The association between depressive symptoms and overweight or obesity in prepubertal children: findings from the QUALITY cohort

Abstract

Background: Youth obesity and depression are public health concerns. Although metaanalyses suggest a positive association between those conditions in adults and adolescents, evidence remains unclear in prepubertal children. We examined the bidirectional associations between levels of depressive symptoms and weight status in 8-10-year-old children with a parental history of obesity, over two years, and whether they differ by sex. Methods: Data were drawn from QUebec Adipose and Lifestyle InvesTigation in Youth Cohort Study’s baseline and first follow-up evaluations (n=558). Depressive symptoms were assessed using the 12-item Center for Epidemiological Studies Depression scale and weight status using body mass index z-scores based on World Health Organization standards. Linear and logistic regression models were used to test the directionality and magnitude of the associations, adjusting for age, sex, physical activity, screen time, parental education, alcohol and cigarette use, and baseline outcome measure. Results: Children with higher levels of depressive symptoms at baseline were not more likely to have overweight/obesity at follow-up (odds ratio [95% Coefficient Interval] = 0.95[0.88;1.02]). Baseline overweight/obesity was not associated with subsequent higher levels of depressive symptoms (beta coefficient [95% Coefficient Interval] = 0.20 [-0.47;0.87]). No sex differences emerged. Limitations: Selection bias may have occurred due to loss at followup (10% attrition) and exclusion of 6 participants taking mood disorder medication. Conclusions: Unlike in adults and adolescents, no association between weight status and depressive symptoms was observed in childhood over two years. Underlying mechanisms linking both conditions later in life may not apply as early as prepubertal childhood.