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Depressive symptoms, sleep quality, physical fitness, and fatigue among adult women with different obesity status

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Abstract

Purpose

The aim of this cross-sectional study was to examine the association between depressive symptoms, sleep quality, objectively assessed physical fitness, and fatigue, among a sample of adult women with different obesity status.

Methods

One hundred and ninety-four volunteer adult women (36.1 ± 11.1 years) participated in the study. Based on body mass index (BMI), the participants were allocated into three groups: normal weight (n = 134), overweight (n = 32), and obese (n = 25). Physical fitness-related parameters such as aerobic fitness, flexibility, lower limb explosive strength, isometric handgrip strength, and sprint performance were assessed with a battery of field tests. Total body fat and trunk fat levels were assessed by bioelectrical impedance analysis. Depressive symptoms were assessed using the Beck depression inventory, sleep quality was assessed using the Pittsburg sleep quality index, and fatigue levels were examined using the fatigue severity scale.

Results

Obese women experienced a significantly worse score regarding depressive symptoms (p < 0.05). Similarly, the obese and overweight women were found to exhibit lower levels of aerobic fitness compared to women with normal BMI (p < 0.05). All examined body composition variables were shown to be inversely associated with the score on all physical fitness tests as well as with poor sleep, depressive symptoms, and fatigue levels (p < 0.05).

Conclusions

Depressive symptoms and performance on various physical fitness tests were found to be significantly impaired in obese and overweight adult women indicating the negative impact of increased body weight in health and well-being.

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References

  1. NCD Risk Factor Collaboration (2016) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. Lancet 387(10026):1377–1396

    Google Scholar 

  2. Baumgartner RN, Heymsfield SB, Roche AF (1995) Human body composition and the epidemiology of chronic disease. Obes Res 3(1):73–95

    CAS  PubMed  Google Scholar 

  3. Britton KA, Massaro JM, Murabito JM, Kreger BE, Hoffmann U, Fox CS (2013) Body fat distribution, incident cardiovascular disease, cancer, and all-cause mortality. J Am Coll Cardiol 62(10):921–925

    PubMed  PubMed Central  Google Scholar 

  4. Masters RK, Reither EN, Powers DA, Yang YC, Burger AE, Link BG (2013) The impact of obesity on US mortality levels: the importance of age and cohort factors in population estimates. Am J Public Health 103(10):1895–1901

    PubMed  PubMed Central  Google Scholar 

  5. Lee IM, Djousse L, Sesso HD, Wang L, Buring JE (2010) Physical activity and weight gain prevention. JAMA 303(12):1173–1179

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Blumel JE, Chedraui P, Aedo S, Fica J, Mezones-Holguin E, Baron G, Bencosme A, Benitez Z, Bravo LM, Calle A, Flores D, Espinoza MT, Gomez G, Hernandez-Bueno JA, Laribezcoa F, Martino M, Lima S, Monterrosa A, Mostajo D, Ojeda E, Onatra W, Sanchez H, Tserotas K, Vallejo MS, Witis S, Zuniga MC (2015) Obesity and its relation to depressive symptoms and sedentary lifestyle in middle-aged women. Maturitas 80(1):100–105

    PubMed  Google Scholar 

  7. Mesarwi O, Polak J, Jun J, Polotsky VY (2013) Sleep disorders and the development of insulin resistance and obesity. Endocrinol Metab Clin North Am 42(3):617–634

    PubMed  PubMed Central  Google Scholar 

  8. Roveda E, Montaruli A, Galasso L, Pesenti C, Bruno E, Pasanisi P, Cortellini M, Rampichini S, Erzegovesi S, Caumo A, Esposito F (2018) Rest-activity circadian rhythm and sleep quality in patients with binge eating disorder. Chronobiol Int 35(2):198–207

    CAS  PubMed  Google Scholar 

  9. Qi Q, Chu AY, Kang JH, Huang J, Rose LM, Jensen MK, Liang L, Curhan GC, Pasquale LR, Wiggs JL, De Vivo I, Chan AT, Choi HK, Tamimi RM, Ridker PM, Hunter DJ, Willett WC, Rimm EB, Chasman DI, Hu FB, Qi L (2014) Fried food consumption, genetic risk, and body mass index: gene–diet interaction analysis in three US cohort studies. BMJ 348:g1610

