Healthy Eating as Potential Mediator of Inverse Association between Purpose in Life and Waist Circumference: Emerging Evidence from US and Chilean Cohorts

High sense of purpose in life, a fundamental domain of eudaimonic well-being, has been consistently associated with lower risk for various obesity-related chronic diseases. Although this psychological feature correlates with some health behaviors as potential mediators, its association with healthy eating remains less explored. In addition, studies of these psycho-behavioral and health relationships in the South American population are lacking. This research sought to assess: (1) the cross-sectional association between self-reported purpose in life and overall healthy eating patterns, and (2) healthy food intake as a potential mediator of the inverse relationship between purpose in life and waist circumference. Data collected of 2060 US adults from the MIDUS study (5 ± 12 years, 55% women, mostly white people, and 42.5% obese) and 223 Chilean adults from the CHILEMED study (46.6 ± 9 years, 58.3% women, and 71.3% obese) were used. Anthropometric and sociodemographic variables were collected. Sense of purpose was assessed using the purpose in life subscale of the Ryff's psychological well-being questionnaire. Diet quality was evaluated using healthy eating or low-fat diet indexes, according to extant food intake data in each cohort. The relationship between these variables was estimated by bivariate and multivariate linear regressions with appropriate adjustments. To establish whether a better diet quality could mediate a link of purpose in life and improved nutritional status (assessed by waist circumference), the association between these three variables was tested by bootstrapping-based mediation analysis. Our results show significant associations of sense of purpose with healthy eating and low-fat dietary patterns in both US and Chilean cohorts, respectively, even after adjusting for sociodemographic variables. According to the mediation analysis, the relationship between sense of purpose and waist circumference, as an indicator of abdominal obesity, appears to be partially mediated by healthier food intake in both samples. In conclusion, our findings suggest a plausible mechanism underlying the favorable impact of this well-being dimension on physical health. Given its protective effects, interventions aimed at increasing purpose in life may facilitate adherence to better dietary patterns, which, in turn, will reduce the risk for obesity-related chronic diseases.

Mediterranean diet and psychological well-being intervention to reverse metabolic syndrome in Chile (CHILEMED trial)

Psychosocial status and lifestyle are key risk factors of non-communicable diseases (NCDs), which, in turn, are main drivers of healthcare costs and morbimortality worldwide, including Chile. Mediterranean diet (MedDiet) is one of the healthiest dietary patterns under study. However, its impact on high-risk conditions, such as metabolic syndrome (MetS), and NCDs outside the Mediterranean Basin remains mostly unexplored. Even though Central Chile has an environment, food production, and culinary traditions comparable to those present in Mediterranean countries, few studies -some with significant methodological limitations- have evaluated the effect of MedDiet on health and/or disease in Chilean subjects. Importantly, a Mediterranean lifestyle is a modus vivendi that integrates physical health with mental and social well-being. Psychological well-being (PWB) is associated with healthy behaviors, positive health outcomes, and longevity, thereby emerging as a novel healthcare goal. We report here an ongoing randomized controlled clinical trial in Chilean patients with MetS seeking to test whether (1) a PWB theory-based intervention facilitates induction to and increases long-term adherence to a locally adapted MedDiet, and (2) a MedDiet intervention -implemented alone or combined with well-being promotion- is more effective at reversing MetS compared to individuals following a low-fat diet without psychological support. The CHILEan MEDiterranean (CHILEMED) diet intervention study is a 1-year trial including patients with MetS living in Chile. Participants will be assigned randomly by a computer-generated random number sequence to one of the three intervention arms: a) low-fat diet as control group, b) MedDiet alone, and c) MedDiet plus well-being support. Patients will be followed-up by individual and/or group online nutritional sessions or phone cal as well as 6- and 12-month in-person re-assessment of medical history, medication use, food intake, PWB, anthropometrics/physical exam, and blood collection for laboratory analysis. The primary outcome of the trial will be the effect of the MedDiet -with or without PWB intervention- on overall reversal of MetS compared to low-fat diet alone. Based on a statistical superiority trial, expected impact, and patient loss, the estimated study sample is 339 subjects (113 individuals per arm in 3 equal-sized groups). Currently, we have enrolled 179 patients, predominantly women, evenly distributed by age (group means ranging from 45.7 to 48,9 years-old), 3/4 are obese with almost all of them showing abdominal obesity, 70% are hypertensive, whereas <10% exhibit diabetes. If findings turn out as expected (e.g., MedDiet -with or without PWB intervention- is better than the low-fat diet for reversion of MetS at 1-year follow-up), CHILEMED will provide further beneficial evidence of the MedDiet on NCD risk conditions beyond the Mediterranean region.

