Experimentally increasing sedentary behavior results in increased anxiety in an active young adult population

Prevalence and associated risk factors of anxiety-induced sleep disturbance: Sex-stratified comparison among school-going adolescents in Paraguay

OBJECTIVES

This study aimed to assess the prevalence and correlates of anxiety-induced sleep disturbance (AISD) in Paraguayan adolescents through sex-stratified analysis.

METHODS

This study used the cross-sectional data from Paraguay's 2017 Global School-Based Student Health Survey (GSHS). A total of 3149 in-school adolescents (12-17 years; 51.2 % female) were included in the final analysis. Anxiety-induced sleep disturbance (AISD) was evaluated using the survey question: "During the past 12 months, how often have you been so anxious about something that you could not sleep at night?" Participants could respond on a scale from 1 (never) to 5 (always). For analysis, responses were categorized as follows: "never/rarely/occasionally" indicated no AISD, while "often/always" indicated the presence of AISD. Age-adjusted univariate and multiple logistic analyses were used to determine the correlates of AISD. Regression analysis findings were presented using adjusted odds ratios (AOR) and 95 % confidence intervals (CI), with a p-value <0.05.

RESULTS

The overall prevalence of AISD was 9.5 % among the respondents, significantly higher in girls (12 %) than boys (6.7 %). Loneliness, suicidal ideation, not attending physical education classes, and sitting activities were significantly associated with respondents' AISD. In both sexes, those with loneliness and those who had suicidal ideation were more likely to suffer from AISD than their counterparts. Among girls, those who did not attend physical education class and those who engaged in sedentary activities for three hours or more had significantly higher odds of AISD than boys.

CONCLUSION

This study found differences in patterns of significant associations between risk factors of AISD for boys and girls. Therefore, different sex-based strategies are recommended to reduce the prevalence of AISD among adolescents in Paraguay.

Association of physical activity and sedentary behaviour with depressive symptoms in Chinese adults

This study aims to examine the independent and joint associations of physical activity (PA) and sedentary behaviour with depressive symptoms. A population-based cross-sectional study conducted in China included 17,861 adults. PA and sedentary behaviour were assessed using the International Physical Activity Questionnaire. Depressive symptoms were determined by the 9-item Patient Health Questionnaire score ≥10. Logistic regression models were used to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs). The prevalence of depressive symptoms among all participants was 20.6% (3679/17861). Higher levels of PA were inversely associated with depressive symptoms, whereas prolonged sedentary behaviour was associated with increased odds of depressive symptoms. The positive associations between sedentary behaviour and depressive symptoms remained significant, regardless of PA levels. In joint analyses, the depressive symptoms OR comparing adults who reported low level of PA with the highest tertile of sedentary behaviour to those reporting high level of PA with the lowest tertile of sedentary behaviour was 1.99 (95% CI 1.64 to 2.40). This study indicated that high level of PA may not offset the increased risk of depressive symptoms associated with high amounts of sedentary behaviour, and therefore these behaviours should be considered jointly to obtain optimal prevention effects.

The effect of replacing sedentary behavior with different intensities of physical activity on depression and anxiety in Chinese university students: an isotemporal substitution model

BACKGROUND

Previous research has suggested that engaging in regular physical activity (PA) can help to reduce symptoms of depression and anxiety in university students. However, there is a lack of evidence regarding the impact of reducing sedentary behavior (SB) and increasing light-intensity PA (LPA) on these symptoms. This study aims to address this gap by using isotemporal substitution (IS) models to explore how substituting SB with LPA or moderate-to-vigorous PA (MVPA) affects depression and anxiety symptoms among university students.

METHODS

The study recruited 318 university students with a mean age of 21.13 years. Accelerometers were used to objectively measure the time spent on SB, LPA, and MVPA, while depression and anxiety symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Self-rating Anxiety Scale (SAS). IS models using multivariable linear regression were employed to estimate the associations between different behaviors and depression and anxiety symptoms when 30 min of one behavior was substituted with another.

RESULTS

In the single-activity model, less SB (β = 0.321, 95% CI: 0.089, 1.297) and more MVPA (β = -0.142, 95% CI: -1.496, - 0.071) were found to be significantly and negatively associated with depression scores, while less SB (β = 0.343, 95% CI: 0.057, 1.014), LPA (β = 0.132, 95% CI: 0.049, 1.023), and more MVPA (β = -0.077, 95% CI: -1.446, - 0.052) were significantly and negatively correlated with anxiety scores. The IS analysis revealed that substituting 30 min of SB with LPA (β = -0.202, 95% CI: -1.371, - 0.146) or MVPA (β = -0.308, 95% CI: -0.970, - 0.073) was associated with improvements in depressive symptoms. Substituting 30 min of SB with MVPA (β = -0.147, 95% CI: -1.863, - 0.034) was associated with reduced anxiety symptoms.

CONCLUSION

Replacing 30 min of SB with MVPA may alleviate depression and anxiety symptoms in university students. Further research is needed to explore the long-term effects of PA interventions on the mental health disorders of this population.

The effects of a group-based intervention through physical activities and dietary changes in young patients with severe psychiatric disorders: a pilot study

Background and objectives

The present study aims to investigate the effect of the 4-F (Fit, Fun, Feel, and Food) group-based program on physical, clinical, and biological outcomes in young patients suffering from severe psychiatric disorders.

Methods

A pilot study with a naturalistic design was conducted to investigate the effect of a group-based intervention on young patients.

Results

A descriptive analysis revealed that out of the 61 outpatients initially enrolled in the program, with a mean age of 26.9 years old (±6.1, 60% men), 71% were overweight or obese. Paired T-tests for the difference between T0 and T1 were used to evaluate the evolution of the outcomes. The 24 patients who completed the full program showed no significant decrease in weight or body composition. Despite the limitations, the main findings of this study were the significant improvement in muscular endurance and coordination (from T0 (M = 13.65, SD = ±1.93) compared to T1 (M = 12.49, SD = ±1.81), [t(20) = 3.072, p < 0.05] and the general increase in mental well-being from baseline to the end of the program according to the type of psychopathology [F(3,10) = 4.25, p < .05]. A slight modification in eating behavior, with a tendency towards a decrease in TFEQ hunger levels, was also noticed. The ANCOVA showed no difference in outcomes between the groups based on diagnosis.

Conclusion

Despite its limitations and the small sample size, this pilot study provides valuable insights, demonstrating the feasibility of the program and its positive impact on physical well-being and improved mental health in young patients with psychiatric disorders, sedentary behavior, and unhealthy lifestyles. These encouraging results warrant further research in controlled, larger population samples to deepen our understanding of the potential effects of such interventions.

Clinical guidelines for the use of lifestyle-based mental health care in major depressive disorder: World Federation of Societies for Biological Psychiatry (WFSBP) and Australasian Society of Lifestyle Medicine (ASLM) taskforce

OBJECTIVES

The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings.

