Depressive symptoms are associated with dietary intake but not physical activity among overweight and obese women from disadvantaged neighborhoods

Evidence suggests that depressive symptoms are associated with poorer dietary intake and inadequate physical activity; however, this association has not been examined in lower-income overweight and obese African American women. The objective of this cross-sectional study was to examine the associations between depressive symptoms and diet and physical activity in 196 women (87% African American; age, 25-51 years). Higher depressive symptoms were hypothesized to predict poorer diet quality, greater emotional eating, lower physical activity levels, and greater sedentary time. Depressive symptoms were measured using the validated short form of the Center for Epidemiological Studies Depression Scale. Dietary intake and quality were assessed using three 24-hour dietary recalls. Emotional eating was evaluated using 4 items from the emotional eating subscale of the Eating Behavior Patterns Questionnaire. Physical activity and sedentary time were objectively measured using the ActiGraph accelerometer. Linear regression models tested the associations between depressive symptoms and each dietary and physical activity outcome variable. Symptoms of depression were positively associated with total daily caloric intake from saturated fat and total sugars, as well as emotional eating scores (P < .05). Although not statistically significant, depressive symptoms were positively associated with sweetened beverage consumption (P = .06) and added sugars (P = .07). Depressive symptoms were not associated with total fat, sodium, fruit and vegetables, fast food consumption, the Alternate Healthy Eating Index score, moderate-to-vigorous physical activity, or sedentary time. Future studies should explore the mechanisms linking the identified associations between depressive symptoms and dietary intake, such as the role of emotional eating.     

Home environments,physical activity,and energy expenditure among low-income overweight and obese women

Ecologic models of physical activity identify multiple environmental domains that influence activity levels, including the home. This study examined aspects of the home environment associated with objective measures of physical activity in overweight and obese women. Study participants were recruited through three federally qualified health centers in rural southwest Georgia as part of a randomized controlled trial of a home-environment-focused weight gain prevention intervention. Data collected from February 2011 to December 2012 were from 301 participants who completed baseline interviews and wore accelerometers for 7 days. Most were African American (83.4%) and obese (50.5%) or morbidly obese with body mass index ≥40 (35.6%). Mean age was 50.6 years. Participants were highly sedentary, with 7.9 hours of non-sedentary time per week, primarily in light activity. In a multivariate model, exercise equipment (p = .03), family support (p = .02), and full-time employment (p = .03) were positively associated with non-sedentary time, whereas age (p = .003), living in a more rural area (p = .03), and having an exercise space (p = .01) were negatively associated. Home environments may be promising targets for programs aimed at increasing activity levels among overweight and obese women.     

Acculturation,physical activity,and obesity among Hispanic adolescents

Objective. Little is known about how acculturation may influence participation in leisure-time physical activity and obesity among adolescents. The objective of this study was to examine these associations among Hispanic adolescents.

Design. Data were drawn from the 2003 National Survey of Children's Health, restricted to Hispanic adolescents aged 10–17 (n=4704). Acculturation was assessed by proxy measures (generation status and language spoken at home). Adolescents who were not reported to engage in physical activity lasting at least 20 minutes, that was vigorous enough to cause sweating and hard breathing, for at least three days per week were defined as failing to meet physical activity requirements. Obesity was defined as gender and age-specific body mass index values at or above the 95th percentile of the reference population. Multiple logistic regressions were performed to adjust for confounders.

Results. Of the Hispanic adolescents studied, 25.2%, 43.8%, and 31.1% were first, second, and third generation or more, respectively. English was the primary language in the home for 42.8% of these adolescents. Compared with adolescents in the third generation, adolescents from immigrant families had higher odds for not obtaining recommended physical activity (first generation: adjusted odds ratio [AOR] = 1.50, 95% conference intervals [CI]: 1.09, 2.05; second generation: AOR = 1.29, 95% CI: 0.99, 1.69). Living in homes where English was not the primary language, vs. English-speaking homes, was also associated with not obtaining recommended physical activity (AOR = 1.36, 95% CI: 1.06, 1.75). The unadjusted prevalence of obesity was higher in homes where English was not the primary language (22.5% vs. 16.1%; p<0.01), but this difference disappeared after adjusting for family socioeconomic status. Generational status was not a significant correlate of obesity.

