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Abstract
Obesity and depression are two diseases of major public health importance. While both
correlate with each other, potential pathways involving depression that would link
socioeconomic status (SES) to lifestyle factors and obesity have not been systematically
examined using nationally representative data. Using rich data on 2217 US young adults
aged 20-39years from the 1999-2004 National Health and Nutrition Surveys (NHANES)
and multivariate linear and logistic regression models, we examined associations between
major depressive disorder (MDD), dietary intake, physical activity (PA), and measured
body mass index (BMI) controlling for socio-demographic factors. Further, structural
equation models (SEM) were fit to test pathway explaining SES disparities in BMI through
MDD and lifestyle factors. Recent prevalence of MDD was lower among young US men than
women (6.4% vs. 9.2%) although their prevalence of obesity was similar (21.2% vs.
22.7%). Among women, MDD was associated with higher BMI and inversely associated with
PA, but not among men. MDD was specifically associated with increased risk of morbid
obesity (BMI>/=40) among women (OR: 2.88 (1.32, 6.30)). Using SEM, a main pathway
linking SES to BMI among women was linking SES-->food insecurity-->MDD-->PA-->BMI.
A main pathway linking MDD to BMI in both genders was going through PA rather than
overall dietary quality. Gender and ethnic differences existed underlying how MDD,
SES and lifestyle factors were associated with adiposity. Future prospective studies
are needed to examine potential mechanisms using physiological markers of depression,
lifestyle and obesity.
Published by Elsevier B.V.