METHODS

Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria.

RESULTS

Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework.

CONCLUSIONS

Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.

Influence of High-Intensity Interval Training on IGF-1 Response, Brain Executive Function, Physical Fitness and Quality of Life in Sedentary Young University Women-Protocol for a Randomized Controlled Trial

Sedentary lifestyles have become a social problem, mainly among women. A sedentary lifestyle has been associated with poorer health in this population, negatively affecting physical and mental health. Physical exercise, in particular high-intensity interval training (HIIT), has been shown to be a neuroprotective tool. The present study provides a protocol design for a parallel-group Randomized Controlled Trial (RCT), whose aim will be to compare the effect of two physical interventions, HIIT and physical activity (increasing daily steps), on Insulin Growth Factor-1 (saliva IGF-1 concentrations), executive functions, quality of life, body composition, physical fitness, and physical activity in young sedentary women. At least 77 women will be recruited and randomly assigned to either a HIIT group (12-week exercise HIIT intervention, 3 sessions/week), the HIIT + PA group (12-week exercise HIIT intervention, 3 sessions/week, plus 10,000 steps/day), or a control group (usual care). The primary outcome measure will the chronic change in IGF-1 concentration levels measured in saliva. Secondary outcome measures will be: (i) executive functions; (ii) body composition; (iii) physical fitness; (iv) physical activity; and (v) quality of life. All outcomes will be assessed at the beginning of the study, after the intervention, and after three months of follow-up. After this intervention, we will be able to determine whether HIIT together with increased physical activity could be more effective than HIIT alone in IGF-1 stimulation. Furthermore, by comparing both intervention groups, we will be able to determine the differential effects on numerous health-related variables. Consequently, the conclusions of this study could help better understand the effects of a training program on IGF-1 concentration levels and executive functions. In addition, various strategies could be proposed through physical exercise to improve cognition in this age group, as well as to improve the health status of this sedentary population.

Dose-response association of total sedentary behaviour and television watching with risk of depression in adults: A systematic review and meta-analysis

BACKGROUND

Although sedentary behaviour has been increasingly linked to depression, evidence remains conflicted and meta-analysis of the dose-response associations in adults is lacking. We aimed to explore the quantitative dose-response association of total sedentary behaviour and television watching with depression among adults.

METHODS

We systematically searched PubMed, Embase and Web of Science for articles to identify observational studies that assessed the association of total sedentary behaviour and television watching with depression in adults. Summary risk ratios (RRs) and 95 % confidence intervals (CIs) were estimated for the dose-response association by using a fixed or random-effects model. Restricted cubic splines were used to evaluate the possible linear or non-linear relations.

RESULTS

We included 16 studies with 221,599 participants in this meta-analysis, 10 for total sedentary behaviour and 6 for television watching. The summary RR of depression for the highest versus lowest total sedentary behaviour and television watching were 1.42 (95 % CI: 1.22-1.67) and 1.26 (95 % CI: 1.14-1.40), respectively. We found a non-linear association between total sedentary behaviour and depression. For participants with total sedentary time 8 h/day and 9 h/day, the risk of depression was increased by 20 % (RR 1.20, 95 % CI 1.09-1.29) and 29 % (RR 1.29, 95 % CI 1.20-1.40), respectively. A linear dose-response association was observed between television watching and depression. For each 1 h/day increase in television watching, risk of depression was increased by 5 % (RR: 1.05, 95 % CI: 1.02-1.09).

CONCLUSIONS

Depression may be associated with increased time spent in total sedentary behaviour and television watching.

Investigating pathways from anxiety sensitivity to impairment in a treatment-seeking sample

BACKGROUND

Previous research suggests that high anxiety sensitivity (AS) - a fear of arousal-related body sensations - may have implications not only for mental health symptoms but also for functional impairment. The aim of the present study was to examine whether elevated AS is associated with functional impairment by way of heightened anxiety symptoms and resultant depressive symptoms or unhealthy coping behaviours (i.e., alcohol use, exercise avoidance, sleep problems) in a chained mediation model.

METHOD

Participants were 128 treatment-seeking individuals with high AS who qualified for an anxiety, depression, or posttraumatic stress disorder diagnosis. They completed self-report measures of AS, anxiety, depression, and unhealthy coping behaviours as part of a pre-treatment assessment battery for a larger study examining the efficacy of a cognitive behavioural intervention for AS. Data were analyzed using path analysis.

RESULTS

Results revealed a direct association between AS and functional impairment that was partially mediated through a chained indirect pathway from AS to anxiety symptoms to depression symptoms to functional impairment. Unhealthy coping behaviours did not serve as mediators.

LIMITATIONS

Results are limited by the cross-sectional nature of the data.

CONCLUSIONS

The present findings have clinical implications insofar as supporting the relevance of reducing AS and focusing on depressive symptoms when seeking to improve clients' functioning.

The health benefit of physical exercise on COVID-19 pandemic: Evidence from mainland China

Objectives

Our study aims to investigate the health benefit of regular physical exercise participation on a series of COVID-19 outcomes including COVID-19 morbidity, mortality, and cure rate.

Methods

Prefecture-level panel data related to physical exercise and the COVID-19 pandemic in China were collected from January 1 to March 17, 2020, (N = 21379). Multiple linear regression was conducted, and the ordinary least squares technique was used to estimate the coefficient.

Results

It was shown that regular sports participation significantly negatively affected COVID-19 morbidity (estimate = -1.1061, p<0.01) and mortality (estimate = -0.3836, p<0.01), and positively affected cure rate (estimate = 0.0448, p<0.01), implying that engaging in physical exercise regularly does have a significant positive effect on COVID-19 outcomes. Then, we explored the heterogeneity of the effect of physical exercise on areas with different risk levels and it was revealed that the effect of physical exercise was more pronounced in high-risk areas in terms of morbidity (estimate = -1.8776, p<0.01 in high-risk areas; estimate = -0.0037, p<0.01 in low-risk areas), mortality (estimate = -0.3982, p<0.01 in high-risk areas; estimate = -0.3492, p<0.01 in low-risk areas), and cure rate (estimate = 0.0807, p<0.01 in high-risk areas; 0.0193 = -0.0037, p<0.05 in low-risk areas).

Conclusions

Our results suggest that regularly engaging in physical exercise before the pandemic has positive health effects, especially in the case of a more severe epidemic. Therefore, we urge readers to actively engage in physical exercise so that we can reduce the risks in the event of a pandemic.

Cross-sectional associations between physical activity pattern, sports participation, screen time and mental health in Swedish adolescents

OBJECTIVES

To investigate the associations between physical activity pattern, sports participation, screen time and mental health in Swedish adolescents.