Mental Health and Well-Being Among Individuals With a Sensory Loss During COVID-19 Lockdown Measures

Hearing and vision impairment are highly prevalent chronic conditions and are associated with poorer mental health and well-being. Mental health problems may be exacerbated by COVID-19-related lockdown measures and limitations of in-person contacts may affect those with sensory impairments more severely. We aimed to determine whether hearing and/or visual impairment were associated with worse mental health and psychological well-being during lockdown measures in Spring/Summer 2020 in Wisconsin. We included 1341 (64% women, aged 20-92 years) Survey of the Health of Wisconsin participants of a COVID-19 survey (May-June, 2020). We assessed self-reported current mental health and psychological well-being and vision and hearing impairment. Logistic regression models with vision and hearing impairments as determinants and multiple mental health and well-being outcomes were used and adjusted for age, gender, race, education, heart disease, hypertension, hyperlipidemia and diabetes. In preliminary analyses, we found associations of vision impairment with increased odds of generalized anxiety disorder (odds ratio=2.10; 95% confidence interval=1.32-3.29) and depression (2.57; 1.58-4.11). Individuals with a vision impairment were more likely to be taking medication for depression (1.75; 1.13-2.68), report being lonely (1.65; 1.00-2.64) and report hopelessness (1.45; 1.01-2.08). Individuals with a hearing impairment were more likely to be taking depression medications (1.72; 1.07-2.73) and to report being lonely (1.80; 1.05-2.98). Sensory impairment was not associated with stress levels or sense of purpose in life. Individuals with sensory impairment may represent a particularly vulnerable population during the COVID-19 pandemic. Future research should determine underlying reasons and interventions to mitigate this populations’ disadvantages.

Sense of Purpose in Life and Likelihood of Future Illicit Drug Use or Prescription Medication Misuse

OBJECTIVE

In the United States, 28.6 million people used illicit drugs or misused prescription drugs in the last 30 days. Thus, identifying factors linked with lower likelihood of future drug misuse is an important target for research and practice. Sense of purpose in life has been linked with better behavioral and physical health outcomes. Furthermore, a higher sense of purpose may reduce the likelihood of drug misuse because it has been linked with several protective factors including enhanced ability to handle stress, higher pain tolerance, and lower impulsivity. However, the association between sense of purpose and drug misuse has been understudied. Thus, we tested whether people with a higher sense of purpose at baseline had a lower likelihood of future drug misuse 9 to 10 years later.

METHODS

This study included 3535 middle-aged adults from the Midlife in the United States Study who were not misusing drugs at baseline. Using multiple logistic regression models, we assessed whether baseline purpose in life was associated with risk of misusing drugs 9 to 10 years later.

RESULTS

Among respondents not misusing drugs at baseline, people in the highest quartile of purpose (versus lowest quartile) had a substantially lower likelihood of future drug misuse in a model adjusting for demographic variables (odds ratio = 0.50, 95% confidence interval = 0.31-0.83). Associations remained evident after additionally adjusting for psychological distress, baseline health, and health behaviors.

CONCLUSIONS

A growing knowledge base suggests that a sense of purpose can be increased. Additional research is needed to evaluate sense of purpose as a novel target in the prevention and reduction of drug misuse.

