Gender Differences in the Association between Eating Behavior and Depression of Adolescents: Evidence from a National Korean Cross-sectional Survey

Hye Sun Hyun

doi:10.12799/jkachn.2016.27.2.106

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Hyun: Gender Differences in the Association between Eating Behavior and Depression of Adolescents: Evidence from a National Korean Cross-sectional Survey

Original Article

J Korean Acad Community Health Nurs 2016;27(2):106-113.

Published online: 12 June 2016

DOI: https://doi.org/10.12799/jkachn.2016.27.2.106

Gender Differences in the Association between Eating Behavior and Depression of Adolescents: Evidence from a National Korean Cross-sectional Survey

Hye Sun Hyun

Department of Nursing, Sangmyung University, Cheonan, Korea

Corresponding author: Hyun, Hye Sun Department of Nursing, Sangmyung University, 13 Sangmyungdae-gil, Dongnam-gu, Cheonan 31066, Korea. Tel: +82-41-550-5380, Fax: +82-41-550-5545, E-mail: hshyun@smu.ac.kr / hshyun76@gmail.com

Received 11 January 2016 Revised 21 April 2016 Accepted 3 May 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to determine the relationship between unhealthy eating behavior and depression in adolescents, with confounding variables adjusted.

Methods

This study is a secondary analysis of the data collected from the 2013 Korean Youth Risk Behavior Web-based Survey (KYRBWS). The analysis included 72,435 participants (36,655 male and 35,780 female). The data were analyzed by x² test, t-test, and logistic regression analysis using SPSS Version 21 by complex samples analysis.

Results

Compared with male adolescents with healthy eating behavior, those who with unhealthy eating behavior were more likely to suffer depression with other factors controlled (OR=1.37, 1.07~1.75). On the other hand, female adolescents with unhealthy eating behavior were less likely to feel depressed compared with female adolescents with unhealthy eating behavior and with other factors controlled (OR=0.98, 0.64~1.50). However, it was not statistically significant.

Conclusion

Our findings suggest that healthy eating behavior may be a protective factor against depression in male adolescents, but not in female adolescents. Furthermore, our results suggest that the longitudinal associations between mental health and healthy eating behavior and other lifestyle factors are complex.

Keywords: Adolescents, Eating behavior, Depression, KYRBS

References

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Table 1.

Comparison of Characteristics between Boys and Girls (% [SE] or M±SE^†)

Characteristics	Categories	All subjects	Girls	Boys	x² or t	p
Depression	No	69.1(0.24)	62.9(0.31)	74.8(0.30)	1,201.07	＜.001
	Yes	30.9(0.24)	37.1(0.31)	25.2(0.30)
Living withfamily	No	3.9(0.17)	3.5(0.23)	4.3(0.24)	26.29	.028
Living withfamily	Yes	96.1(0.17)	96.5(0.23)	95.7(0.24)
Economic level	Very rich	7.5(0.16)	5.1(0.18)	9.7(0.24)	695.36	＜.001
	Rich	24.9(0.24)	23.7(0.36)	25.9(0.32)
	Medium	47.4(0.23)	50.4(0.33)	44.7(0.32)
	Poor	15.8(0.21)	16.5(0.31)	15.1(0.29)
	Very poor	4.5(0.10)	4.2(0.14)	4.7(0.14)
School performance	Very high	10.9(0.14)	9.4(0.18)	12.3(0.21)	223.49	＜.001
	High	23.7(0.18)	24.4(0.26)	23.1(0.26)
	Medium	28.1(0.18)	28.8(0.27)	27.4(0.23)
	Low	24.9(0.19)	25.8(0.25)	24.1(0.27)
	Very low	12.4(0.15)	11.6(0.20)	13.1(0.22)
Smoke	Non-smoke	54.4(0.61)	62.7(1.01)	51.3(0.73)	163.60	＜.001
	Smoke	45.6(0.61)	37.3(1.01)	48.7(0.73)
Drink	No	42.2(0.59)	50.1(0.86)	37.4(0.76)	184.49	＜.001
	Yes	57.8(0.59)	49.9(0.86)	62.6(0.76)
Moderate physical activities (day)	Never	34.9(0.29)	43.1(0.38)	27.3(0.31)	3,873.11	＜.001
	1	17.5(0.17)	19.7(0.24)	15.4(0.24)
	2	15.6(0.18)	15.0(0.23)	16.1(0.26)
	3	12.9(0.15)	10.8(0.19)	14.8(0.21)
	4	6.7(0.12)	4.6(0.13)	8.6(0.16)
	≥5	12.6(0.18)	6.9(0.16)	17.8(0.26)
Vigorous	Never	23.8(0.31)	34.2(0.44)	14.2(0.26)	6,663.08	＜.001
physical	1	20.8(0.20)	23.9(0.29)	18.0(0.25)
activities	2	19.5(0.20)	18.4(0.26)	20.5(0.30)
(day)	3	15.3(0.17)	12.1(0.24)	18.2(0.22)
	4	7.0(0.12)	4.6(0.14)	9.3(0.16)
	≥5	13.6(0.20)	6.7(0.16)	19.8(0.310)
Sleep	＜4	1.8(0.07)	1.9(0.10)	1.6(0.09)	1,138.88	＜.001
duration	4	8.0(0.20)	9.2(0.29)	6.9(0.28)
(hour/day)	5	19.3(0.32)	20.8(0.44)	17.8(0.47)
	6	26.2(0.23)	26.8(0.31)	25.6(0.35)
	7	25.4(0.31)	24.3(0.41)	26.5(0.47)
	≥8	19.3(0.36)	17.0(0.47)	21.5(0.54)
BMI	Underweight	5.6(0.13)	6.9(0.20)	4.5(0.16)	6,280.57	＜.001
(percentile)	Normal	80.0(0.26)	89.5(0.20)	71.3(0.31)
	Overweight	9.1(0.18)	3.3(0.10)	14.4(0.25)
	Obese	5.3(0.15)	0.3(0.03)	9.8(0.22)
Perceived	Underweight	27.6(0.20)	19.7(0.22)	34.7(0.24)	2,123.36	＜.001
weight status	Normal	33.7(0.19)	35.9(0.28)	31.8(0.25)
	Overweight	38.7(0.20)	44.4(0.28)	33.5(0.25)
Healthy eating	No	81.9(0.22)	81.7(0.32)	82.0(0.29)	1.31	.409
behavior	Yes	18.1(0.22)	18.3(0.32)	18.0(0.29)