    PubMed  PubMed Central  Google Scholar 

  10. Pataky Z, Armand S, Muller-Pinget S, Golay A, Allet L (2014) Effects of obesity on functional capacity. Obesity 22(1):56–62

    PubMed  Google Scholar 

  11. Bjorngaard JH, Carslake D, Lund Nilsen TI, Linthorst AC, Davey Smith G, Gunnell D, Romundstad PR (2015) Association of body mass index with depression, anxiety and suicide—an instrumental variable analysis of the HUNT study. PLoS One 10(7):e0131708

    PubMed  PubMed Central  Google Scholar 

  12. Martin-Rodriguez E, Guillen-Grima F, Auba E, Marti A, Brugos-Larumbe A (2016) Relationship between body mass index and depression in women: a 7-year prospective cohort study. The APNA study. Eur Psychiatry 32:55–60

    CAS  PubMed  Google Scholar 

  13. Jia H, Lubetkin EI (2005) The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxf) 27(2):156–164

    Google Scholar 

  14. Ortega FB, Tresaco B, Ruiz JR, Moreno LA, Martin-Matillas M, Mesa JL, Warnberg J, Bueno M, Tercedor P, Gutierrez A, Castillo MJ (2007) Cardiorespiratory fitness and sedentary activities are associated with adiposity in adolescents. Obesity (Silver Spring) 15(6):1589–1599

    Google Scholar 

  15. Tomlinson DJ, Erskine RM, Morse CI, Winwood K, Onambele-Pearson G (2016) The impact of obesity on skeletal muscle strength and structure through adolescence to old age. Biogerontology 17(3):467–483

    CAS  PubMed  Google Scholar 

  16. Backholer K, Wong E, Freak-Poli R, Walls HL, Peeters A (2012) Increasing body weight and risk of limitations in activities of daily living: a systematic review and meta-analysis. Obes Rev 13(5):456–468

    CAS  PubMed  Google Scholar 

  17. Roberts CK, Barnard RJ (2005) Effects of exercise and diet on chronic disease. J Appl Physiol 98(1):3–30

    PubMed  Google Scholar 

  18. Bruno E, Roveda E, Vitale J, Montaruli A, Berrino F, Villarini A, Venturelli E, Gargano G, Galasso L, Caumo A, Carandente F, Pasanisi P (2018) Effect of aerobic exercise intervention on markers of insulin resistance in breast cancer women. Eur J Cancer Care 27(2):e12617

    CAS  Google Scholar 

  19. Galasso L, Montaruli A, Bruno E, Pesenti C, Erzegovesi S, Ce E, Coratella G, Esposito F (2018) Aerobic exercise training improves physical performance of patients with binge-eating disorder. Sport Sci Health 14(1):47–51

    Google Scholar 

  20. Roveda E, Vitale JA, Bruno E, Montaruli A, Pasanisi P, Villarini A, Gargano G, Galasso L, Berrino F, Caumo A, Carandente F (2017) Protective effect of aerobic physical activity on sleep behavior in breast cancer survivors. Integr Cancer Ther 16(1):21–31

    PubMed  Google Scholar 

  21. Vitale JA, Lombardi G, Weydahl A, Banfi G (2018) Biological rhythms, chronodisruption and chrono-enhancement: the role of physical activity as synchronizer in correcting steroids circadian rhythm in metabolic dysfunctions and cancer. Chronobiol Int 35(9):1185–1197

    CAS  PubMed  Google Scholar 

  22. Suija K, Timonen M, Suviola M, Jokelainen J, Jarvelin MR, Tammelin T (2013) The association between physical fitness and depressive symptoms among young adults: results of the Northern Finland 1966 birth cohort study. BMC Public Health 13:535

    PubMed  PubMed Central  Google Scholar 

  23. Mollaoglu H, Ucok K, Kaplan A, Genc A, Mayda H, Guzel HI, Sener U, Uygur E, Ozbulut O (2012) Association analyses of depression, anxiety, and physical fitness parameters in Turkish obese adults. J Back Musculoskelet Rehabil 25(4):253–260

