# Dietary inflammatory index mediation lifestyle patterns and depression among women with osteopenia or osteoporosis

## TL;DR

This study shows that unhealthy or sedentary lifestyles increase depression risk in women with osteopenia or osteoporosis, partly due to inflammatory diets.

## Contribution

The study introduces the Dietary Inflammatory Index as a partial mediator between lifestyle patterns and depression in women with bone conditions.

## Key findings

- Unhealthy and sedentary lifestyle groups showed higher depression risk in women.
- DII partially mediated the link between unhealthy/sedentary lifestyles and depression scores.
- Healthy but inactive lifestyle was the largest group but not significantly linked to depression.

## Abstract

Lifestyle factors play a critical role in osteoporosis management and are closely linked to the development and progression of comorbid depression. This study examines lifestyle patterns and their association with depression in individuals with osteopenia or osteoporosis, while assessing the mediating role of the Dietary Inflammatory Index (DII).

Data from the National Health and Nutrition Examination Survey (NHANES) 2009–2020 were analyzed using latent class analysis (LCA) to classify 3,384 adults based on their lifestyle behaviors. A generalized linear model (GLM) evaluated the effects of lifestyle patterns on depression, and mediation analysis tested associations between these patterns, DII, and Patient Health Questionnaire-9 (PHQ-9) scores.

LCA identified three lifestyle groups: healthy but inactive (34.16%), unhealthy (8.78%), and sedentary (57.06%). The unhealthy (OR = 2.848, 95% CI = 1.550–5.234, p = 0.001) and sedentary (OR = 1.600, 95% CI = 1.127–2.271, p = 0.009) groups were associated with higher depression risk in women. DII partially mediated the relationships between unhealthy lifestyle and PHQ-9 (effect coefficient = 0.095, 95% CI: 0.056–0.135) and between sedentary lifestyle and PHQ-9 (effect coefficient = 0.059, 95% CI: 0.017–0.115).

These findings suggest that lifestyle patterns significantly influence depression in women with osteopenia or osteoporosis, with DII serving as a partial mediator.