Poor dietary behaviors and physical activity may contribute to the development of metabolic syndrome in patients with depression. According to a study published in the Journal of Affective Disorders, these lifestyle factors were found to mediate 23% of the association between depressive symptoms and risk of metabolic syndrome.
The investigators of this large population-based study sought to estimate how much diet and physical activity further mediate the relationship between depressive symptoms and metabolic syndrome.
The study investigators analyzed baseline data from 64,861 adults who participated in the French population-based Constances cohort. Depressive symptoms were measured using the Center of Epidemiologic Studies Depression scale along with self-reported limitations related to depression. Metabolic syndrome was diagnosed according to criteria put forth by the International Diabetes Federation.
Results from a food frequency questionnaire were entered into a principal component analysis to determine the participants’ dietary patterns; physical activity was calculated using 3 questions resulting in a composite score ranging from 0 (being very active) to 6 (being not active at all). Logistic regression analyses were used to estimate associations between depression, dietary patterns, and physical activity and measure the association between depressive symptoms and metabolic syndrome. Path analyses were used to examine the extent to which diet and physical activity mediated the association between depressive symptoms and metabolic syndrome.
Individuals with depression were significantly associated with a high fat, high sugar diet pattern (odds ratio [OR] 1.23; 95% CI, 1.20-1.26; P <.0001) and with low physical activity (OR 2.88; 95% CI, 2.53-3.29). Adjusting for variables, including gender, age, education status, and income, a significant association was found between depression and metabolic syndrome with a 75% higher likelihood of individuals with depression having metabolic syndrome (OR 1.75; 95% CI, 1.57-1.96). Path analysis showed that metabolic syndrome was mediated by diet and physical activity by 23% (with physical activity making up two-thirds of the mediation effect), meaning 77% of the association between depressive symptoms and metabolic syndrome was explained by a direct correlation.
Limitations of the study included the cross-sectional nature of the analyses in which causation cannot be inferred, as well as the absence of relevant dietary data, including energy intake. Data on inflammatory or genetic factors were not available, potentially confounding the associations of depression and metabolic syndrome. Diet and physical activity were self-reported, and no ethnic data was provided for the French cohort, possibly limiting the generalizability of the results.
The study investigators found that diet and physical activity are mediating factors for the association between depressive symptoms and metabolic syndrome but indicate that other factors, including inflammatory and genetic factors, have a greater influence on how depression is associated with metabolic syndrome. However, they suggest that dietary behaviors and physical activity may be targeted in the prevention of metabolic syndrome in patients with depression.
Disclosures: Multiple authors declare associations with the pharmaceutical industry. Please see original reference for a full list of authors’ disclosures.
Matta J, Hoertel N, Kesse-Guyot E, et al. Diet and physical activity in the association between depression and metabolic syndrome: Constances study. J Affect Disord. 2019; 244:25-32.