The Association Between Healthy Lifestyle with Depression and Anxiety Among Adults in Esfahan

Association of a combination of lifestyle-related factors and mental health is less studied in earlier studies, especially in Middle Eastern countries.
This study aimed to examine how combinations of several lifestyle-related factors is related to depression and anxiety in a large group of middle-age Isfahani population.
In a cross-sectional study in 2012 on 3363 Isfahani adults (19-70 yr), a healthy lifestyle score was constructed by the use of data from dietary intakes, physical activity, smoking status, psychological distress and obesity. A dish-based 106-item semi-quantitative validated food frequency questionnaire (FFQ), General Practice Physical Activity Questionnaire (GPPAQ), General Health Questionnaire (GHQ) and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. The Hospital Anxiety and Depression Scale (HADS) was applied to screen for anxiety and depression.
The prevalence rates of anxiety and depression among study participants were 15.2 and 30.0%, respectively. After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle were 93% less likely to be anxious (OR: 0.07; 95% CI: 0.02-0.30) and 97% less likely to be depressed (OR: 0.03; 95% CI: 0.01-0.11), compared with those with the lowest score. In addition, non-smokers had lower odds of anxiety (OR: 0.65; 95% CI: 0.47-0.89) and depression (OR: 0.63; 95% CI: 0.48-0.82), compared with smokers. Individuals with low levels of psychological distress had expectedly lower odds of anxiety (OR: 0.13; 95% CI: 0.10-0.16) and depression (OR: 0.10; 95% CI: 0.08-0.12) than those with high levels. Individuals with a healthy diet had 25% lower odds of depression (OR: 0.75; 95% CI: 0.61-0.91) than those with a non-healthy diet.
We found evidence indicating that healthy lifestyle score was associated with lower odds of anxiety and depression in this group of Isfahani adults. Healthy diet, psychological distress, and smoking status were independent predictors of mental disorders.