A healthy lifestyle is positively associated with mental health and well-being and core markers in ageing

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Abstract

Background

Studies often evaluate mental health and well-being in association with individual health behaviours although evaluating multiple health behaviours that co-occur in real life may reveal important insights into the overall association. Also, the underlying pathways of how lifestyle might affect our health are still under debate. Here, we studied the mediation of different health behaviours or lifestyle factors on mental health and its effect on core markers of ageing: telomere length (TL) and mitochondrial DNA content (mtDNAc).

Methods

In this study, 6054 adults from the 2018 Belgian Health Interview Survey (BHIS) were included. Mental health and well-being outcomes included psychological and severe psychological distress, vitality, life satisfaction, self-perceived health, depressive and generalised anxiety disorder and suicidal ideation. A lifestyle score integrating diet, physical activity, smoking status, alcohol consumption and BMI was created and validated. On a subset of 739 participants, leucocyte TL and mtDNAc were assessed using qPCR. Generalised linear mixed models were used while adjusting for a priori chosen covariates.

Results

The average age (SD) of the study population was 49.9 (17.5) years, and 48.8% were men. A one-point increment in the lifestyle score was associated with lower odds (ranging from 0.56 to 0.74) for all studied mental health outcomes and with a 1.74% (95% CI: 0.11, 3.40%) longer TL and 4.07% (95% CI: 2.01, 6.17%) higher mtDNAc. Psychological distress and suicidal ideation were associated with a lower mtDNAc of − 4.62% (95% CI: − 8.85, − 0.20%) and − 7.83% (95% CI: − 14.77, − 0.34%), respectively. No associations were found between mental health and TL.

Conclusions

In this large-scale study, we showed the positive association between a healthy lifestyle and both biological ageing and different dimensions of mental health and well-being. We also indicated that living a healthy lifestyle contributes to more favourable biological ageing.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12916-022-02524-9.

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Most cited references 94

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While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity. The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). The PHQ-9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. As PHQ-9 depression severity increased, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and health care utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-9 score > or =10 had a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 represented mild, moderate, moderately severe, and severe depression, respectively. Results were similar in the primary care and obstetrics-gynecology samples. In addition to making criteria-based diagnoses of depressive disorders, the PHQ-9 is also a reliable and valid measure of depression severity. These characteristics plus its brevity make the PHQ-9 a useful clinical and research tool.

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A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.

J. Ware, M Kosinski, S Keller (1996)

Regression methods were used to select and score 12 items from the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) to reproduce the Physical Component Summary and Mental Component Summary scales in the general US population (n=2,333). The resulting 12-item short-form (SF-12) achieved multiple R squares of 0.911 and 0.918 in predictions of the SF-36 Physical Component Summary and SF-36 Mental Component Summary scores, respectively. Scoring algorithms from the general population used to score 12-item versions of the two components (Physical Components Summary and Mental Component Summary) achieved R squares of 0.905 with the SF-36 Physical Component Summary and 0.938 with SF-36 Mental Component Summary when cross-validated in the Medical Outcomes Study. Test-retest (2-week)correlations of 0.89 and 0.76 were observed for the 12-item Physical Component Summary and the 12-item Mental Component Summary, respectively, in the general US population (n=232). Twenty cross-sectional and longitudinal tests of empirical validity previously published for the 36-item short-form scales and summary measures were replicated for the 12-item Physical Component Summary and the 12-item Mental Component Summary, including comparisons between patient groups known to differ or to change in terms of the presence and seriousness of physical and mental conditions, acute symptoms, age and aging, self-reported 1-year changes in health, and recovery for depression. In 14 validity tests involving physical criteria, relative validity estimates for the 12-item Physical Component Summary ranged from 0.43 to 0.93 (median=0.67) in comparison with the best 36-item short-form scale. Relative validity estimates for the 12-item Mental Component Summary in 6 tests involving mental criteria ranged from 0.60 to 107 (median=0.97) in relation to the best 36-item short-form scale. Average scores for the 2 summary measures, and those for most scales in the 8-scale profile based on the 12-item short-form, closely mirrored those for the 36-item short-form, although standard errors were nearly always larger for the 12-item short-form.

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Author and article information

Contributors

Pauline Hautekiet:

ORCID: http://orcid.org/0000-0003-3805-3004

pauline.hautekiet@sciensano.be

Journal

Journal ID (nlm-ta): BMC Med

Journal ID (iso-abbrev): BMC Med

Title: BMC Medicine

Publisher: BioMed Central (London )

ISSN (Electronic): 1741-7015

Publication date (Electronic): 29 September 2022

Publication date PMC-release: 29 September 2022

Publication date Collection: 2022

Volume: 20

Electronic Location Identifier: 328

Affiliations

[1 ]GRID grid.508031.f, Sciensano, , Risk and Health Impact Assessment, ; Juliette Wytsmanstraat 14, 1050 Brussels, Belgium

[2 ]GRID grid.12155.32, ISNI 0000 0001 0604 5662, Centre for Environmental Sciences, , Hasselt University, ; 3500 Hasselt, Belgium

[3 ]GRID grid.508031.f, Sciensano, , Epidemiology and Public Health, ; Juliette Wytsmanstraat 14, 1050 Brussels, Belgium

[4 ]GRID grid.5596.f, ISNI 0000 0001 0668 7884, Centre for Environment and Health, , Leuven University, ; 3000 Leuven, Belgium

Author information

Pauline Hautekiet http://orcid.org/0000-0003-3805-3004

Article

Publisher ID: 2524

DOI: 10.1186/s12916-022-02524-9

PMC ID: 9520873

PubMed ID: 36171556

SO-VID: b7805622-c1cd-4918-a1c0-e50702b31185

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 4 February 2022

Date accepted : 10 August 2022

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100003130, Fonds Wetenschappelijk Onderzoek;

Award ID: FWO 12X9620N

Award Recipient : Dries S. Martens

Funded by: Sciensano

Award ID: 1179–101

Custom metadata

ScienceOpen disciplines: Medicine

Keywords: mental health,lifestyle,biological ageing,mitochondrial dna content,telomere length

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ScienceOpen disciplines: Medicine

Keywords: mental health, lifestyle, biological ageing, mitochondrial dna content, telomere length

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A healthy lifestyle is positively associated with mental health and well-being and core markers in ageing

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Abstract

Background

Methods

Results

Conclusions

Supplementary Information

Related collections

UCL: UN SDG 03 Good Health and Well-Being

Most cited references 94

The PHQ-9: validity of a brief depression severity measure.

The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.

A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.

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