Abstract
ObjectiveTo assess the association between indicators of psychosocial stress and central adiposity in adult users of the Unified Health System (SUS) from Southeast of Brazil.MethodsThis cross-sectional study was conducted with 384 adults (20 to 59 years old) from the city of Alegre, Southeastern Brazil. The simple random sample represented the population using the public health system of the municipality. The prevalence of obesity was based on the Body Mass Index, and central adiposity (dependent variable) was measured by waist circumference in centimeters. The independent variables were the following indicators of psychosocial stress: food and nutrition insecurity (yes/no), serum cortisol (μg/dL), symptoms suggestive of depression using the Beck Depression Inventory-II ≥ 17 (yes/no), and altered blood pressure ≥ 130/85 mmHg (yes/no). Univariate linear regression was performed between central adiposity and each stress indicator, and later the models were adjusted for socioeconomic, health, and lifestyle variables. All analyses were made separately by rural and urban location.ResultsThe prevalence of weight excess, by the classification of the Body Mass Index ≥ 25.0 kg/m2, was 68.3% and, by waist circumference, 71.5% of individuals presented an increased risk for metabolic complications related to central adiposity. Mean waist circumference scores for the rural and urban population were 89.3 ± 12.7 cm and 92.9 ± 14.7 cm, respectively (p = 0.012). Indicators of stress that were associated with central adiposity were: cortisol in the rural population (β = -0.60; 95% CI = -1.09;-0.11) and altered blood pressure in the urban population (β = 6.66; 95% CI = 2.14;11.18). This occurred both in the raw analysis and in the models adjusted for confounding factors.ConclusionCentral adiposity was inversely associated with cortisol in the rural population and directly associated with higher arterial blood pressure in the urban population, suggesting a local influence on how individuals react to stress.
Highlights
Overweight and obesity are defined as abnormal or excessive accumulation of fat that can be detrimental to heath.[1]
The prevalence of weight excess, by the classification of the Body Mass Index ! 25.0 kg/ m2, was 68.3% and, by waist circumference, 71.5% of individuals presented an increased risk for metabolic complications related to central adiposity
Waist circumference (WC) was measured using an inextensible anthropometric tape TBW1 (1.5 m and 0.1 cm accuracy), with reference to the midpoint between the last rib and the iliac crest. [34,35] This study considered that increased risk of metabolic complications for men was associated with abdominal obesity with WC values ! 94 cm; and very high risk with WC ! 102
Summary
Overweight and obesity are defined as abnormal or excessive accumulation of fat that can be detrimental to heath.[1]. The prevalence is higher in the United States of America, Mexico, and Chile, where weight excess affects between six and seven out of 10 adults.[3,4] In Brazil, the National Health Survey (NHS) presented a similar scenario, with 56.9% of overweight adults.[5]
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