From The New York Times

1. The power of rest
At the top of the list is a good night’s rest. Sleeping seven to nine hours per night, on average, reduced the risk of depression by about 22% in the study.
Not only does sleep enable us to consolidate memories, helping us remember what we’ve learned during the day, but research shows it plays a key role in keeping our immune systems strong. For instance, a well-rested person is better at fending off the common cold. And though dreaming is still a bit of a mystery, the idea that dreams may help us regulate our emotions goes back decades.
If you have insomnia or trouble sleeping, there’s lots of evidence that these strategies, based on cognitive behavioral therapy, can help.

2. Exercise is an elixir
There’s a solid body of evidence linking physical activity to improved moods. A previous study, based on data from Centers for Disease Control and Prevention surveys, found that people who exercise regularly report fewer days of bad mental health.

And a recent meta-analysis found that physical activity was more effective than medications in reducing symptoms of depression. Antidepressant medicines tend to be faster in treating an episode of depression, says Douglas Noordsy, a psychiatrist with the Stanford Lifestyle Medicine Program. “But physical exercise has more durable effects than an antidepressant does,” he says.

For some people, medication gives them a benefit in the beginning, but then it fades over time, Noordsy says. “Whereas a lifestyle change can have a more permanent and lasting effect.” Noordsy and his colleagues use a range of evidence-based recommendations and tools, from medicines to therapy to behavioral approaches including fitness, nutrition, sleep and stress management, to help empower patients.

3. Good nourishment is a necessity
The researchers found that people who maintained a healthy pattern of eating were less likely to have an episode of depression. Multiple studies show that a plant-forward approach — full of greens, vegetables, berries, whole grains, lean proteins including beans and healthy fats including nuts — can help reduce the risk of disease.

The MIND diet is a mashup of a Mediterranean diet and the DASH diet, which has been shown to reduce hypertension, diabetes, heart attack and stroke. One study found that eating a salad each day is tied to sharper memory and slower cognitive decline among healthy seniors.

And a randomized controlled trial found that college students who followed a Mediterranean diet improved their depression scores after three weeks, whereas depression scores among students who continued to eat lots of refined carbohydrates, ultraprocessed foods and sugary snacks and drinks remained higher.

4 & 5. Limit alcohol and don’t smoke
Having a glass of wine or a beer helps many people feel relaxed, but limiting alcohol consumption to one drink a day or less for women and two drinks a day or less for men is the recommendation in the Dietary Guidelines for Americans. People who regularly consume more than this amount have an increased risk of certain cancers and a higher risk of depression. Why?

People think of alcohol as a pick-me-up, but actually alcohol is a central nervous system depressant that slows down brain activity. The more you drink, the more you chase the temporary high, which can increase the risk of dependence.

There are lots of strategies to help people drink less, and increasingly, as the sober-curious movement grows, there are people taking a break from drinking.

And when it comes to smoking, there’s loads of evidence that tobacco is not a healthy habit. And there are programs to help people quit, including medications, therapy and smoke-free apps.

6. Limit sedentary time by cutting back on screen time
At a time when cultural norms and the pull of technology are leading to more time in front of screens, there’s growing evidence that this can harm our physical and mental health.

Humans are meant to move, and though binge-watching your favorite streaming shows may be fun in the moment, if this behavior sets in as a daily habit, you’re probably spending too much time on the sofa and not enough time interacting with people or moving.

“The rate of mental health problems is increasing in close correlation with the deterioration in lifestyle factors,” Noordsy says. As helpful as smartphones and internet-based technologies are in making our lives convenient, it’s common for people to sit for hours and hours playing video games or scrolling.

“We know that long periods of being sedentary are an independent risk factor for depression, independent from how much exercise you get,” Noordsy says. So even if you go out for a 30-minute jog or bike ride every day, if you then spend most of the day in front of a screen, it can have a deleterious effect on your mental health.

This is a particular concern for young people who spend a lot of time on social media. At a time when teenagers are facing high rates of depression, anxiety and loneliness, there is mounting evidence that social media can exacerbate and even cause these problems.

7. Cultivate friendships and social connections through hobbies
This may sound obvious, but spending time with people we like, especially when we’re engaged in activities we like, helps boost our mood. Another new study, published in Nature Medicine, based on surveys of people in 16 countries, finds that people 65 and older who have hobbies report higher life satisfaction and less depression.

Noordsy says people tend to know about the connections between crossword puzzles and the slowing of cognitive decline, but there’s not as much awareness that hobbies, whether it’s gardening, knitting, painting, playing games or volunteering, can help boost our moods. As the authors of the study point out, hobbies involve imagination, novelty, creativity, relaxation and stimulation.

