How does lifestyle intervention affect depressive symptoms? Results from the Finnish Diabetes Prevention Study

Authors

  • A. Ruusunen,

    1. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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  • S. Voutilainen,

    1. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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  • L. Karhunen,

    1. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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  • S. M. Lehto,

    1. Department of Psychiatry, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
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  • T. Tolmunen,

    1. Department of Psychiatry, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
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  • S. Keinänen-Kiukaanniemi,

    1. University of Oulu, Institute of Health Sciences, Faculty of Medicine, Oulu, Finland
    2. Oulu University Hospital, Unit of General Practice, Oulu, Finland
    3. Health Centre of Oulu, Oulu, Finland
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  • J. Eriksson,

    1. Department of General Practice and Primary Health Care, University of Helsinki, Finland
    2. Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland
    3. Folkhalsan Research Centre, Helsinki, Finland
    4. Vasa Central Hospital, Vasa, Finland
    5. Diabetes Prevention Unit, Department of Health Promotion and Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
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  • J. Tuomilehto,

    1. Diabetes Prevention Unit, Department of Health Promotion and Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
    2. South Ostrobothnia Central Hospital, Seinäjoki, Finland and
    3. Centre for Vascular Prevention, Danube-University Krems, Krems, Austria
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  • M. Uusitupa,

    1. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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  • J. Lindström

    1. Diabetes Prevention Unit, Department of Health Promotion and Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland
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Anu Ruusunen, University of Eastern Finland, Kuopio Campus, Institute of Public Health and Clinical Nutrition. PO Box 1627, FI-70211 Kuopio, Finland. E-mail: anu.ruusunen@uef.fi

Abstract

Diabet. Med. 29, e126–e132 (2012)

Abstract

Aims  To assess the effect of lifestyle intervention on depressive symptoms during a 36-month randomized clinical trial designed to prevent Type 2 diabetes.

Methods  A total of 522 middle-aged participants, who were overweight or obese and had impaired glucose tolerance, were randomized to the lifestyle intervention or control group in the Finnish Diabetes Prevention Study. The intervention group received individualized counselling aimed at reducing weight and increasing physical activity. Depressive symptoms were measured using the Beck Depression Inventory among a subgroup of 140 participants.

Results  On study entry, the mean Beck Depression Inventory scores ± sd were 6.8 ± 5.6 in the intervention group and 6.7 ± 5.5 in the control group. Beck Depression Inventory scores reduced during the intervention study: the mean ± sd (95% CI) reduction was 0.90 ± 4.54 (−1.99 to −0.19) scores in the intervention group and 0.75 ± 4.47 (−1.80 to 0.31) in the control group, with no difference between the groups. In a stepwise linear multivariate regression analysis, the variables with the strongest associations with the change in Beck Depression Inventory scores were baseline Beck Depression Inventory scores, marital status, weight change and change of total energy intake (R2 = 0.209, P < 0.001).

Conclusions  Participation in the study lowered depression scores, with no specific group effect. Among the lifestyle changes, particularly successful reduction of body weight was associated with the greater reduction of depressive symptoms. Thus, regardless of the intensity of the treatment, the success in executing alterations in one’s lifestyle and behaviour is associated with beneficial changes in mood.

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