Beydoun May A, Kuczmarski Marie T Fanelli, Mason Marc A, Ling Shari M, Evans Michele K, Zonderman Alan B
Laboratory of Personality and Cognition, National Institute on Aging, National Institutes of Health, Intramural Research Program, Baltimore, MD 21224, USA.
Am J Clin Nutr. 2009 Oct;90(4):1084-95. doi: 10.3945/ajcn.2009.27782. Epub 2009 Aug 26.
The link between socioeconomic status (SES), depression, dietary quality, and central adiposity remains unclear.
Pathways linking SES to dietary quality and central adiposity through depressive symptoms were examined across sex-ethnicity groups.
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.
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 > or =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.
Future mental health interventions targeted at reducing SES disparities in dietary quality and central adiposity may have different effects across sex-ethnicity groups.
社会经济地位（SES）、抑郁、饮食质量和中心性肥胖之间的联系尚不清楚。
在不同性别 - 种族群体中研究通过抑郁症状将SES与饮食质量和中心性肥胖联系起来的途径。
来自“跨生命周期多元邻里健康老龄化”（HANDLS）研究的30 - 64岁美国成年人的大量数据被用于多元线性逻辑回归模型和结构方程模型，以检验途径关联。测量指标包括流行病学研究中心抑郁量表（CES - D）得分、2005年健康饮食指数（HEI）值以及双能X线吸收法。大多数分析的样本量在人体测量结果的1789例至躯干脂肪结果的1227例之间。
除非洲裔美国男性外，CES - D得分在所有性别 - 种族群体中均与较低的HEI得分相关，而在非洲裔美国女性中与较高的腰臀比（WHR）相关。CES - D得分≥16分别与白人女性和男性的腰围（WC）及躯干脂肪呈正相关。SES与非洲裔美国男性（中心性肥胖和WC）及非洲裔美国女性（中心性肥胖和躯干脂肪百分比）的中心性肥胖呈正相关，但与白人女性的中心性肥胖呈负相关。仅在白人中，SES对HEI的总正向影响显著由CES - D得分介导。在白人女性中，SES对WC和WHR的总负向影响显著由CES - D得分和HEI解释，而在非洲裔美国女性中，CES - D得分与WHR呈正相关，且独立于SES。
未来旨在减少饮食质量和中心性肥胖方面SES差异的心理健康干预措施在不同性别 - 种族群体中可能会有不同效果。