Conclusions. Findings suggest that future public health interventions that aim to increasing physical activity among Hispanic adolescents should be tailored based on generational status and English-language use.     

The impact of a randomized dietary and physical activity intervention on chronic inflammation among obese African-American women

ABSTRACT

Lifestyle interventions may reduce inflammation and lower breast cancer (BrCa) risk. This randomized trial assessed the impact of the Sistas Inspiring Sistas Through Activity and Support (SISTAS) study on plasma C-reactive protein (CRP), interleukin-6 (IL-6) and Dietary Inflammatory Index (DII). This unblinded, dietary and physical activity trial was implemented in 337 obese (body mass index [BMI] ≥30 kg/m²) African American (AA) women recruited between 2011 and 2015 in South Carolina through a community-based participatory approach with measurements at baseline, 3 months, and 12 months. Participants were randomized into either intervention (n = 176) or wait-list control group (n = 161). Linear mixed-effect models were used for analyses of CRP and IL-6. Baseline CRP was significantly higher in those with greater obesity, body fat percentage, and waist circumference (all p <.01). No difference was observed between groups for CRP or IL-6 at 3 or 12 months; however, improvements in diet were observed in the intervention group compared to the control group (p = .02) at 3 months but were not sustained at 12 months. Although the intervention was not successful at reducing levels of CRP or IL-6, a significant decrease was observed in DII score for the intervention group, indicating short-term positive dietary change.     

Exploring the linkage between greenness exposure and depression among Chinese people: Mediating roles of physical activity,stress and social cohesion and moderating role of urbanicity

Although a plethora of studies have investigated the association between green exposure and mental health in developed countries, it is only recently that academics and policymakers have paid attention to how this association works in rapidly urbanizing and developing countries. This study aims to explore biopsychosocial pathways linking residential greenness exposure to depression in the Chinese context using data from the 2016 wave of China Labour-force Dynamics Survey. Results from multilevel models along with mediation analysis show that exposure to residential greenness is negatively associated with depression, and that physical activity, stress and neighbourhood social cohesion altogether have a complete mediation effect on this association. Results from moderation analysis suggest that urbanicity moderates the relationship between greenness exposure and depression, and that the relationship is strongest at the upper level of urbanicity. Our findings suggest the necessity of increasing the provision of recreational green spaces and improving the quality of green spaces in Chinese less urbanized areas.     

Diabetes among US- and foreign-born blacks in the USA

Objective. Little is known about diabetes status among US blacks by nativity. This study aims to measure differences in diabetes among US blacks by region of birth and examines potential explanations for subgroup differences.

Design. Data from 47,751 blacks aged 25–74 pooled from the 2000–2013 waves of the National Health Interview Survey were analyzed. Logistic regression models predicted self-reported diabetes. The roles of education, income, body mass index (BMI), smoking, and duration of US residence were explored.

Results. Compared to the US-born, foreign-born blacks had significantly lower reported diabetes prevalence (8.94% vs. 11.84%) and diabetes odds ratio [OR: 0.75; 95% confidence interval (CI): 0.62, 0.89], adjusting for socio-demographic characteristics. Further inclusion of education, income, household size, and smoking did not appreciably change the OR (0.77; 95% CI: 0.61, 0.86). Including an adjustment for BMI entirely eliminated the foreign-born advantage (OR 0.93; 95% CI: 0.78, 1.11). The foreign-born from the Caribbean/Americas had similar diabetes odds compared to the African-born. Among the foreign-born, an increased duration of US residence was associated with a higher diabetes odds, but these associations did not reach statistical significance (p > 0.05).

Conclusion. The healthy immigrant advantage extended to diabetes among US blacks, a finding that is explained by lower levels of overweight/obesity among the foreign-born compared to the US-born. Nonetheless, more than 71.4% of the foreign-born were overweight or obese. Understanding the mechanisms through which exposure to the US environment leads to higher obesity and diabetes risk may aid prevention efforts for the rapidly growing foreign-born black subpopulation.     

