The relationship between psychological distress and weight maintenance in weight cycling: mediating role of eating behavior

BACKGROUND

Obesity is a global public health concern. The goal of this study was to see if eating habits could mediate the relationship between psychological distress and weight maintenance in a population with a history of weight cycling.

METHODS

A 3-month outpatient intervention consisting of a diet and exercise program was provided to 153 participants. Psychological distress, appetite, and behavior were assessed at the beginning and end of the study. Anthropometric measurements were taken at baseline and six months.

RESULTS

After the structural equation model was developed, it was discovered that the psychological status of people with obesity and weight cycling histories correlated with the weight loss outcome effect (three and six months). This effect was mediated by factors related to eating behavior. Associative psychological factors had a direct effect on eating behavior (three months: β = 0.181, 95% CI: 0.055-0.310; six months: β = 0.182, 95% CI: 0.039-0.332) and appetite had a direct effect on eating behavior (three months: β = 0.600, 95% CI: 0.514-0.717; six months: β = 0.581, 95% CI: 0.457-0.713), both of which were significant (p < 0.01). At three months, psychological distress has a more substantial positive impact on weight change, with eating behavior acting as a partial mediator. At six months, there was no support for appetite's moderating role in eating behavior.

CONCLUSIONS

The findings suggest that psychological interventions should be strengthened to improve weight loss effectiveness, particularly in participants with a history of weight cycling, making weight loss more complicated and prone to rebound.

CLINICAL TRIAL REGISTRATION

The study has been registered in Clinical Trials (NCT05311462).

Cognitive-adaptive Functioning Gap and Mediating Factors that Impact Adaptive Functioning in Chinese Preschool-aged Children with Autism Spectrum Disorder

This study aimed to investigate the gap between adaptive functioning and cognitive functioning, especially verbal and nonverbal intelligence quotient (IQ) in Chinese children with ASD. We systematically explored cognitive functioning, ASD severity, early signs of developmental abnormalities, and socioeconomic factors as mediating factors of adaptive functioning. We enrolled 151 children (age: 2.5?6 years) with ASD and categorized them into one group with IQ ≥ 70 and another with IQ < 70. The two groups were calibrated for age, age at diagnosis, and IQ, and the relationship of adaptive skills with vocabulary acquisition index (VAI) and nonverbal index (NVI) were separately analyzed. Results show that the gap between IQ and adaptive functioning was significant in children with ASD having IQ ≥ 70, with both VAI and NVI showing statistically significant differences (all P < 0.001). VAI correlated positively with scores for overall adaptive skills and specific domains, whereas NVI had no significant correlations with adaptive skill scores. Age of first walking unaided had an independent positive correlation (all P < 0.05) with scores of adaptive skills and specific domains. IQ-adaptive functioning gap is significant in children with ASD having IQ ≥ 70, suggesting that defining "high-functioning autism" merely on the basis of IQ is not appropriate. Verbal IQ and early signs of motor development are specific and possible predictors of adaptive functioning in children with ASD, respectively.

The relationship between big five personality traits, coping strategies, and emotional problems through the COVID-19 pandemic

Considering the impact of pandemic condition on mental health and functioning in daily life, the main purpose of this study was to investigate the relationship between Big Five personality traits, coping strategies and emotional problems such as symptoms of depression and anxiety, during the COVID-19 pandemic period. Specifically, the purpose of this study is to create a model of the impact of coping strategies as mediating factors in the relationship between Big Five personality traits personality traits and emotional problems. For the purposes of this study, a sample of 200 Kosovar respondents was used, where the age of the participants varies from 18 to 54 years. As a result of the pandemic situation created, the method of data collection for this study was done in the form of self-reporting, divided into physical questionnaires and online ones. The BFI Personality Inventory is used to classify Big Five personality traits, the Coping Control Checklist (WCCL) to classify coping strategies, and the Adult Self-Reporting Questionnaire (ASR) used to identify emotional problems. The analysis of the results in this study was done by means of the statistical package of SPSS and R program. After the analysis, it is seen that there is a significant correlation between Big Five personality traits (extraversion and neuroticism) and coping strategies (seeking social support and avoidance), as well as there is a correlation between Big Five personality traits (compliance and neuroticism) and emotional problems (symptoms of anxiety and depression). An association was also found between coping strategies (avoidance) and emotional problems (anxiety symptoms). As for gender differences in experiencing anxiety and depression symptoms and using desired thoughts as coping strategies, it was found that women are more predisposed to experience anxiety symptoms and use desired thoughts than men. The findings highlighted the part that coping strategies are significant mediator factors in the relationship between Big Five personality traits and emotional problems.

Nut consumption, risk of cardiovascular mortality, and potential mediating mechanisms: The Women's Health Study

BACKGROUND

The link between nut consumption and cardiovascular (CV) mortality remains unclear.

