheless, daily dietary management in older adults should be emphasized.

Depression mediates the links between climacteric symptoms and food and nutritional insecurity

OBJECTIVE

This study is perhaps the first to evaluate the influence of depression on the relationship between climacteric symptoms and food and nutritional insecurity (FNI).

METHODS

In this cross-sectional study with a relatively large sample of climacteric women (N = 400), sociodemographic and clinical variables were investigated. We measured FNI, depression and climacteric symptoms with psychometrically sound instruments, namely the Brazilian Food Security Scale, the Center for Epidemiologic Studies Depression Scale and the Kupperman Index, respectively.

RESULTS

Statistically significant differences were observed in the means of FNI according to education, income, marital status, history of depression, use of antidepressants and current depression. Furthermore, depression had strong indirect effects on the relationship between climacteric symptoms and FNI.

CONCLUSION

Our study suggests that targeting depression could benefit climacteric women, especially those with severe symptoms and in FNI.