The Association Between Lifestyle Patterns and Depression in United States Emerging Adults: A Latent Class Analysis

Background: Lifestyle behaviors are a potential adjunctive treatment for depression in emerging adults (18-25 years), but the combination of behaviors associated with depression remains unclear. Methods: 2,019 emerging adults from the National Health and Nutrition Examination Survey between 2011 and 2018 were selected. Latent class analysis (LCA) identified patterns of lifestyle behaviors (diet [Dietary Inflammatory Index], sleep [quantity/quality], physical activity, sedentary behavior, substance use [alcohol/smoking]). Multiple logistic regression examined associations between lifestyle patterns and depression. Results: LCA identified 6 male classes and 5 female classes. Compared to the Healthy reference group, males in the Poor Sleep Sedentary Drinkers (aOR [95% CI]: 4.40 [1.10, 17.55], P = 0.032) and Pro-inflammatory Diet (PID) Smokers Drinkers (aOR [95% CI]: 6.11 [1.94, 19.25], P = 0.002) groups and females in the PID Smokers Drinkers (aOR [95% CI]: 4.96 [2.07, 11.89], P < 0.001), Trouble Sleeping (aOR [95% CI]: 6.65 [2.17, 20.33], P < 0.001), and PID Sedentary (aOR [95% CI]: 4.74 [1.37, 16.35], P = 0.012) groups had increased odds of depression. Conclusions: We found unique sex-specific lifestyle patterns associated with depression (males: diet, sleep [quantity/quality], sedentary behavior, substance use; females: sleep quality). Lifestyle behaviors should be comprehensively targeted to prevent and treat depression in emerging adults.