Eur J Prev Cardiol：生活方式干预延缓抑郁症状进展

　　健康饮食、运动与生活方式项目（Healthy Eating and Exercise Lifestyle Program，HEELP）是一项在心脏病和/或2型糖尿病患者中展开的二级预防危险因素干预项目，该项目被证实通过减重与运动使参与者获益。

　　澳大利亚学者Gallagher R等人对HEELP进行二级分析，从心脏康复与糖尿病教育计划项目中选取147例体质指数（BMI）在27-39之间的受试者。其中HEELP参与者接受为期16周的以组为单位的生活方式干预，每周两次监测下进行运动并报告5项指标；对照组接受常规治疗。第16周时对推荐水平运动量（≥5日/周，中度到强烈运动，总时长≥150分钟/周）达标率和抑郁症状（医院抑郁焦虑量表）进行评估。

　　结果显示HEELP参与者在运动频率（71vs.50%，p = 0.036）、强度(76 vs. 60%, p = 0.05)、总时长(65 vs. 43%, p = 0.047)等各方面达标率均更高。HEELP组抑郁症状进展发生率仅为对照组一半（17 vs. 34%; OR值0.397）。HEELP参与者中达到推荐的总运动时长者，报告抑郁症状进展的比例较少（OR值0.29）。

　　由此研究者认为，尽管存在多重危险因素，以组为单位的生活方式干预仍然改善了患者运动功能，延缓了抑郁症状进展。 

与抑郁相关的拓展阅读： 

• 1型糖尿病合并抑郁者转归较差
• 老年抑郁症转归的调节因素
• ADAA：应用氯胺酮抗抑郁 时机尚不成熟
• ADAA：抗抑郁药联合认知行为疗法对老年焦虑效果好
• 初诊抑郁症与动脉粥样硬化相关 更多信息请点击：有关抑郁更多资讯

Impact of the Healthy Eating and Exercise Lifestyle Programme on depressive symptoms in overweight people with heart disease and diabetes.
BACKGROUND
The Healthy Eating and Exercise Lifestyle Program (HEELP) is a secondary risk factor intervention programme for people with heart disease and/or type 2 diabetes, which has proven benefits for weight loss and exercise. This secondary analysis evaluated the effects of HEELP on achieving recommended levels of exercise and the prevalence of depressive symptoms, and whether meeting exercise recommendations had an independent effect on depressive symptoms.
DESIGN
A randomized parallel controlled trial of patients (n = 147) with body mass index 27-39 kg/m2 were recruited from cardiac rehabilitation and diabetes education programmes.
METHODS
HEELP participants received a 16-week group-based lifestyle intervention of twice-weekly supervised exercise and five information sessions; the control group received usual care. At 16 weeks, achievement of recommended levels of exercise (≥5 days/week, moderate or higher intensity, and total duration of ≥150 minutes/week) and depressive symptoms (Hospital Anxiety and Depression Scale) were assessed.
RESULTS
More HEELP participants met the recommendations for exercise frequency (71 vs. 50%, p = 0.036), intensity (76 vs. 60%, p = 0.05), and total duration (65 vs. 43%, p = 0.047). The prevalence of depressive symptoms in HEELP was half that of the control group (17 vs. 34%; OR 0.397, 95% CI 0.18-0.86). Participants who met recommendations for total duration of exercise were less likely to report depressive symptoms (OR 0.29, 95% CI 0.112-0.717) after adjusting for treatment group and weight change.
CONCLUSIONS
A group-based lifestyle intervention improves exercise and reduces depressive symptoms despite multiple risk factors.