Abstract
Background Patients with type 2 diabetes have an elevated risk of depression. This study sought to evaluate whether an overall healthy lifestyle, encompassing factors such as never smoking, moderate alcohol consumption, regular physical activity, healthy diet, less sedentary time, adequate sleep duration, and appropriate social connection, is associated with a lower incidence of depression in this population. Methods and findings This study included 10,294 participants with type 2 diabetes from the UK Biobank, excluding those with baseline cardiovascular disease or cancer. Lifestyle data were collected via baseline questionnaires, while depression was from the first occurrences data. Among the participants, 559 developed depression during follow-up. All individual lifestyle factors except regular exercise and healthy diet showed significant associations with depression. A clear dose-response relationship was observed between the composite lifestyle score and depression risk. Furthermore, this protective association remained significant and was independent of individuals' genetic risk for depression. The optimal lifestyle combination for reducing depression risk was defined as never smoking, moderate alcohol consumption, adequate sleep duration, and limited sedentary time. Conclusions A composite healthy lifestyle was significantly associated with a lower risk of depression in individuals with type 2 diabetes, showing a clear dose-response relationship that was independent of genetic susceptibility.</p>