Sedentary behaviour and its link to depression and anxiety in adults: a systematic review and meta-analysis 10.55131/jphd/2024/220324
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Abstract
The increased mechanization and advancements in technology over the past few years have increased the time an individual spends sitting. Various studies have established links between non-communicable diseases and sedentary behaviour (SB). The risk of weight gain, diabetes, hypercholesterolemia, etc. has been associated with a sedentary lifestyle. Prolonged sedentary time has also been linked to poor mental health. Many studies report a positive relationship between a sedentary lifestyle and depression & anxiety, while some others have not established a clear link. The current review was conducted to examine the recent literature about the relationship between SB and depression & anxiety. An extensive review of the literature was conducted by using Google Scholar, Scopus, PubMed, and Science Direct databases using PRISMA guidelines. Sixteen articles were finally included in the review of which four studies reported odds ratio (OR) for anxiety. A pooled OR of 1.52 (95% CI 1.44-1.60) (p=0.000) was obtained for depression and 1.53 (95% CI 1.40-1.68) (p=0.000) for anxiety. Four studies conducted during COVID-19 also reported SB was linked to depression and anxiety. Sub-group analysis indicated that this relationship was impacted by a few confounders such as BMI, gender, activity levels, etc. SB increases the odds of depression and anxiety, which could be affected by other lifestyle factors. Therefore, it is vital to adhere to physical activity guidelines given by WHO, which would help in improving the mental well-being of individuals. There is a need for more RCTs with larger samples to understand the dose-response relationship between SB and mental health.
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References
Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-1462. doi: 10.1136/ bjsports-2020-102955
Biddle SJH, Henson J, Davies MJ, Khunti K, Sutton S, Yates T, et al. Device-assessed total and prolonged sitting time: associations with anxiety, depression, and health-related quality of life in adults. J Affect Disord. 2021; 287:107–114. doi: 10.1016/j.jad.2021. 03.037
Keadle SK, Conroy DE, Buman MP, Dunstan DW, Matthews CE. Targeting reductions in sitting time to increase physical activity and improve health. Med Sci Sports Exerc. 2017;49(8): 1572–1582. doi: 10.1249/MSS. 0000000000001257
Biswas A, Oh PI, Faulkner GE, Bajaj RR, Silver MA, Mitchell MS, et al. Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults a systematic review and meta-analysis. Ann Intern Med. 2015;162(2):123–132. doi: 10.7326/M14-1651
Blom V, Lönn A, Ekblom B, Kallings L V., Väisänen D, Hemmingsson E, et al. Lifestyle habits and mental health in light of the two covid-19 pandemic waves in Sweden, 2020. Int J Environ Res Public Health. 2021;18(6):3313. doi: 10.3390/ijerph18063313
Werneck AO, Silva DR, Malta DC, Souza-Júnior PRB, Azevedo LO, Barros MBA, et al. Physical inactivity and elevated TV-viewing reported changes during the COVID-19 pandemic are associated with mental health: A survey with 43,995 Brazilian adults. J Psychosom Res. 2021;140: 110292. doi: 10.1016/j.jpsychores. 2020.110292
Teychenne M, Ball K, Salmon J. Sedentary behavior and depression among adults: A review. International Journal of Behavioral Medicine. 2010;17(4):246-254. doi: 10.1007/ s12529-010-9075-z
Zhai L, Zhang Y, Zhang D. Sedentary behaviour and the risk of depression: A meta-analysis. British Journal of Sports Medicine. BMJ Publishing Group. 2015;49(11):705-709. doi: 10.1136/ bjsports-2014-093613.
Depressive disorder (depression) [Internet]. [cited 2022 August 27]. Available from: https://www.who.int /news-room/fact-sheets/detail/ depression
Yang X, Fang Y, Chen H, Zhang T, Yin X, Man J, et al. Global, regional and national burden of anxiety disorders from 1990 to 2019: Results from the Global Burden of Disease Study 2019. Epidemiol Psychiatr Sci. 2021;30:e36. doi: 10.1017/S2045796021000275
Teychenne M, Hinkley T. Associations between screen-based sedentary behaviour and anxiety symptoms in mothers with young children. PLoS One. 2016;11(5):e0155696. doi: 10.1371/journal.pone.0155696
Wu X, Tao S, Zhang Y, Zhang S, Tao F. Low physical activity and high screen time can increase the risks of mental health problems and poor sleep quality among Chinese college students. PLoS One. 2015;10(3): e0119607. doi: 10.1371/journal.pone. 0119607
Felez-Nobrega M, Haro JM, Erickson KI, Koyanagi A. Physical activity is associated with fewer subjective cognitive complaints in 47 low-and middle-income countries. J Am Med Dir Assoc. 2020;21(10):1423-1429.e2. doi: 10.1016/j.jamda.2020.02.014
Hamer M, Smith L. Sedentary behaviour and depression. In: Leitzmann, M.F., Jochem, C., Schmid, D. (eds) Sedentary Behaviour Epidemiology. Springer Series on Epidemiology and Public Health. Springer, Cham. 2023.