SENSE OF PURPOSE IN LIFE AND REDUCED LIKELIHOOD OF FUTURE DRUG MISUSE

A stronger sense of purpose in life is hypothesized to reduce the likelihood of drug misuse because it has been linked with several protective factors including: increased ability to handle stress and pain tolerance, decreased impulsivity, and reduced risk of depression and chronic conditions. However, the association between purpose in life and drug misuse has been understudied. We tested whether people with a stronger sense of purpose in life had a decreased likelihood of incident drug misuse 9-10 years later. We also tested whether people with a stronger sense of purpose were less likely to cope with stress by misusing drugs. Participants were drawn from the Midlife in the United States Study (MIDUS; n=3,483) and from a stress coping module of the Health and Retirement Study (HRS; n=498). Among MIDUS respondents not misusing drugs at baseline, people in the highest quartile of purpose (compared to people in the lowest quartile) had 42% reduced odds (95% CI: 0.37-0.92) of incident drug misuse 9-10 years later in the fully-adjusted model (e.g., sociodemographic factors, depression, chronic conditions, and chronic pain). Among HRS respondents, people in the highest purpose quartile had 65% decreased odds (95% CI: 0.14-0.89) of misusing drugs to cope with stress in the fully-adjusted model. A growing number of intervention studies show that purpose in life can be raised. With additional research, these data suggest that sensitively tailored and administered purpose in life may reduce the likelihood of drug misuse and help stem the tide of our nation’s growing drug epidemic.

Vagally-mediated heart rate variability and indices of well-being: Results of a nationally representative study

OBJECTIVE

High frequency (HF) heart rate variability (HRV) has long been accepted as an index of cardiac vagal control. Recent studies report relationships between HF-HRV and indices of positive and negative affect, personality traits and well-being but these studies generally are based on small and selective samples.

METHOD

These relationships were examined using data from 967 participants in the second Midlife in the U.S. (MIDUS II) study. Participants completed survey questionnaires on well-being and affect. HF-HRV was measured at rest. A hierarchical series of regression analyses examined relationships between these various indices and HF-HRV before and after adjustment for relevant demographic and biomedical factors.

RESULTS

Significant inverse relationships were found only between indices of negative affect and HF-HRV. Relationships between indices of psychological and hedonic well-being and positive affect failed to reach significance.

CONCLUSIONS

These findings raise questions about relationships between cardiac parasympathetic modulation, emotion regulation, and indices of well-being. (PsycINFO Database Record

Unequally distributed psychological assets: are there social disparities in optimism, life satisfaction, and positive affect?

Socioeconomic status is associated with health disparities, but underlying psychosocial mechanisms have not been fully identified. Dispositional optimism may be a psychosocial process linking socioeconomic status with health. We hypothesized that lower optimism would be associated with greater social disadvantage and poorer social mobility. We also investigated whether life satisfaction and positive affect showed similar patterns. Participants from the Midlife in the United States study self-reported their optimism, satisfaction, positive affect, and socioeconomic status (gender, race/ethnicity, education, occupational class and prestige, income). Social disparities in optimism were evident. Optimistic individuals tended to be white and highly educated, had an educated parent, belonged to higher occupational classes with more prestige, and had higher incomes. Findings were generally similar for satisfaction, but not positive affect. Greater optimism and satisfaction were also associated with educational achievement across generations. Optimism and life satisfaction are consistently linked with socioeconomic advantage and may be one conduit by which social disparities influence health.

