Journal List > J Nutr Health > v.46(3) > 1081295

J Nutr Health. 2013 Jun;46(3):261-275. Korean.
Published online June 30, 2013.
© 2013 The Korean Nutrition Society
Relationships between obesity, blood and urinary compositions, and dietary habits and depressed mood in Koreans at the age of 40, a life transition period
Ji Eun Chu,1,2 Ji Min Lee,3 Han-Ik Cho,2,4 and Yoon Jung Park1,3
1Department of Clinical Health Sciences, Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 120-750, Korea.
2Korea Association of Health Promotion, Seoul 157-705, Korea.
3Department of Food and Nutrition, College of Health Science, Ewha Womans University, Seoul 120-750, Korea.
4College of Medicine, Seoul National University, Seoul 151-742, Korea.

To whom correspondence should be addressed. (Email: )
Received March 26, 2013; Revised April 11, 2013; Accepted April 30, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


This study was designed to investigate the relationships of depressed mood with obesity, blood and urinary compositions, and dietary habits in Koreans at the age of 40, a critical transition to the middle adulthood stage. A total of 27,684 people who have taken the Life Transition Period Health Examination at the Korea Association of Health Promotion in 2011 were divided into two groups; the depressed mood group (DG) and the non-depressed group (NG) according to results of the primary questionnaire for mental health. The results were analyzed using the health examination criteria of the National Health Insurance Corporation. Women and medicaid recipients showed higher incidence of depressed mood than men and health insurance subscribers. People with underweight in BMI or abdominal obesity showed correlation with depressed mood, while there was no significant relationship with metabolic syndrome. Regarding blood and urinary compositions, DG was related to a higher level of hemoglobin and lower levels of HDL-cholesterol and triglyceride, although the relationships diminished after adjustment for other confounder effects. According to dietary habits, more people in DG were categorized as a group for "Needs Much Improvement", and the odds ratio of the depressed mood showed a significant increase. Significant difference regarding the frequency of food items such as milk products, animal proteins, Kimchi, and fruits was observed between DG and NG. In addition, a higher portion of subjects in DG did not consume regular meals and various kinds of food. In conclusion, the depressed mood of 40 year-old adults was significantly related to underweight, higher waist measurement, and undesirable dietary habits. Results of our study can be applicable as a basic resource for development of effective nutrition counseling and education programs for improvement of mental health promotion during the critical transition to the middle adulthood stage.

Keywords: depressed mood; dietary habits; bmi; abdominal obesity


Fig. 1
Flowchart of sample for analysis. 1) MDA: Mini Dietary Assesment.
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Table 1
Social environment factor, existing disease, family history, obesity and metabolic syndrome assessment of non-depressed and depressed mood group
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Table 2
Odds ratio (OR) and 95% confidence interval (CI) of depressed mood according to BMI, waist circumference, and metabolic syndrome
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Table 3
Blood pressure, blood biochemical analysis, and urinalysis results of non-depressed and depressed mood group
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Table 4
Odds ratio (OR) and 95% confidence interval (CI) of depressed mood according to blood pressure, blood biochemical analysis, and urinalysis results
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Table 5
Evaluation of dietary patterns of non-depressed and depressed mood group
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Table 6
Odds ratio (OR) and 95% confidence interval (CI) of depressed mood according to dietary patterns
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This research was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (No. 2012018819). The authors acknowledge Mr. Cheong-Ha Yoon, Korea Association of Health Promotion, for the valuable suggestions.

