Abstract
Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is linked to slower weight gain over time. Elevated depressive symptoms may lead to poor quality diets, potentially increasing Body Mass Index (BMI). This study explored these pathways using longitudinal data extracted from 1201–1458 Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study participants. DASH mean score was computed using four 24 h recalls [visits(v)1 + v2/2: 2004–2013] and depressive symptoms using the Center for Epidemiologic Studies Depression (CES-D) scale (v1 + v2/2: 2004–2013). BMI was measured at v2: 2009–2013 and v3: 2013–2017. Multiple linear mixed regression and mediation modeling were conducted, linking CES-D(mean) and DASH(mean) to BMI [v2 and annualized change ΔBMI (v3-v2)] and exploring mediation of the CES-D(mean)–BMI(v3) and DASH(mean)–BMI(v3) associations through DASH(mean) and CES-D(mean), respectively. Models were further stratified by sex, race and poverty status. Inverse cross-sectional and longitudinal relationships of DASH(mean) with BMI(v2) and ΔBMI were detected, mainly in women and <125% of poverty participants. CES-D(mean) was not associated with BMI(v3); no mediation was detected through DASH(mean) in all socio-demographic strata. Moreover, the inverse DASH(mean)–BMI(v3) total effect was not mediated through CES-D(mean). Future studies should explore other pathways aside from depressive symptoms by which DASH can have a preventive effect on weight status over time.
Highlights
Diet quality is associated with body mass index (BMI), waist circumference, and body weight [1,2,3,4,5].The Dietary Approaches to Stop Hypertension (DASH) diet, characterized by high intakes of fruits, vegetables, low-fat dairy, and whole grains, is recognized as a healthful dietary pattern [6]
In African American women across the United States (US), adherence to the DASH diet was associated with reduced obesity risk over a 16 years follow-up
Women were more likely than men to be in the uppermost Center for Epidemiologic Studies Depression (CES-D) tertile (p = 0.004)
Summary
The Dietary Approaches to Stop Hypertension (DASH) diet, characterized by high intakes of fruits, vegetables, low-fat dairy, and whole grains, is recognized as a healthful dietary pattern [6]. Adherence to this high-quality diet is associated with less weight gain with aging [3], as well as weight loss and maintenance [7,8]. In African American women across the US, adherence to the DASH diet was associated with reduced obesity risk over a 16 years follow-up. Improvement in adherence to the DASH diet is associated with decreases in BMI and weight, especially in persons at high genetic risk for obesity [10]
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