儿童肥胖脂肪因子与血管内皮功能、氧化应激的关系研究

目的 探讨儿童肥胖脂肪因子与血管内皮功能和氧化应激的关系.方法 将2009年12月至2012年12月在东阳妇女儿童医院诊断的肥胖症患儿160例纳入肥胖组,随机抽取同期体检的健康儿童50例纳入对照组.采用ELISA法分别对两组儿童血清瘦素(LP)、内脂素(VFT)和肿瘤坏死因子-α(TNF-α)脂肪因子进行检测,采用高分辨率超声检测肱动脉扩张力,评估两组儿童血管内皮功能,采用相应的方法检测丙二醛(MDA)、维生素E、低密度脂蛋白胆固醇(LDL-C).结果 肥胖组儿童血清中LP、VFT和TNF-α表达水平均高于对照组,差异均有统计学意义(t值分别为0.043、0.039和0.042,均P＜0.05).肥胖组儿童肱动脉反应性充血后及含服硝酸甘油(GTN)后相对于静息状态的扩张百分率均低于对照组,差异均有统计学意义(t值分别为0.049和0.047,均P＜0.05).血清LP、VFT、TNF-α指标表达水平与肱动脉扩张百分率均呈负相关(rLP=-0.407、rVFT=-0.397、rTNF-α=-0.420,均P＜0.05).与对照组相比,肥胖组的LDL-C和MDA较高(t值分别为0.037和0.039,均P＜0.05),血浆维生素E水平较低(t =0.031,P＜0.05).结论 肥胖儿童血清LP、VFT、TNF-α脂肪因子表达水平与血管内皮功能呈负相关,肥胖儿童体内存在氧化应激.     

The relationship among physical activity, obesity, and physical function in community-dwelling older women

BACKGROUND: The relationship between obesity and physical function is not well understood. Physical activity may be a key factor impacting on the relationship between obesity and physical function. METHODS: Subjects included 171 community-dwelling women (mean age = 74.3, SD = 4.3) participating in a 14-year follow-up study to a walking intervention trial. Measures of obesity [body mass index (BMI)] and physical activity (Modified Paffenbarger Questionnaire) were collected in 1982, 1985, 1995, and 1999. Physical function was assessed in 1999 using the Functional Status Questionnaire (FSQ) and gait speed. RESULTS: Measures of obesity from 1982 to 1995 and measures of physical activity from 1982 to 1995 were related to physical function in 1999. However, hierarchical regression analysis to predict physical function in 1999 controlling for the presence of chronic conditions indicated that physical activity from 1982 to 1995, and not obesity from 1982 to 1995, was an independent predictor of physical function (FSQ: adjusted R2 = 0.09, F = 4.68, P < 0.001; gait speed: adjusted R2 = 18.0, F = 9.41, P < 0.0001. CONCLUSION: Physical activity appears to be as important if not more important than body weight in predicting future physical function.     

Social support,depression, and physical disability: Age and diagnostic group effects

BackgroundSocial support is an important resource that may benefit individuals aging with physical disabilities, although its effects may vary depending on age, sex, and type of disability.ObjectivesTo (1) examine differences in social support – and how support might vary as a function of age and sex – in samples of individuals with multiple sclerosis (MS), spinal cord injury (SCI), and muscular dystrophy (MD) and (2) understand the extent that associations between different support domains and depression might be moderated by disability diagnosis, sex and age.MethodsA convenience sample (N = 1416) of individuals with MS, SCI, and MD completed surveys that included measures of perceived social support and depressive symptoms.ResultsNo significant support differences were found between diagnostic groups. There was a gradual decrease in social support with chronological age, and women reported more support than men, particularly friend support. Levels of perceived friend support were negatively associated with depression, and the associations between social support and depression did not differ as a function of age, sex, or diagnosis.ConclusionsSocial support is similarly associated with lower levels of depression for men and women, across disability diagnoses and all ages. Being a man and being older may be associated with lower levels of perceived support. Research is needed to determine if interventions that improve support will decrease depression and improve quality of life in persons with disabilities, particularly for men and individuals who are aging.     