“It’s really nice to have a specific effect on mental health,” Noordsy says of the new study. “Hobbies really involve aspects of creativity and engagement,” compared with the passive pursuits of watching TV or scrolling social media, he says. Whether it’s knitting or playing bridge — hobbies that may be familiar to our grandparents — “they keep us connected in ways that people have been connected over generations,” Noordsy says.

It’s probably not possible to eliminate depression, which afflicts millions of Americans. Many people do improve with medicines and therapy, and now there’s a growing body of evidence to show lifestyle medicine can help people alter their behaviors. “I certainly see some people who can effectively manage their symptoms with lifestyle interventions,” Noordsy says. The key is for people to get the support they need to navigate change.

The mechanisms underlying the health benefits of the Mediterranean diet for heart disease include the antioxidant and anti-inflammatory properties of the foods included in the Mediterranean diet, namely fruits, vegetables, legumes, nuts, or olive oil that contain vitamins, minerals, polyphenols, [and] fiber.

The Mediterranean diet leaves a great deal of room for individual preferences. The general idea is to eat:

Fruits, vegetables, and legumes — such as eating fruits and vegetables that are in season
Nutritious, minimally processed healthy fats, such as extra virgin olive oil, nuts and seeds and their butters, and avocados
High-quality, whole-grain carbohydrates — while white bread, pasta, and rice often make their way to Mediterranean tables, their glycemic effect is offset by fiber-rich vegetables, fats, and proteins
Aromatic herbs and spices.
It is equally important to reduce one’s consumption of:

Dairy
Large portions of meat
Alcohol

By ordering thoughtfully, one can eat according to a Mediterranean diet at a wide range of international restaurants, including Thai, Chinese, Mexican, Italian, and Japanese eateries.

GLP-1 Agonist and Reduction of Cancer:

While some people use GLP-1 agonists to attain weight loss, this may not be the only beneficial side effect of this group of drugs.
People with obesity are more likely to develop cancer, though the mechanisms that underpin this risk are myriad, and subject to intense debate. This may partly be because people with obesity have more cells in their bodies that can become cancerous. Weight loss has been shown to reduce the overall risk of cancer. Another reason why people with obesity might be more likely to develop cancer is due to the impact it can have on a type of immune cells known as natural killer cells. These cells are crucial for detecting and destroying tumor cells. Evidence has existed since 2010 showing that obesity disrupts the ability of natural killer cells to do this, therefore increasing the risk of cancers developing.

Determining the impact of GLP-1 drugs on cancer risk is complex due to multiple factors. These include patient heterogeneity, the role of concomitant medications, variations in the duration and dosage of GLP-1 drugs, and the presence of other risk factors like genetics and lifestyle factors. Also, cancer is a disease that develops over a long period, making it challenging to establish a direct cause-effect relationship in clinical studies.
The FDA currently includes a warning on the drug that it has been linked to medullary thyroid cancer and can not be used in people with a family history of this cancer.

GLP-1 Agonist and Reduction of Cardiovascular Disease:

In May 2023, a study was published in the Annals of Internal Medicine that showed that the risk of heart failure and hospital admission for major cardiac events, such as heart attack and stroke, was lower in individuals who had received GLP-1 drugs, compared to other glucose-lowering medications.
GLP-1 agonists help with weight loss, which improves a patient’s cardiometabolic status. Glycemic control is essential to benefit cardiovascular health. GLP-1 agonists slightly reduce blood pressure and slightly improve cholesterol levels. These agents are most useful in patients with established atherosclerotic cardiovascular disease. They are thought to possibly have anti-inflammatory effects that may lead to more stabilized atherosclerotic plaques.

GLP-1 Agonist and Reduction of Alzheimer’s and Chronic Inflammation:

Both obesity and type 2 diabetes are linked to developing Alzheimer’s disease — obesity more strongly. One 2020 study of a cohort of over 6,500 individuals in England showed that obesity and a higher waist measurement were both linked to a higher rate of Alzheimer’s disease.
The link between type 2 diabetes, drugs to treat it, and Alzheimer’s risk is more complex, in part because tightly controlled blood sugar actually increases the risk of cognitive impairment, thought to be due to low levels of sugar reaching a part of the brain called the hippocampus.
However, recently, some evidence has emerged suggesting GLP-1 treatment can help to reduce the accumulation of amyloid protein in the hippocampus, the presence of which is believed to contribute to the development of Alzheimer’s disease symptoms.

This study did not investigate the possibility that GLP-1 treatment reduces the risk of developing Alzheimer’s disease due to other actions, such as the reduction in inflammation, which is also thought to contribute to Alzheimer’s disease development.

Further research is needed to expand the understanding of which patient groups beyond the existing ones can benefit from the use of GLP-1 medications. Specifically, there is a need to investigate the long-term effects of these medications in non-diabetic individuals, as the existing data primarily focuses on diabetic patients.