DESIGN, SETTING AND PARTICIPANTS

A total of 1139 Swedish adolescents (mean age 13.4) from 34 schools participated in the cross-sectional study 'Physical Activity for Healthy Brain Functions in School Youth' in 2019.

METHODS

Time spent sedentary and in moderate-to-vigorous physical activity (MVPA) was measured using accelerometers for seven consecutive days. Screen time and sports participation were self-reported. Anxiety and health-related quality of life (HRQoL) were assessed using a Short version of the Spence Children's Anxiety Scale and Kidscreen-10.

RESULTS

MVPA was positively associated (95% CI 0.01 to 0.05 in girls and 0.02 to 0.07 in boys) whereas screen time on weekdays was inversely associated with HRQoL (-4.79 to -2.22 in girls and -2.66 to -0.41 in boys). The largest effect sizes were observed between the high/low MVPA group in boys (Cohen's d=0.51) and screen time groups in girls (Cohen's d=0.59 on weekdays). With regards to anxiety, high compared with lower time spent in MVPA during leisure time on weekdays was associated with lower anxiety scores (95% CI -0.13 to -0.05 in girls and -0.07 to -0.01 in boys). Gender differences were observed, boys who participated in organised sports had low anxiety scores (95% CI -3.49 to -0.13) whereas girls who reported 5 hours or more of screen time had high scores (95% CI 1.94 to 6.18 on weekdays and 1.39 to 5.29 on weekend days).

CONCLUSIONS

This study showed that MVPA was associated with better mental health, whereas the opposite was seen for screen time. These associations were not consistently significant throughout all time domains, between the genders and mental health outcomes. Our results could create a paradigm for future studies to decide which types of PA patterns and time domains to target in intervention studies with the aim improve mental health among adolescents.

Effects of a Gamified, Behavior Change Technique-Based Mobile App on Increasing Physical Activity and Reducing Anxiety in Adults With Autism Spectrum Disorder: Feasibility Randomized Controlled Trial

BACKGROUND

Physical activity (PA) has an impact on physical and mental health in neurotypical populations, and addressing these variables may improve the prevalent burden of anxiety in adults with autism spectrum disorder (ASD). Gamified mobile apps using behavior change techniques present a promising way of increasing PA and reducing sedentary time, thus reducing anxiety in adults with ASD.

OBJECTIVE

This study aimed to compare the effectiveness of a gamified and behavior change technique-based mobile app, PuzzleWalk, versus a commercially available app, Google Fit, on increasing PA and reducing sedentary time as an adjunct anxiety treatment for this population.

METHODS

A total of 24 adults with ASD were assigned to either the PuzzleWalk or Google Fit group for 5 weeks using a covariate-adaptive randomization design. PA and anxiety were assessed over 7 days at 3 different data collection periods (ie, baseline, intervention start, and intervention end) using triaxial accelerometers and the Beck Anxiety Inventory. Group differences in outcome variables were assessed using repeated-measures analysis of covariance, adjusting for age, sex, and BMI.

RESULTS

The findings indicated that the PuzzleWalk group spent a significantly longer amount of time on app use compared with the Google Fit group (F2,38=5.07; P=.01; partial η2=0.21), whereas anxiety was unfavorably associated with increases in light PA and decreases in sedentary time after intervention (all P<.05).

CONCLUSIONS

Further research is needed to clarify the determinants of physical and mental health and their interrelationship in adults with ASD to identify the factors that facilitate the use and adoption of mobile health technologies in these individuals. Despite these mixed results, the small changes in PA or anxiety may be clinically significant for adults with ASD.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05466617; https://clinicaltrials.gov/show/NCT05466617.

Exercise hormone irisin prevents physical inactivity-induced cognitive decline in mice

We previously reported that physical inactivity (PI) induces cognitive decline and depressive states, which were ameliorated by regular exercise. However, the mechanism underlying the preventive effect of exercise remains unelucidated. Irisin has recently been identified as an exercise-inducible myokine that improves cognitive impairment. Plasma irisin levels increase during physical exercise; therefore, PI could lead to a decline in cognitive function by reducing plasma irisin. Therefore, this study aimed to examine whether irisin is associated with cognitive decline and mental deterioration altered by PI and exercise. The mice were housed for eight weeks in the PI cage, whose living space was one-sixth that of a standard cage. Simultaneously, the mice were subjected to regular exercise in the presence or absence of an irisin-neutralizing antibody. PI increased the epididymal fat mass without increasing body weight, muscle mass, or plasma corticosterone levels. Additionally, PI induced anxiety, depressive states, and a decline in working memory. In contrast, regular exercise after PI elevated irisin levels in plasma and increased fibronectin type III domain-containing 5 (FNDC5) and peroxisome proliferator-activated receptor gammacoactivator 1α expression in skeletal muscle. Regular exercise also increased hippocampal brain-derived neurotrophic factor (BDNF) expression and BrdU-positive cells, alleviating cognitive decline and mental deterioration induced by PI. The beneficial effects of exercise were compromised by the administration of an irisin-neutralizing antibody. Moreover, plasma irisin level was positively correlated with working memory, hippocampal BDNF levels, and hippocampal cell proliferation. These findings suggest that exercise-inducible irisin is critical for maintaining cognitive function in the PI state.

Factors Associated With Depression and Anxiety in Korean Adolescents During the COVID-19 Pandemic

OBJECTIVE

This study was performed to identify factors associated with depression and anxiety among Korean adolescents during the coronavirus disease (COVID-19) pandemic.

METHODS

We conducted a cross-sectional study of 1,898 Korean adolescents (55.2% male, 44.8% female) ranging in age from 12 to 17 years (mean±standard deviaion age, 15.4±2.6 years). Depression and anxiety were defined as a Patient Health Questionnaire-9 score ≥10 and Generalized Anxiety Disorder-7 score ≥10, respectively. Other questionnaires included sociodemographic data, psychosocial stresses, and experiences in association with COVID-19. Psychiatric scales included Gratitude Questionnaire-6, Perceived Stress Scale-10, and UCLA Loneliness Scale-3.

RESULTS

The prevalence rates of depressive and anxiety symptoms among participants were 13.8% and 21.0%, respectively. Multivariable logistic regression analysis revealed that female sex, fear of COVID-19 infection, low gratitude were risk factors for depression. Fear of COVID-19 infection, increased TV watching time, and academic-related stress were risk factors for anxiety.

CONCLUSION

Depression and anxiety were prevalent during the pandemic in Korean adolescents, and were associated with fear of COVID-19 infection. Providing appropriate information on COVID-19, helping adolescents manage academic-related stress and maintain daily life patterns, and implementing interventions to foster gratitude are important for preventing depression and anxiety in Korean adolescents.