Päivärinne V, Kautiainen H, Heinonen A, Kiviranta I. Relations between subdomains of physical activity, sedentary lifestyle, and quality of life in young adult men. Scand J Med Sci Sports. 2018;28(4):1389-1396. doi: 10.1111/sms.13003.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. doi: 10.1136/bmj.n71
Allen MS, Walter EE, Swann C. Sedentary behaviour and risk of anxiety: A systematic review and meta-analysis. J Affect Disord. 2019;242:5-13. doi: 10.1016/j.jad.2018.08.081.
Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open. 2016;6(12):e011458. doi: 10.1136/bmjopen-2016-011458
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.4 (updated August 2023). Cochrane, 2023.
Adamson BC, Yang Y, Motl RW. Association between compliance with physical activity guidelines, sedentary behavior and depressive symptoms. Prev Med. 2016;91:152-157. doi: 10.1016/j.ypmed.2016.08.020
Arredondo EM, Lemus H, Elder JP, Molina M, Martinez S, Sumek C, et al. The relationship between sedentary behavior and depression among Latinos. Ment Health Phys Act. 2013; 6(1):3–9. doi: 10.1016/j.mhpa.2012. 10.005
Teychenne M, Abbott G, Ball K, Salmon J. Prospective associations between sedentary behaviour and risk of depression in socio-economically disadvantaged women. Prev Med. 2014;65:82–86. doi: 10.1016/j.ypmed. 2014.04.025
Madhav KC, Sherchand SP, Sherchan S. Association between screen time and depression among US adults. Prev Med Rep. 2017;8:67–71. doi: 10.1016/ j.pmedr.2017.08.005
Blodgett JM, Mitchell JJ, Stamatakis E, Chastin S, Hamer M. Associations between the composition of daily time spent in physical activity, sedentary behaviour and sleep and risk of depression: Compositional data analyses of the 1970 British cohort Study. J Affect Disord. 2023;320:616–620. doi: 10.1016/j.jad.2022.09.110
Rees-Punia E, Newton CC, Westmaas JL, Chantaprasopsuk S, Patel AV., Leach CR. Prospective COVID-19 related changes in physical activity and sedentary time and associations with symptoms of depression and anxiety. Ment Health Phys Act. 2021;21: 100425. doi: 10.1016/j.mhpa.2021. 100425
Peeters GM, Burton NW, Brown WJ. Associations between sitting time and a range of symptoms in mid-age women. Prev Med. 2013;56(2):135–141. doi: 10.1016/j.ypmed.2012.12.008
Wu X, Tao S, Zhang S, Zhang Y, Chen K, Yang Y, et al. Impact of screen time on mental health problems progression in youth: A 1-year follow-up study. BMJ Open. 2016;6(11):e011533. doi: 10.1136/bmjopen-2016-011533
Schuch FB, Bulzing RA, Meyer J, Vancampfort D, Firth J, Stubbs B, et al. Associations of moderate to vigorous physical activity and sedentary behavior with depressive and anxiety symptoms in self-isolating people during the COVID-19 pandemic: A cross-sectional survey in Brazil. Psychiatry Res. 2020;292:113339. doi: 10.1016/j.psychres.2020.113339
van Uffelen JG, van Gellecum YR, Burton NW, Peeters G, Heesch KC, Brown WJ. Sitting-time, physical activity, and depressive symptoms in mid-aged women. Am J Prev Med. 2013;45(3):276-281. doi: 10.1016/ j.amepre.2013.04.009
Stubbs B, Vancampfort D, Firth J, Schuch FB, Hallgren M, Smith L, et al. Relationship between sedentary behavior and depression: A mediation analysis of influential factors across the lifespan among 42,469 people in low- and middle-income countries. J Affect Disord. 2018;229:231–238. doi: 10.1016/j.jad.2017.12.104
Werneck AO, Silva DR, Malta DC, Souza-Júnior PRB, Azevedo LO, Barros MBA, et al. Changes in the clustering of unhealthy movement behaviors during the COVID-19 quarantine and the association with mental health indicators among Brazilian adults. Transl Behav Med. 2021;11(2):323–331. doi: 10.1093/ tbm/ibaa095
Vancampfort D, Stubbs B, Herring MP, Hallgren M, Koyanagi A. Sedentary behavior and anxiety: Association and influential factors among 42,469 community-dwelling adults in six low- and middle-income countries. Gen Hosp Psychiatry. 2018;50:26–32. doi: 10.1016/j.genhosppsych.2017.09.006
Breland JY, Fox AM, Horowitz CR. Screen time, physical activity and depression risk in minority women. Ment Health Phys Act. 2013;6(1):10–15. doi: 10.1016/j.mhpa.2012.08.002