    PubMed  Google Scholar 

  24. Rebar AL, Stanton R, Geard D, Short C, Duncan MJ, Vandelanotte C (2015) A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychol Rev 9(3):366–378

    PubMed  Google Scholar 

  25. Mitrou GI, Grigoriou SS, Konstantopoulou E, Theofilou P, Giannaki CD, Stefanidis I, Karatzaferi C, Sakkas GK (2013) Exercise training and depression in ESRD: a review. Semin Dial 26(5):604–613

    PubMed  Google Scholar 

  26. Olvera RL, Williamson DE, Fisher-Hoch SP, Vatcheva KP, McCormick JB (2015) Depression, obesity, and metabolic syndrome: prevalence and risks of comorbidity in a population-based representative sample of Mexican Americans. J Clin Psychiatry 76(10):e1300–e1305

    PubMed  PubMed Central  Google Scholar 

  27. Kuehner C (2017) Why is depression more common among women than among men? Lancet Psychiatry 4(2):146–158

    PubMed  Google Scholar 

  28. Beccuti G, Pannain S (2011) Sleep and obesity. Curr Opin Clin Nutr Metab Care 14(4):402–412

    PubMed  PubMed Central  Google Scholar 

  29. Vitale JA, Montaruli A, Michielon G, Scurati R, Alberti G, Carandente F, Roveda E (2017) Sleep quality and cytokine expression after an exhaustive exercise: influence of ACE polymorphism I/D. Sleep Biol Rhythm 15(1):31–37

    Google Scholar 

  30. Sakkas GK, Giannaki CD, Karatzaferi C, Maridaki M, Koutedakis Y, Hadjigeorgiou GM, Stefanidis I (2015) Current trends in the management of uremic restless legs syndrome: a systematic review on aspects related to quality of life, cardiovascular mortality and survival. Sleep Med Rev 21:39–49

    PubMed  Google Scholar 

  31. Beck AT, Guth D, Steer RA, Ball R (1997) Screening for major depression disorders in medical inpatients with the Beck depression inventory for primary care. Behav Res Ther 35(8):785–791

    CAS  PubMed  Google Scholar 

  32. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213

    CAS  PubMed  Google Scholar 

  33. Krupp LB, LaRocca NG, Muir-Nash J, Steinberg AD (1989) The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol 46(10):1121–1123

    CAS  PubMed  Google Scholar 

  34. Leger LA, Mercier D, Gadoury C, Lambert J (1988) The multistage 20 metre shuttle run test for aerobic fitness. J Sports Sci 6(2):93–101

    CAS  PubMed  Google Scholar 

  35. Browning LM, Mugridge O, Chatfield MD, Dixon AK, Aitken SW, Joubert I, Prentice AM, Jebb SA (2010) Validity of a new abdominal bioelectrical impedance device to measure abdominal and visceral fat: comparison with MRI. Obesity (Silver Spring) 18(12):2385–2391

    Google Scholar 

  36. Hryhorczuk C, Sharma S, Fulton SE (2015) Metabolic disturbances connecting obesity and depression. Front Neurosci 7:177

    Google Scholar 

  37. Titchener K, Wong QJ (2014) A weighty issue: explaining the association between body mass index and appearance-based social anxiety. Eat Behav 16:13–16

    PubMed  Google Scholar 

  38. Murabito JM, Massaro JM, Clifford B, Hoffmann U, Fox CS (2013) Depressive symptoms are associated with visceral adiposity in a community-based sample of middle-aged women and men. Obesity (Silver Spring) 21(8):1713–1719

    CAS  Google Scholar 

  39. Hryhorczuk C, Sharma S, Fulton SE (2013) Metabolic disturbances connecting obesity and depression. Front Neurosci 7:177

    PubMed  PubMed Central  Google Scholar 

  40. Stunkard AJ, Faith MS, Allison KC (2003) Depression and obesity. Biol Psychiatry 54(3):330–337

    PubMed  Google Scholar 

  41. Silveira H, Moraes H, Oliveira N, Coutinho ES, Laks J, Deslandes A (2013) Physical exercise and clinically depressed patients: a systematic review and meta-analysis. Neuropsychobiology 67(2):61–68

