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Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (3): 397-402. doi: 10.19723/j.issn.1671-167X.2024.03.004

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Association between self-control and co-occurrence of depressive symptoms and overweight or obesity during adolescence and early adulthood: A ten-year prospective cohort study based on national surveys

Jing CHEN1,Rui SHAN1,Wucai XIAO1,Xiaorui ZHANG2,Zheng LIU1,*()   

  1. 1. Department of Maternal and Child Health, Peking University School of Public Health, Beijing 100191, China
    2. Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
  • Received:2024-02-06 Online:2024-06-18 Published:2024-06-12
  • Contact: Zheng LIU E-mail:liuzheng@bjmu.edu.cn
  • Supported by:
    Supported by the National Natural Science Foundation of China(82373694);the Beijing Municipal Education Sciences "14th Five-Year Plan" Project(BECA23111)

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Abstract:

Objective: To explore the association between self-control and the co-occurrence of depressive symptoms and overweight or obesity from adolescence to early adulthood in the Chinese population, and to provide a scientific basis for personalized interventions targeting individuals with different risks in the future. Methods: From a prospective cohort study that lasted for 10 years: The China family panel studies (CFPS), a total of 608 children and adolescents meeting the following inclusion and exclusion criteria were included as study subjects: (1) Aged 10 to 19 years, at normal weight according to Chinese standards, and without depressive symptom in 2010; (2) Had self-control scores, and with at least two measurements of depressive symptoms and body mass index (BMI) between 2010 and 2020; (3) The only one or the youngest child and adolescent from each family. The co-occurrence of depressive symptoms and overweight or obesity was defined in three ways: Both of the average level of standardized scores of depressive symptoms and BMI Z-scores across multiple measurements over time were at a high level, or both of the trajectories of depressive symptoms and BMI over time based on the latent classification trajectory model (LCTM) belonging to the "risk-type", or individuals had depressive symptoms and overweight/obesity at the last follow-up survey. The multinomial Logistic regression model was used to examine the association between standardized scores of self-control and the co-occurrence of depressive symptoms and overweight or obesity. Results: The score of self-control was associated with the co-occurrence of depressive symptoms and overweight or obesity when using healthy individuals as the reference group after adjusting for age (years), gender (male/female), area (urban/rural), weekly physical activity duration (high/low), parental education level (college or above/high school or below), parental weight status (overweight or obese or not), and parental depressive symptoms (with depressive symptoms or not), regardless of the definition of the risk population. Specifically, the risk of co-occurrence of depressive symptoms and overweight or obesity was reduced by 33% (95%CI: 14% to 48%, based on the average level across multiple measurements over time) to 78% (95%CI: 6% to 95%, based on the joint trajectories of depressive symptoms and BMI over time) per 1-standard deviation (1-SD) increase in self-control score. In addition, the risk of depressive-symptom-dominant and overweight-or-obesity-dominant was reduced by 25% (95%CI: 4% to 42%, only based on the average level across multiple measurements over time) and 21% (95%CI: 1% to 37%, only based on the joint trajectories of depressive symptoms and BMI over time) per 1-SD increase in self-control score, respectively. The results from sensitivity analysis that defined individuals' weight status according to World Health Organization (WHO) standards were consistent with our main findings. Conclusion: Individuals with higher self-control scores from adolescence to early adulthood have a lower risk of co-occurrence of depressive symptoms and overweight or obesity, suggesting that personalized interventions for co-occurrence of depressive symptoms and overweight or obesity can be carried out based on self-control scores in the future.

Key words: Self-control, Depressive symptom, Overweight, Obesity, Co-occurrence, Association

CLC Number: 

  • R479.4

Figure 1

Selection of study population BMI, body mass index."

Figure 2

The trajectory of depressive symptoms over time among study population 30 and 578 out of 608 individuals' trajectory of depressive symptoms belonged to the type of red and black line, respectively."

Figure 3

The trajectory of BMI over time among study population BMI, body mass index; 96, 441, and 71 out of 608 individuals' trajectory of BMI belonged to the type of black, green, and red line, respectively."

