title: Body mass, depressive symptoms and menopausal status: an examination of the "Jolly Fat" hypothesis.
abstract: OBJECTIVE
  Estrogens are linked with depression due to their ability to alter the function of the serotonin neural systems. We hypothesize that postmenopausal women should have a higher degree of depressive symptoms than premenopausal women. Further, because estrogen levels in postmenopausal women positively correlate with body fat, we hypothesize that there is an inverse relationship between body fat and depressive symptoms among postmenopausal women.
  
  
  METHODS
  We enrolled 1156 Polish urban women aged 45 to 64 in a cross-sectional study. Depressive symptoms were assessed by the Center for Epidemiologic Studies-Depression Scale (CES-D) scale. Menopausal status and education level was assessed by a standardized questionnaire.
  
  
  RESULTS
  Postmenopausal women had higher mean CES-D scores of depressive symptoms than premenopausal women (14.4 versus 13.2 respectively, p = .018). Both among pre- and postmenopausal women, those with higher education had lower scores of depressive symptoms. In addition, in postmenopausal women with lower education an inverse relationship was observed between body mass index (BMI) and depressive symptoms: a higher BMI was associated with a lower score of depressive symptoms (p = .009). Such a relationship was not present among premenopausal women or women who were postmenopausal but better educated.
  
  
  CONCLUSIONS
  This study indicates that menopausal status is related to differences in the degree of occurrence of depressive symptoms. Our results support the "Jolly Fat" hypothesis for postmenopausal women with lower education, namely, a higher BMI is associated with lower score of depressive symptoms.
authors.affiliation: Department of Epidemiology and Population Studies, Jagiellonian University Collegium Medicum, Krakow, Poland. jasienska@post.harvard.edu
authors.forename: Grazyna
authors.initials: G
authors.lastname: Jasienska
authors.forename: Anna
authors.initials: A
authors.lastname: Ziomkiewicz
authors.forename: Maciej
authors.initials: M
authors.lastname: Górkiewicz
authors.forename: Andrzej
authors.initials: A
authors.lastname: Pajak
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000368:Aged; D015992:Body Mass Index; D001835:Body Weight; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D004522:Educational Status; D004967:Estrogens / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D011044:Poland / Q000453:epidemiology; D017698:Postmenopause / Q000378:metabolism; D017697:Premenopause / Q000378:metabolism; D012931:Social Environment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D004967:Estrogens