Background: Although the bidirectional association between depressive symptoms and adiposity has been recognized, the contribution of neighborhood factors to this relationship has not been assessed. Objective: This study evaluates whether physical and social neighborhood environments modify the bidirectional relationship between depressive symptoms and adiposity (measured by waist circumference and body mass index). Methods: Using data on 5,122 men and women (ages 45 to 84 years) from the Multi-Ethnic Study of Atherosclerosis (MESA) we investigated whether neighborhood physical (i.e., walking environment and availability of healthy food) and social (i.e., safety, aesthetics, and social coherence) environments modified the association between the following: (1) baseline elevated depressive symptoms (Center for Epidemiologic Study Depression Scale score ≥ 16) and change in adiposity (as measured by waist circumference and body mass index) and (2) baseline overweight/obesity (waist circumference > 102cm for men and >88cm for women, or body mass index ≥ 25kg/m2) and change in depressive symptoms using multilevel models. Neighborhood-level factors were obtained from the MESA Neighborhood Study. Results: A greater increase in waist circumference in participants with vs without elevated depressive symptoms was observed in those living in poorly-rated physical environments but not in those living in better-rated environments (interaction p = 0.045). No associations were observed with body mass index. Baseline overweight/obesity was not associated with change in depressive symptoms and there was no modification by neighborhood-level factors. Conclusions: Elevated depressive symptoms were associated with greater increase in waist circumference among individuals living in poorly-rated physical environments than in those in better-rated physical environments. No association was found between overweight/obesity and change in depressive symptoms.
Bibliographical noteFunding Information:
The NIDDK training grant ( T32-DK062707 ) supported this work. MESA was supported by N01-HC-95159 through N01-HC-95169 from NHLBI and UL1-RR-024156 and UL1-RR-025005 from NCRR . The MESA Neighborhood Study was supported by 2R01-HL-071759 from NHLBI . R.A.R., S.H.G., M.S., R.C., J.L., and M.F. were involved in literature review, study design, concept development, and analysis. All authors contributed to writing and editing the manuscript. We would also like to acknowledge Ms. Kari Moore for her assistance with the neighborhood data (University of Michigan, Center for Social Epidemiology and Population Health).