Abstract
BackgroundThere is now evolving data exploring the relationship between depression and various individual lifestyle factors such as diet, physical activity, sleep, alcohol intake, and tobacco smoking. While this data is compelling, there is a paucity of longitudinal research examining how multiple lifestyle factors relate to depressed mood, and how these relations may differ in individuals with major depressive disorder (MDD) and those without a depressive disorder, as ‘healthy controls’ (HC).MethodsTo this end, we assessed the relationships between 6 key lifestyle factors (measured via self-report) and depressed mood (measured via a relevant item from the Patient Health Questionnaire) in individuals with a history of or current MDD and healthy controls (HCs). Cross-sectional analyses were performed in the UK Biobank baseline sample, and longitudinal analyses were conducted in those who completed the Mental Health Follow-up.ResultsCross-sectional analysis of 84,860 participants showed that in both MDD and HCs, physical activity, healthy diet, and optimal sleep duration were associated with less frequency of depressed mood (all p < 0.001; ORs 0.62 to 0.94), whereas screen time and also tobacco smoking were associated with higher frequency of depressed mood (both p < 0.0001; ORs 1.09 to 1.36). In the longitudinal analysis, the lifestyle factors which were protective of depressed mood in both MDD and HCs were optimal sleep duration (MDD OR = 1.10; p < 0.001, HC OR = 1.08; p < 0.001) and lower screen time (MDD OR = 0.71; p < 0.001, HC OR = 0.80; p < 0.001). There was also a significant interaction between healthy diet and MDD status (p = 0.024), while a better-quality diet was indicated to be protective of depressed mood in HCs (OR = 0.92; p = 0.045) but was not associated with depressed mood in the MDD sample. In a cross-sectional (OR = 0.91; p < 0.0001) analysis, higher frequency of alcohol consumption was surprisingly associated with reduced frequency of depressed mood in MDD, but not in HCs.ConclusionsOur data suggest that several lifestyle factors are associated with depressed mood, and in particular, it calls into consideration habits involving increased screen time and a poor sleep and dietary pattern as being partly implicated in the germination or exacerbation of depressed mood.
Highlights
There is evolving data exploring the relationship between depression and various individual lifestyle factors such as diet, physical activity, sleep, alcohol intake, and tobacco smoking
Sample characteristics The entire sample for cross-sectional analyses consisted of all 84,860 participants of the UK Biobank who (i) had provided sufficient information to establish major depressive disorder (MDD) vs non-depression status, (ii) provided sufficient data on exposure and outcome measures to be included in the analyses and (iii) did not meet the exclusion criteria
Lifestyle factors affecting mood Increased physical activity, as measured by a one sd increase in metabolic equivalent of task (MET) minutes per week (MDD group: OR = 0.94, 95% CI 0.91–0.96, p < 0.0001; healthy controls’ (HC) group: OR = 0.94, 95% CI 0.92–0.96, p < 0.0001), healthy diet (MDD group: OR = 0.91, 95% CI 0.86–0.97, p = 0.0026; HCs: OR = 0.88, 95% CI 0.84–0.92, p < 0.0001) and optimal sleep (MDD group: OR = 0.62, 95% CI 0.58–0.66, p < 0.0001; HCs: OR = 0.65, 95% CI 0.62–0.68, p < 0.0001) were significantly cross-sectionally associated with less depressive mood in both groups (Fig. 1, Online Table 1)
Summary
There is evolving data exploring the relationship between depression and various individual lifestyle factors such as diet, physical activity, sleep, alcohol intake, and tobacco smoking. Key analyses to date tend to explore the association with physical activity [4] and dietary quality [5], the relationships with other modifiable lifestyle elements have been generally less explored. These lifestyle factors are all modifiable, providing an additional array of treatment options in concert with existing strategies. For milder forms of depression, notable treatment guidelines recommend addressing lifestyle factors before commencing pharmacotherapy [6]
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