Psychosocial stress is associated with obesity and diet quality in Hispanic/Latino adults

doi:10.1016/j.annepidem.2014.11.002

Annals of Epidemiology

Volume 25, Issue 2, February 2015, Pages 84-89

https://doi.org/10.1016/j.annepidem.2014.11.002 Get rights and content

Abstract

Purpose

To examine the association of psychosocial stress with obesity, adiposity, and dietary intake in a diverse sample of Hispanic/Latino adults.

Methods

Participants were 5077 men and women, aged 18 to 74 years, from diverse Hispanic/Latino ethnic backgrounds. Linear regression models were used to assess the association of ongoing chronic stressors and recent perceived stress with measures of adiposity (waist circumference and percentage body fat) and dietary intake (total energy, saturated fat, alternative healthy eating index-2010). Multinomial logistic models were used to describe the odds of obesity or overweight relative to normal weight.

Results

Greater number of chronic stressors and greater perceived stress were associated with higher total energy intake. Greater recent perceived stress was associated with lower diet quality as indicated by alternative healthy eating index-2010 scores. Compared with no stressors, reporting three or more chronic stressors was associated with higher odds of being obese (odds ratio = 1.5, 95% confidence interval [CI] 1.01–2.1), greater waist circumference (β = 3.3, 95% CI 1.0–5.5), and percentage body fat (β = 1.5, 95% CI 0.4–2.6).

Conclusions

The study found an association between stress and obesity and adiposity measures, suggesting that stress management techniques may be useful in obesity prevention and treatment programs that target Hispanic/Latino populations.

Introduction

Obesity is currently a public health problem in the United States and disproportionately affects minority and low-income populations. Among Hispanic/Latino adults, 40% of men and 44% of women are obese [1]. Psychosocial stress is emerging as a potential risk factor for excess weight, and it may contribute to the race/ethnic disparities observed in prior research. Cross-sectional and prospective studies indicate that individuals with higher stress levels are more likely to be obese and experience greater weight gain over time [2], [3], [4], [5], [6]. Psychosocial stress may be related to the development of obesity through biological and behavioral pathways. Biological responses to stress include the activation of neuroendocrine and inflammatory pathways that directly increase fat accumulation, promoting visceral adiposity [7], [8], and the release of appetite hormones that increase food consumption, leading to a positive energy balance [7]. Furthermore, when under stress, as the brain reward system becomes activated [9], individuals may show a preference for more palatable foods that are richer in sugars and fats, contributing to excess calories [2], [10], [11], [12], [13]. Other behavioral changes have also been proposed as possible explanations for the stress–obesity relationship, such as engaging in less physical activity [14] and consuming fast foods more frequently [15].

Few studies distinguish between chronic ongoing stress and recent exposure to stress, which may have different associations with obesity. Prolonged exposure to stress may be needed to activate and maintain the biological and behavioral pathways that lead to increased weight, whereas the effects of recent exposure may be observed in terms of changes in lifestyle behaviors that, if occurring for a limited amount of time, may not lead to excess weight. In this study, we examined ongoing chronic stress in important life domains and perceived stress during the past 30 days in relation to obesity and dietary intake in Hispanic/Latino adults who are participants in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a large multicenter cohort. This study includes a subset of HCHS/SOL participants who completed a separate assessment of sociocultural factors, including stress measures. We hypothesized that participants reporting more chronic stressors would be more likely to be obese and have higher adiposity (assessed by waist circumference and percentage body fat) than participants with lower stress levels. In addition, we hypothesized that participants reporting higher recent perceived stress (past 30 days) would have a higher intake of total calories and saturated fat. However, we would not expect that those participants with higher recent perceived stress would be more likely to be obese than participants experiencing lower recent stress because a longer period would be needed for the excess calories to manifest as obesity. Furthermore, because prior research has shown evidence for differences in the stress/obesity association by sex [5], [6], [8], we also examined whether the relationship between stress and obesity was modified by sex.