Nam JY, Kim J, Cho KH, Choi J, Shin J, Park EC. The impact of sitting time and physical activity on major depressive disorder in South Korean adults: A cross-sectional study. BMC Psychiatry. 2017;17(1):274. doi: 10.1186/s12888-017-1439-3
Barros MB de A, Lima MG, de Azevedo RCS, Medina LB de P, Lopes C de S, Menezes PR, et al. Depression and health behaviors in Brazilian adults - PNS 2013. Rev Saude Publica. 2017; 51(suppl 1):8s. doi: 10.1590/S1518-8787.2017051000084
World Health Organization. Mental disorders [Internet][cited 2022 Aug 27] Available from https://www.who.int/ news-room/fact-sheets/detail/mental-disorders/?gad_source=1&gclid=Cj0KCQiAz8GuBhCxARIsAOpzk8xJhuKeaDXVU15f-VH6OwRt328wM2aq KTX-chqYfABV3C9_PIbWwDAa AipDEALw_wcB
Wang X, Li Y, Fan H. The associations between screen time-based sedentary behavior and depression: a systematic review and meta-analysis. BMC Public Health. 2019;19(1):1524. doi: 10.1186/ s12889-019-7904-9
Meyer J, McDowell C, Lansing J, Brower C, Smith L, Tully M, et al. Changes in physical activity and sedentary behavior in response to covid-19 and their associations with mental health in 3052 us adults. Int J Environ Res Public Health. 2020; 17(18):6469. doi: 10.3390/ijerph 17186469
Lewis R, Roden LC, Scheuermaier K, Gomez-Olive FX, Rae DE, Iacovides S, et al. The impact of sleep, physical activity and sedentary behaviour on symptoms of depression and anxiety before and during the COVID-19 pandemic in a sample of South African participants. Sci Rep. 2021;11(1): 24059. doi: 10.1038/s41598-021-02021-8
Romero-Blanco C, Rodríguez-Almagro J, Onieva-Zafra MD, Parra-Fernández ML, Prado-Laguna MDC, Hernández-Martínez A. Physical activity and sedentary lifestyle in university students: Changes during confinement due to the COVID-19 pandemic. Int J Environ Res Public Health. 2020; 17(18):6567. doi: 10.3390/ijerph 17186567
Lamers F, Milaneschi Y, Smit JH, Schoevers RA, Wittenberg G, Penninx BWJH. Longitudinal Association Between Depression and Inflammatory Markers: Results From the Netherlands Study of Depression and Anxiety. Biol Psychiatry. 2019;85(10):829–837. doi: 10.1016/j.biopsych.2018.12.020
Endrighi R, Steptoe A, Hamer M. The effect of experimentally induced sedentariness on mood and psychobiological responses to mental stress. Br J Psychiatry. 2016;208(3): 245–351. doi: 10.1192/bjp.bp.114. 150755
Henson J, Yates T, Edwardson CL, Khunti K, Talbot D, Gray LJ, et al. Sedentary time and markers of chronic low-grade inflammation in a high risk population. PLoS One. 2013;8(10): e78350. doi: 10.1371/journal.pone. 0078350
Werneck AO, Kandola A, Tebar WR, Silva DR, Stubbs B, Christofaro DGD. Does physical activity moderate the association between device-measured sedentary time patterns and depressive symptoms in adults? Braz J Psychiatry. 2022;44(6):584-589. doi: 10.47626/ 1516-4446-2022-2533
Anderson E, Shivakumar G. Effects of exercise and physical activity on anxiety. Front Psychiatry. 2013;4:27. doi: 10.3389/fpsyt.2013.00027
Lin TW, Kuo YM. Exercise benefits brain function: the monoamine connection. Brain Sci. 2013;3(1):39-53. doi: 10.3390/brainsci3010039
Kandola AA, Del Pozo Cruz B, Osborn DPJ, Stubbs B, Choi KW, Hayes JF. Impact of replacing sedentary behaviour with other movement behaviours on depression and anxiety symptoms: a prospective cohort study in the UK Biobank. BMC Med. 2021;19(1):133. doi: 10.1186/s12916-021-02007-3
Levin KA. Study design III: Cross-sectional studies. Evid Based Dent. 2006;7(1):24-5. doi: 10.1038/sj.ebd. 6400375
WHO guidelines on physical activity and sedentary behaviour [Internet]. [Cited 2022 August 27] Available from: https://www.who.int/publications/i/item/9789240014886
Al-Ajlouni YA, Park SH, Alawa J, Dodin B, Shamaileh G, Makarem N, et al. Staying Physically Active Is Associated with Better Mental Health and Sleep Health Outcomes during the Initial Period of COVID-19 Induced Nation-Wide Lockdown in Jordan. Int J Environ Res Public Health. 2022;19(2): 776. doi: 10.3390/ijerph19020776