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Concept: Whitehall Study

361

Sitting behaviours have been linked with increased risk of all-cause mortality independent of moderate to vigorous physical activity (MVPA). Previous studies have tended to examine single indicators of sitting or all sitting behaviours combined. This study aims to enhance the evidence base by examining the type-specific prospective associations of four different sitting behaviours as well as total sitting with the risk of all-cause mortality.

Concepts: Epidemiology, PH, Dustin Thomason, Cultural studies, Whitehall Study, Social determinants of health

308

Intake of sweet food, beverages and added sugars has been linked with depressive symptoms in several populations. Aim of this study was to investigate systematically cross-sectional and prospective associations between sweet food/beverage intake, common mental disorder (CMD) and depression and to examine the role of reverse causation (influence of mood on intake) as potential explanation for the observed linkage. We analysed repeated measures (23,245 person-observations) from the Whitehall II study using random effects regression. Diet was assessed using food frequency questionnaires, mood using validated questionnaires. Cross-sectional analyses showed positive associations. In prospective analyses, men in the highest tertile of sugar intake from sweet food/beverages had a 23% increased odds of incident CMD after 5 years (95% CI: 1.02, 1.48) independent of health behaviours, socio-demographic and diet-related factors, adiposity and other diseases. The odds of recurrent depression were increased in the highest tertile for both sexes, but not statistically significant when diet-related factors were included in the model (OR 1.47; 95% CI: 0.98, 2.22). Neither CMD nor depression predicted intake changes. Our research confirms an adverse effect of sugar intake from sweet food/beverage on long-term psychological health and suggests that lower intake of sugar may be associated with better psychological health.

Concepts: Scientific method, Psychology, Epidemiology, Nutrition, Mental disorder, Major depressive disorder, Sugar, Whitehall Study

180

Prospective studies report associations between indicators of time spent sitting and obesity risk. Most studies use a single indicator of sedentary behavior and are unable to clearly identify whether sedentary behavior is a cause or a consequence of obesity.

Concepts: Epidemiology, Obesity, Indicator, Whitehall Study, Social determinants of health

174

BACKGROUND: It has been suggested that dietary patterns are associated with future risk of depressive symptoms. However, there is a paucity of prospective data that have examined the temporality of this relation. OBJECTIVE: We examined whether adherence to a healthy diet, as defined by using the Alternative Healthy Eating Index (AHEI), was prospectively associated with depressive symptoms assessed over a 5-y period. DESIGN: Analyses were based on 4215 participants in the Whitehall II Study. AHEI scores were computed in 1991-1993 and 2003-2004. Recurrent depressive symptoms were defined as having a Center for Epidemiologic Studies Depression Scale score ≥16 or self-reported use of antidepressants in 2003-2004 and 2008-2009. RESULTS: After adjustment for potential confounders, the AHEI score was inversely associated with recurrent depressive symptoms in a dose-response fashion in women (P-trend < 0.001; for 1 SD in AHEI score; OR: 0.59; 95% CI: 0.47, 0.75) but not in men. Women who maintained high AHEI scores or improved their scores during the 10-y measurement period had 65% (OR: 0.35%; 95% CI: 0.19%, 0.64%) and 68% (OR: 0.32%; 95% CI: 0.13%, 0.78%) lower odds of subsequent recurrent depressive symptoms than did women who maintained low AHEI scores. Among AHEI components, vegetable, fruit, trans fat, and the ratio of polyunsaturated fat to saturated fat components were associated with recurrent depressive symptoms in women. CONCLUSION: In the current study, there was a suggestion that poor diet is a risk factor for future depression in women.

