PT  - JOURNAL ARTICLE
AU  - Flávia Vitorino Freitas
AU  - Wagner Miranda Barbosa
AU  - Laíz Aparecida Azevedo Silva
AU  - Marianna Junger de Oliveira Garozi
AU  - Júlia de Assis Pinheiro
AU  - Aline Ribeiro Borçoi
AU  - Catarine Lima Conti
AU  - Juliana Krüger Arpini
AU  - Heberth de Paula
AU  - Mayara Mota de Oliveira
AU  - Anderson Barros Archanjo
AU  - Érika Aparecida Silva de Freitas
AU  - Daniela Rodrigues de Oliveira
AU  - Elizeu Batista Borloti
AU  - Iuri Drumond Louro
AU  - Adriana Madeira Alvares-da-Silva
TI  - Psychosocial stress and central adiposity: A Brazilian study with users of the public health system
AID  - 10.1101/317891
DP  - 2018 Jan 01
TA  - bioRxiv
PG  - 317891
4099  - http://biorxiv.org/content/early/2018/05/09/317891.short
4100  - http://biorxiv.org/content/early/2018/05/09/317891.full
AB  - Objective To assess the association between indicators of psychosocial stress and central adiposity in adult users of the Unified Health System (SUS) from Southeast of Brazil.Methods This cross-sectional study was conducted with 384 adults (20 to 59 years old) from the city of Alegre, Southeastern Brazil. The simple random sample represented the population using the public health system of the municipality. The prevalence of obesity was based on the Body Mass Index, and central adiposity (dependent variable) was measured by waist circumference in centimeters. The independent variables were the following indicators of psychosocial stress: food and nutrition insecurity (yes/no), serum cortisol (μg/dL), symptoms suggestive of depression using the Beck Depression Inventory-II ≥ 17 (yes/no), and altered blood pressure ≥ 130/85 mmHg (yes/no). Univariate linear regression was performed between central adiposity and each stress indicator, and later the models were adjusted for socioeconomic, health, and lifestyle variables. All analyses were stratified by rural and urban location.Results The prevalence of weight excess was 68.3%, and 71.5% of individuals presented an increased risk for metabolic complications related to central adiposity. Mean waist circumference scores for the rural and urban population were 89.3 ± 12.7 cm and 92.9 ± 14.7 cm, respectively (p = 0.012). Indicators of stress that were associated with central adiposity were: cortisol in the rural population and altered blood pressure in the urban population. This occurred both in the raw analysis and in the models adjusted for confounding factors.Conclusion The associations between stress and adiposity were different between rural (cortisol - inverse association) and urban (altered blood pressure) lifestyles, confirming the influence of local and psychosocial subsistence on the modulation of stress and on how individuals react or restrain stressors. Stress reduction strategies can be useful in public health programs designed to prevent or treat obesity.