Sirpa Sarlio-Lähteenkorva

Emotional eating, depressive symptoms and self-reported food consumption. A population-based study.

We examined the associations of emotional eating and depressive symptoms with the consumption of sweet and non-sweet energy-dense foods and vegetables/fruit, also focusing on the possible interplay between emotional eating and depressive symptoms. The participants were 25-64-year-old Finnish men (n=1679) and women (n=2035) from the FINRISK 2007 Study (DILGOM substudy). The Three-Factor Eating Questionnaire-R18, Center for Epidemiological Studies Depression Scale, and a 132-item Food Frequency Questionnaire were used. Emotional eating and depressive symptoms correlated positively (r=0.31 among men and women), and both were related to a higher body mass. Emotional eating was related to a higher consumption of sweet foods in both genders and non-sweet foods in men independently of depressive symptoms and restrained eating. The positive associations of depressive symptoms with sweet foods became non-significant after adjustment for emotional eating, but this was not the case for non-sweet foods. Depressive symptoms, but not emotional eating, were related to a lower consumption of vegetables/fruit. These findings suggest that emotional eating and depressive symptoms both affect unhealthy food choices. Emotional eating could be one factor explaining the association between depressive symptoms and consumption of sweet foods, while other factors may be more important with respect to non-sweet foods and vegetables/fruit.

A descriptive study of weight loss maintenance: 6 and 15 year follow-up of initially overweight adults.

OBJECTIVE: To describe factors associated with long-term maintenance of weight loss.DESIGN AND SUBJECTS: We identified initially overweight individuals (body mass index>27 kg/m2, n=911) from the nationwide Finnish Twin Cohort and studied those who lost at least 5% of their body weight between 1975 and 1981. Subjects who had maintained weight loss until 1990 (38 men, 17 women) were compared to both re-gainers (28 men, 26 women) and the other overweight subjects in the cohort.MEASUREMENTS: Self-report data on weight, height, health behaviours and perceived well-being; self-report and register-based data on health status and use of medication.RESULTS: Only 6% of all overweight individuals lost and maintained at least 5% weight loss. In men weight loss maintenance was associated with a low level of stress and health-promoting behaviours but also with medical problems. Failure to maintain weight loss seemed to be associated with stressful life and past high alcohol intake. In women weight loss maintenance was associated with low initial well-being and health-compromising behaviours that improved after weight loss.CONCLUSION: Long-term weight loss maintenance is rare. Predictors of weight loss maintenance are different between women and men.

Eating styles, self-control and obesity indicators. The moderating role of obesity status and dieting history on restrained eating.

We examined whether obesity status and dieting history affected the associations of eating styles with measured obesity indicators and self-control among Finnish men (n = 2325) and women (n = 2699) aged 25-75 years. Uncontrolled and emotional eating were positively associated with obesity and reversely with self-control. Among obese subjects and current/past dieters, higher restrained eating was related to lower adiposity, uncontrolled and emotional eating, and higher self-control while these associations were opposite among normal weight subjects and never dieters. These results suggest that restrained eating may be related to better weight control among those who need and/or are motivated to lose weight while among others it may indicate problems with eating.

Emotional eating and physical activity self-efficacy as pathways in the association between depressive symptoms and adiposity indicators

BACKGROUND There is increasing evidence that depressive symptoms and obesity are positively related, but the mechanisms that explain the association between them are unclear. OBJECTIVE We examined direct and indirect associations between depressive symptoms, emotional eating, physical activity (PA) self-efficacy (ie, an individuals confidence in his or her ability to overcome barriers to maintain PA behaviors), and adiposity indicators. DESIGN Structural equation modeling was used to test the hypothesized mediation model in Finnish men (n = 2312) and women (n = 2674) aged 25-74 y from the National Cardiovascular Risk Factor Survey conducted in 2007. The Center for Epidemiologic Studies-Depression Scale, the Three-Factor Eating Questionnaire-R18, and a PA barriers self-efficacy scale were used. Body mass index (BMI), waist circumference (WC), and percentage body fat of participants were measured in a health examination. RESULTS Depressive symptoms and emotional eating had positive correlations and PA self-efficacy had negative correlations with BMI, WC, and percentage body fat. Elevated depressive symptoms were related to higher emotional eating (β = 0.38 for men and 0.31 for women) and lower PA self-efficacy (β = -0.41 for men and -0.31 for women), whereas emotional eating and PA self-efficacy were inversely correlated (r = -0.12 and -0.18, respectively). The positive bivariate associations between depressive symptoms and adiposity indicators became nonsignificant in models that included emotional eating and PA self-efficacy, and both of these factors significantly mediated the effects of depressive symptoms on adiposity indicators. CONCLUSIONS Psychological factors related to both eating and PA may be relevant in explaining the positive relation between depressive symptoms and adiposity. Interventions that target obesity should take into account the effects of these factors on weight regulation.