Optimal movement behaviors: correlates and associations with anxiety symptoms among Chinese university students

Background

The Canadian 24-Hour Movement Guidelines for Adults was released in 2020. There is a dearth of evidence on the association between adherence to the 24 h movement guidelines and health indicators. This study aims to (a) explore the associations between potential correlates and meeting the 24 h movement guidelines using a sample of Chinese university students; and (b) examine if meeting 24 h movement guidelines is associated with the severity of anxiety symptoms.

Methods

Cross-sectional findings are based on 1846 Chinese university students (mean age = 20.7 years, 64.0% female). Movement behaviors (physical activity, sedentary behavior, and sleep duration), possible correlates, and anxiety symptoms were measured through self-reported online questionnaires. Logistic regression models were performed to examine the associations.

Results

We found that male students and those who had a mother with a master’s degree or above, more close friends and higher perceived family affluence were more likely to meet the overall 24 h guidelines. Meeting all 24 h movement guidelines presented the lower odds for severe anxiety symptoms than those meeting fewer recommendations in the 24 h movement guidelines.

Conclusions

As one of the first to examine the correlates of adherence to the 24 h movement guidelines and the relationship between anxiety symptoms and meeting the guidelines among Chinese university students, our findings contribute to the growing body of evidence linking movement behaviors, psychosocial correlates, and heath indicators. Schools and health providers can encourage movement behaviors that follow the guidelines on campus.

State Anxiety after Exergame Beach Volleyball Did Not Differ between the Single and Multiplayer Modes in Adult Men

This study compared the exergame beach volleyball’s acute effects on state anxiety level in single vs. multiplayer mode in adult men. Sixty adult men (age: 21.98 [4.58] years, body mass: 75.40 [15.70] kg, height: 1.77 [0.09] m, and body mass index: 24.19 [5.44] kg/m²; data are expressed as median [interquartile range]) were assigned to play exergame of beach volleyball in single- or multiplayer mode for approximately 30 min using the Xbox 360 Kinect^®. The state anxiety level was evaluated before and after the intervention. There was no significant difference in the state anxiety levels after an exergame session between the single and multiplayer modes (p-value = 0.407, effect size (r_B) = −0.12, defined as small). Furthermore, there was no significant difference in the state anxiety levels before and after an exergame session in single-player mode (p-value = 0.516, effect size (d) = 0.14, defined as trivial) and multiplayer mode (p-value = 0.053, r_B = 0.43, defined as medium). In conclusion, state anxiety level after exergame beach volleyball did not differ between the single and multiplayer modes in adult men.

Acute effects of exergame-based calisthenics versus traditional calisthenics on state-anxiety levels in young adult men: a randomized trial

Purpose

This study compared the acute effects of an exergame-based calisthenics (EXG) session versus a traditional calisthenics (TC) session on state anxiety levels in healthy adult men, and compared the mean heart rate, number of repetitions performed, enjoyment, and affective valence reported by the participants between sessions.

Methods

Thirty-six young adult men performed two 30-min sessions of physical exercise in random order (EXG and TC). The same exercise protocol was used for each session; however, the TC session was guided by an exercise science professional. State anxiety was assessed before and immediately after each session. Heart rate was monitored during the sessions. Enjoyment and affective valence were assessed immediately after the sessions. In addition, the number of repetitions performed was recorded.

Results

There was no significant interaction between sessions (EXG vs. TC) and time (pre vs. post-session) (p = 0.102), no significant effect of session (p = 0.587), and no significant effect of time (p = 0.121). Participants presented a higher mean heart rate (+ 3.5%, p = 0.020) and number of repetitions performed (+ 43.7%, p < 0.001) in the TC session compared with the EXG session. There was no difference in enjoyment (p = 0.804) and affective (p = 0.195) valence between the EXG and TC sessions.

Conclusion

The EXG and TC sessions did not reduce state anxiety levels. Nor did they increase enjoyment or affective valence in healthy young adult men. However, the TC session evoked a higher mean heart rate and higher training volume than the EXG session.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11332-021-00841-9.

Active Coping and Anxiety Symptoms during the COVID-19 Pandemic in Spanish Adults

The features of the COVID-19 pandemic and the social operations to contain the spread of the virus might have limited or altered coping, including healthy habits such as exercise, this contributing to a myriad of negative consequences for the mental health of the global population. We explored the contribution of coping and physical activity to the management of anxiety in Spanish adults during an active phase of the epidemic, as well as the relationship between these strategies. A total of 200 young and adult individuals (70% women) voluntarily completed an anxiety inventory, a coping skills self-report and a personal data section including exercise practice. The participants reported in average a mild yet existing level of anxiety symptoms; a third reported noticeable symptoms. At the time of the study, the participants used more adaptive than maladaptive coping styles. Participants' anxiety was inversely correlated with an active coping style, and positively with an avoidant style; physical activity correlated positively with an active coping style, and regular exercisers used more frequently active coping. Controlling for confounders, active coping, avoidant coping and exercise during the pandemic predicted anxiety symptoms. Other findings indicated that exercise was used as a coping strategy for dealing with emotional distress. Our results highlight the positive impact of functional coping and exercise for the management of negative states such as anxiety during the pandemic, and underline the importance of developing interventions aimed at enhancing coping skills for promoting physical and mental well-being of the population during health and social crises.

Effect of both dance exergame and a traditional exercise on state anxiety and enjoyment in women

BACKGROUND

Anxiety disorders affect many people around the world and women are more affected than men. Physical exercise might be an important nonpharmacological tool to ameliorate these disorders. The aim of this study was to compare state anxiety level and enjoyment between a dance exergame session and a traditional aerobic exercise.

METHODS

Twenty healthy young women completed 3 visits, on separate days. At the first visit, participants performed a graded exercise testing and familiarization procedures. In other two visits, participants completed two exercise sessions (dance exergame and traditional aerobic exercise), with similar intensities and duration. Each session lasted approximately 45 minutes. State anxiety level was evaluated before, immediately post- and 10 minutes post sessions. Enjoyment was evaluated immediately post sessions.

RESULTS

There was a significant interaction between session and time (p<0.001), a main effect of time (p=0.007) but no significant main effect of session (p=0.057) on state anxiety level. State anxiety level immediately post (p<0.001) and 10 minutes post-session (p<0.001) were significantly lower than pre-dance exergame session. There were no significant changes between pre-, immediately post and 10 minutes post-traditional aerobic exercise session (p>0.05). State anxiety level at immediately post dance exergame session was significantly lower than immediately post traditional aerobic exercise session (p=0.026). Dance exergame session was significantly more enjoyable than traditional aerobic exercise session (p<0.0001).

CONCLUSIONS

Dance exergames might be used as a tool to reduce anxiety level in young women.

