ANXIETY, DEPRESSION, DIET AND LIFESTYLE AMONG LEBANESE ADULTS LIVING IN BEIRUT

Abstract

Scientific Background: Depression is the leading cause of disability worldwide and it’s not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder. Although dietary intake and nutritional status are suggested to affect mental health, few studies were carried out to examine the correlation between mental health and nutrition.

Objectives: In a sample of Lebanese adults, the main objectives of this study were 1) to determine the proportion of anxiety and depression in a sample of Lebanese adults

2) to assess the proportion of healthy lifestyle in a sample of Lebanese adults

and 3) to Study the relationship between eating habits, exercise, smoking and Mediterranean diet with depression and anxiety in Lebanese adults.

Methods: Subjects for this study were selected from participants in a previous research conducted among adults working in various faculties and offices at the American University of Beirut (AUB). Individuals who provided a consent to be re-contacted for future research, were contacted, and asked kindly to participate in the current study. After ensuring eligibility, subjects completed 3 questionnaires the Patient Health Questionnaire PHQ9, Generalized Anxiety Disorder and the History questionnaire. Data from these questionnaires were collected in a one-to-one interview on campus. Data for the nutrient intake were retrieved from the previous study and included: The Food Frequency questionnaire, Socio-Demographic questionnaire, Lifestyle questionnaire and Anthropometric assessment. The lifestyle score was computed based on the data collected from the previous study. Each participant received a score of one for each of the lifestyle factors if they were never smokers; were regularly active, i.e. performing 150 min/week of moderate intensity physical activity or 60 min/week of vigorous intensity physical activity; had a ‘‘normal’’ BMI of 25 kg/m2; and the Mediterranean diet pattern score = 1 (MDP scored of 3 and 4 is considered =1) otherwise participants received a score of zero for each of these factors. Lifestyle Factors score is generated by summing the score for each of the four components (smoking, MDP score, physical activity, and BMI). The Mediterranean score is based on the intake of olive oil, fibers, fruits, vegetables, fish, meat, and refined cereals whereby higher scores indicating better adherence to the Mediterranean dietary pattern. ANOVA and chi squared test were conducted to assess the associations between anxiety, depression, and lifestyle score. Statistical Package for Social Sciences (SPSS) was used in the analysis and a p<0.05 indicated significance.

Results: The majority of our sample were males (65%) while the age of the participants ranged between 23 to 45 years and above, among which 29.4% are below the age of 35 years. Of the participants, 72.9 % were either overweight or obese. Nearly 36.5% of the study sample had an elevated depression while 30.7% had an elevated anxiety score. Also, the majority of the participants had a moderately severe unhealthy to a moderately healthy lifestyle (Moderately severe unhealthy= score of 1;Moderately healthy lifestyle= score of 2) from which 80% of the participants have a moderate to high physical activity level, more than half of the participants (56.5 %) reported to be smokers and 72.9 % were either overweight or obese. Moreover, there’s a low adherence to the Mediterranean diet in the Lebanese adults (51.8%). No significant association was found between lifestyle scores, depression, and anxiety. Lower nonalcoholic beverages intake may be associated with depression and lower niacin intake is present among participants with anxiety . Furthermore, marital status, education level, higher income and an academic employment were significantly association with a better lifestyle (P=0.028, P=0.002, P=0.008).

Conclusion: The study’s findings demonstrated that anxiety, depression, unhealthy lifestyle characteristics and a low adherence to the Mediterranean dietary pattern are considerably prevalent among Lebanese adults. In addition, the results suggested some nutrients may be associated with depression and anxiety. Further studies are needed to set nutritional recommendations in order to maximize the mental health treatment effectiveness.