Socio-economic disparities in the consumption of vegetables, fruit and energy-dense foods: the role of motive priorities

OBJECTIVE A low socio-economic status (SES) is related to less healthy dietary habits, but the reasons for this remain unclear. We examined whether the absolute or relative importance of various food choice motives contributed to SES disparities in vegetable/fruit and energy-dense food intake. DESIGN We analysed cross-sectional data from the FINRISK Study 2007 by means of structural equation modelling and used a shortened version of the Food Choice Questionnaire to assess the absolute importance of health, pleasure, convenience, price, familiarity and ethicality motives. We calculated the relative importance of each motive by dividing the participants rating of it by his/her mean score on all motives. Dietary intake was measured with an FFQ. SETTING A population-based survey in Finland. SUBJECTS Men (n 1691) and women (n 2059) aged 25-64 years. RESULTS Higher education and income were related to a greater vegetable/fruit intake (β = 0·12, P < 0·001), while education was associated negatively with the consumption of energy-dense foods (β = -0·09, P < 0·001). Socio-economically disadvantaged individuals considered price and/or familiarity more important in their food choices in both absolute and relative terms. A higher income was related to a greater relative importance of health considerations. Relative motives were more strongly associated with vegetable/fruit and energy-dense food consumption than absolute motives and the relative importance of price, familiarity and health partly mediated the effects of the SES indicators on the consumption of these food items. CONCLUSIONS Individual priorities in food choice motives, rather than the absolute importance of single motives, play a role in producing SES disparities in diet.

Having lunch at a staff canteen is associated with recommended food habits

OBJECTIVE To describe the characteristics of employees having lunch at staff canteens and to examine the association between workplace lunch and recommended food habits. DESIGN A mailed questionnaire including data on lunch pattern, food habits, sociodemographic background, work-related factors and body weight. Logistic regression models including food habits as dependent variables and lunch pattern, sociodemographic factors, work-related factors and body mass index as independent variables. SETTING Helsinki Health Study survey data, collected in spring 2001. SUBJECTS Employees from the City of Helsinki reaching 40, 45, 50, 55 and 60 years. The data included 2474 women and 591 men; the response rate was 68%. RESULTS About half of those with a staff canteen at work had lunch there. Those with higher educational level were more likely to have lunch at the staff canteen, as also were women with pre-school children and normal-weight men. Those having lunch at staff canteens were more likely to follow recommended food habits, compared with other subjects. Having lunch at the staff canteen seemed to increase the consumption frequency of vegetables and fish. CONCLUSIONS Having lunch at staff canteens is associated with the quality of the diet. To serve a cooked meal including vegetables during working time may be an efficient way to improve diet among adult employees. More emphasis should be put on increasing the possibility for employees to have lunch at staff canteens.

