Block Jason P, He Yulei, Zaslavsky Alan M, Ding Lin, Ayanian John Z
Harvard Center for Population and Development Studies, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
Am J Epidemiol. 2009 Jul 15;170(2):181-92. doi: 10.1093/aje/kwp104. Epub 2009 May 22.
The association of psychosocial stress with weight gain may have important implications for clinical practice and workplace and public health interventions. To determine whether multiple domains of psychosocial stress were associated with weight gain from 1995 to 2004, the authors analyzed a nationally representative longitudinal cohort of 1,355 men and women in the United States. Change in body mass index was assessed for multiple domains of psychosocial stress related to work, personal relationships, life constraints, and finances, controlling for other factors associated with weight gain. All analyses were stratified by sex and weighted to account for the complex survey design. Among men with high baseline body mass index, weight gain was associated with increasing levels of psychosocial stress related to job-related demands (P < 0.001 for interaction with baseline body mass index), lack of skill discretion (P = 0.014), lack of decision authority (P = 0.026), and difficulty paying bills (P = 0.004). Among women with high baseline body mass index, weight gain was associated with job-related demands (P < 0.001 for interaction with baseline body mass index), perceived constraints in life (P < 0.001), strain in relations with family (P = 0.016), and difficulty paying bills (P = 0.010). Interventions to address psychosocial stress may limit weight gain among overweight and obese men and women.
心理社会压力与体重增加之间的关联可能对临床实践、职场及公共卫生干预具有重要意义。为了确定1995年至2004年间心理社会压力的多个领域是否与体重增加相关,作者分析了美国1355名男性和女性具有全国代表性的纵向队列。针对与工作、人际关系、生活限制和财务相关的心理社会压力的多个领域评估体重指数变化,并控制其他与体重增加相关的因素。所有分析均按性别分层,并加权以考虑复杂的调查设计。在基线体重指数较高的男性中,体重增加与与工作相关需求相关的心理社会压力水平升高有关(与基线体重指数的交互作用P<0.001)、缺乏技能自主权(P=0.014)、缺乏决策权(P=0.026)以及支付账单困难(P=0.004)。在基线体重指数较高的女性中,体重增加与工作相关需求(与基线体重指数的交互作用P<0.001)、感知到的生活限制(P<0.001)、与家人关系紧张(P=0.016)以及支付账单困难(P=0.010)有关。解决心理社会压力的干预措施可能会限制超重和肥胖男性及女性的体重增加。