title: Associations between Psychological Distress and Body Mass Index among Law Enforcement Officers: The National Health Interview Survey 2004-2010.
abstract: OBJECTIVE
  To investigate the association between psychological distress and obesity among law enforcement officers (LEOs) in the United States.
  
  
  METHODS
  Self-reported data on psychological distress based on six key questions were obtained from LEOs who participated in the National Health Interview Survey (2004-2010). We used Prochaska's cut-point of a Kessler 6 score ≥ 5 for moderate/high mental distress in our analysis. Mean levels of body mass index (BMI) were compared across three levels of psychological distress.
  
  
  RESULTS
  The average age of LEOs (n = 929) was 39.3 years; 25% were female. Overall, 8.1% of LEOs had moderate or high psychological distress; 37.5% were obese (BMI ≥ 30). Mean BMI increased with increasing psychological distress (no distress, BMI = 27.2 kg/m(2); mild distress, 27.6 kg/m(2); and moderate/high distress, 33.1 kg/m(2); p = 0.016) after adjustment for age, race, income, and education level among female officers only. Physical activity modified the association between psychological distress and BMI but only among male LEOs (interaction p = 0.002). Among male LEOs reporting low physical activity, psychological distress was positively associated with BMI (30.3 kg/m(2) for no distress, 30.7 for mild distress, 31.8 for moderate/high distress; p = 0.179) after adjustment, but not significantly. This association was not significant among males reporting high physical activity.
  
  
  CONCLUSIONS
  Mean BMI significantly increased as psychological distress increased among female LEOs. A longitudinal study design may reveal the directionality of this association as well as the potential role that physical activity might play in this association.
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
authors.forename: Ja K
authors.initials: JK
authors.lastname: Gu
authors.forename: Luenda E
authors.initials: LE
authors.lastname: Charles
authors.forename: Cecil M
authors.initials: CM
authors.lastname: Burchfiel
authors.forename: Michael E
authors.initials: ME
authors.lastname: Andrew
authors.forename: Claudia
authors.initials: C
authors.lastname: Ma
authors.forename: Ki Moon
authors.initials: KM
authors.lastname: Bang
authors.forename: John M
authors.initials: JM
authors.lastname: Violanti
keywords: Adiposity; Law enforcement officers; Psychological distress