Stress eating and health. Findings from MIDUS, a national study of US adults

The epidemic of obesity and its related chronic diseases has provoked interest in the predictors of eating behavior. Eating in response to stress has been extensively examined, but currently unclear is whether stress eating is associated with obesity and morbidity. We tested whether self-reported stress eating was associated with worse glucose metabolism among nondiabetic adults as well as with increased odds of prediabetes and diabetes. Further, we investigated whether these relationships were mediated by central fat distribution. Participants were 1138 adults (937 without diabetes) in the Midlife in the US study (MIDUS II). Glucose metabolism was characterized by fasting glucose, insulin, insulin resistance (HOMAIR), glycosylated hemoglobin (HbA1c), prediabetes, and diabetes status. Multivariate-adjusted analyses showed that stress eating was associated with significantly higher nondiabetic levels of glucose, insulin, insulin resistance, and HbA1c as well as higher odds of prediabetes or diabetes. Relationships between stress eating and all outcomes were no longer statistically significant once waist circumference was added to the models, suggesting that it mediates such relationships. Findings add to the growing literature on the relationships among psychosocial factors, obesity, and chronic disease by documenting associations between stress eating and objectively measured health outcomes in a national sample of adults. The findings have important implications for interventive targets related to obesity and chronic disease, namely, strategies to modify the tendency to use food as a coping response to stress.

Relation between optimism and lipids in midlife

The present research examined optimism's relation with total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides. The hypothesis that optimism is associated with a healthier lipid profile was tested. The participants were 990 mostly white men and women from the Midlife in the United States study, who were, on average, 55.1 years old. Optimism was assessed by self-report using the Life Orientation Test. A fasting blood sample was used to assess the serum lipid levels. Linear and logistic regression models examined the cross-sectional association between optimism and lipid levels, accounting for covariates such as demographic characteristics (e.g., education) and health status (e.g., chronic medical conditions). After adjusting for covariates, the results suggested that greater optimism was associated with greater high-density lipoprotein cholesterol and lower triglycerides. Optimism was not associated with low-density lipoprotein or total cholesterol. The findings were robust to a variety of modeling strategies that considered the effect of treatment of cholesterol problems. The results also indicated that diet and body mass index might link optimism with lipids. In conclusion, this is the first study to suggest that optimism is associated with a healthy lipid profile; moreover, these associations can be explained, in part, by the presence of healthier behaviors and a lower body mass index.

Varieties of Resilience in MIDUS

Population-based studies of health typically focus on psychosocial contributors to illness and disease. We examine findings from a national longitudinal study of American adults, known as MIDUS (Midlife in the U.S.) to examine the role of psychosocial factors in promoting resilience, defined as the maintenance, recovery, or improvement in health following challenge. Classic studies of resilience are briefly noted, followed by a look at three categories of resilience in MIDUS. The first pertains to having good health and well-being in the face of low socioeconomic standing. The second pertains to maintaining good health and well-being despite the challenges that accompany aging. The third pertains to resilience in the face of targeted life challenges such as abuse in childhood, loss of spouse in adulthood, or having cancer. Across each area, we summarize evidence of positive health, and where possible, highlight protective influences that account for such salubrious outcomes. We conclude with opportunities for future research in MIDUS such as examining cultural and genetic influences on resilience as well as utilizing laboratory challenge data to illuminate underlying mechanisms.

Fewer ups and downs: daily stressors mediate age differences in negative affect

The current study examined age differences in daily stressors, positive events (uplifts), and their associations with emotional experience among healthy older women. Women (N = 101, 63-93 years old) reported their daily experiences across 1 week. Older age was related to fewer stressors and less frequent negative affect. However, the association between negative affect and age was no longer significant after accounting for the occurrence of daily stressors. Older age was not significantly related to positive affect, although positive uplifts were reported less frequently with age. Findings provide a contextual explanation for emotional experience in very late life, where reduced exposure to stressors partially explains age-related reductions in negative affect.

The Wisconsin Longitudinal Study: Adults As Parents And Children At Age 50

The Wisconsin Longitudinal Study: Adults As Parents And Children At Age 50

Parental and family well-being in families of children with Down syndrome: a comparative study

The purpose of this study was to examine the effects of a child with Down syndrome on the individual functioning of both parents, marital functioning, and family functioning. Thirty-four families of children with Down syndrome were compared to 41 families with nondisabled children. Mothers and fathers in both groups completed a series of self-report measures. No significant differences were obtained between the two groups of families on any of the measures of individual, marital, or family functioning. The results of this study support a competence model in which parents may respond to the challenges associated with parenting a child with Down syndrome with resilience and adaptive functioning.