摘要：Objectives. We examined whether healthy lifestyles are associated with absence of depressed mood. Methods. A sample of 1169 adult participants in the Maastricht Aging Study provided baseline and 6-year follow-up data on smoking, alcohol use, physical exercise, body mass index, and mood. We examined associations between lifestyles and depressed mood using longitudinal analyses controlling for baseline depressive symptoms and covariates. Results. Reports of excessive alcohol use at baseline predicted depressed mood at follow-up (relative risk [RR] = 2.48; 95% confidence interval [CI] = 1.08, 5.69), and reports of more than 30 minutes of physical exercise per day at baseline were associated with an absence of depressed mood at follow-up (RR=0.52; 95% CI=0.29, 0.92). Reports of being engaged in physical exercise throughout the 6-year follow-up period were also associated with absence of depressed mood (RR=0.56; 95% CI=0.34, 0.93). Conclusions. In this relatively healthy population sample, certain lifestyles either predicted or protected against depressed mood. Adopting or maintaining healthy lifestyles might be a starting point in preventing or treating depressed mood over time. Depressed mood is presumed to be caused by a variety of physical, psychological, and socioenvironmental factors. 1 For example, unhealthy lifestyles such as smoking, excessive alcohol use, low levels of physical exercise, or being overweight or obese may provoke chronic diseases 2 , 3 or worsen one’s health status over time. 4 Chronic diseases frequently coincide with increased symptoms of depression, 5 and feelings of depression may in turn result in unhealthy lifestyles. 6 Potentially intensifying this “downward spiral,” unhealthy lifestyles might elicit or exacerbate feelings of depression, 7 , 8 and depression may subsequently provoke or worsen the consequences associated with chronic diseases. 9 , 10 However, it is not unequivocally clear how unhealthy lifestyles and the emergence of depressed mood (i.e., a clinically relevant level of depressive symptoms 11 ) are associated over time. Although research has consistently established that there is a cross-sectional association between smoking and depressed mood, 12 – 14 little evidence is available regarding whether there is a longitudinal association, that is, whether smoking precedes or follows depressed mood. It has been shown that, in general, heavy alcohol use is associated with depressed mood. 15 , 16 Moreover, depressed mood is more often secondary to alcoholism than primary (i.e., clinicians more often treat individuals with alcoholism who have also developed depressed mood as a secondary reason for treatment than vice versa). 15 Physical activity seems to help counteract prevalent depressive symptoms and protect against subsequent depression, but longitudinal studies are necessary to further unravel this association. 17 , 18 The relation between being overweight or obese and being depressed is controversial; different studies have revealed negative, positive, and no associations between these conditions. 19 – 22 If healthy lifestyles are associated with the absence of depressed mood or protect against the emergence of depressed mood, this common and debilitating condition might be prevented or treated in the future through promoting healthy lifestyles. We sought to determine whether healthy lifestyles are associated, over time, with absence of depressed mood in the general population.