Depression severity, diet quality, and physical activity in women with obesity and depression

Major depressive disorder (MDD) is prevalent in clinical weight-loss settings and predicts poor weight-loss outcomes. It is unknown whether the severity of depressive symptoms among those with MDD is associated with diet quality or physical activity levels. This knowledge is important for improving weight-loss treatment for these patients. It was hypothesized that more severe depression is associated with poorer diet quality and lower physical activity levels among individuals with obesity and MDD. Participants were 161 women with current MDD and obesity enrolled in the baseline phase of a weight-loss trial between 2007 and 2010. Depression severity was measured with the Beck Depression Inventory II. The Alternate Healthy Eating Index was applied to data from three 24-hour diet recalls to capture overall diet quality. Daily metabolic equivalents expended per day were calculated from three 24-hour physical activity recalls. Greater depression severity was associated with poorer overall diet quality (estimate=-0.26, standard error 0.11; P=0.02), but not with physical activity (estimate=0.07, standard error 0.05; P=0.18), in linear regression models controlling for income, education, depression-related appetite change, binge eating disorder, and other potential confounds. Associations with diet quality were primarily driven by greater intake of sugar (r=0.20; P<0.01), saturated fat (r=0.21; P<0.01), and sodium (r=0.22; P<0.01). More severe depression was associated with poorer overall diet quality, but not physical activity, among treatment-seeking women with MDD and obesity. Future studies should identify mechanisms linking depression to diet quality and determine whether diet quality improves with depression treatment.     

Intimate partner violence, depression, and PTSD among pregnant Latina women

PURPOSE We undertook a study to describe factors related to depression and posttraumatic stress disorder (PTSD) among pregnant Latinas who were or were not exposed to intimate partner violence.METHODS We interviewed 210 pregnant Latinas attending prenatal clinics located in Los Angeles, California. Latinas who did and did not have histories of intimate partner violence were recruited. We then assessed the women for strengths, adverse social behavioral circumstances, posttraumatic stress disorder (PTSD), and depression.RESULTS Significantly more women exposed to intimate partner violence scored at or above the cutoff point for depression than women who were not (41% vs 18.6%; P<.001). Significantly more women exposed to intimate partner violence scored at or above the cutoff point for PTSD than women who were not (16% vs 7.6%; P <.001). Lack of mastery, which measures feelings of being in control of forces that affect life (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.62–0.84), a history of trauma not associated with intimate partner violence (OR, 1.33; 95% CI, 1.08–1.63), and exposure to intimate partner violence (OR, 2.43; 95% CI, 1.16–5.11) were associated with depression after adjusting for age, language of interview, and site effects. Stress (OR, 1.72; 95% CI, 1.34–2.2) and a history of trauma (OR, 1.45; 95% CI, 1.03–2.04) were independently associated with PTSD, whereas higher income was associated with decreased risk of PTSD (OR, 0.10; 95% CI, 0.02–0.63), after adjusting for age, language of interview, and site effects.CONCLUSIONS Intimate partner violence was significantly associated with depression and PTSD but was associated with depression only after controlling for other factors in the multivariate model. The risk for depression declined with greater mastery but increased with a history of trauma or exposure to intimate partner violence. Stress, a history of trauma not associated with intimate partner violence, and lower income were all independently associated with increased risk for PTSD.     

