title: Changes in Body Mass Index and the Trajectory of Depressive Symptoms Among Rural Men and Women.
abstract: This study examined the association between body mass index (BMI) changes over time and the risk of elevated depressive symptoms in a cohort of Midwestern rural adults.
  
  
  
  The longitudinal study used data from a telephone survey in 2005 including 1,475 men and women enrolled in the Walk the Ozarks to Wellness Project from 12 rural communities in Missouri, Arkansas, and Tennessee. Multilevel random intercept mixed models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between BMI calculated from self-reported height and body weight and elevated depressive symptoms, adjusting for sociodemographic, behavioral, and medical variables.
  
  
  
  Elevated depressive symptoms were common in this rural population (17%-19%) and the mean BMI was 28 kg/m2. For each unit increase in BMI over time, representing an average increase of about 5.8 pounds from baseline weight, there was a 6% increased odds of elevated depressive symptoms (aOR: 1.06, 95% CI: 1.02-1.12).
  
  
  
  Our findings hold important public health implications given the increasing rates of overweight and obesity over the past couple of decades, particularly among rural adults.
authors.affiliation: Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, St. Louis, Missouri.
authors.forename: Jen Jen
authors.initials: JJ
authors.lastname: Chang
authors.affiliation: Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, Missouri.
authors.forename: Joanne
authors.initials: J
authors.lastname: Salas
authors.affiliation: Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, St. Louis, Missouri.
authors.forename: Maya
authors.initials: M
authors.lastname: Tabet
authors.affiliation: Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, St. Louis, Missouri.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Kasper
authors.affiliation: Department of Health Management and Policy, Saint Louis University College for Public Health and Social Justice, St. Louis, Missouri.
authors.forename: Keith
authors.initials: K
authors.lastname: Elder
authors.affiliation: SSM Health Care, St. Louis, Missouri.
authors.forename: Holly
authors.initials: H
authors.lastname: Staley
authors.affiliation: The Prevention Research Center in St. Louis, the Brown School and the Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, School of Medicine, Washington University, St. Louis, Missouri.
authors.forename: Ross C
authors.initials: RC
authors.lastname: Brownson
mesh_terms: D000328:Adult; D000368:Aged; D001131:Arkansas / Q000453:epidemiology; D015992:Body Mass Index; D001835:Body Weight; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D012424:Rural Population / Q000706:statistics & numerical data*; D013714:Tennessee / Q000453:epidemiology
keywords: body mass index; depression; obesity; overweight; rural health