    PubMed  Google Scholar 

  42. Dixon JB, Dixon ME, O’Brien PE (2003) Depression in association with severe obesity: changes with weight loss. Arch Intern Med 163(17):2058–2065

    PubMed  Google Scholar 

  43. Sui X, Laditka JN, Church TS, Hardin JW, Chase N, Davis K, Blair SN (2009) Prospective study of cardiorespiratory fitness and depressive symptoms in women and men. J Psychiatr Res 43(5):546–552

    PubMed  Google Scholar 

  44. De Schutter A, Lavie CJ, Milani RV (2014) The impact of obesity on risk factors and prevalence and prognosis of coronary heart disease—the obesity paradox. Prog Cardiovasc Dis 56(4):401–408

    PubMed  Google Scholar 

  45. Kim TN, Park MS, Kim YJ, Lee EJ, Kim MK, Kim JM, Ko KS, Rhee BD, Won JC (2014) Association of low muscle mass and combined low muscle mass and visceral obesity with low cardiorespiratory fitness. PLoS One 9(6):e100118

    PubMed  PubMed Central  Google Scholar 

  46. Augustine JA, Yoon ES, Choo J, Heffernan KS, Jae SY (2016) The relationship between cardiorespiratory fitness and aortic stiffness in women with central obesity. J Women Health 25(7):680–686

    Google Scholar 

  47. Hunter GR, Chandler-Laney PC, Brock DW, Lara-Castro C, Fernandez JR, Gower BA (2010) Fat distribution, aerobic fitness, blood lipids, and insulin sensitivity in African-American and European-American women. Obesity (Silver Spring) 18(2):274–281

    CAS  Google Scholar 

  48. Kim S, Kim JY, Lee DC, Lee HS, Lee JW, Jeon JY (2014) Combined impact of cardiorespiratory fitness and visceral adiposity on metabolic syndrome in overweight and obese adults in Korea. PLoS One 9(1):e85742

    PubMed  PubMed Central  Google Scholar 

  49. Abidin NZ, Adam MB (2013) Prediction of vertical jump height from anthropometric factors in male and female martial arts athletes. Malays J Med Sci 20(1):39–45

    PubMed  PubMed Central  Google Scholar 

  50. Trombetti A, Reid KF, Hars M, Herrmann FR, Pasha E, Phillips EM, Fielding RA (2016) Age-associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life. Osteoporos Int 27(2):463–471

    CAS  PubMed  Google Scholar 

  51. Grossschadl F, Freidl W, Rasky E, Burkert N, Muckenhuber J, Stronegger WJ (2014) A 35-year trend analysis for back pain in Austria: the role of obesity. PLoS One 9(9):e107436

    PubMed  PubMed Central  Google Scholar 

  52. Sarsan A, Ardic F, Ozgen M, Topuz O, Sermez Y (2006) The effects of aerobic and resistance exercises in obese women. Clin Rehabil 20(9):773–782

    PubMed  Google Scholar 

  53. Lau C, Yu R, Woo J (2015) Effects of a 12-week Hatha yoga intervention on cardiorespiratory endurance, muscular strength and endurance, and flexibility in Hong Kong Chinese adults: a controlled clinical trial. Evid Based Complement Alternat Med 2015:958727

    PubMed  PubMed Central  Google Scholar 

  54. Impellizzeri FM, Agosti F, De Col A, Sartorio A (2013) Psychometric properties of the fatigue severity scale in obese patients. Health Qual Life Outcomes 11:32

    PubMed  PubMed Central  Google Scholar 

  55. Lasselin J, Laye S, Dexpert S, Aubert A, Gonzalez C, Gin H, Capuron L (2012) Fatigue symptoms relate to systemic inflammation in patients with type 2 diabetes. Brain Behav Immun 26(8):1211–1219

    CAS  PubMed  Google Scholar 

  56. Alam MA, Rahman MM (2014) Mitochondrial dysfunction in obesity: potential benefit and mechanism of co-enzyme Q10 supplementation in metabolic syndrome. J Diabetes Metab Disord 13:60