OBJECTIVE

to examine whether nut consumption is associated with CV mortality and estimate the proportion of reduced risk of CV mortality explained by intermediate factors.

METHODS

We studied 39,167 women from the Women's Health Study; 28,034 provided blood samples. Nut consumption was self-reported at baseline and at follow-up using a food frequency questionnaire. Our primary outcome was cardiovascular death, which was ascertained via medical records, confirmed with the national death index and death certificates.

RESULTS

During a mean follow-up of 19 years, 959 CV deaths occurred. In a multivariable Cox regression model adjusting for age, body mass index, smoking, alcohol use, physical activity, postmenopausal status, marital status, family history of premature myocardial infarction and the alternate healthy eating index score, hazard ratios for CV mortality were 0.93 (0.76-1.14) for nut consumption of 1-3 times/month, 0.84 (0.69-1.01) for nut intake of 1 time/week, and 0.73 (0.61-0.87) for nut consumption of ≥2 times/week when compared to women who did not consume nuts (p = 0.0004). LDL and total cholesterol accounted for about 19%, HbA1c 18% and all mediating factors together accounted for about 6.6% of the lower risk of CV mortality for those who consumed nuts ≥2 times/week. For the secondary outcome of CV events, although the effect was noted to be in the same direction with increasing nut consumption associated with lower risk of CV events, it was not statistically significant (p = 0.07).

CONCLUSION

This study suggests that nut consumption is inversely associated with cardiovascular mortality in women. Lipids, inflammatory markers and glucose metabolism account for a modest proportion of the lowered CV mortality observed with nut consumption, assuming a causal nut-CV mortality association.

Early symptomatic improvement affects treatment outcome in a study of major depressive disorder

Early symptomatic improvement immediately following randomization can affect signal detection in clinical trials. The impact of early improvement of the Montgomery-Asberg depression rating scale (MADRS) on eventual treatment outcome was examined in a 6-week, double-blind, placebo-controlled trial of a putative antidepressant (CX157) versus placebo in depressed subjects with major depressive disorder (MDD) who had had an inadequate response to ongoing antidepressant treatment (NCT00739908). MADRS score changes within one week after randomization directly affected treatment outcome at the study endpoint (week 6). The response and remission rates at week 6 increased significantly as the percent of MADRS score improvement increased between baseline and week 1 regardless of treatment assignment. Less MADRS improvement or actual worsening within the first week after randomization was associated with minimal overall MADRS score changes by week 6 in either treatment assignment. Alternatively, CX157 assigned subjects who had ≥30% improvement by week 1 achieved a significantly greater treatment response rate than the matched placebo group at the study endpoint (p = 0.025) that converted the lack of signal detection in the mITT population. This post-hoc analysis highlights the potent effect that early symptomatic improvement immediately following randomization can have on treatment outcome, and is particularly relevant for antidepressant drugs with rapid onset of action. The findings compel further exploration of possible moderating and mediating factors, including the experimental condition itself that can influence early response, and the need to identify "bio-types" within the population of MDD subjects.

Neo-Marxian social class inequalities in self-rated health among the employed in South Korea: the role of material, behavioral, psychosocial, and workplace environmental factors

BACKGROUND

The aim of this study was to examine the pattern of social inequality in self-rated health among the employed using the Wright's social class location indicator, and to assess the roles of material, behavioral, psychosocial, and workplace environmental factors as mediating factors in explaining the social class inequality in self-rated health in South Korea.

METHODS

This study used data from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Study subjects included the employed population of 4392 men and 3309 women aged 19-64 years. Subjects were classified into twelve social class positions based on the Wright's social class map. The health outcome was self-rated health. Material, psychosocial, behavioral, and workplace environmental factors were considered as potential mediators in explaining social class health inequality. We calculated prevalence ratios of poor self-rated health according to social class, adjusted for age and mediating factors using Poisson regression models.

RESULTS

Nonskilled workers and petty bourgeoisie reported worse self-rated health than other social classes among men. The age-adjusted prevalence of petty bourgeoisie and nonskilled workers were about four-fold greater than that of managers. Expert supervisors in the contradictory class location had a greater prevalence of poor self-rated health than experts in men. In women, the prevalence of poor self-rated health was greater in most social classes than their male counterparts, while the differences among social classes within women were not statistically significant. Workplace environmental factors explained the social class inequality by from 24 to 31% in nonskilled and skilled workers and nonskilled supervisors, respectively, and material factors showed an explanatory ability of about 8% for both nonskilled workers and petty bourgeoisie in men.

CONCLUSIONS

We showed the inequality in self-rated health according to the Wright's social class in an industrialized Asian country. Policy efforts to improve workplace environments in nonskilled and skilled workers and nonskilled supervisors would have a moderate effect on reducing the magnitude of social class inequality in self-rated health. Furthermore, the means to improve power relations in the workplace should be devised to further reduce the social class inequalities in health.