MedWire News: Small lifestyle and behavioral changes are associated with significant improvements in depressive symptoms among overweight or obese individuals with impaired glucose tolerance (IGT), show results from the Finnish Diabetes Prevention Study (FDPS).
Weight loss seems to be the factor most strongly associated with improved depressive symptoms in such patients, say the researchers.
Anu Ruusunen (University of Eastern Finland, Kuopio) and team analyzed data for 522 FDPS participants to assess whether a lifestyle intervention decreased depressive symptoms in middle-aged overweight or obese (body mass index >25 kg/m2) individuals with IGT.
Trial participants were randomly assigned to either an intervention group to receive individualized counseling aimed at reducing weight and increasing physical activity, or a control to receive general verbal and written information about diet and exercise at baseline only.
Those in the intervention group received detailed advice to achieve a weight reduction of at least 5%, to obtain less than 30% of their daily energy intake from fat and less than 10% from saturated fat, to ensure a daily fiber intake of at least 15 g per 100 kcal, and to complete at least 30 minutes of exercise per day. This advice was delivered through seven face-to-face counseling sessions with a nutritionist during the first year of the study and one session every 3 months thereafter until study-end at 3 years.
Depressive symptoms were measured using the Beck Depression Inventory (BDI) among a subgroup of 140 individuals (69 from the intervention group and 71 from the control group). The BDI score ranges from 0 to 63, with a cut-off point for elevated depressive symptoms of 11 points.
The authors compared baseline BDI scores with those obtained after 3 years between the two groups.
As reported in Diabetes Medicine, the researchers found that participation in the study lowered depression scores with no specific group effect.
At study entry, the mean BDI score was 6.8 in the intervention group and 6.7 in the control group. The scores reduced by 0.90 and 0.75 points, respectively, by the end of the intervention (a nonsignificant difference).
Multivariate analysis revealed that the variables most strongly associated with the change in BDI scores were baseline BDI scores, marital status, and weight change, at correlation coefficients of -0.302, 0.196, and 0.194.
"Among the lifestyle changes, particularly successful reduction of body weight was associated with the greater reduction of depressive symptoms," write Ruusunen and team.
"Thus, regardless of the intensity of the treatment, the success in executing alterations in one's lifestyle and behavior is associated with beneficial changes in mood and psychologic well-being," conclude the researchers.
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