1. Ministry of Health and Welfare. The manual for national health screening program for the people in transition. Seoul: Ministry of Health and Welfare; 2007.
2. Jun SJ, Kim HK, Lee SM, Kim SA. Factors influencing middle-aged women's depression. J Korean Community Nurs 2004;15(2):266–276.
3. Kim MC. In: Mid-life crisis and it's related variables [PhD thesis]. Seoul: Ewha Womans University; 1989.
4. Choi MK, Lee YH. Depression, powerlessness, social support, and socioeconomic status in middle aged community residents. J Korean Acad Psychiatr Ment Health Nurs 2010;19(2):196–204.
5. Choi TS, Park HJ. The effect of self-consciousness and gender role stress upon mid-life crisis of middle-aged male. Korean J Couns 2011;12(3):931–944.
6. Kim YT, Lee WC, Cho B. National screening program for the transitional ages in Korea. J Korean Med Assoc 2010;53(5):371–376.
7. National Health Insurance Service. 2011 health examination implementation guide. Seoul: National Health Insurance Service; 2011.
8. Ministry of Health and Welfare. Korea Centers for Disease Control and Prevention. 2010 health behavior and chronic diseases analysis - Korean National Health and Nutrition Examination Survey (KNHANES V-1) - Korea youth risk behavior web-based survey. Cheongwon: Korea Centers for Disease Control and Prevention; 2011.
9. Ministry of Health and Welfare. Epidemiological survey of psychiatric illnesses in Korea. Seoul: Ministry of Health and Welfare; 2010.
10. Kwon SM. Relationship between depression and anxiety. Psychol Sci 1996;5(1):13–38.
11. Hong KW. Korean depression genetics studies. Public Health Wkly Rep 2010;5(19):342–345.
12. Kim HC. Diagnosis and assessment of depression according to biological methods. J Korean Soc Biol Ther Psychiatry 1999;5(1):11–28.
13. Lee MS. Chronic diseases, depressive symptoms and the effects of social networks in Korean elderly population. Health Soc Sci 2010;(27):5–30.
14. Zhao G, Ford ES, Li C, Tsai J, Dhingra S, Balluz LS. Waist circumference, abdominal obesity, and depression among overweight and obese U.S. adults: National Health and Nutrition Examination Survey 2005-2006. BMC Psychiatry 2011;11:130.
15. Maeng WJ. In: The association of risk factors of metabolic syndrome and health-related quality of life [PhD thesis]. Seoul: Kyung Hee University; 2010.
16. Choi WH. The relationship of depression, fatigue and quality of life in middle-aged adults. Korean J Health Serv Manag 2012;6(2):91–99.
17. Kim EJ, Lee AR, Hwang MJ, Cho JH, Song MY. Relationship between depression, stress and obesity indexes in overweight and obese Korean women. J Soc Korean Med Obes Res 2011;11(1):15–24.
18. Kang JH, Oh SW, Yoon SJ, Choi MK, Suh SY, Lee IG, Cho BR, Hwang HS, Huh BY. Relationship of serum lipid profile and the degree of depressive symptoms in Korean adults. J Korean Acad Fam Med 2000;21(2):276–288.
19. Lee BJ, Lee JS. Mediating effects of alcohol-induced stress in the relation between alcohol use and depressive symptoms. Soc Sci Res Rev 2007;23(2):193–212.
20. Lee JW. In: A comparative study on eating habits and nutrients intake of depressed and normal subjects: base on 2008 Korean National Health and Nutrition Examination Survey [MA thesis]. Daejeon: Chungnam National University; 2011.
21. Kim KH. A survey on the relation between depressive trends, stress and attitudes of food intake in adults. Korean J Diet Cult 1998;13(4):327–337.
22. Beydoun MA, Kuczmarski MT, Mason MA, Ling SM, Evans MK, Zonderman AB. Role of depressive symptoms in explaining socioeconomic status disparities in dietary quality and central adiposity among US adults: a structural equation modeling approach. Am J Clin Nutr 2009;90(4):1084–1095.
23. Nanri A, Kimura Y, Matsushita Y, Ohta M, Sato M, Mishima N, Sasaki S, Mizoue T. Dietary patterns and depressive symptoms among Japanese men and women. Eur J Clin Nutr 2010;64(8):832–839.
24. Park JY, You JS, Chang KJ. Dietary taurine intake, nutrients intake, dietary habits and life stress by depression in Korean female college students: a case-control study. J Biomed Sci 2010;17 Suppl 1:S40.
25. Kim SH, Kim H, Park SH, Hwang JY, Chung HW, Chang N. Dietary intake, dietary habits, and depression in Korean women with polycystic ovary syndrome. Korean J Nutr 2012;45(3):229–239.
26. Ministry of Health and WelfareHealth examination practice. Seoul: Ministry of Health and Welfare; 2010.
