Joint Effects of Physical Activity and Diet Quality on Depression and Mortality in Diabetes

NCT07122271 | Completed

• 1 other identifier: WuhanSU
• Study Type: observational
• Target: 3,621
• Locations: 1 country
• Sites: 1

Brief Summary

This observational study aims to investigate whether physical activity (PA) and diet quality (DQ) can reduce depression and mortality risk in individuals with diabetes. Participants will be adults diagnosed with diabetes during the 2007-2018 cycle of the National Health and Nutrition Examination Survey (NHANES). The main questions to be answered include: Does higher levels of physical activity significantly reduce the risk of depression in individuals with diabetes? Is higher diet quality associated with lower mortality in individuals with diabetes? Investigators will compare individuals with varying levels of PA and DQ to examine whether these two lifestyle factors, both individually and in combination, have protective effects on mental health and survival. Participants will: Complete questionnaires regarding their physical activity and dietary intake; Be assessed for depressive symptoms (PHQ-9); Be enrolled in long-term mortality follow-up (from the National Death Index); Analyses will be categorized according to their PA (measured in MET-min/week) and HEI-2015 dietary score.

Conditions

Diabetes Complications; Depression Anxiety Disorder; Diabetes

Outcome Measures

Primary Outcomes (1)

• Proportion of Adults With Diabetes Meeting Depression Criteria at Baseline (PHQ-9 ≥5)

  Depression will be measured using the Patient Health Questionnaire-9 (PHQ-9), a validated 9-item self-report instrument scored from 0 to 27. Participants scoring ≥5 will be classified as having depressive symptoms. The outcome is the percentage of participants who meet this criterion at baseline.

  At the time of baseline NHANES examination for each 2-year survey cycle, including 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 (6 cycles in total, each lasting 2 years).

Secondary Outcomes (4)

• Odds Ratio for Depression by Physical Activity Category in Adults With Diabetes

  At the time of baseline NHANES examination for each 2-year survey cycle, including 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 (6 cycles in total, each lasting 2 years).

• Odds Ratio for Depression by Diet Quality Category in Adults With Diabetes

  At the time of baseline NHANES examination for each 2-year survey cycle, including 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 (6 cycles in total, each lasting 2 years).

• Odds Ratio for Depression by Combined Physical Activity and Diet Quality Categories in Adults With Diabetes

  At the time of baseline NHANES examination for each 2-year survey cycle, including 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 (6 cycles in total, each lasting 2 years).

• Subgroup analysis for All-Cause Mortality by Combined Physical Activity and Diet Quality Categories in Adults With Diabetes and Comorbid Depression

  From baseline NHANES examination to December 31, 2019 (up to 120 months follow-up)

Other Outcomes (2)

• SHAP Analysis of Key Predictors of Depression Risk in Adults With Diabetes

  At the time of baseline NHANES examination for each 2-year survey cycle, including 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 (6 cycles in total, each lasting 2 years).

• Mediation Effect of BMI on the Association Between Combined Physical Activity and Diet Quality and Depression in Adults With Diabetes

  At the time of baseline NHANES examination for each 2-year survey cycle, including 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 (6 cycles in total, each lasting 2 years).

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

This study includes adult participants aged 20 years and older with a confirmed diagnosis of diabetes mellitus from the NHANES 2007-2018 dataset. The population comprises individuals with available data on physical activity, diet quality, and depression symptoms, as well as complete demographic and mortality information. Participants represent a nationally representative sample of the non-institutionalized US population. Subgroup analyses were conducted by sex, age group, and BMI category to explore potential effect modification.Machine learning and mediation analysis were also applied to further explore the underlying mechanisms and effect modification.

You may qualify if:

• Adults aged 20 years and older.
• Diagnosed with diabetes mellitus, defined by self-report, fasting plasma glucose ≥126 mg/dL, or HbA1c ≥6.5%.
• Available data on physical activity, diet quality (HEI-2015), and depression status (PHQ-9).
• Complete demographic and mortality follow-up data.

You may not qualify if:

• Missing key exposure or outcome data (e.g., physical activity, HEI-2015, PHQ-9, mortality).
• Pregnant individuals at the time of the survey.
• Participants with unreliable or extreme dietary intake data (e.g., energy intake \<500 or \>5000 kcal/day).

Sponsors & Collaborators

• Minghui Wang: lead

Study Sites (1)

Wuhan Sports University

Wuhan, Hubei, 430000, China

Location

Related Links

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MeSH Terms

Conditions

Diabetes Complications; Diabetes Mellitus

Condition Hierarchy (Ancestors)

Endocrine System Diseases; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases

Study Officials

• zeng chen

  Geriatric Hospital of Hainan province

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Target Duration: 120 Months
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 3, 2025
• First Posted: August 14, 2025
• Study Start: March 16, 2025
• Primary Completion: June 20, 2025
• Study Completion: July 24, 2025
• Last Updated: August 14, 2025

Record last verified: 2025-07

Locations

CN (1)