不同肥胖易感性大鼠体内的氧化应激反应

目的观察不同肥胖易感性大鼠的氧化应激反应和抗氧化能力的差异。方法 40只雄性Wistar大鼠(200～220g)随机分为高脂饲料组(30只)和正常对照组(10只),高脂饲料组大鼠给予高脂饲料6周后依据体重增加量筛选出肥胖易感(OP)大鼠和肥胖抵抗(OR)大鼠各10只,OP组和OR组大鼠继续喂养高脂饲料,正常对照组大鼠给予基础饲料,13周末处死大鼠,采集样本,测定血清中超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)以及空腹血糖(FBG)、胰岛素、甘油三酯(TG)、总胆固醇(TC)、游离脂肪酸(FFA)等指标。结果 OP组大鼠SOD含量显著低于OR组和正常对照组;OP组大鼠GSH-Px水平显著低于OR组;OP组MDA浓度显著高于正常对照组;同时OP组总能量摄入、体脂含量、血糖、血脂、血清胰岛素、胰岛素敏感指数(ISI)和游离脂肪酸水平都与OR组大鼠的差异有显著性,而OR组大鼠与正常对照组相比的差异无显著性。结论与肥胖抵抗大鼠相比,肥胖易感大鼠的氧化应激水平增高,抗氧化能力降低,血糖血脂升高并出现胰岛素抵抗。     

John Henryism, self-reported physical health indicators, and the mediating role of perceived stress among high socio-economic status Asian immigrants

This study examined the relationship between John Henryism (a strong behavioral predisposition to engage in high effort coping with difficult barriers to success) and self-reported physical health among high socio-economic (SES) status Asian immigrants to the USA. Cross-sectional data were collected from a community sample of 318 self-identified Chinese and Indian immigrants aged 18-73, averaging 10.2 yr lived in the US. In addition to the John Henryism Active Coping Scale, health status was measured using ordinal ratings of global self-rated health, somatic symptoms and physical health functioning. We also evaluated whether perceived stress would explain the relationship between John Henryism and health. Controlling for demographic factors, regression analyses showed that higher John Henryism significantly predicted better self-rated health and physical functioning, and fewer somatic symptoms. These relationships were significantly and fully mediated (for physical functioning and somatic symptoms) or partially mediated (for self-rated health) by lower perceived stress. Results suggest that John Henryism relates to better health among high SES Asian immigrants in part by reducing perceived stress. To better understand and improve health in all racial/ethnic groups, especially racial minorities and immigrants, more research is needed on John Henryism and perceived stress as important psychosocial mechanisms intervening between environmental exposures and health outcomes.     

Perspectives on diet and physical activity among urban African Americans with serious mental illness

African Americans are burdened by high rates of obesity that contribute to chronic disease and early mortality. To tailor a weight loss intervention to meet the needs of African Americans with serious mental illness, a community-based participatory research (CBPR) team comprised primarily of African Americans with serious mental illness guided qualitative research to understand factors that affect weight and interventions that may diminish obesity. Data from five focus groups (n = 55) were analyzed to better understand this group's needs. Participants voiced individual, social, and structural barriers to maintaining and achieving a healthy weight and provided perspectives on potential solutions.     

Sex ratio,poverty, and concurrent partnerships among men and women in the United States: a multilevel analysis

PurposeSocial and economic contextual factors may promote concurrent sexual partnerships, which can accelerate population HIV transmission and are more common among African Americans than U.S. Whites. We investigated the relationship between contextual factors and concurrency.MethodsWe analyzed past 12-month concurrency prevalence in the 2002 National Survey of Family Growth and its contextual database in relation to county sex ratio (among respondent's racial and ethnic group), percentage in poverty (among respondent's racial and ethnic group), and violent crime rate. Analyses examined counties with balanced (0.95–1.05 males/female) or low (<0.9) sex ratios.ResultsConcurrency prevalence was greater (odds ratio [OR]; 95% confidence interval [CI]) in counties with low sex ratios (OR, 1.67; 95% CI, 1.17–2.39), more poverty (OR, 1.18; 95% CI, 0.98–1.42 per 10 percentage-point increase), and higher crime rates (OR, 1.04; 95% CI, 1.00–1.09 per 1000 population/year). Notably, 99.5% of Whites and 93.7% of Hispanics, but only 7.85% of Blacks, lived in balanced sex ratio counties; about 5% of Whites, half of Hispanics, and three-fourths of Blacks resided in counties with >20% same-race poverty.ConclusionsThe dramatic Black-White differences in contextual factors in the United States and their association with sexual concurrency could contribute to the nation's profound racial disparities in HIV infection.     

