title: Concurrent occurrence of multiple positive lifestyle behaviors and depression among adults in the United States.
abstract: BACKGROUND
  To our knowledge, no studies have examined the dose-response association between concurrent occurrence of multiple positive health behaviors and depression. As a result, the purpose of this study was to examine the dose-response association between concurrent occurrence of lifestyle behaviors (i.e., diet, physical activity, and smoking) on depression symptoms among a national sample of U.S. adults (20-85 yr).
  
  
  METHODS
  Using data from the 2005-2006 NHANES (n=2574), diet was assessed from the healthy eating index variable; physical activity was assessed via accelerometry; smoking was assessed from cotinine levels; and depression was assessed from the Patient Health Questionnaire 9 (PHQ-9).
  
  
  RESULTS
  Each lifestyle behavior was independently associated with depression in the expected direction, and there was also evidence of a dose-response relationship. Compared to those having 0 positive lifestyle factors, those with 1, 2, and 3 positive lifestyle factors, respectively, were 15% (p=0.38), 67% (p=0.001), and 82% (p=0.01) less likely to be classifed as having moderate or greater depression symptoms (PHQ-9 ≥10).
  
  
  CONCLUSIONS
  The main limitation of this study was the cross-sectional design.
  
  
  CONCLUSIONS
  there is a dose-response relationship between concurrent occurrence of positive lifestyle behaviors and depression symptoms.
authors.affiliation: Bellarmine University, Department of Exercise Science, Donna & Allan Lansing School of Nursing & Health Sciences, Louisville, KY 40205, United States. Electronic address: ploprinzi@bellarmine.edu.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Loprinzi
authors.affiliation: Bellarmine University, Department of Exercise Science, Donna & Allan Lansing School of Nursing & Health Sciences, Louisville, KY 40205, United States.
authors.forename: Sara
authors.initials: S
authors.lastname: Mahoney
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Depression; Diet; Physical activity; Smoking