BMI=body mass index; SE=standard error; ^†Values are presented as weighted % (SE) or Mean±SE unless otherwise indicated.

Table 2.

Characteristics of the Study Sample according to Depression by Gender (% [SE] or Mean±SE^†)

Characteristics	Categories	Boys				Girls
Characteristics	Categories	Normal	Depression	x² or t	p	Normal	Depression	x² or t	p
Depression		14.9±0.04	15.2±0.04	−1.03	.303	14.88±0.04	15.05±0.04	−1.68	.093
Living withfamily	No	67.8 (1.31)	32.3 (1.31)	43.58	＜.001	56.3 (1.60)	43.7 (1.60)	24.89	＜.001
Living withfamily	Yes	75.1 (0.30)	24.9 (0.30)			63.2 (0.32)	36.9 (0.32)
Economic level	Very rich	75.7 (0.71)	24.3 (0.71)	374.11	＜.001	64.3 (1.17)	35.7 (1.17)	483.62	＜.001
	Rich	77.4 (0.50)	22.6 (0.50)			66.5 (0.56)	33.5 (0.56)
	Medium	76.7 (0.39)	23.3 (0.39)			65.2 (0.42)	34.9 (0.42)
	Poor	68.7 (0.73)	31.3 (0.73)			55.6 (0.65)	44.4 (0.65)
	Very poor	60.1 (1.16)	39.9 (1.16)			42.9 (1.27)	57.2 (1.27)
School performance	Very high	79.6 (0.63)	20.4 (0.63)	231.88	＜.001	70.4 (0.79)	29.6 (0.79)	586.80	＜.001
	High	77.3 (0.51)	22.7 (0.51)			67.9 (0.52)	32.1 (0.52)
	Medium	76.0 (0.46)	24.0 (0.46)			65.5 (0.52)	34.6 (0.52)
	Low	72.2 (0.55)	27.8 (0.55)			58.6 (0.56)	41.4 (0.56)
	Very low	68.3 (0.69)	31.7 (0.69)			49.7 (0.81)	50.3 (0.81)
Smoke	Non-smoke	69.9 (0.65)	30.1 (0.65)	98.35	＜.001	49.3 (1.01)	50.7 (1.01)	100.71	＜.001
	Smoke	60.9 (0.69)	39.1 (0.69)			34.1 (1.10)	65.9 (1.10)
Drink	No	69.8 (0.92)	30.2 (0.92)	63.20	＜.001	49.6 (1.07)	50.4 (1.07)	32.14	＜.001
	Yes	60.4 (0.76)	39.6 (0.76)			41.5 (1.01)	58.5 (1.01)
Moderate physical activities (day)	Never	78.9 (0.44)	21.0 (0.44)	136.45	＜.001	65.8 (0.43)	34.3 (0.43)	105.22	＜.001
	1	73.6 (0.65)	26.4 (0.65)			61.7 (0.61)	38.3 (0.61)
	2	73.7 (0.67)	26.3 (0.67)			61.1 (0.76)	38.9 (0.76)
	3	73.8 (0.63)	26.2 (0.63)			60.7 (0.88)	39.3 (0.88)
	4	73.9 (0.75)	26.1 (0.75)			58.2 (1.18)	41.8 (1.18)
	≥5	71.8 (0.59)	28.3 (0.59)			59.0 (0.95)	41.0 (0.95)
Vigorous physical activities (day)	Never	77.5 (0.59)	22.5 (0.59)	48.63	＜.001	64.0 (0.45)	36.0 (0.45)	25.60	＜.001
	1	76.2 (0.52)	23.8 (0.52)			63.7 (0.57)	36.4 (0.57)
	2	75.1 (0.57)	24.9 (0.57)			62.3 (0.62)	37.7 (0.62)
	3	74.0 (0.61)	26.1 (0.61)			62.0 (0.82)	38.0 (0.82)