Concepts: Health, Epidemiology, Nutrition, Saturated fat, Trans fat, Unsaturated fat, Polyunsaturated fat, Whitehall Study

20

According to the ‘use it or lose it’ hypothesis, a lack of mentally challenging activities might exacerbate the loss of cognitive function. On this basis, retirement has been suggested to increase the risk of cognitive decline, but evidence from studies with long follow-up is lacking. We tested this hypothesis in a cohort of 3433 civil servants who participated in the Whitehall II Study, including repeated measurements of cognitive functioning up to 14 years before and 14 years after retirement. Piecewise models, centred at the year of retirement, were used to compare trajectories of verbal memory, abstract reasoning, phonemic verbal fluency, and semantic verbal fluency before and after retirement. We found that all domains of cognition declined over time. Declines in verbal memory were 38% faster after retirement compared to before, after taking account of age-related decline. In analyses stratified by employment grade, higher employment grade was protective against verbal memory decline while people were still working, but this ‘protective effect’ was lost when individuals retired, resulting in a similar rate of decline post-retirement across employment grades. We did not find a significant impact of retirement on the other cognitive domains. In conclusion, these findings are consistent with the hypothesis that retirement accelerates the decline in verbal memory function. This study points to the benefits of cognitively stimulating activities associated with employment that could benefit older people’s memory.

Concepts: Psychology, Epidemiology, Cognitive psychology, Cognition, Memory, Retirement, Reasoning, Whitehall Study

13

We examined whether obesity at ages 50, 60, and 70 years is associated with subsequent dementia. Changes in body mass index (BMI) for more than 28 years before dementia diagnosis were compared with changes in BMI in those free of dementia.

Concepts: Epidemiology, Obesity, Mass, Body mass index, Body shape, Whitehall Study, Social determinants of health, Galileo Galilei

10

Evidence suggests that short and long sleep are associated with a higher risk of type 2 diabetes. Using successive data waves spanning >20 years, we examined whether a change in sleep duration is associated with incident diabetes.

Concepts: Epidemiology, Diabetes mellitus type 2, Diabetes mellitus, Integer, Long, Short, Whitehall Study, Social determinants of health

6

Physical activity is associated with reduced cardiovascular disease risk, mainly through effects on atherosclerosis. Aortic stiffness may be an alternative mechanism. We examined whether patterns of physical activity and sedentary behavior are associated with rate of aortic stiffening.

Concepts: Medicine, Epidemiology, Blood vessel, Cardiovascular disease, Whitehall Study, Social determinants of health

6

Physical activity is key for successful ageing, but questions remain regarding the optimal physical activity pattern. We examined the cross-sectional association between physical activity and successful ageing using data on 3,749 participants (age range = 60-83years) of the Whitehall II study. The participants underwent a clinical assessment, completed a 20-item physical activity questionnaire, and wore a wrist-mounted accelerometer for 9 days. Successful ageing was defined as good cognitive, motor, and respiratory functioning, along with absence of disability, mental health problems, and major chronic diseases. Time spent in moderate-to-vigorous physical activity (MVPA) episodes assessed by accelerometer was classified as “short” (1-9.59 minutes) and “long” (≥10 minutes) bouts. Linear multivariate regression showed that successful agers (N = 789) reported 3.79 (95% confidence interval (CI): 1.39-6.19) minutes more daily MVPA than other participants. Accelerometer data showed this difference to be 3.40 (95% CI:2.44-4.35) minutes for MVPA undertaken in short bouts, 4.16 (95% CI:3.11-5.20) minutes for long bouts, and 7.55 (95% CI:5.86-9.24) minutes for all MVPA bouts lasting 1 minute or more. Multivariate logistic regressions showed that participants undertaking ≥150 minutes of MVPA per week were more likely to be successful agers with both self-reported (Odd Ratio (OR) = 1.29,95% (CI):1.09-1.53) and accelerometer data (length bout ≥1 minute:OR = 1.92, 95%CI:1.60-2.30). Successful agers practice more MVPA, having both more short and long bouts, than non-successful agers.

Concepts: Regression analysis, Epidemiology, Statistics, Age, Ageing, Mental disorder, Whitehall Study, Social determinants of health

5

Aortic stiffness is an important predictor of future morbidity and mortality. Diabetes is associated with increased aortic stiffness, but the importance of nondiabetic glucometabolic status for accelerated aortic stiffening is unclear. We tested the hypothesis that adverse glucometabolic status is associated with accelerated aortic stiffening in individuals without diabetes, independently of known risk factors for arterial stiffening.

Concepts: Epidemiology, Mortality rate, Whitehall Study, Social determinants of health