Effects of Online Bodyweight High-Intensity Interval Training Intervention and Health Education on the Mental Health and Cognition of Sedentary Young Females

This study aimed to assess the effectiveness of an online high-intensity interval training (HIIT) intervention and health education on the behaviors, mental health, and cognitive function of sedentary young females. A single-blinded, six-week, randomized controlled pilot trial involving 70 sedentary young Chinese females, aged 18-30 years, was conducted. An intervention group (IG) (n = 33) underwent a HIIT intervention and health education, while a waitlist group (WG) (n = 37) only received health education. In pre-, mid-, and post-tests, both groups filled out questionnaires about physical activity, sedentary behavior, and mental health. Cognitive functions were assessed at the pre- and post-tests by computer-administered cognitive tests. A mixed-effect model with repeated measures was used to analyze outcomes of interest. The retention rate of the IG and WG was 100% and 78.38%, respectively. The IG were found to have significantly increased rates of moderate-to-vigorous physical activity (MVPA) (M_diff = 940.61, p < 0.001, 95% confidence interval (95% CI): 576.67, 1304.55) from pre-test to post-test, while the WG demonstrated a more marked reduction in sedentary time (M_diff = -73.02, p = 0.038, 95% CI: -141.90, -4.14) compared with the IG in the post-test. Moreover, anxiety and stress levels were shown to significantly reduce in the IG over the six-week period (M_diff = -4.73, p = 0.002, 95% CI: -7.30, -2.15 and M_diff = -5.09, p = 0.001, 95% CI: -8.29, -1.89, respectively). In addition, we observed a significant improvement in verbal ability (p = 0.008, ηp2 = 0.19) following the HIIT intervention and effects of the interaction with time on processing speed (p = 0.050, ηp2 = 0.10) and episodic memory (p = 0.048, ηp2 = 0.11). Moreover, the IG had better global cognitive performance than the WG in the post-test (M_diff = 8.28, p = 0.003, 95% CI: 3.06, 13.50). In summary, both an online bodyweight HIIT intervention combined with health education, or health education alone, can effectively improve health-related behaviors, but the behavioral consequences may differ based on the emphasis of different intervention modalities. Furthermore, the "bodyweight HIIT plus health education" modality might be a more promising online intervention strategy to mitigate against negative emotions and improve cognitive function.

Moving More and Sitting Less as Healthy Lifestyle Behaviors are Protective Factors for Insomnia, Depression, and Anxiety Among Adolescents During the COVID-19 Pandemic

PURPOSE

This study aimed to investigate associations of physical activity time (PAT) and sitting time (ST) independently and jointly with insomnia, depressive and anxiety symptoms among Chinese adolescents in the context of COVID-19.

METHODS

A cross-sectional study including 965 adolescents (mean age = 15.26, SD = 0.46) was conducted in May 2020. PAT, ST and the symptoms of insomnia, depression and anxiety were assessed with the International Physical Activity Questionnaire Short Form, the Youth Self-Rating Insomnia Scales, the 9-item Patient Health Questionnaire and the Generalized Anxiety Disorder scale via an online survey platform. Logistic regression was used to analyze the association between COVID-19-related fear, PAT, ST and combinations of PAT and ST with insomnia, depressive and anxiety symptoms.

RESULTS

COVID-19-related fear was associated with higher odds of insomnia, depressive and anxiety symptoms. PAT was associated with lower odds of insomnia and depressive symptoms, while ST was associated with higher odds of these three symptoms. After combining PAT and ST, the group with both low PAT and high ST was set as the referent. For insomnia, groups with low ST reported significantly lower odds of symptoms. For depression, groups with high PAT and/or low ST reported lower odds of symptoms. Regarding anxiety, only the group with both high PAT and low ST reported lower odds of symptoms. Generally, group with both high PAT and low ST reported lower odds of the three symptoms than the referent.

CONCLUSION

COVID-19-related fear was a risk factor for developing insomnia, depressive and anxiety symptoms among Chinese adolescents. Fortunately, moving more and sitting less were good for sleep and mental health in Chinese adolescents during the pandemic. Educators should help adolescents to be more physically active in their daily life in the primary prevention of adolescent insomnia, depression and anxiety.

Physical Exercise and Immune System in the Elderly: Implications and Importance in COVID-19 Pandemic Period

Physical exercise is seen as the main ally for health promotion, preventing and protecting the organism from several diseases. According to WHO, there is a tendency of constant growth in the elderly population in the coming years. The regular practice of exercises by the elderly becomes relevant to minimize the deleterious effects of the aging process and to increase the fitness index. Recently, the world population started a confrontation against Corona Virus Disease (COVID-19), which is the most significant public health challenge globally. Although social isolation is a reasonable measure in an attempt to stop contamination by COVID-19, this measure has limited the ability of individuals to exercise outdoors or in gyms and health clubs, which increased the risk of developing chronic illnesses related to a sedentary lifestyle. The critical point is that the recent recommendations on exercise prescription to combat the potentially harmful effects of COVID-19 failure to adequately address resistance exercise interventions as home-based exercise strategy. Thus, in this paper, we discussed the physical exercise as medicine if the training status is enough to protect the elderly against COVID-19 infection, about the role of physical activity on immunosuppression. Possible risks for COVID-19 infection, and the old training methods, such as no-load resistance training as possible resistance exercise strategies and high-intensity interval training, as new proposals of home-based exercise interventions, could perform during the current COVID-19 pandemic.

Prevalence and associated factors of psychological distress among a national sample of in-school adolescents in Morocco

BACKGROUND

The goal of the study was to estimate the prevalence and correlates of psychological distress among adolescent school children in Morocco.

METHODS

Nationally representative cross-sectional data were analysed from 6745 adolescents (15 years median age) that responded to questions on a two-item measure of psychological distress from "2016 Morocco Global School-Based Student Health Survey (GSHS)."

RESULTS

The prevalence of psychological distress was 23.3, 18.0% among males and 29.2% among females. In adjusted logistic regression analysis, female sex, older age, bullying victimization, infrequently physically attacked, frequent participation in physical fights, having no close friends, frequent experience of hunger, parental emotional neglect, parental disrespect of privacy, school truancy, sedentary behaviour and having sustained a single or multiple serious injuries (past year) were associated with psychological distress. In addition, in unadjusted analysis, low peer support, parents never check homework, exposure to passive smoking, substance use (current tobacco use, current cannabis use and ever used amphetamine), frequent soft drink and frequent fast food consumption were positively and fruit and vegetable intake was negatively associated with psychological distress.

CONCLUSION

Almost one in four students reported psychological distress and several associated factors were identified which can aid prevention and control strategies.

