Combined healthy lifestyles and risk of depressive symptoms: a cross-sectional study in China

Objectives: To investigate the association between combined healthy lifestyle factors and risk of depressive symptoms. Methods: We conducted a cross-sectional study from April to October 2021,including 5,027 Chinese adults from the general population.A healthy lifestyle score was constructed by assigning 1 point to each healthy lifestyle factor, including active physical activity, non-smoking, no or moderate alcohol consumption, and healthy diet. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusting for confounding variables. Results: Each additional healthy lifestyle factor was associated with a 29% lower risk of having depressive symptoms (OR (95% CI): 0.71 (0.66-0.77)). Compared with individuals with 0-2 healthy lifestyle factors, individuals with four healthy lifestyle factors had a 55% reduced risk of depressive symptoms (0.45 (0.38-0.54)). After stratification by age, the significant inverse association with healthy lifestyle score was stronger in individuals aged younger than 45 years old. Besides, the significant negative association between healthy lifestyle score and depressive symptoms remained the same for different severity of depressive symptoms. Conclusions: Our study indicated that adherence to healthy lifestyle factors was associated with a reduced risk of depressive symptoms among Chinese adults, especially among individuals aged younger than 45 years old. These findings warrant further verification in interventional studies.