Comparative effectiveness of a standard behavioral and physical activity enhanced behavioral weight loss intervention in Black women

ABSTRACT

Black women typically lose small amounts of weight in behavioral weight loss interventions, partially due to low engagement in physical activity. Culturally relevant enhancement of the physical activity component may improve weight loss. This study compared the effectiveness of a culturally-relevant, physical activity-enhanced behavioral weight loss intervention to a standard behavioral weight loss intervention in Black women (n = 85) over 6 months. The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. Participants had an average age of 48.30 ± 11.02 years with an average body mass index of 36.46 ± 4.50 kg/m². Standard and enhanced groups’ weight change (?2.83 kg and ?2.08 kg, respectively) and change in physical activity (43.93 min/ week and 15.29 min/week, respectively) did not differ between groups. Significantly more standard group participants lost 5% of baseline weight compared to enhanced group participants. This study produced typical weight loss results in Black women. Behavioral weight loss treatment remains moderately effective for Black women. Strategies to increase attendance and self-monitoring, and the inclusion of cultural contexts to weight-related behaviors are needed to improve outcomes.     

Factors influencing food choices, dietary intake, and nutrition-related attitudes among African Americans: application of a culturally sensitive model

Objectives. The goals of the project were: (1) to explore how culture and community impact on the nutrition attitudes, food choices, and dietary intake of a select group of African Americans in north central Florida; and (2) to identify segments of the population and community that should be targeted for education programs, desirable components of nutrition education programs, topics of interest, and health promotion channels to reach the target group. Design. Six focus groups were conducted with African American males and females. The data were analyzed using the PEN-3 model, a theoretical model that centralizes culture as the primary reason for health behavior and the primary consideration for health promotion and disease prevention programs. Results. There was a general perception that 'eating healthfully' meant giving up part of their cultural heritage and trying to conform to the dominant culture. Friends and relatives usually are not supportive of dietary changes. Barriers to eating a healthful diet also included no sense of urgency, the social and cultural symbolism of certain foods, the poor taste of 'healthy' foods, the expense of 'healthy' foods, and lack of information. Segments of the population that potentially could be motivated to make dietary changes included women, men with health problems, young adults, the elderly, and those diagnosed with a severe, life-threatening disease. Conclusion. The findings suggest that the PEN-3 model is an appropriate framework for assessing how community and culture impact dietary habits of African Americans. African Americans still need information on basic nutrition topics such as serving sizes and reading food labels. The findings also suggest that programs and materials should be specifically developed for churches, neighborhood grocery stores, and local restaurants.     

Barriers and facilitators to physical activity and exercise among adults with depression: A scoping review

BackgroundExercise is now recommended as a treatment for depression in Canada. What remains less clear is how best to encourage exercise uptake by individuals with mood disorders. The purpose of this scoping review is to identify barriers and facilitators to exercise and physical activity participation among individuals with depression.MethodA scoping review with systematic searches was conducted. Eligible studies required samples >50% diagnosed with depression or a mood disorder, and reported empirical data on barriers and/or facilitators to physical activity using quantitative and/or qualitative methods. Extracted barriers and facilitators were classified into the fourteen domains of the Theoretical Domains Framework (TDF).ResultsThirteen studies were included (seven quantitative, six qualitative). The most common barriers were classified under the TDF domains of Emotion, Environmental Context & Resources, Beliefs about Capabilities, and Intentions. The most common facilitators were classified under the domains of Beliefs about Consequences, Social Influences, Emotion and Behavioural Regulation.ConclusionsMost identified domains are all common determinants of health behaviours in various models and theories applied to physical activity participation. However, the Emotion domain appears to be particularly important to individuals with depression, and yet is not covered by these traditional theories of behaviour change, and may be overlooked when trying to promote physical activity among this population. Future research should investigate the effectiveness of behaviour change interventions that specifically target the Emotion domain, and clearly report the behaviour change techniques employed to do so.