Association of DASH and Depressive Symptoms with BMI over Adulthood in Racially and Socioeconomically Diverse Adults Examined in the HANDLS Study

Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet is linked to slower weight gain over time. Elevated depressive symptoms may lead to poor quality diets, potentially increasing Body Mass Index (BMI). This study explored these pathways using longitudinal data extracted from 1201–1458 Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study participants. DASH mean score was computed using four 24 h recalls [visits(v)1 + v2/2: 2004–2013] and depressive symptoms using the Center for Epidemiologic Studies Depression (CES-D) scale (v1 + v2/2: 2004–2013). BMI was measured at v2: 2009–2013 and v3: 2013–2017. Multiple linear mixed regression and mediation modeling were conducted, linking CES-D((mean)) and DASH((mean)) to BMI [v2 and annualized change ΔBMI (v3-v2)] and exploring mediation of the CES-D((mean))–BMI((v3)) and DASH((mean))–BMI((v3)) associations through DASH((mean)) and CES-D((mean)), respectively. Models were further stratified by sex, race and poverty status. Inverse cross-sectional and longitudinal relationships of DASH((mean)) with BMI((v2)) and ΔBMI were detected, mainly in women and <125% of poverty participants. CES-D((mean)) was not associated with BMI((v3)); no mediation was detected through DASH((mean)) in all socio-demographic strata. Moreover, the inverse DASH((mean))–BMI((v3)) total effect was not mediated through CES-D((mean)). Future studies should explore other pathways aside from depressive symptoms by which DASH can have a preventive effect on weight status over time.