Prevalence of Worry-Induced Sleep Disturbance and Associated Factors among a National Sample of In-School Adolescents in Lebanon

Persistent worry can cause significant distress among adolescents. The goal of this study was to estimate the prevalence and correlates of worry-induced sleep disturbance (WISD) among adolescent school children in Lebanon. Cross-sectional, nationally representative data were analysed from 5849 adolescents (15 years median age) that took part in the "2017 Lebanon Global School-Based Student Health Survey (GSHS)". The results indicate that the prevalence of WISD was 14.7%, 9.6% among males and 17.2% among females. In adjusted logistic regression analysis, loneliness, older age, female sex, having no close friends, infrequent bullying victimization, parents disrespected privacy, current tobacco use, ever cannabis use, high leisure-time sedentary behaviour and having sustained multiple serious injuries (past year) were associated with WISD. In addition, in unadjusted analysis, mostly or always feeling hungry (or low economic status), school truancy, having been physically attacked, frequently being in physical fights (past year), low peer support, parental emotional neglect, parents never checking homework, ever drunk and frequent soft drink intake were positively, and infrequent fast food intake was negatively, associated with WISD. One in seven students reported WISD and several associated factors were identified, which can aid intervention strategies. Multi-level interventions are needed targeting psychosocial distress, social-environmental factors and health risk behaviours to prevent WISD in this adolescent school population.

The effects of aerobic training on subclinical negative affect: A randomized controlled trial

OBJECTIVE

The antidepressant and anxiolytic effects of aerobic exercise are well known, but less is known about its effects on subclinical levels of trait negative affect in healthy but sedentary adults. In the present study, we test the effects of a 3-month randomized controlled trial of aerobic exercise training in young to midlife adults on trait measures of depression, anxiety, hostility, and anger.

METHOD

One-hundred and 19 men (n = 56) and women (n = 63) aged 20-45 were randomized to 1 of 2 conditions: (a) 12 weeks of aerobic exercise after which they were asked to halt exercising and decondition for 4 weeks, or (b) a 16-week waitlist control group. Assessments of depression, anxiety, hostility and anger were completed at study entry, Week 12 and Week 16.

RESULTS

At study entry, participants scored low on measures of depression, anxiety, hostility and anger. Analyses among the intent-to-treat and per protocol samples found significant treatment effects of aerobic training for hostility and depression, but not for anxiety and anger. Within-group analyses demonstrated that depression and hostility scores decreased in the exercise group over the course of the intervention, while remaining stable in the control group. These effects persisted for the exercise group at nonsignificant levels after 4 weeks of deconditioning.

CONCLUSIONS

Aerobic exercise training has significant psychological effects even in sedentary yet euthymic adults, adding experimental data on the known benefits of exercise in this population. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Cannabis use and leisure-time sedentary behavior among 94,035 adolescents aged 12-15 years from 24 low- and middle-income countries

Adolescents spend a high proportion of their leisure time in sedentary behavior, which is associated with adverse physical and mental health outcomes. Exploring factors associated with leisure-time sedentary behavior (LTSB) is important for the development of targeted interventions. The aim of this study was to explore associations between cannabis use and LTSB in adolescents from 24 low- and middle-income countries. Data from the Global School-based Student Health Survey were analyzed. Data on past month cannabis use and LTSB during a typical day were collected. Multivariable logistic regressions were conducted to assess the associations. Among 94,035 adolescents aged 12-15 years [age = 13.7 ± SD 0.9 years; 49.2% female], the prevalence of high LTSB (≥3 h/day) was 26.6%, while 2.8% used cannabis at least once in the past 30 days. In adjusted analyses, compared to those who did not consume cannabis in the past 30 days, the OR (99%CI) for high LTSB among those who used cannabis 1-2 times, 3-9 times, 10-19 times, and ≥20 times were 0.89 (0.58-1.35), 1.96 (1.26-3.07), 1.97 (0.71-5.47), and 2.34 (0.95-5.78), respectively (test for trend p < 0.01). Our data suggest that frequent cannabis use is associated with increased odds for being more sedentary in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public health campaigns.

Inducing Physical Inactivity in Mice: Preventing Climbing and Reducing Cage Size Negatively Affect Physical Fitness and Body Composition

Physical inactivity has emerged as an important and risk factor for cardiovascular and metabolic diseases, independent of levels of exercise engagement. Moreover, inactivity is associated with poor brain functioning. However, little data on the effects of physical inactivity on the brain is available and few methods are suitable to investigate this matter. We tested whether preventing lid climbing and reducing cage size could be used to model physical inactivity in mice. Sixty young adult C57Bl6 mice (10 weeks old) were divided over six groups with different housing conditions: in cages of three different sizes with lids that either allowed or prevented lid climbing. Housing under these conditions was maintained for a period of 19 weeks before the mice were killed for body composition analysis. Physical fitness tests performed around 5 and 10 weeks into the intervention revealed that motor coordination in the balance beam test was reduced by 30.65%, grip strength by 8.91% and muscle stamina in the inverted screen test by 70.37% in non-climbing mice as compared to climbing controls. Preventing climbing increased visceral fat mass by 17.31%, but did not reduce muscle mass. Neither preventing climbing nor reducing cage size affected anxiety assessed in the Open Field test and the Elevated Plus Maze. We did not find any negative effect of inactivity on spatial learning and memory in the novel object location test or working memory measured with the Y-maze Alternation test. The reduced physical fitness and increase in visceral fat mass show that our inactivity method models most effects of physical inactivity that are observed in experimental and observational studies in humans. Whereas established methods such as hindlimb unloading mimic many of the effects of bed rest, our novel method can be applied to study the effects of less extreme forms of physical inactivity (i.e., sedentary behavior) in various disease models including rodent models for brain diseases (i.e., stroke, Alzheimer’s disease).

Physical activity and sedentary levels among people living with epilepsy: A systematic review and meta-analysis

How physically active and sedentary people with epilepsy are is unclear. We conducted a meta-analysis to investigate physical activity and sedentary behavior levels compared with the general population in people with epilepsy across the lifespan. Embase, PubMed, PsycARTICLES, and CINAHL Plus were searched from inception until 1/3/2019. A random effects meta-analysis was conducted. Adults with epilepsy (mean age range = 30-47 years) were significantly less likely to comply with physical activity recommendations [odds ratio (OR) = 0.68; 95% confidence interval (CI) = 0.53-0.87; P < 0.001; N analyses = 10; n epilepsy = 1599; n controls = 137,800] and more likely to be inactive (as defined by individual study criteria) (OR = 1.57; 95% CI = 1.34-1.84; P < 0.001; N analyses = 6; n epilepsy = 6032; n controls = 928,184). Data in children (mean age range = 10-12 years) were limited (N = 4; n = 170) and inconsistent while there were no data available for middle-aged and old age (>65 years) people with epilepsy. Our data demonstrate that adults with epilepsy are less physically active than the general population. Public health campaigns specifically targeting the prevention of physical inactivity in adults with epilepsy are warranted. More research on physical activity and sedentary levels in children, adolescents, middle-aged, and old age but also adult people with epilepsy is needed before specific recommendations can be formulated.

