Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, 9000 Gent, Belgium.
Nutrients. 2021 Jan 28;13(2):406. doi: 10.3390/nu13020406.
Within mental health as risk factor for excess weight, prevention-relevant questions remain: does the relation persist after considering lifestyle, which lifestyle parameters might be most important to target, which gender or age subgroups are most at risk? The cross-sectional Belgian health survey 2013 ( = 4687; ≥15 years) measured mental health via anxiety and depression symptoms (Symptom Check List 90-R) and distress (General Health Questionnaire-12). Logistic regression, multiple mediation and moderated mediation were applied. Poor mental health was significantly related to a higher excess weight prevalence (odds ratio (OR) = 1.18 with 95% confidence interval (0.17-1.19)) and an unhealthier lifestyle i.e., more smoking, sleep problems, disordered eating, soft-drink, and alcohol consumption; while less fruit/vegetables and physical activity and even lower snack intake. Associations were often gender- and age-specific e.g., poor mental health was only related to less snacking in men and middle-adulthood, while an association with more snacking appeared in youth (<25 years). Disordered eating, physical activity and smoking were significant mediators explaining 88% of mental-weight associations, after which the association became negative (OR = 0.92 (0.91-0.93)). Mediation by snacking and disordered eating was stronger in the youngest and mediation by smoking was stronger in women. Thus, especially youth has high mental health associated behavioral and weight risks and gender or age differences can explain conflicting literature results on lifestyle.
在心理健康作为超重的风险因素方面，仍存在一些预防相关的问题：在考虑生活方式后，这种关系是否仍然存在？哪些生活方式参数最重要？哪些性别或年龄组风险最大？2013 年比利时横断面健康调查（=4687；≥15 岁）通过焦虑和抑郁症状（症状检查表 90-R）和痛苦（一般健康问卷-12）来衡量心理健康。应用了逻辑回归、多重中介和调节中介。心理健康状况较差与更高的超重患病率显著相关（优势比（OR）=1.18，95%置信区间（0.17-1.19））和更不健康的生活方式，即更多的吸烟、睡眠问题、饮食失调、软饮料和酒精消费；而水果/蔬菜和体育活动较少，甚至零食摄入量较低。这些关联通常具有性别和年龄特异性，例如，心理健康状况较差仅与男性和中年人的零食摄入量较少有关，而与更多零食摄入有关的关联出现在年轻人（<25 岁）中。饮食失调、体育活动和吸烟是解释 88%心理健康与体重关联的重要中介因素，之后关联变为负值（OR=0.92（0.91-0.93））。在最年轻的人群中，零食和饮食失调的中介作用更强，而女性的吸烟中介作用更强。因此，尤其是年轻人有较高的心理健康相关行为和体重风险，性别或年龄差异可以解释生活方式方面相互矛盾的文献结果。
