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Author Notes:

Corresponding Author: Daurice A. Grossniklaus, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA Email: dgrossn@hotmail.com


Research Funding:

This work was supported by funding from The National Institutes of Health, National Institute for Nursing Research, National Research Service Award; Nurses Educational Funds, Inc.; American Nurses Foundation; Southern Nurses Research Society; Sigma Theta Tau International, Alpha Epsilon Chapter; National Institutes of Health, National Center for Research Resources, PHS Grant UL1RR025008 Clinical and Translational Science Award program and PHS Grant MO1 RR0039 General Clinical Research Center program.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Cardiac & Cardiovascular Systems
  • Nursing
  • Cardiovascular System & Cardiology
  • Depressive symptoms
  • dietary energy density
  • waist circumference
  • abdominal obesity
  • FOOD

Dietary energy density: a mediator of depressive symptoms and abdominal obesity or independent predictor of abdominal obesity?


Journal Title:

European Journal of Cardiovascular Nursing


Volume 11, Number 4


, Pages 423-431

Type of Work:

Article | Post-print: After Peer Review


In the U.S., Europe, and throughout the world, abdominal obesity prevalence is increasing. Depressive symptoms may contribute to abdominal obesity through the consumption of diets high in energy density. To test dietary energy density ([DED]; kilocalories/gram of food and beverages consumed) for an independent relationship with abdominal obesity or as a mediator between depressive symptoms and abdominal obesity. This cross-sectional study included 87 mid-life, overweight adults; 73.6% women; 50.6% African-American. Variables and measures: Beck depression inventory-II (BDI-II) to measure depressive symptoms; 3-day weighed food records to calculate DED; and waist circumference, an indicator of abdominal obesity. Hierarchical regression tested if DED explained waist circumference variance while controlling for depressive symptoms and consumed food and beverage weight. Three approaches tested DED as a mediator. Nearly three-quarters of participants had abdominal obesity, and the mean waist circumference was 103.2 (SD 14.3) cm. Mean values: BDI-II was 8.67 (SD 8.34) which indicates that most participants experienced minimal depressive symptoms, and 21.8% reported mild to severe depressive symptoms (BDI-II ≥ 14); DED was 0.75 (SD 0.22) kilocalories/gram. Hierarchical regression showed an independent association between DED and waist circumference with DED explaining 7.0% of variance above that accounted for by BDI-II and food and beverage weight. DED did not mediate between depressive symptoms and abdominal obesity. Depressive symptoms and DED were associated with elevated waist circumference, thus a comprehensive intervention aimed at improving depressive symptoms and decreasing DED to reduce waist circumference is warranted.

Copyright information:

© 2012, SAGE Publications

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