Role of depressive symptoms in explaining socioeconomic status disparities in dietary quality and central adiposity among US adults: a structural equation modeling approach
Role of depressive symptoms in explaining socioeconomic status disparities in dietary quality and central adiposity among US adults: a structural equation modeling approach
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DOI：
10.3945/ajcn.2009.27782
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发表时间：
2009-10-01
影响因子：
7.1
通讯作者：
Zonderman, Alan B.
中科院分区：
文献类型：
--
作者：
Beydoun, May A.;Kuczmarski, Marie T. Fanelli;Zonderman, Alan B.
工作背景：社会经济地位（SES）、抑郁症、饮食质量和中心性肥胖之间的联系尚不清楚。目的：通过抑郁症状检查不同性别种族人群SES与饮食质量和中心性肥胖之间的联系。设计：关于美国30-64岁成年人的广泛数据，来自整个生命周期多样性社区的健康老龄化（HANDLS）研究采用多元线性逻辑回归模型和结构方程模型来检验通路关联。测量方法包括流行病学抑郁中心（CES-D）评分、2005年健康饮食指数（HEI）值和双能X线吸收测定法。大多数分析的样本量范围为1789之间的人体测量结果和1227躯干脂肪outcome.Results：CES-D评分与低HEI评分在所有性别种族组，除了在非洲裔美国人的男性，和较高的腰臀比（WHR）在非洲裔美国人的妇女。在白色女性和男性中，CES-D评分≥ 16分分别与腰围（WC）和躯干脂肪呈正相关。SES与非裔美国男性（中心性肥胖和WC）和非裔美国女性（中心性肥胖和躯干脂肪百分比）的中心性肥胖呈正相关，但与白色女性的中心性肥胖呈负相关。仅在白人中，SES对HEI的总的积极影响是由CES-D评分介导的。在白色妇女中，总的负效应的SES WC和WHR的CES-D评分和HEI的显着解释，而CES-D评分与WHR非洲裔美国妇女，独立的SES.Conclusion：未来的心理健康干预措施，针对减少SES的差异，在饮食质量和中心性肥胖可能有不同的影响，跨性别种族群体。美国临床营养杂志2009;90：1084-95。
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. Am J Clin Nutr 2009;90:1084-95.