Psychosocial stress and central adiposity: A Brazilian study with users of the public health system
Flavia V Freitas, Wagner Barbosa, Laiz Silva, Mariana Garozi, Julia Pinheiro, Aline Borçoi, Catarine Conti, Juliana Arpini, Heberth Paula, Mayara Oliveira, Anderson Archanjo, Erika Freitas
Objective: To assess the association between indicators of psychosocial stress and central adiposity in adult users of the Unified Health System (SUS) from Southeast of Brazil. Methods: This 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
... endent 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 stratified by rural and urban location. Results: The prevalence of weight excess was 68.3%, and 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 and altered blood pressure in the urban population. This occurred both in the raw analysis and in the models adjusted for confounding factors. Conclusion: The associations between stress and adiposity were different between rural (cortisol - inverse association) and urban (altered blood pressure) lifestyles, confirming the influence of local and psychosocial subsistence on the modulation of stress and on how individuals react or restrain stressors. Stress reduction strategies can be useful in public health programs designed to prevent or treat obesity.