Abstract
Major depressive disorder (MDD) is prevalent in clinical weight-loss settings and
predicts poor weight-loss outcomes. It is unknown whether the severity of depressive
symptoms among those with MDD is associated with diet quality or physical activity
levels. This knowledge is important for improving weight-loss treatment for these
patients. It was hypothesized that more severe depression is associated with poorer
diet quality and lower physical activity levels among individuals with obesity and
MDD. Participants were 161 women with current MDD and obesity enrolled in the baseline
phase of a weight-loss trial between 2007 and 2010. Depression severity was measured
with the Beck Depression Inventory II. The Alternate Healthy Eating Index was applied
to data from three 24-hour diet recalls to capture overall diet quality. Daily metabolic
equivalents expended per day were calculated from three 24-hour physical activity
recalls. Greater depression severity was associated with poorer overall diet quality
(estimate=−0.26, standard error 0.11; P=0.02), but not with physical activity (estimate=0.07, standard error 0.05; P=0.18), in linear regression models controlling for income, education, depression-related
appetite change, binge eating disorder, and other potential confounds. Associations
with diet quality were primarily driven by greater intake of sugar (r=0.20; P<0.01), saturated fat (r=0.21; P<0.01), and sodium (r=0.22; P<0.01). More severe depression was associated with poorer overall diet quality, but
not physical activity, among treatment-seeking women with MDD and obesity. Future
studies should identify mechanisms linking depression to diet quality and determine
whether diet quality improves with depression treatment.
Keywords
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Biography
B. M. Appelhans is an assistant professor, Departments of Preventive Medicine and Behavioral Sciences, Rush University Medical Center, Chicago, IL
Biography
M. C. Whited is a postdoctoral fellow, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
Biography
K. L. Schneider is an assistant professor, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
Biography
P. A. Merriam is an assistant professor, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
Biography
Y. Ma is an associate professor, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
Biography
S. L. Pagoto is an associate professor, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
Biography
J. L. Oleski is a research project director, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
Biography
B. C. Olendzki is a research assistant professor, Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA
Biography
M. E. Waring is an assistant professor, Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
Biography
I. S. Ockene is the David and Barbara Milliken Professor of Preventive Cardiology, Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School, Worcester, MA
Biography
D. M. Mann is an assistant professor, Section of Preventive Medicine and Epidemiology, and Section of General Internal Medicine, Boston University School of Medicine, Boston, MA
Article Info
Publication History
Published online: April 25, 2012
Accepted:
February 3,
2012
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This project was supported by grant R01MH078012-01A1 from the National Institute of Mental Health to Dr Pagoto. Dr Ma is supported by the National Heart, Lung, and Blood Institute (NHLBI) grant 1R01HL094575-01A1 . Partial salary support for Dr Waring is provided by the National Institutes of Health grant 1U01HL105268-01 .
Identification
Copyright
© 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
