Negative affect and loss-of-control eating in relation to adiposity among non-Hispanic youth identifying as black or white

Abstract

Negative affect and loss-of-control (LOC)-eating are consistently linked and prevalent among youth identifying as non-Hispanic Black (NHB) and non-Hispanic White (NHW), particularly those with high weight. Given health disparities in high weight and associated cardiometabolic health concerns among NHB youth, elucidating how the association of negative affect with adiposity may vary by racial/ethnic group, and whether that relationship is impacted by LOC-eating, is warranted. Social inequities and related stressors are associated with negative affect among NHB youth, which may place this group at increased risk for excess weight gain. Across multiple aggregated protocols, 651 youth (13.0 ± 2.7 y; 65.9 % girls, 40.7 % NHB; 1.0 ± 1.1 BMIz; 37.6 % LOC-eating) self-reported trait anxiety and depressive symptoms as facets of negative affect. LOC-eating was assessed by interview and adiposity was measured objectively. Cross-sectional moderated mediation models predicted adiposity from ethno-racial identification (NHB, NHW) through the pathway of anxiety or depressive symptoms and examined whether LOC-eating influenced the strength of the pathway, adjusting for SES, age, height, and sex. The association between ethno-racial identity and adiposity was partially mediated by both anxiety (95 % CI = [0.01, 0.05]) and depressive symptoms (95 % CI = [0.02, 0.08]), but the mediation was not moderated by LOC-eating for either anxiety (95 % CI = [-0.04, 0.003]) or depressive symptoms (95 % CI = [-0.07, 0.03]). Mechanisms underlying the link between negative affect and adiposity among NHB youth, such as stress from discrimination and stress-related inflammation, should be explored. These data highlight the need to study impacts of social inequities on psychosocial and health outcomes.

Keywords: Adiposity; Ethno-racial identity; Loss-of-control eating; Negative affect; Sociocultural factors.

Figure 1:

Trait Anxiety Mediation Analyses Predicting Adiposity. 1a) Trait anxiety significantly mediated the relationship between ethno-racial identity (NHB = Non-Hispanic Black; NHW = Non-Hispanic White) and adiposity. Cross-sectional mediation models with sociodemographic group as the independent variable (NHB = reference group), trait anxiety as the mediator, and adiposity (fat mass, kg) as the dependent variable. The a pathway represents the relationship between ethno-racial identity and trait anxiety, and the b pathway represents the relationship between trait anxiety and adiposity. The c’ pathway represents the direct relationship between ethno-racial identity and adiposity, accounting for trait anxiety. The ab pathway represents the indirect relationship between ethno-racial identity and adiposity, through the trait anxiety pathway. The c pathway represents the total effect (sum of direct and indirect effect) between ethno-racial identity and adiposity. Models adjusted for age, sex, height, and socioeconomic status. 1b) Loss-of-control (LOC)-eating did not significantly moderate the mediation of ethno-racial identity and adiposity through trait anxiety. Cross-sectional mediation models with sociodemographic group as the independent variable (NHB = reference group), trait anxiety as the mediator, LOC-eating as the moderator, and adiposity (fat mass kg) as the dependent variable. The a pathway represents the relationship between ethno-racial identity and trait anxiety. The b₁ pathway represents the relationship between trait anxiety and adiposity, the b₂ pathway represents the relationship between LOC-eating and adiposity, and the b₃ pathway represents the relationship between the interaction of trait anxiety and LOC-eating on adiposity. The c’ pathway represents the direct relationship between ethno-racial identity and adiposity, accounting for trait anxiety. Models adjusted for age, sex, height, and socioeconomic status.

Figure 2:

Depressive Symptom Mediation Analyses Predicting Adiposity. 2a) Depressive symptoms significantly mediated the relationship between ethno-racial identity (NHB = Non-Hispanic Black; NHW = Non-Hispanic White) and adiposity. Cross-sectional mediation models with sociodemographic group as the independent variable (NHB = reference group), depressive symptoms as the mediator, and adiposity (fat mass, kg) as the dependent variable. The a pathway represents the relationship between ethno-racial identity and depressive symptoms, and the b pathway represents the relationship between depressive symptoms and adiposity. The c’ pathway represents the direct relationship between ethno-racial identity and adiposity, accounting for depressive symptoms. The ab pathway represents the indirect relationship between ethno-racial identity and adiposity, through the depressive symptoms pathway. The c pathway represents the total effect (sum of direct and indirect effect) between ethno-racial identity and adiposity. Models adjusted for age, sex, height, and socioeconomic status. 2b) Loss-of-control (LOC)-eating did not significantly moderate the mediation of ethno-racial identity and adiposity through depressive symptoms. Cross-sectional mediation models with sociodemographic group as the independent variable (NHB = reference group), depressive symptoms as the mediator, LOC-eating as the moderator, and adiposity (fat mass kg) as the dependent variable. The a pathway represents the relationship between ethno-racial identity and depressive symptoms. The b₁ pathway represents the relationship between depressive symptoms and adiposity, the b₂ pathway represents the relationship between LOC-eating and adiposity, and the b₃ pathway represents the relationship between the interaction of depressive symptoms and LOC-eating on adiposity. The c’ pathway represents the direct relationship between ethno-racial identity and adiposity, accounting for depressive symptoms. Models adjusted for age, sex, height, and socioeconomic status.