Obesity and its relationship with eating behaviors, mental health, and food intake in congregate meal participants
Porter, Kathryn Nicole
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This dissertation identifies potential modifiable risk factors related to obesity in participants of the Older American Act Nutrition Program (OAANP). Three studies were conducted and focused on: 1) exploring the association of eating behaviors (cognitive restraint, uncontrolled eating, and emotional eating) and mental health (depression, anxiety, and stress) with obesity assessment body mass index (BMI), 2) determining the relationship of food group intake (sweets, salty snacks, fruit, vegetables, whole grains, and milk) with four measures of obesity (BMI class I obesity, BMI class II obesity, waist circumference-National Heart Lung Blood Institute (WC-NHLBI), and waist circumference (WC) class I obesity), and 3) identifying the independent associations of eating behaviors, mental health symptoms, and food patterns with four measures of obesity. Both bivariate and multivariate models provided insight into this complex relationship. In bivariate analyses, all four measures of obesity were associated significantly with higher cognitive restraint and uncontrolled eating, while two measures of obesity were associated with emotional eating. Cognitive restraint was the only eating behavior associated with all four measures of obesity in fully adjusted and stepwise regression analyses. Anxiety was also associated with three measures of obesity in bivariate analyses, however, only two measures of obesity in fully adjusted logistic and stepwise regression analyses. The relationship among obesity and anxiety may be a result of physiological symptoms of obesity-related health problems rather than psychological symptoms of anxiety. Significant associations of sweets, salty snacks, fruits and vegetables with the four measures of adiposity emerged in bivariate analyses; however in the fully adjusted and stepwise regression models, sweets were the only food group associated with only one measure of obesity – WC class I obesity. Together these studies identified modifiable risk factors that can be used as part of a process to develop multidisciplinary interventions that target eating behaviors, mental health, and food intake to improve healthy weight management.