Associations of physical activity with anxiety symptoms and status: results from The Irish longitudinal study on ageing

AIMS

Anxiety is debilitating and associated with numerous mental and physical comorbidities. There is a need to identify and investigate low-risk prevention and treatment strategies. Therefore, the purpose of this study was to investigate cross-sectional and longitudinal associations between different volumes of moderate-to-vigorous physical activity (PA) and anxiety symptoms and status among older adults in Ireland.

METHODS

Participants (n = 4175; 56.8% female) aged ⩾50 years completed the International PA Questionnaire (IPAQ) at baseline, and the anxiety subscale of the Hospital Anxiety and Depression Scale at baseline and follow-up (2009-2013). Participants were classified according to meeting World Health Organisation PA guidelines, and divided into IPAQ categories. Respondents without anxiety at baseline (n = 3165) were included in prospective analyses. Data were analysed in 2017.

RESULTS

Anxiety symptoms were significantly higher among females than males (p < 0.001). Models were adjusted for age, sex, waist circumference, social class, smoking status and pain. In cross-sectional analyses, meeting PA guidelines was associated with 9.3% (OR = 0.91, 95% confidence interval 0.78-1.06) lower odds of anxiety. Compared with the inactive group, the minimally- and very-active groups were associated with 8.4% (OR = 0.92, 0.76-1.10) and 18.8% (OR = 0.81, 0.67-0.98) lower odds of anxiety, respectively. In prospective analyses, meeting guidelines was associated with 6.3% (OR = 0.94, 0.63-1.40) reduced odds of anxiety. Compared with the inactive group, the minimally and very-active groups were associated with 43.5% (OR = 1.44, 0.89-2.32) increased, and 4.3% (OR = 0.96, 0.56-1.63) reduced odds of anxiety. The presence of pain, included in models as a covariate, was associated with a 108.7% (OR = 2.09, 1.80-2.42) increase in odds of prevalent anxiety, and a 109.7% (OR = 2.10, 1.41-3.11) increase in odds of incident anxiety.

CONCLUSION

High volumes of PA are cross-sectionally associated with lower anxiety symptoms and status, with a potential dose-response apparent. However, significant associations were not observed in prospective analyses. The low absolute number of incident anxiety cases (n = 109) potentially influenced these findings. Further, as older adults may tend to experience and/or report more somatic anxiety symptoms, and the HADS focuses primarily on cognitive symptoms, it is plausible that the HADS was not an optimal measure of anxiety symptoms in the current population.

Leisure-Time Sedentary Behavior Is Associated with Psychological Distress and Substance Use among School-Going Adolescents in Five Southeast Asian Countries: A Cross-Sectional Study

Sedentary behavior has been found to be associated with poorer mental health. The aim of this study was to estimate associations of sedentary behavior with psychological distress and substance use among adolescents in five Southeast Asian countries. The cross-sectional sample included 32,696 nationally representative samples of school-going adolescents (median age 14 years) from Indonesia, Laos, Philippines, Thailand and Timor-Leste. Leisure-time sedentary behavior, physical activity, psychological distress and substance use were assessed by self-report. Overall, the students engaged in <1 h (35.7%), 1-2 h (31.6%), 3-4 h (18.2%), 5-6 h (7.2%), and 7 or more hours (7.2%) of sedentary time a day. The prevalence of psychological distress was 14.6% single and 8.6% multiple psychological distress, and the prevalence of current tobacco use was 13.9% and current alcohol use 12.5%. In fully adjusted multinomial logistic regression analysis, compared to students who spent less than one hour a day engaged in sedentary leisure time, students who spent three or more hours engaged in leisure-time sedentary behavior were more likely to have single and multiple psychological distress. In fully adjusted logistic regression analysis, five or more hours of leisure-time sedentary behavior was associated with current tobacco use and one or more hours of leisure-time sedentary behavior with current alcohol use. Findings suggest an association of leisure-time sedentary behavior with psychological distress and with substance use in this adolescent population.

Leisure-time sedentary behavior and loneliness among 148,045 adolescents aged 12-15 years from 52 low- and middle-income countries

BACKGROUND

Loneliness is widespread in adolescents and associated with a myriad of adverse physical and mental health outcomes. Exploring variables associated with loneliness is important for the development of targeted interventions. The aim of the current study was to explore associations between leisure-time sedentary behavior (LTSB) and loneliness in adolescents from 52 low- and middle-income countries.

METHODS

Data from the Global School-based Student Health Survey were analyzed. Data on past 12-month self-perceived loneliness and LTSB were collected. Multivariable logistic regression and meta-analysis were conducted to assess the associations.

RESULTS

Among 148,045 adolescents (mean age 13.7± SD 1.0 years; 48.5% female), the prevalence of loneliness increased from 8.7% among those with 1-2 h/day of LTSB to 17.5% among those spending >8 h/day sedentary. Compared to those who engage in less than 1 h of LTSB per day, the OR (95%CI) of loneliness for 1-2 h/day, 3-4 h/day, 5-8 h/day and >8 h/day were 1.00 (0.91-1.11), 1.29 (1.15-1.45), 1.37 (1.17-1.61), and 1.66 (1.39-1.99), respectively.

LIMITATIONS

The study is cross-sectional, therefore the directionality of the relationships cannot be deduced.

CONCLUSIONS

Our data suggest that LTSB is associated with increased odds for feeling lonely in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public health campaigns.

Acute Exercise Effects among Young Adults with Analogue Generalized Anxiety Disorder

Recent findings support positive effects of acute aerobic exercise on worry, state anxiety, and feelings of energy and fatigue among young adult women with subclinical, or analogue, generalized anxiety disorder (GAD). However, exercise effects among young adult men with analogue GAD are unstudied.

PURPOSE

This study replicated initial findings of positive effects of acute vigorous-intensity aerobic exercise on worry, state anxiety, and feelings of energy and fatigue among young adult women with analogue GAD, examined responses among young adult men with analogue GAD, and explored sex-related differences and moderation by physical activity level, trait anxiety, depression, and poor sleep status.

METHODS

Thirty-five young adults (21.4 ± 2.3 yr; 19 males; 16 females) with Penn State Worry Questionnaire scores ≥45 (60 ± 8) completed two counterbalanced 30-min conditions: treadmill running at ~71.2% ± 0.04% HR reserve and seated quiet rest. Outcomes included worry, worry engagement, absence of worry, state anxiety, and feelings of energy and fatigue.

RESULTS

No outcome or moderator differed at baseline between sexes. Exercise significantly improved state anxiety (P < 0.04; d = 0.27) and feelings of energy (P < 0.001; d = 1.09). Small nonsignificant improvements were found for worry (d = 0.22), worry engagement (d = 0.18), and feelings of fatigue (d = 0.21). The magnitude of improvements in worry, worry engagement, absence of worry, and feelings of energy were stronger among females. Significant large, potentially clinically meaningful increases in feelings of energy were found among women (d = 1.35) and men (d = 0.92). A nonsignificant, but potentially clinically meaningful, moderate reduction in worry (d = 0.53) was found among women. High-trait anxiety and poor sleep quality were supported as moderators.

