Marta Garaulet, Francisca Perez-Llamas, Millan Perez-Ayala, Pedro Martinez, Fermin Sanchez de Medina, Francisco J Tebar, Salvador Zamora
Nov 1, 2001; 74:585-591
Lipids
November 1, 2001
February 5, 2012
Role of depressive symptoms in explaining socioeconomic status disparities in dietary quality and central adiposity among US adults: a structural equation modeling approach [Nutritional epidemiology and public health]
Background: The link between socioeconomic status (SES), depression, dietary quality, and central adiposity remains unclear.
Objective: Pathways linking SES to dietary quality and central adiposity through depressive symptoms were examined across sex-ethnicity groups.
Design: Extensive data on US adults aged 30–64 y from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used in multiple linear logistic regression models and structural equation models to test pathway associations. Measures included Center for Epidemiologic Studies–Depression (CES-D) scores, 2005 Healthy Eating Index (HEI) values, and dual-energy X-ray absorptiometry. Sample sizes for most analyses ranged between 1789 for anthropometric outcomes and 1227 for trunk fat outcomes.
Results: The CES-D score was associated with lower HEI scores in all sex-ethnicity groups, except in African American men, and with higher waist-to-hip ratios (WHRs) among African American women. A CES-D score ≥16 was positively associated with waist circumference (WC) and with trunk fat among white women and men, respectively. SES was positively related to central adiposity among African American men (central obesity and WC) and African American women (central obesity and percentage trunk fat) but was inversely related to central adiposity among white women. Among whites only, the total positive effect of SES on HEI was significantly mediated by CES-D score. Among white women, the total inverse effect of SES on WC and WHR was significantly explained by the CES-D score and HEI, whereas the CES-D score was positively associated with WHR among African American women, independently of SES.
Conclusion: Future mental health interventions targeted at reducing SES disparities in dietary quality and central adiposity may have different effects across sex-ethnicity groups.
Obesity indicators and cardiometabolic status in 4-y-old children [Nutritional epidemiology and public health]
Background: In adults and adolescents, obesity is positively associated with cardiovascular disease risk factors; however, evidence in preschool children is scarce.
Objective: The objective was to assess the relations between obesity indicators and cardiometabolic risk factors in 324 Chilean children 4 y of age.
Design: We collected anthropometric measurements and calculated general indicators of obesity [weight, body mass index (BMI), sum of 4 skinfold thicknesses, percentage fat, and body fat index] and central obesity (waist circumference, waist-to-hip ratio, waist-to-height ratio, and truncal fatness based on skinfold thickness). We measured blood sample concentrations of C-reactive protein, interleukin-6, homeostasis model assessment of insulin resistance, triglycerides, and total, LDL, and HDL cholesterol. We used correlation and multiple linear regression analyses.
Results: The prevalence of obesity (BMI-for-age z score >2, World Health Organization 2006), central obesity (≥90th percentile, third National Health and Nutrition Examination Survey), and lipid disorders was high (13%, 11%, and ≥ 20%, respectively), and 70% of the children had at least one cardiometabolic risk factor. Most correlations between obesity and central obesity indicators were moderate to strong (0.40 < r < 0.96). Obesity was positively but weakly associated with C-reactive protein in both sexes and with homeostasis model assessment of insulin resistance only in girls (all r < 0.3, P < 0.05). Obesity indicators were unrelated to interleukin-6 and lipid concentrations (P > 0.05). Overall, obesity indicators explained, at most, 8% of the variability in cardiometabolic risk factors.
Conclusions: Obesity and central obesity were common, and most of the children had at least one cardiometabolic risk factor, particularly lipid disorders. Obesity and central obesity indicators were highly intercorrelated and, overall, were weakly related to cardiometabolic status. At this age, body mass index and waist circumference were poor predictors of cardiometabolic status.