	4	73.0 (0.83)	27.0 (0.83)			61.2 (1.24)	38.8 (1.24)
	≥5	72.9 (0.53)	27.1 (0.53)			59.4 (1.00)	40.6 (1.00)
Sleep duration (hour/day)	＜4	56.8 (2.47)	43.2 (2.47)	373.92	＜.001	43.7 (1.79)	56.3 (1.79)	381.76	＜.001
	4	66.4 (1.11)	33.6 (1.11)			54.8 (0.94)	45.2 (0.94)
	5	70.8 (0.74)	29.2 (0.74)			59.6 (0.67)	40.4 (0.67)
	6	75.1 (0.55)	24.9 (0.55)			63.6 (0.56)	36.4 (0.56)
	7	78.3 (0.49)	21.7 (0.49)			66.7 (0.61)	33.3 (0.61)
	≥8	81.2 (0.56)	19.0 (0.56)			71.4 (0.72)	28.6 (0.72)
BMI (percentile)	Underweight	80.7 (1.05)	19.3 (1.05)	40.40	＜.001	65.0 (1.03)	35.0 (1.03)	7.71	.054
BMI (percentile)	Normal	75.3 (0.34)	24.7 (0.34)			63.1 (0.32)	36.9 (0.32)
	Overweight	73.4 (0.62)	26.6 (0.62)			61.4 (1.47)	38.6 (1.47)
	Obese	73.5 (0.76)	26.5 (0.76)			55.7 (4.53)	44.3 (4.53)
Perceived weight status	Underweight	73.8 (0.44)	26.2 (0.44)	17.87	＜.001	62.8 (0.62)	37.2 (0.62)	72.12	＜.001
Perceived weight status	Normal	76.2 (0.43)	23.9 (0.43)			65.6 (0.43)	34.4 (0.43)
	Overweight	74.6 (0.41)	25.4 (0.41)			60.8 (0.46)	39.2 (0.46)
Healthy eating behavior	No	74.9 (0.34)	25.1 (0.34)	42.04	＜.001	62.0 (0.33)	38.0 (0.33)	67.33	＜.001
Healthy eating behavior	Yes	76.2 (0.63)	23.8 (0.63)			67.9 (0.65)	32.1 (0.65)

BMI=body mass index; SE=standard error; a Values are presented as weighted % (SE) or M±SE unless otherwise indicated.

Table 3.

Association between Healthy Eating Behavior and Depression

Characteristics	Categories	Boys^†			Girls^‡
Characteristics	Categories	OR	95% CI	p	OR	95% CI	p
Eating behavior	Non-healthy eating behavior	1.37	1.07~1.75	.013	0.98	0.64~1.50	.933
Eating behavior	Healthy eating behavior	1.00			1.00

BMI=body mass index OR=odds ratio; CI=confidence interval;

^† Calculated by complex sample multi-logistic regression analysis, adjusted for family live together, economic status, academic performance, smoking, alcohol use, exercise habits, sleep duration, perceived weight status, BMI;

^‡ Calculated by complex sample multi- logistic regression analysis, adjusted for family live together, economic status, academic performance, smoking, alcohol use, exercise habits, sleep duration, perceived weight status.

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