The Association Between Dietary Changes to Lose Weight and Mental Health Status in the National Health and Nutrition Examination Survey, 2005-2006

Jihyun Jane Min, Keeyoon Noh, Sojeong Nam, Alejandra Ellison-Barnes
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Abstract

Background Weight loss is a common endeavor taken by millions of residents annually in the U.S.—a country with a 31% overweight and 42% obesity rate. Weight loss is associated with numerous physical health benefits, such as better cardiovascular health. However, unhealthy weight loss strategies can cause adverse mental health effects. Past research has focused on how weight loss strategies affect the mental health of a general population—rather than those who are trying to lose weight—or has investigated a diverse array of weight loss strategies. This paper explores how dietary changes for weight loss are associated with mental health, specifically through several variables used in the Patient Health Questionnaire-9 (PHQ9), which measures depression severity. We hypothesize that eating less and skipping meals will be associated with poorer mental health status, while eating fewer carbohydrates, eating less fat, and drinking more water will be associated with better mental health status. Methods and Findings This study uses the U.S. 2005-2006 National Health and Nutrition Examination Survey (NHANES) 2005. Univariate (descriptive statistics), bivariate (correlation coefficient), and multivariate (ordinal logistic regression) analyses were performed. The main results show that ‘skipped meals’ was positively associated with ‘feeling bad about yourself,’ ‘feeling down, depressed, or hopeless,’ and ‘little interest in doing things.’ ‘Ate fewer carbohydrates’ was negatively associated with the ‘little interest in doing things.’ Conclusion Differing dietary changes used for weight loss, particularly skipping meals and eating fewer carbohydrates, are associated with differences in mental health status. Health care professionals providing weight loss guidance should be cognizant of patients’ baseline mental health and the potential for changes in mental health with different dietary strategies. Future research employing a longitudinal approach to determine whether there is evidence of a causal relationship between these and other dietary strategies and subsequent mental health outcomes.
2005-2006 年全国健康与营养调查中为减肥而改变饮食与心理健康状况之间的关系
背景 减肥是美国数百万居民每年都要做的一件事,美国超重率为 31%,肥胖率为 42%。减肥对身体健康有诸多益处,如改善心血管健康。然而,不健康的减肥策略会对心理健康造成不良影响。过去的研究主要关注减肥策略如何影响普通人群的心理健康,而不是那些试图减肥的人,也没有对各种减肥策略进行调查。本文探讨了为减肥而改变饮食习惯与心理健康之间的关系,特别是通过患者健康问卷-9(PHQ9)中使用的几个变量,该问卷用于测量抑郁症的严重程度。我们假设,少吃和不吃饭与较差的心理健康状况有关,而少吃碳水化合物、少吃脂肪和多喝水与较好的心理健康状况有关。方法与结果 本研究使用了美国 2005-2006 年全国健康与营养调查(NHANES)2005 年的数据。进行了单变量(描述性统计)、双变量(相关系数)和多变量(序数逻辑回归)分析。主要结果显示,"不吃正餐 "与 "自我感觉不好"、"情绪低落、抑郁或绝望 "和 "做事兴趣不大 "呈正相关。少吃碳水化合物 "与 "做事兴趣不大 "呈负相关。结论 不同的减肥饮食习惯,尤其是不吃正餐和少吃碳水化合物,与心理健康状况的差异有关。提供减肥指导的医护人员应了解患者的基本心理健康状况,以及不同饮食策略可能导致的心理健康状况变化。未来的研究将采用纵向方法来确定是否有证据表明这些和其他饮食策略与随后的心理健康结果之间存在因果关系。
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