Association of Dietary Intake, Lifestyle Behaviours and Body Composition with Depression among School-Going Adolescents in Mumbai

Background & Objectives: Adolescence is a critical developmental period marked by increased vulnerability to mental health disorders, particularly depression, which is a leading contributor to global disease burden. Emerging evidence highlights the role of nutrition, lifestyle behaviours, and body composition in influencing mental health outcomes. However, data exploring these associations in Indian adolescents remain limited. This study aimed to assess the prevalence and severity of depression and examine its association with dietary habits, nutritional intake, lifestyle behaviours, anthropometry, and body composition among adolescents in Mumbai.

Methods: A cross-sectional study was conducted among 753 school-going adolescents (13–18 years) from low-, middle-, and high-income groups in Mumbai, selected using random sampling. Data on socio-demographic characteristics, dietary habits, and lifestyle practices were collected using a standardized questionnaire. Anthropometric measurements and body composition parameters were recorded using standard techniques. Dietary intake was assessed using multiple 24-hour dietary recalls and a food frequency questionnaire (FFQ). Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9) and Beck Depression Inventory-II (BDI-II). Statistical analyses included chi-square tests, correlation analysis, and comparison of means.

Results: Approximately one-third (33.5%) of adolescents exhibited depression based on BDI-II scores, with 15.8%, 11.8%, and 5.8% categorized as mild, moderate, and severe, respectively. Depression prevalence and severity of depression were significantly higher among girls and adolescents from higher socioeconomic status (p<0.05). Higher BMI, body fat percentage, and anthropometric indices (weight, waist and hip circumference) were positively associated with depression severity (p<0.05). Lifestyle factors such as reduced sleep duration were significantly associated with higher depression severity (p<0.05). Dietary behaviours including meal skipping, frequent eating out, and food avoidance were significantly associated with increased depression severity. Consumption of nutrient-dense foods such as sprouts, eggs, fish, and chicken showed a negative association, while intake of ultra-processed foods (momos, energy bars, chocolate) showed a positive association with depression severity (p<0.05). Adolescents with depression had significantly lower intake of energy, protein, carbohydrates, vitamin C, magnesium, and lower nutrient adequacy ratios (p<0.05). BDI-II scores were inversely correlated with intake of macronutrients and key micronutrients including niacin, folate, riboflavin, and magnesium (p<0.05).

Conclusion: Depression is highly prevalent among adolescents and is significantly associated with poor dietary intake, unhealthy eating behaviours, inadequate sleep, and adverse body composition. The findings underscore the importance of integrating nutritional and lifestyle interventions into mental health strategies for adolescents. Early screening and targeted, multidisciplinary approaches focusing on diet quality and lifestyle modification may play a crucial role in the prevention and management of adolescent depression.

Dr. Chandni Chopra is a holistic nutritionist, researcher, and academician with a PhD in Interdisciplinary Studies (University of Mumbai), specializing in nutrition and mental health among adolescents. Her work explores the relationship between diet, lifestyle, and depression. She is a recipient of the national research scholarship. She has held research positions at All India Institute of Medical Sciences and SNDT Women's University, and serves on the Local Executive Committee (Mumbai Chapter) of the Nutrition Society of India. She also holds a certification in Nutritional Psychiatry from Deakin University in collaboration with the Royal Australian and New Zealand College of Psychiatrists.