Cross-Sectional Associations of Lifestyle Behaviors with Depressive Symptoms in Adolescents

This study aimed to examine the associations between lifestyle behaviors and depressive symptoms in adolescents. Self-reported data from the 2019 Youth Risk Behavior Survey (YRBS) was analyzed. Depressive symptoms were set as the outcome variable. Movement variables (physical activity, muscle-strengthening exercise, physical education attendance, sports team participation, television watching, video or computer games, and sleep), eating behaviors (fruit intake, vegetable intake, milk intake, and eating breakfast or not), and substance use (alcohol use and cigarette use) were included as explanatory variables. Binary logistic regression was used to explore the asso-ciations between lifestyle behaviors and depressive symptoms after adjusting for sex, age, grade, race, and weight status. Of 13,677 participants who completed the investigation, girls were more than boys (50.3% vs. 48.6%). The proportion of participants in grades 9, 10, 11, and 12 was 26.6, 27.2, 24.3, and 20.8, respectively. Of them, the prevalence of depressive symptoms was 36.0% (weighted%: 36.7% [35.1%, 38.3% ]). Among all the lifestyle behaviors included, participating in no sports teams (OR = 1.53 [1.32, 1.77]), spending more than 2 h in video or computer games (OR = 1.64 [1.40, 1.92]), sleeping less than 8 h nightly (OR = 1.79 [1.45, 2.20]), not eating breakfast (OR = 1.56 [1.37, 1.78]), alcohol use (OR = 1.74 [1.49, 2.02]), and cigarette use (OR = 1.83 [1.42, 2.37]) were associated with higher odds of depressive symptoms. To reduce depressive symptoms in adolescents, interventions can consider encouraging adolescents to engage in team sports activity, limit time for video or com-puter games, sleep enough, regularly eat breakfast, and avoid using alcohol and cigarette. Future studies are encouraged to verify our research findings by using a more improved study design.