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European Journal of Epidemiology

, Volume 27, Issue 2, pp 119–130 | Cite as

Psychosocial risk factors, weight changes and risk of obesity: the Copenhagen City Heart Study

  • Louise Bagger Iversen
  • Katrine Strandberg-Larsen
  • Eva Prescott
  • Peter Schnohr
  • Naja Hulvej Rod
Obesity

Abstract

The aim of the study was to establish the effects of a range of psychosocial factors on weight changes and risk of obesity. The study population consisted of the 4,753 participants in the third (1991–1994) and fourth wave (2001–2003) of the Copenhagen City Heart Study, Denmark. At baseline the participants were asked comprehensive questions on major life events, work stress, vital exhaustion, social network, economic hardship, and intake of sleep medication. Weight and height were measured by health professionals. Weight changes and incident obesity was used as outcome measures. The participants on average gained 2 kg of weight and 8% became obese during follow-up. The experience of major life events in childhood, work life and adult life was associated with weight gain and obesity in women, but not in men. Vital exhaustion was associated with weight gain in a dose–response manner in men (P = 0.002) and younger women (P = 0.02). Persons with high vital exhaustion gained approximately 2 kg more during follow-up compared to those with no vital exhaustion. Women with high vital exhaustion were also more likely to become obese during follow-up (OR = 2.39; 95% CI: 1.14–5.03). There were no clear patterns in the associations between social network, economic hardship and weight gain or obesity. The number of psychosocial risk factors, as an indicator for clustering, was not associated with weight gain or obesity. In conclusion, major life events and vital exhaustion seem to play a role for weight gain and risk of obesity, especially in women.

Keywords

Life change events Obesity Body mass index Psychological stress Prospective studies Social support 

Notes

Acknowledgments

We thank the staff and the participants of the Copenhagen City Heart Study. This work was supported by the Danish Medical Research Council [09-062115 to L.B.I and N.H.R.]. The Copenhagen City Heart Study is supported by funds from the Danish Heart Foundation and the Lundbeck Foundation.

Conflicts of interests

None declared.

