Exploring the Link Between Lifestyle Patterns and Depression in Diabetic Individuals

A recent study examining the effects of diet and lifestyle choices on depression in people with diabetes was published in BMC Public Health. Their results show that dietary inflammation plays a mediating role in the major influence of lifestyle patterns on depression. This implies that encouraging anti-inflammatory diets and healthy lifestyle behaviors may help prevent and treat depression in patients with diabetes.

Context
Millions of individuals worldwide are afflicted by diabetes, and millions more are predicted to get a diagnosis in the next few years. Compared to people without diabetes, people with diabetes have a significantly higher risk of developing depression.

Diabetes patients who experience depression may experience worsening health consequences, such as ineffective blood sugar management and bad lifestyle choices. Prior studies have largely examined the relationship between depression and individual lifestyle patterns, such as smoking or inactivity.

It is unknown, therefore, how different lifestyle choices interact to affect depressed feelings in diabetic patients.

About the Study

This study examined how various dietary practices and lifestyle patterns—particularly those that cause inflammation—influence depression in individuals with diabetes, filling a research vacuum in the literature.

The National Health and Nutrition Examination Survey (NHANES), which was conducted between 2009 and 2020, provided the researchers with data. NHANES is a comprehensive survey that evaluates Americans’ health and nutrition.

Medical examinations and interviews were used to collect data. 3,009 adults with diabetes were chosen for study from this data, with incomplete information being excluded.

Five lifestyle patterns were taken into consideration by the researchers: smoking, drinking alcohol, getting enough sleep, exercising, and being sedentary. Every action was classified as either healthy or unhealthy.

The Dietary Inflammatory Index (DII), which assigns a score to diets according to how likely they are to induce inflammation, was also used to measure dietary practices.

A depression severity score survey was used to evaluate depressive symptoms. Numerous statistical techniques were employed to find trends in lifestyle choices and examine how those choices affected depression.

The relationship between lifestyle choices and depression was then investigated in relation to the function of dietary inflammation as a mediator. Potential confounding variables such as age, sex, race, income, education, and body mass index (BMI) were taken into consideration in the study.

Results
The average age of the 3,009 persons with diabetes whose data were evaluated for this study was 61.3. In all, 13.7% of the subjects experienced signs of depression.

Three lifestyle categories were found by the researchers: those who led unhealthy lifestyles (44.5%), those who did not consume alcohol but led unhealthy lifestyles (48.1%), and those who smoked but otherwise led healthy lives (7.4%).

The unhealthy lifestyle group exhibited high rates of alcohol consumption, insomnia, inactivity, and sedentary behavior.

Even though they consumed less alcohol, people leading unhealthy lifestyles nevertheless engaged in harmful habits. While there were more smokers in the third group, there were less other risky behaviors.

According to the study, compared to the first group that drank alcohol, the second group, which abstained, had a higher risk of developing depression.

Pro-inflammatory diets may exacerbate depressive symptoms as higher DII scores were linked to higher levels of depression.

Dietary inflammation in diabetes patients appears to have an impact on depressive symptoms; the DII appeared to totally mediate the association between the risk of depression and smoking in the otherwise healthy group, and to partially mediate the relationship between the unhealthy group and their alcohol consumption.

In conclusion

The interdependence of lifestyle choices and their combined benefits on health outcomes—especially for those with diabetes—are highlighted by this study.

Research shows that anti-inflammatory diets high in fruits, vegetables, whole grains, and omega-3 fatty acids can lower the incidence of depression in diabetics.

It also highlights the necessity of multimodal therapies that deal with several undesirable habits at once.

The results are in line with earlier studies that demonstrated that men smoke at higher rates than women. They imply that bad habits can compound as people age and might even play a role in the emergence of chronic illnesses.

The study also confirms the finding that anti-inflammatory food habits are frequently followed by those who lead better lives.

Questions concerning the role of moderate alcohol use in potentially moderating depressive symptoms are raised by the unexpected finding that the unhealthy group who did not consume alcohol had a higher likelihood of reporting depressed symptoms than the group that did.

This study casts doubt on the notion that drinking alcohol raises the risk of depression and indicates the need for more investigation into the potential neuroprotective benefits of moderate alcohol use.

The huge sample size and utilization of high-quality, nationally representative data are two of the study’s strongest points. However, there are certain drawbacks, such as the use of self-reported data, which may introduce recall bias, and the cross-sectional design’s inability to prove causation.

In order to gain a deeper understanding of these links and create efficient intervention techniques, future research should make use of clinical trials and longitudinal investigations.

For more information: Influence of lifestyle patterns on depression among adults with diabetes: a mediation effect of dietary inflammatory index, BMC Public Health, doi: 10.1186/s12889-024-19319-7