The Contribution of Health Behaviors to Depression Risk Across Birth Cohorts

Abstract

Background: More recent birth cohorts are at a higher depression risk than cohorts born in the early 20th century. We aimed to investigate to what extent changes in alcohol consumption, smoking, physical activity, and obesity contribute to these birth cohort variations. Methods: We analyzed panel data from US adults born 1916-1966 enrolled in the Health and Retirement Study (N = 163,760 personyears). We performed a counterfactual decomposition analysis by combining age-period-cohort models with g-computation. We thereby compared the predicted probability of elevated depressive symptoms (CES-D 8 score ≥3) in the natural course to a counterfactual scenario where all birth cohorts had the health behaviors of the 1945 birth cohort. We stratified analyses by sex and race-ethnicity. Results: We estimated that depression risk of the 1916-1949 and 1950-1966 birth cohort would be on average 2.0% (-2.3 to -1.7) and 0.5% (-0.9 to -0.1) higher with the alcohol consumption levels of the 1945 cohort. In the counterfactual with the 1945 BMI distribution, depression risk is on average 2.1% (1.8 to 2.4) higher for the 1916-1940 cohorts and 1.8% (-2.2 to -1.5) lower for the 1950-1966 cohorts. We find no cohort variations in depression risk for smoking and physical activity. The contribution of alcohol is more pronounced for Whites than for other race-ethnicity groups, and the contribution of BMI more pronounced for women than for men. Conclusion: Increased obesity levels were associated with exacerbated depression risk in recent birth cohorts in the United States, while drinking patterns only played a minor role.

Risk of major depressive increases with increasing frequency of alcohol drinking: a bidirectional two-sample Mendelian randomization analysis

“…Considering the potential impact of alcohol consumption on depression-related metabolites ( 45 ), we performed a two-step Mendelian randomization study, incorporating inflammation levels [including IL-6 ( 24 ) and CRP ( 25 )], diet-related metabolites ( 28 ) (such as vitamin A, mannitol, and hippuric acid), acid sphingomyelinase ( 16 ), body mass index ( 26 ), and BFP ( 27 ) as mediating factors. Figure 2 (see Supplementary Data Sheet 9 for included SNPs) illustrates the study design.…”

“…Other data, such as drinking frequency and drinking type, were extracted from published GWAS studies from UK Biobank. Additionally, there are several risk factors associated with alcohol consumption and depression, including inflammation levels [inflammatory biomarkers IL-6 ( 24 ) and C-reactive protein ( 25 )], acid sphingomyelinase ( 16 ), body mass index ( 26 ), body fat percentage (BFP) ( 27 ), and diet-related metabolites ( 28 ). These data were obtained from the IEU Open GWAS database summary website.…”