References

  1. 1.
    World Health Organization. Obesity: Preventing and managing the global epidemic. Report of a WHO Consultation. (WHO technical report series 894). World Health Organization: Geneva, Switzerland, 2000.Google Scholar
  2. 2.
    Savica V, Bellinghieri G, Kopple JD. The effect of nutrition on blood pressure. Annu Rev Nutr. 2010;30:365–401.PubMedCrossRefGoogle Scholar
  3. 3.
    Mensah GA, Mokdad AH, Ford E, Narayan KM, Giles WH, Vinicor F, et al. Obesity, metabolic syndrome, and type 2 diabetes: emerging epidemics and their cardiovascular implications. Cardiol Clin. 2004;22:485–504.PubMedCrossRefGoogle Scholar
  4. 4.
    Nguyen NT, Nguyen XM, Wooldridge JB, Slone JA, Lane JS. Association of obesity with risk of coronary heart disease: findings from the National Health and Nutrition Examination Survey, 1999–2006. Surg Obes Relat Dis. 2010;6:465–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Epel E, Lapidus R, McEwen B, Brownell K. Stress may add bite to appetite in women: a laboratory study of stress-induced cortisol and eating behavior. Psychoneuroendocrinology. 2001;26:37–49.PubMedCrossRefGoogle Scholar
  6. 6.
    Newman E, O’Connor DB, Conner M. Daily hassles and eating behaviour: the role of cortisol reactivity status. Psychoneuroendocrinology. 2007;32:125–32.PubMedCrossRefGoogle Scholar
  7. 7.
    Adam TC, Epel ES. Stress, eating and the reward system. Physiol Behav. 2007;91:449–58.PubMedCrossRefGoogle Scholar
  8. 8.
    Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition. 2007;23:887–94.PubMedCrossRefGoogle Scholar
  9. 9.
    Overgaard D, Gyntelberg F, Heitmann BL. Psychological workload and body weight: is there an association? A review of the literature. Occup Med (Lond). 2004;54:35–41.CrossRefGoogle Scholar
  10. 10.
    Block JP, He Y, Zaslavsky AM, Ding L, Ayanian JZ. Psychosocial stress and change in weight among US adults. Am J Epidemiol. 2009;170:181–92.PubMedCrossRefGoogle Scholar
  11. 11.
    Rod NH, Gronbaek M, Schnohr P, Prescott E, Kristensen TS. Perceived stress as a risk factor for changes in health behaviour and cardiac risk profile: a longitudinal study. J Intern Med. 2009;266:467–75.PubMedCrossRefGoogle Scholar
  12. 12.
    Ishizaki M, Nakagawa H, Morikawa Y, Honda R, Yamada Y, Kawakami N. Influence of job strain on changes in body mass index and waist circumference–6-year longitudinal study. Scand J Work Environ Health. 2008;34:288–96.PubMedCrossRefGoogle Scholar
  13. 13.
    Kivimaki M, Head J, Ferrie JE, Shipley MJ, Brunner E, Vahtera J, et al. Work stress, weight gain and weight loss: evidence for bidirectional effects of job strain on body mass index in the Whitehall II study. Int J Obes (Lond). 2006;30:982–7.CrossRefGoogle Scholar
  14. 14.
    Schnohr P, Jensen G, Lange P, Scharling H, Appleyard M. The Copenhagen City Heart Study—introduction. Eur Heart J Suppl. 2001;3:H1–83.CrossRefGoogle Scholar
  15. 15.
    Appleyard M, Hansen AT, Jensen G, Schnohr P, Nyboe J. Copenhagen City Heart Study osterbroundersogelsen a book of tables with data from the first examination 1976–1978 and a five year follow-up 1981–1983. Scand J Soc Med. 1989;41:1–160.Google Scholar
  16. 16.
    World Health Organization. Global Database on Body Mass Index. Available at: http://apps.who.int/bmi. Accessed April 2010.
  17. 17.
    Holmes TH, Rahe RH. Social readjustment rating scale. J Psychosom Res. 1967;11:213–8.PubMedCrossRefGoogle Scholar
  18. 18.
    Schuitemaker GE, Dinant GJ, van der Pol GA, Appels A. Assessment of vital exhaustion and identification of subjects at increased risk of myocardial infarction in general practice. Psychosomatics. 2004;45:414–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Appels A, Hoppener P, Mulder P. A questionnaire to assess premonitory symptoms of myocardial infarction. Int J Cardiol. 1987;17:15–24.PubMedCrossRefGoogle Scholar
  20. 20.
    Akerstedt T, Knutsson A, Westerholm P, Theorell T, Alfredsson L, Kecklund G. Sleep disturbances, work stress and work hours—a cross-sectional study. J Psychosom Res. 2002;53:741–8.PubMedCrossRefGoogle Scholar
  21. 21.
    Greenland S, Pearl J, Robins JM. Causal diagrams for epidemiologic research. Epidemiology. 1999;10:37–48.PubMedCrossRefGoogle Scholar
  22. 22.
    Glymour MM, Greenland S. Causal Diagrams. In: Rothman, Greenland, Lash (eds). Modern Epidemiology. Wolters Kluwer: Philadelphia, 2008; p. 183–209.Google Scholar
  23. 23.
    Serlachius A, Hamer M, Wardle J. Stress and weight change in university students in the United Kingdom. Physiol Behav. 2007;92:548–53.PubMedCrossRefGoogle Scholar
  24. 24.
    Van Strien T, Rookus MA, Bergers GP, Frijters JE, Defares PB. Life events, emotional eating and change in body mass index. Int J Obes. 1986;10:29–35.PubMedGoogle Scholar
  25. 25.
    Gunstad J, Paul RH, Spitznagel MB, Cohen RA, Williams LM, Kohn M, et al. Exposure to early life trauma is associated with adult obesity. Psychiatry Res. 2006;142:31–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Rookus MA, Burema J, Frijters JE. Changes in body mass index in young adults in relation to number of life events experienced. Int J Obes. 1988;12:29–39.PubMedGoogle Scholar
  27. 27.
    Bryant MJ, Stevens J, Truesdale KP, Mosley T, Chambless L. Obesity and vital exhaustion: analysis of the atherosclerosis risk in the communities study. Obesity (Silver Spring). 2008;16:1545–51.CrossRefGoogle Scholar
  28. 28.
    Huijbrechts IP, Erdman RA, Duivenvoorden HJ, Passchier J. Modification in Quetelet index five months after myocardial infarction: relevance of biographic and personality characteristics. Prev Med. 1999;28:86–91.PubMedCrossRefGoogle Scholar
  29. 29.
    Prescott E, Godtfredsen N, Osler M, Schnohr P, Barefoot J. Social gradient in the metabolic syndrome not explained by psychosocial and behavioural factors: evidence from the Copenhagen City Heart Study. Eur J Cardiovasc Prev Rehabil. 2007;14:405–12.PubMedCrossRefGoogle Scholar
  30. 30.
    Anderson AS, Marshall DW, Lea EJ. Shared lives-an opportunity for obesity prevention? Appetite. 2004;43:327–9.PubMedCrossRefGoogle Scholar
  31. 31.
    The NS, Gordon-Larsen P. Entry into romantic partnership is associated with obesity. Obesity (Silver Spring). 2009;17:1441–7.Google Scholar
  32. 32.
    Ball K, Crawford D. Socioeconomic status and weight change in adults: a review. Soc Sci Med. 2005;60:1987–2010.PubMedCrossRefGoogle Scholar
  33. 33.
    Greeno CG, Wing RR. Stress-induced eating. Psychol Bull. 1994;115:444–64.PubMedCrossRefGoogle Scholar
  34. 34.
    Epel E, Jimenez S, Brownell K, Stroud L, Stoney C, Niaura R. Are stress eaters at risk for the metabolic syndrome? Ann N Y Acad Sci. 2004;1032:208–10.PubMedCrossRefGoogle Scholar
  35. 35.
    van Diest R, Appels A. Vital exhaustion and depression: a conceptual study. J Psychosom Res. 1991;35:535–44.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Louise Bagger Iversen
    • 1
  • Katrine Strandberg-Larsen
    • 1
  • Eva Prescott
    • 2
    • 3
  • Peter Schnohr
    • 3
  • Naja Hulvej Rod
    • 1
  1. 1.Department of Public HealthUniversity of CopenhagenCopenhagen KDenmark
  2. 2.Department of CardiologyBispebjerg University HospitalCopenhagenDenmark
  3. 3.The Copenhagen City Heart Study, Epidemiological Research UnitBispebjerg University HospitalCopenhagenDenmark

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