How healthy lifestyle can help to prevent depression

A healthy lifestyle that involves moderate alcohol consumption, a healthy diet, regular physical activity, healthy sleep and frequent social connection can help to reduce the risk of depression, according to a new analysis.

International research published in the latest Nature Mental Health examined a combination of factors including lifestyle factors, genetics, brain structure and immune and metabolic systems to identify the underlying mechanisms that might explain the link.

Using data from almost 290,000 people in the UK Biobank, of whom 13,000 had depression, they followed the individuals for nine years and identified seven healthy lifestyle factors linked with a lower risk of depression.

These were: moderate alcohol consumption; healthy diet; regular physical activity; healthy sleep; not smoking; low-to-moderate sedentary behaviour; and frequent social connection, although having between seven and nine hours of sleep a night made the biggest difference, reducing the risk of depression by 22%.

Frequent social connection, which reduced the risk of depression by 18%, was the most protective against recurrent depressive disorder.

Moderate alcohol consumption decreased the risk of depression by 11%, healthy diet by 6%, regular physical activity by 14%, never smoking by 20%, and low-to-moderate sedentary behaviour by 13%.

Individuals in the cohort were assigned to one of three groups – unfavourable, intermediate and favourable – based on the number of healthy lifestyle factors they reported.

Those in the intermediate group were about 41% less likely to develop depression compared to those in the unfavourable lifestyle group, while those in the favourable lifestyle group were 57% less likely.

When each person’s DNA was examined, with everyone being assigned a genetic risk score, those with the lowest genetic risk score were 25% less likely to develop depression compared to those with the highest score.

In people at high, medium, and low genetic risk for depression, the team further found that a healthy lifestyle can cut the risk of depression.

Professor Barbara Sahakian, from the Department of Psychiatry at the University of Cambridge, said: “Although our DNA can increase our risk of depression, we’ve shown that a healthy lifestyle is potentially more important.

“Some of these lifestyle factors are things we have a degree control over, so trying to find ways to improve them – making sure we have a good night’s sleep and getting out to see friends, for example – could make a real difference to people’s lives.”

To understand why a healthy lifestyle might reduce the risk of depression, the team studied a number of other factors, including examining MRI brain scans from just under 33,000 participants. They found a number of regions of the brain, including the pallidum, thalamus, amygdala and hippocampus, where more neurons and connections were linked to a healthy lifestyle.

They also looked for markers in the blood that indicated problems with the immune system or metabolism and among those found to be linked to lifestyle were the C-reactive protein and triglycerides. These links are supported by a number of previous studies.

Dr Christelle Langley, also from the Department of Psychiatry at the University of Cambridge, said: “We’re used to thinking of a healthy lifestyle as being important to our physical health, but it’s just as important for our mental health. It’s good for our brain health and cognition, but also indirectly by promoting a healthier immune system and better metabolism.”

Zhao Y, Yang L, Sahakian BJ et al. The brain structure, immunometabolic and genetic mechanisms underlying the association between lifestyle and depression. Nature Mental Health 11 September 2023; doi: 10.1038/s44220-023-00120-1


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