Dong Yu, Huang Jinghong, Liu Hongqing
School of Public Health, Shandong Second Medical University, Weifang, 261053, China.
School of Public Health, Lanzhou University, Lanzhou, 730000, China.
BMC Public Health. 2025 Feb 13;25(1):599. doi: 10.1186/s12889-025-21834-0.
The joint association of dietary diversity (DD) and physical activity (PA) on anxiety, depressive symptoms, and their comorbidity have not been extensively explored. Hence, this study focused on examining this association.
Data in this cross-sectional study was derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Based on self-reported dietary diversity score (DDS) questions were used to assess DD, ranging from 0 to 8. DDS < 5 was defined as insufficient DD and DDS ≥ 5 was defined as sufficient DD. PA was based on a self-reported binary question. Anxiety was assessed using the Generalized Anxiety Disorder Scale-7 (GAD-7), and depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression Scale-10 (CESD-10). The independent and joint associations of DD and PA on anxiety, depressive symptoms, and their comorbidity were examined by multivariable-adjusted binary logistic regression models.
In this cross-sectional study, sufficient DD was independently associated with a decreased risk of anxiety (adjusted OR = 0.57, 95% CI = 0.50-0.65), depressive symptoms (adjusted OR = 0.69, 95% CI = 0.63-0.77), and their comorbidity (adjusted OR = 0.58, 95% CI = 0.49-0.68). Similarly, exposure to current exercise was also a significant protective factor for mental health. Importantly, co-exposure to sufficient DD and current exercise may amplify the protective effects on mental health (adjusted OR = 0.47, 95% CI = 0.38-0.57 for anxiety; adjusted OR = 0.36, 95% CI = 0.31-0.42 for depressive symptoms; adjusted OR = 0.37, 95% CI = 0.29-0.48 for their comorbidity). The robustness of these associations was demonstrated in four sensitivity analyses.
Our study found that sufficient DD and current exercise were associated with a decreased risk of mental health disorders. Importantly, the combination of both appeared to enhance this protective effect. Our findings promote the joint assessment of DD and PA to provide new insights into health-related behaviors for prevention strategies for mental health disorders in older adults.
饮食多样性（DD）与身体活动（PA）对焦虑、抑郁症状及其共病的联合影响尚未得到广泛研究。因此，本研究聚焦于探究这种关联。
本横断面研究的数据来源于中国老年健康长寿纵向调查（CLHLS）。基于自我报告的饮食多样性得分（DDS）问题来评估DD，范围为0至8。DDS < 5被定义为饮食多样性不足，DDS≥5被定义为饮食多样性充足。PA基于一个自我报告的二元问题。使用广泛性焦虑障碍量表-7（GAD-7）评估焦虑，通过流行病学研究中心抑郁量表-10（CESD-10）评估抑郁症状。通过多变量调整的二元逻辑回归模型检验DD和PA对焦虑、抑郁症状及其共病的独立和联合关联。
在本横断面研究中，充足的饮食多样性与焦虑风险降低独立相关（调整后的OR = 0.57，95% CI = 0.50 - 0.65）、抑郁症状风险降低独立相关（调整后的OR = 0.69，95% CI = 0.63 - 0.77）以及它们的共病风险降低独立相关（调整后的OR = 0.58，95% CI = 0.49 - 0.68）。同样，当前进行锻炼也是心理健康的一个重要保护因素。重要的是，同时具备充足的饮食多样性和当前进行锻炼可能会增强对心理健康的保护作用（焦虑的调整后OR = 0.47，95% CI = 0.38 - 0.57；抑郁症状的调整后OR = 0.36，95% CI = 0.31 - 0.42；它们共病的调整后OR = 0.37，95% CI = 0.29 - 0.48）。四项敏感性分析证明了这些关联的稳健性。
我们的研究发现，充足的饮食多样性和当前进行锻炼与心理健康障碍风险降低相关。重要的是，两者结合似乎会增强这种保护作用。我们的研究结果促进了对饮食多样性和身体活动的联合评估，为老年人心理健康障碍预防策略的健康相关行为提供了新的见解。
