Longitudinal relationship between body mass index and depressive symptoms among Chinese adults: The moderating roles of lifestyle factors and age

Hanfang Zhao; Hong Shi; Zheng Ren; Minfu He; Li Cui; Shixun Wang; Jieyu Zhao; Wenjun Li; Yachen Wei; Wenjing Zhang; Ziqiang Chen; Hongjian Liu; Xiumin Zhang

doi:10.1016/j.jpsychores.2023.111380

Longitudinal relationship between body mass index and depressive symptoms among Chinese adults: The moderating roles of lifestyle factors and age

J Psychosom Res. 2023 Jul:170:111380. doi: 10.1016/j.jpsychores.2023.111380. Epub 2023 May 22.

Authors

Hanfang Zhao¹, Hong Shi¹, Zheng Ren¹, Minfu He¹, Li Cui¹, Shixun Wang¹, Jieyu Zhao¹, Wenjun Li², Yachen Wei³, Wenjing Zhang⁴, Ziqiang Chen⁵, Hongjian Liu⁶, Xiumin Zhang⁷

Affiliations

¹ Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
² Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China. Electronic address: wenjun22@mails.jlu.edu.cn.
³ Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China. Electronic address: weiyc22@mails.jlu.edu.cn.
⁴ Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China. Electronic address: wenjing22@mails.jlu.edu.cn.
⁵ Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China. Electronic address: chenzq22@mails.jlu.edu.cn.
⁶ Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China.
⁷ Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China. Electronic address: xiu_min@jlu.edu.cn.

PMID: 37244071
DOI: 10.1016/j.jpsychores.2023.111380

Abstract

Objective: This study aims to verify the moderating roles of lifestyle factors and age between body mass index (BMI), BMI trajectory and depressive symptoms of Chinese adults through a prospective design.

Methods: The participants who are 18 years old and above from the China Family Panel Studies (CFPS) were included in the 2016 baseline and 2018 follow-up research. BMI was calculated according to self-report weight (kilogram) and height (centimeter). Depressive symptoms were evaluated via the Center for Epidemiologic Studies Depression (CESD-20) scale. Inverse probability-of-censoring weighted estimation (IPCW) was used to check whether selection bias existed. Modified Poisson regression was performed to calculate prevalence and risk ratios as well as 95% confidence intervals.

Results: After adjustment, it was found that the positive associations of persistent underweight (RR = 1.154, P < 0.001) and normal weight → underweight (RR = 1.143, P < 0.001) with 2018 depressive symptoms were significant among middle-aged people, while the negative association of persistent overweight/obesity (RR = 0.972, P < 0.001) was significant in young adults. Notably, smoking moderated the relationship between baseline BMI and subsequent depressive symptoms (interaction P = 0.028). Also, exercise regularly and exercise duration weekly moderated the relationships of baseline BMI (interaction P = 0.004 and 0.015) and trajectories of BMI (interaction P = 0.008 and 0.011) with depressive symptoms among Chinese adults, respectively.

Conclusion: Weight management strategies for underweight and normal weight → underweight adults should pay attention to the role of exercise in maintaining normal weight and improving depressive symptoms.

Keywords: Age; BMI; Chinese adults; Depressive symptoms; Lifestyle.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Body Mass Index
China / epidemiology
Depression* / epidemiology
East Asian People
Humans
Life Style
Longitudinal Studies
Middle Aged
Thinness* / epidemiology