27. Ministry of Health and WelfareHealth examination operation rule. Seoul: Ministry of Health and Welfare; 2010.
28. Yoon SJ, Kim DJ. Neurobiological mechanism of nicotine dependence. Korean J Psychopharmacol 2005;16(5):351–360.
29. Mendelsohn C. Smoking and depression--a review. Aust Fam Physician 2012;41(5):304–307.
30. Korhonen T, Koivumaa-Honkanen H, Varjonen J, Broms U, Koskenvuo M, Kaprio J. Cigarette smoking and dimensions of depressive symptoms: longitudinal analysis among Finnish male and female twins. Nicotine Tob Res 2011;13(4):261–272.
31. Suh GH, Kim JK, Yeon BK, Park SK, Yoo KY, Yang BK, Kim YS, Cho MJ. Prevalence and risk factors of dementia and depression in the elderly. J Korean Neuropsychiatr Assoc 2000;39(5):809–824.
32. Sunwoo YK, Bae JN, Hahm BJ, Lee DW, Park JI, Cho SJ, Lee JY, Kim JY, Chang SM, Jeon HJ, Cho MJ. Relationships of mental disorders and weight status in the Korean adult population. J Korean Med Sci 2011;26(1):108–115.
33. Chang HH, Yen ST. Association between obesity and depression: evidence from a longitudinal sample of the elderly in Taiwan. Aging Ment Health 2012;16(2):173–180.
34. Yu NW, Chen CY, Liu CY, Chau YL, Chang CM. Association of body mass index and depressive symptoms in a Chinese community population: results from the health promotion knowledge, attitudes, and performance survey in Taiwan. Chang Gung Med J 2011;34(6):620–627.
35. Li ZB, Ho SY, Chan WM, Ho KS, Li MP, Leung GM, Lam TH. Obesity and depressive symptoms in Chinese elderly. Int J Geriatr Psychiatry 2004;19(1):68–74.
36. Samaan Z, Anand SS, Zhang X, Desai D, Rivera M, Pare G, Thabane L, Xie C, Gerstein H, Engert JC, Craig I, Cohen-Woods S, Mohan V, Diaz R, Wang X, Liu L, Corre T, Preisig M, Kutalik Z, Bergmann S, Vollenweider P, Waeber G, Yusuf S, Meyre D. The protective effect of the obesity-associated rs9939609 A variant in fat mass- and obesity-associated gene on depression. Mol Psychiatry.
Forthcoming 2013.
37. Rivera M, Cohen-Woods S, Kapur K, Breen G, Ng MY, Butler AW, Craddock N, Gill M, Korszun A, Maier W, Mors O, Owen MJ, Preisig M, Bergmann S, Tozzi F, Rice J, Rietschel M, Rucker J, Schosser A, Aitchison KJ, Uher R, Craig IW, Lewis CM, Farmer AE, McGuffin P. Depressive disorder moderates the effect of the FTO gene on body mass index. Mol Psychiatry 2012;17(6):604–611.
38. de Wit LM, van Straten A, van Herten M, Penninx BW, Cuijpers P. Depression and body mass index, a u-shaped association. BMC Public Health 2009;9:14.
39. Son YJ, Kim G. The relationship between obesity, self-esteem and depressive symptoms of adult women in Korea. Korean J Obes 2012;21(2):89–98.
40. Han IY, Yoo HJ, Ryu OH, Sim KW, Rhee YS. Obesity and depression in women at an obesity clinic: the mediation effects of social physique anxiety and stress. Korean J Health Promot 2010;10(4):147–153.
41. Jung JW, Kim CH, Sin HC, Park YW, Cheong SY, Sung E. The relationship between metabolic syndrome, stress and depression - among the 35-64 years old clients of comprehensive medical examination center in one university hospital. Korean J Health Promot Dis Prev 2004;4(1):10–17.
42. Yoon DH, Park JH, Cho SC, Park MJ, Kim SS, Choi SH, Choi SY, Jeong IK, Lee CM, Shin CS, Cho SH, Oh BH, Choi JK. Depressive symptomatology and metabolic syndrome in Korean women. Korean J Obes 2005;14(4):213–219.
43. Kinder LS, Carnethon MR, Palaniappan LP, King AC, Fortmann SP. Depression and the metabolic syndrome in young adults: findings from the Third National Health and Nutrition Examination Survey. Psychosom Med 2004;66(3):316–322.
44. Kim JH, Lee MJ, Moon SJ, Shin SC, Kim MK. Ecological analysis of food behavior and life-styles affecting the prevalence of depression in Korea. Korean J Nutr 1993;26(9):1129–1137.
45. Mamplekou E, Bountziouka V, Psaltopoulou T, Zeimbekis A, Tsakoundakis N, Papaerakleous N, Gotsis E, Metallinos G, Pounis G, Polychronopoulos E, Lionis C, Panagiotakos D. Urban environment, physical inactivity and unhealthy dietary habits correlate to depression among elderly living in eastern Mediterranean islands: the MEDIS (MEDiterranean ISlands elderly) study. J Nutr Health Aging 2010;14(6):449–455.
46. Tsai AC, Chang TL, Chi SH. Frequent consumption of vegetables predicts lower risk of depression in older Taiwanese - results of a prospective population-based study. Public Health Nutr 2012;15(6):1087–1092.