Associations of work–family conflicts with food habits and physical activity

OBJECTIVE This study examines the relationship between family-work conflicts with food habits and physical activity, and whether the relationship is dependent on family structure and work-related factors. DESIGN AND SETTING Cross-sectional postal surveys were carried out in 2001 and 2002 among employees of the City of Helsinki, Finland, aged 40-60 years (n = 5346, response rate 66%; for women 70% and for men 60%). Dependent variables in logistic regression analyses were nationally recommended food habits and physical activity. Independent variables were work-family conflicts and family-work conflicts. Covariates included age, marital status, number of children, occupational class, working hours, time travelling to work, and physical and mental work load. RESULTS Women reporting strong work-family conflicts were more likely to follow recommended food habits (odds ratio (OR) and 95% confidence intervals 1.49 (1.19-1.86)), but this relationship weakened when adjusting for work-related factors (OR 1.20 (0.93-1.55)). Women and men with strong family-work conflicts were less likely to report recommended food habits after adjusting for family structure and work-related factors (women OR 0.75 (0.61-0.92), men OR 0.57 (0.34-0.96)). Women and men with strong work-family conflicts were less likely to follow the recommended amount of physical activity (women OR 0.76 (0.60-0.96), men OR 0.54 (0.34-0.87)). Additionally, women with strong family-work conflicts were less likely to follow the recommended amount of physical activity (OR 0.77 (0.63-0.94)). Adjusting for family and work-related factors did not affect these associations. CONCLUSIONS Conflicts between paid work and family life are likely to constitute barriers for a physically active lifestyle and possibly also for healthy food habits. Improving the balance between work and family may provide a route for promoting health-related behaviours.

Psychosocial working conditions and weight gain among employees

OBJECTIVE:To study the associations between psychosocial working conditions and weight gain.DESIGN, SUBJECTS AND MEASUREMENTS:Data from postal questionnaires (response rate 67%) sent to 40- to 60-y-old women (n=7093) and men (n=1799) employed by the City of Helsinki in 2000–2002 were analysed. Weight gain during the previous 12 months was the outcome variable in logistic regression analyses. Independent variables included Karaseks job demands and job control, work fatigue, working overtime, work-related mental strain, social support and the work–home interface. The final models were adjusted for age, education, marital status, physical strain and body mass index.RESULTS:In the previous 12 months, 25% of women and 19% of men reported weight gain. Work fatigue and working overtime were associated with weight gain in both sexes. Women who were dissatisfied with combining paid work and family life were more likely to have gained weight. Men with low job demands were less likely to have gained weight. All of these associations were independent of each other.CONCLUSIONS:Few work-related factors were associated with weight gain. However, our study suggests that work fatigue and working overtime are potential risk factors for weight gain. These findings need to be confirmed in prospective studies.

Weight loss maintenance: Determinants of long-term success

To analyse determinants of long-term weight maintenance we studied energy expenditure, dietary intake, eating behaviour and psychological symptoms of 9 women (SS BMI=26.6) who reached their ideal weight during 1985-86 and were still an average 16.2 kg below their original weight in 1993. Controls were 42 obese, non-reducing females (OC BMI=34.8). Dietary intake was calculated from four-day food records. Dietary restraint was assessed by the Three-Factor Eating Questionnaire (TFEQ) and symptoms of bulimia or binge eating by Bulimic Investigatory Test, Edinburgh (BITE). Physical exercise was estimat ed by open interviews, resting metabolic rate (RMR) by indirect calorimetry and body com position by bioelectrical impedance. Psychological characteristics were studied using the Defense Style Questionnaire (DSQ), Beck Depression Inventory (BDI) and Symptom Check list (SCL-90). SS had lower RMR (1320 kcal vs. 1540 kcal, p=0.004), lower daily energy intake (1208 kcal vs. 1525 kcal, p=0.020) and higher scores for dietary restraint (14.6 vs. 8.4, p=0.002 than OC. Restraint scores correlated negatively with energy intake and RMR in both groups especially in SS (r= −0.75, p=0.021 and r=−0.87, p=0.002, respectively). Attempts to incorpo rate habitual physical activities to daily life (89% vs. 39%, p=0.011) and weekly sports hobbies (67% vs. 13%, p=0.002) were more often reported by SS. The scores of BITE, DSQ, BDI and SCL-90 were within normal range in both groups but SS had higher scores in most mea sures, especially for anxiety (16.4 vs. 14.3, p=0.045). In conclusion, long-term maintenance o weight loss was associated with highly restrained eating, regular physical activity, and per haps with increased anxiety.

Relative Weight and Sickness Absence

Objectives: To examine whether high relative weight increases the risk of future sickness absence and to what extent any differences in short and long absence periods can be explained by specific obesity‐related disorders, general health, and working conditions.