    PubMed  PubMed Central  Google Scholar 

  57. Filler K, Lyon D, Bennett J, McCain N, Elswick R, Lukkahatai N, Saligan LN (2014) Association of mitochondrial dysfunction and fatigue: a review of the literature. BBA Clin 1:12–23

    PubMed  PubMed Central  Google Scholar 

  58. Puetz TW (2006) Physical activity and feelings of energy and fatigue: epidemiological evidence. Sports Med 36(9):767–780

    PubMed  Google Scholar 

  59. Drager LF, Togeiro SM, Polotsky VY, Lorenzi-Filho G (2013) Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome. J Am Coll Cardiol 62(7):569–576

    PubMed  PubMed Central  Google Scholar 

  60. Prather AA, Puterman E, Epel ES, Dhabhar FS (2015) Poor sleep quality potentiates stress-induced cytokine reactivity in postmenopausal women with high visceral abdominal adiposity. Brain Behav Immun 35:155–162

    Google Scholar 

  61. Kritikou I, Basta M, Tappouni R, Pejovic S, Fernandez-Mendoza J, Nazir R, Shaffer ML, Liao D, Bixler EO, Chrousos GP, Vgontzas AN (2012) Sleep apnoea and visceral adiposity in middle-aged male and female subjects. Eur Respir J 41(3):601–609

    PubMed  PubMed Central  Google Scholar 

  62. Xu W, Zhang H, Paillard-Borg S, Zhu H, Qi X, Rizzuto D (2016) Prevalence of overweight and obesity among chinese adults: role of adiposity indicators and age. Obes Facts 9(1):17–28

    PubMed  PubMed Central  Google Scholar 

  63. Mauvais-Jarvis F, Clegg DJ, Hevener AL (2013) The role of estrogens in control of energy balance and glucose homeostasis. Endocr Rev 34(3):309–338

    CAS  PubMed  PubMed Central  Google Scholar 

  64. Cao X, Xu P, Oyola MG, Xia Y, Yan X, Saito K, Zou F, Wang C, Yang Y, Hinton A Jr, Yan C, Ding H, Zhu L, Yu L, Yang B, Feng Y, Clegg DJ, Khan S, DiMarchi R, Mani SK, Tong Q, Xu Y (2014) Estrogens stimulate serotonin neurons to inhibit binge-like eating in mice. J Clin Invest 124(10):4351–4362

    CAS  PubMed  PubMed Central  Google Scholar 

  65. Vitale JA, Weydahl A (2017) Chronotype, physical activity, and sport performance: a systematic review. Sports Med 47(9):1859–1868

    PubMed  Google Scholar 

  66. Rossi A, Formenti D, Vitale JA, Calogiuri G, Weydahl A (2015) The effect of chronotype on psychophysiological responses during aerobic self-paced exercises. Percept Mot Skills 121(3):840–855

    PubMed  Google Scholar 

  67. Bonato M, Agnello L, Galasso L, Montaruli A, Roveda E, Merati G, La Torre A, Vitale JA (2017) Acute modification of cardiac autonomic function of high-intensity interval training in collegiate male soccer players with different chronotype: a cross-over study. J Sports Sci Med 16(2):286–294

    PubMed  PubMed Central  Google Scholar 

  68. Vitale JA, Banfi G, La Torre A, Bonato M (2018) Effect of a habitual late-evening physical task on sleep quality in neither-type soccer players. Front Physiol 9:1582

    PubMed  PubMed Central  Google Scholar 

  69. Vitale JA, La Torre A, Baldassarre R, Piacentini MF, Bonato M (2017) Ratings of perceived exertion and self-reported mood state in response to high intensity interval training a crossover study on the effect of chronotype. Front Psychol 8:1232

    PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We would like to thank all the women who volunteered for the purposes of the study.

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Correspondence to Christoforos D. Giannaki.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the National Bioethical Committee (No.: EEBK/ΕΠ/2015/34) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Evangelou, C., Kartakoullis, N., Hadjicharalambous, M. et al. Depressive symptoms, sleep quality, physical fitness, and fatigue among adult women with different obesity status. Sport Sci Health 15, 605–614 (2019). https://doi.org/10.1007/s11332-019-00559-9

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  • DOI: https://doi.org/10.1007/s11332-019-00559-9

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