Healthy behaviours and mental health: findings from the German Health Update (GEDA)

BACKGROUND: Health risk behaviours such as smoking, physical inactivity and poor diet are independently associated with depression. However, there is a paucity of data examining associations between combined healthy behaviours and mental distress and depression. METHODS: Using cross-sectional data from a nationwide population-based sample of adults in Germany German Health Update (GEDA) 2009 and 2010 telephone surveys; n = 21 940 women, n = 17 061 men, we examined associations between five healthy behaviours and frequent mental distress (FMD) and self-reported diagnosed depression in the past 12 months. Healthy behaviours included non-smoking, low-risk alcohol drinking, regular sport, maintaining normal weight and healthy fruit and vegetable consumption. Multiple logistic regression analyses adjusted for potential confounders examined associations between the combined number of healthy behaviours and FMD and self-reported diagnosed depression. RESULTS: FMD was reported by 13.6 and 8.0% and diagnosed depression in the last 12 months by 8.3 and 4.7% of women and men, respectively. At least four of five assessed healthy behaviours were reported by 29.1% of women and 17.8% of men. Compared with those with less than two healthy behaviours, women and men with at least four behaviours were about half as likely to report FMD [odds ratio (OR) 0.53, 95% confidence interval (CI) 0.44-0.64, and OR 0.52, 95% CI 0.41-0.66, respectively) and women with at least four behaviours were less likely to report diagnosed depression (OR 0.76, 95% CI 0.61-0.95). CONCLUSION: A higher number of healthy behaviours are associated with a lower prevalence of FMD for both women and men and of self-reported diagnosed depression in women.