Hayward Joshua, Jacka Felice N, Skouteris Helen, Millar Lynne, Strugnell Claudia, Swinburn Boyd A, Allender Steven
Global Obesity Centre, Centre for Population Health Research, Deakin University, Geelong, VIC, Australia
Food & Mood Centre, Deakin University, Geelong, VIC, Australia.
Aust N Z J Psychiatry. 2016 Nov;50(11):1064-1073. doi: 10.1177/0004867416671596. Epub 2016 Oct 12.
Depression affects many Australian adolescents. Research points to the potential of lifestyle improvement for the population-level prevention of mental disorders. However, most studies examine single relationships without considering the combined contribution of lifestyle factors to variance in depression. This study examined associations between adolescent diet, physical activity and screen time behaviours and depressive symptomatology.
A cross-sectional sample of year 8 and 10 students was recruited from 23 participating schools in 18 Victorian communities. Students were recruited using opt-out consent, resulting in 3295 participants from 4680 registered school enrolments (Participation Rate: 70.4%). Participants completed a supervised self-report questionnaire comprising Moods and Feelings Questionnaire-Short Form, an assessment of physical activity and sedentary behaviours during and outside school, and weekly food intake. Surveyed covariates included hours of sleep per night, age, socio-economic status and measured anthropometry. A hierarchical regression stratified by gender was conducted, with dichotomised Moods and Feelings Questionnaire-Short Form score as the outcome, and screen time, physical activity and dietary patterns as predictors. Nested regression analyses were then conducted to ascertain the variance in Moods and Feelings Questionnaire-Short Form score attributable to each significant predictor from the initial regression.
Increased scores on an unhealthy dietary pattern (odds ratio = 1.18; 95% confidence interval = [1.07, 1.32]) and physical activity guideline attainment (0.91; [0.85, 0.97]) were associated with depressive symptomatology in males, while screen time guideline attainment (0.95; [0.91, 0.98]) was associated with depression in females. No association was observed between healthy diet pattern and Moods and Feelings Questionnaire-Short Form. Overall, effect sizes were generally small, and the regression model accounted for 5.22% of Moods and Feelings Questionnaire-Short Form variance.
Gender-specific associations were observed between physical activity and both sedentary and dietary behaviours and depressive symptomatology among adolescents, although reverse causality cannot be refuted at this stage. Lifestyle behaviours may represent a modifiable target for the prevention of depressive symptomatology in adolescents.
抑郁症影响着许多澳大利亚青少年。研究表明改善生活方式对于在人群层面预防精神障碍具有潜力。然而，大多数研究仅考察单一关系，未考虑生活方式因素对抑郁症差异的综合影响。本研究考察了青少年饮食、身体活动和屏幕使用时间行为与抑郁症状之间的关联。
从维多利亚州18个社区的23所参与学校招募了八年级和十年级学生的横断面样本。采用退出同意的方式招募学生，4680名注册在校学生中有3295名参与（参与率：70.4%）。参与者完成了一份有监督的自我报告问卷，包括情绪和感受问卷简表、对在校期间和校外身体活动及久坐行为的评估，以及每周食物摄入量。调查的协变量包括每晚睡眠时间、年龄、社会经济地位和测量的人体测量数据。进行了按性别分层的分层回归分析，以情绪和感受问卷简表的二分得分作为结果，屏幕使用时间、身体活动和饮食模式作为预测变量。然后进行嵌套回归分析，以确定初始回归中每个显著预测变量对情绪和感受问卷简表得分差异的贡献率。
不健康饮食模式得分增加（比值比 = 1.18；95%置信区间 = [1.07, 1.32]）和达到身体活动指南要求（0.91；[0.85, 0.97]）与男性抑郁症状相关，而达到屏幕使用时间指南要求（0.95；[0.91, 0.98]）与女性抑郁相关。未观察到健康饮食模式与情绪和感受问卷简表之间存在关联。总体而言，效应大小通常较小，回归模型解释了情绪和感受问卷简表得分差异的5.22%。
在青少年中，观察到身体活动与久坐和饮食行为以及抑郁症状之间存在性别特异性关联，尽管现阶段无法排除反向因果关系。生活方式行为可能是预防青少年抑郁症状的一个可改变的目标。