Table 1

Baseline characteristics of study population"

Items Health-sustaining
(n=145)		 Depressive-symptom-
dominant (n=159)		 Overweight-or-obesity-
dominant (n=159)		 Co-occurrence of both
conditions (n=145)		 F/χ2 Pa
Age/years, ${\bar x}$±s 11.4±1.14 11.4±1.10 11.5±1.15 11.3±1.04 0.718 0.542
Gender, n (%) 6.424 0.093
  Male 73 (50.3) 73 (45.9) 81 (50.9) 55 (37.9)
  Female 72 (49.7) 86 (54.1) 78 (49.1) 90 (62.1)
Area, n (%) 0.970 0.809
  Urban 59 (40.7) 65 (40.9) 71 (44.7) 65 (44.8)
  Rural 86 (59.3) 94 (59.1) 88 (55.3) 80 (55.2)
Physical activity duration per week, n (%) 1.451 0.694
  Low 72 (49.7) 87 (54.7) 85 (53.5) 71 (49.0)
  High 73 (50.3) 72 (45.3) 74 (46.5) 74 (51.0)
Fathers’ education levelb, n (%) 1.161 0.763
  High school or below 129 (91.5) 148 (94.3) 137 (91.9) 131 (93.4)
  College or above 12 (8.5) 9 (5.7) 12 (8.1) 9 (6.6)
Mothers’ education levelb, n (%) 6.623 0.085
  High school or below 127 (93.4) 153 (97.5) 137 (90.7) 131 (94.9)
  College or above 9 (6.6) 4 (2.5) 14 (9.3) 7 (5.1)
Fathers’ weight statusb, n (%) 6.195 0.103
  Overweight or obese 40 (34.8) 34 (28.8) 46 (44.7) 39 (34.2)
  Without overweight and obesity 75 (65.2) 84 (71.2) 57 (55.3) 75 (65.8)
Mothers’ weight statusb, n (%) 16.393 <0.001
  Overweight or obese 28 (22.8) 22 (15.9) 46 (35.9) 39 (31.7)
  Without overweight and obesity 95 (77.2) 116 (84.1) 82 (64.1) 84 (68.3)
Fathers’ depressive symptomsb, n (%) 11.676 0.009
  With depressive symptoms 23 (16.8) 41 (26.8) 22 (15.7) 40 (29.4)
  Without depressive symptoms 114 (83.2) 112 (73.2) 118 (84.3) 96 (70.6)
Mothers’ depressive symptomsb, n (%) 30.227 <0.001
  With depressive symptoms 23 (17.4) 65 (43.3) 30 (20.5) 46 (34.1)
  Without depressive symptoms 109 (82.6) 85 (56.7) 116 (79.5) 89 (65.9)
Standardized self-control scores, ${\bar x}$±s 0.24±1.00 0.01±0.93 0.03±0.99 -0.12±1.08 3.182 0.024

Figure 4

The associations between self-control and co-occurrence of depressive symptoms and overweight or obesity among adolescents and young adults aged 10 to 29 years 1 to 3 in the forest plot means three assessment ways: 1 means the average level of standardized scores of depressive symptoms and BMI Z-scores over time. Based on this way, there were 145, 159, 159, and 145 individuals in health-sustaining, depressive-symptom-dominant, overweight-or-obesity-dominant, and co-occurrence of both conditions groups, respectively. 2 means the joint trajectories of depressive symptoms and BMI over time. Based on this way, there were 486, 26, 92, and 4 individuals in health-sustaining, depressive-symptom-dominant, overweight-or-obesity-dominant, and co-occurrence of both conditions groups, respectively. 3 means the single measurement of center for epidemiologic studies depression score (CES-D) and body mass index (BMI) Z-score at the last follow-up. Based on this way, there were 464, 77, 56, and 11 individuals in health-sustaining, depressive-symptom-dominant, overweight-or-obesity-dominant, and co-occurrence of both conditions groups, respectively."

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