Section snippets

Methods

HCHS/SOL is a population-based cohort study of 16,415 Hispanic/Latino adults (aged 18–74 years) who were selected using two-stage probability sampling design from four US communities (Chicago, IL; Miami, FL; Bronx, NY; and San Diego, CA). The HCHS/SOL SocioCultural Ancillary Study (SCAS) enrolled 5313 participants from the HCHS/SOL between February 2010 and June 2011. Participants were asked to return to the HCHS/SOL clinic within 9 months of their baseline examination to complete a

Results

In this sample, 3141 (61.9%) were women and 3106 (61.2%) were 45 years or older. Participants were predominantly born outside of the 50 US states (82.5%) and were of low socioeconomic status: 36.1% did not graduate from high school; 34.1% had annual household income of $20,000 or less. Thirty-five percent of women were overweight and 44% were obese, whereas 39% of men were overweight and 38% were obese. Women had a significantly higher percent body fat than men (38.5% standard error [SE] = 0.27

Discussion

As we hypothesized, the present study identified positive associations of chronic stress with obesity and other measures of adiposity that were independent of physical activity, energy intake, depressive symptoms, or presence of chronic conditions. In contrast, perceived stress was not associated with overweight or obesity. Our findings are consistent with other studies showing an association of chronic psychological stress with obesity [3], [4], [5], [6], [14], [15], [31]. Baseline data from

Acknowledgments

The HCHS/SOL SocioCultural Ancillary Study was supported by grant number RC2HL101649 from NHLBI. The Hispanic Community Health Study/Study of Latinos was carried out as a collaborative study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The

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Citation Excerpt :
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Food processing changes the nature of foods, and it is growing globally due to its availability and affordability and its effects on the palatability of foods. Consumption of ultraprocessed foods (UPFs) may adversely affect weight gain.
The purpose of the current study is to examine the association between UPFs consumption and adiposity among Iranian adults.
A cross-sectional study was conducted on 1459 Iranian adults (≥19 years). Dietary intakes were assessed using a validated 136-item food frequency questionnaire (FFQ), and foods were classified based on the NOVA system. Overweight, obesity, and abdominal obesity were defined as body mass index (BMI) ≥25 and < 30, ≥30, respectively, and waist circumference (WC) ≥91 for women and WC ≥ 89 for men. The odds of general and abdominal obesity across the quartiles of UPFs were assessed by binary logistic regression.
UPFs consumption contributed to 20.17% of daily energy intake. After adjustment for potential confounders, UPFs consumption was not associated with general or abdominal obesity. However, in the fully adjusted model, men in the top quartile of UPFs were twice as likely to be overweight compared with those in the bottom quartile (OR = 2.06, 95% CI: 1.03, 4.10; P = 0.047). No association was found in women or stratified analysis by age.
The present findings suggest a sex-specific association between UPFs consumption and overweight. UPFs consumption might be associated with an increased risk of overweight in men, but no such association was found in women. Future cohort studies are required to confirm these results.

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Original articlePsychosocial stress is associated with obesity and diet quality in Hispanic/Latino adults

Abstract

Purpose

Methods

Results

Conclusions

Introduction

Section snippets

Methods

Results

Discussion

Acknowledgments

Nutrition

Physiol Behav

Physiol Behav

J Psychosom Res

Appetite

Ann Epidemiol

Ann Epidemiol

J Nutr

Am J Clin Nutr

Am J Prev Med

Prev Med

Soc Sci Med

Appetite

Soc Sci Med

Appetite

J Psychosom Res

Complement Ther Med

Prevalence of childhood and adult obesity in the United States, 2011-2012

JAMA

Psychosocial stress is positively associated with body mass index gain over 5 years: evidence from the longitudinal AusDiab study

Obesity (Silver Spring)

Psychosocial stress and change in weight among US adults

Am J Epidemiol

Psychosocial stress and 13-year BMI change among blacks: the Pitt County Study

Obesity (Silver Spring)

Original article
Psychosocial stress is associated with obesity and diet quality in Hispanic/Latino adults