Associations between Depressive Symptomatology, Diet, and Body Mass Index among Participants in the Supplemental Nutrition Assistance Program

• Published in: Journal of the Academy of Nutrition and Dietetics 2015-07, Vol.115 (7), p.1102-1108
• Main Authors: Flórez, Karen R., DrPH, Dubowitz, Tamara, ScD, Ghosh-Dastidar, Madhumita (Bonnie), PhD, Beckman, Robin, MPH, Collins, Rebecca L., PhD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; African Americans; Aged; Body Mass Index; Body Weight; Cross-Sectional Studies; Depression - epidemiology; Depressive symptomatology; Diet - psychology; Dietary quality; Educational Status; Female; Food Assistance - statistics & numerical data; Food Quality; Food Supply; Gastroenterology and Hepatology; Humans; Internal Medicine; Low-income populations; Male; Middle Aged; Obesity; Pennsylvania; Poverty; Supplemental Nutrition Assistance Program; Young Adult
• ISSN: 2212-2672; 2212-2680
• DOI: 10.1016/j.jand.2015.01.001

Abstract Background Participation in the Supplemental Nutrition Assistance Program (SNAP) has been shown to increase food security, or access to adequate food; however, SNAP participation has also been associated with obesity among certain demographic groups (eg, women, but not men and children), possibly due to poorer dietary quality. Depressive symptomatology is an understudied factor, which is associated with obesity across the lifespan. Objective This study examined the relationship between depressive symptomatology, dietary quality, and body weight among a sample of SNAP participants (n=639). Design The analysis was cross-sectional; survey data were collected in May to December 2011 by trained data collectors. Participants/setting Adults who self-identified as the primary food shopper of the household in two predominantly low-income African-American neighborhoods characterized as “food deserts” in Pittsburgh, PA, were recruited to participate in this study. Measures Dietary quality was calculated using the US Department of Agriculture’s Healthy Eating Index-2005. Body mass index (BMI; calculated as kg/m2 ) was based on objective measurements taken by the interviewer. Current depressive symptomatology was assessed by a trained interviewer using the Patient Health Questionnaire-2. Statistical analyses performed Descriptive statistics (means and percentages); two multivariate ordinary least-square regression analyses predicting BMI and dietary quality from depressive symptomatology while controlling for sociodemographic factors and food insecurity were performed. Results Depression was a strong and statistically significant predictor of both dietary quality and BMI; higher score in depressive symptomatology was associated with lower scores in dietary quality (β=−1.26; P