CONCLUSIONS

Findings replicated positive effects of acute aerobic exercise among young adult women with analogue GAD, and extended to support for positive effects among young adult men with analogue GAD.

Leisure-time sedentary behavior and suicide attempt among 126,392 adolescents in 43 countries

BACKGROUND

Adolescent suicide is a major global mental health problem. Exploring variables associated with suicide attempts is important for the development of targeted interventions. The aim of the current study was to explore associations between leisure-time sedentary behavior and suicide attempts.

METHODS

Data from the Global School-based Student Health Survey were analyzed. Data on past 12-month suicide attempts and self-reported leisure-time sedentary time were collected. Multivariable logistic regression and meta-analysis were conducted to assess the associations.

RESULTS

Among 126,392 students from 43 countries (mean age 13.8 ± 0.96 years; 48.9% female), 10.6% had attempted suicide. The prevalence of suicide attempts increased with increasing sedentary leisure-time per day (from 9% at <1 h/day to 16.8% at >8 h/day). Compared to those engaging in <1 h/day sedentary during leisure-time, there was a dose-dependent increase in odds ratios (ORs) for suicide attempts, with the OR for >8 h/day being 1.45 (95% confidence interval=1.19-1.77).

LIMITATIONS

The study is cross-sectional, therefore the directionality of the relationships cannot be deduced.

CONCLUSIONS

Our data suggest that leisure-time sedentary behavior is associated with increased odds for suicide attempt in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public prevention campaigns.

Sedentary behaviors and anxiety among children, adolescents and adults: a systematic review and meta-analysis

Background

Although the number of studies examining the relationships between sedentary behaviors (SB) and anxiety is growing, an overarching evidence, taking into account children, adolescents, and adults as well as different types of SB and different categories of anxiety outcomes, is still missing. Thus, this systematic review and meta-analysis aimed at obtaining a comprehensive overview of existing evidence.

Methods

A search in the following databases: PsycINFO, PsycARTICLES, Academic Search Complete, ERIC, HealthSource: Nursing/Academic Edition and MEDLINE, resulted in k = 31 original studies included in the systematic review (total N = 99,192) and k = 17 (total N = 27,443) included in the meta-analysis. Main inclusion criteria referred to testing the SB--anxiety relationship, the quality score (above the threshold of 65%), and the language of publications (English). The study was following the PRISMA statement and was registered at PROSPERO (CRD42017068517).

Results

Both the systematic review and meta-analysis indicated that overall average effects were small: higher levels of symptoms of anxiety were associated with higher levels of SB (weighted r = .093, 95% CI [.055, .130], p < .001). Moderator analyses indicated that trends for stronger effects were observed among adults, compared to children/adolescents (p = .085).

Conclusions

Further longitudinal studies are necessary to elucidate the predictive direction of the anxiety—SB relationship and to clarify whether the effects depend on the type of anxiety indicators.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6715-3) contains supplementary material, which is available to authorized users.

Experimental Evaluation of the Joint Effects of Exercise and Sedentary Behavior on Cognitive Function

Background

The objective of this study was to evaluate the potential joint effects of sedentary behavior and exercise on cognitive function.

Methods

Participants (M_age = 20 yrs) were randomly assigned to one of three experimental groups. The No Exercise Group (n = 19) was instructed to reduce steps to less than 5000/day and were not allowed to exercise for one-week; the Reduced MVPA (moderate-to-vigorous PA) Group (n = 18) was instructed to reduce steps to less than 5000/day but exercised for 50% of their previously reported vigorous PA for one-week; and the Control Group (n = 20) maintained normal activity for one-week. Cognitive functions (via Stroop and Trail Making tasks) were assessed at baseline, post-intervention, and after one week of resumed normal activity for the intervention groups.

Results

Statistically significant main effects for time were observed for Stroop Congruent (F_time = 11.7, p < 0.001, η ² _p = 0.18), Stroop Incongruent (F_time = 19.4, p < 0.001, η ² _p = 0.26), Stroop Control (F_time = 54.4, p > 0.001, η ² _p = 0.50), Trail Making-A (F_time = 19.1, p < 0.001, η ² _p = 0.26) and Trail Making-B (F_time = 13.8, p < 0.001, η ² _p = 0.21) tasks. However, there were no statistically significant group x time interactions (all p's > 0.05) for any of the cognitive parameters.

Conclusion

These experimental findings do not suggest an interaction effect between sedentary behavior and physical activity on cognitive function.

Sedentary behavior and anxiety-induced sleep disturbance among 181,093 adolescents from 67 countries: a global perspective

OBJECTIVES

Sleep problems are burdensome in adolescents. Understanding modifiable environmental risk factors is essential. There is evidence that physical activity is protective against sleep problems in adolescents. However, the association between sedentary behavior (SB) and anxiety-induced sleep disturbance has not been investigated.

METHODS

Using cross-sectional data from the Global school-based Student Health Survey, we explored the association between SB and anxiety-induced sleep disturbance in 181,093 adolescents [mean (standard deviation, SD) age 13.7 (1.0) years; 48.4% girls] from 67 countries, controlling for confounders (including physical activity). Adolescents reported anxiety-induced sleep disturbance during the past 12 months, and SB, which was a composite variable assessing time spent sitting and watching television, playing computer games, talking with friends during a typical day excluding the hours spent sitting at school and doing homework. Multivariable logistic regression analysis was conducted and a countrywide meta-analysis undertaken.

RESULTS

Overall, 7.8% of adolescents had anxiety-induced sleep disturbance. The prevalence of SB was: <1 h/day 39.9%; 1-2 h/day 33.8%; 3-4 h/day 15.4%; 5-8 h/day 7.4%; and >8 h/day 3.6%. Compared to <1 h/day of SB, >8 h/day was associated with a 2.27 [95% confidence interval (CI) = 1.98-2.62] times higher odds for anxiety-induced sleep disturbance. The association was similar among both sexes. The pooled odds ratio for anxiety-induced sleep disturbance when being sedentary ≥3 h/day was 1.42 (95% CI = 1.36-1.48) with only a small degree of between-country heterogeneity (I² = 41.4%).

CONCLUSIONS

Future longitudinal data are required to confirm/refute the findings to inform public interventions which aim to reduce anxiety and sleep disturbance in adolescents.

Sedentary behaviour and risk of anxiety: A systematic review and meta-analysis

OBJECTIVE

This research synthesis sought to determine the magnitude of the association between sedentary behaviour (sitting time) and anxiety.

EVIDENCE ACQUISITION

A comprehensive literature search of eight electronic databases (and a manual search) identified 13 observational studies that met inclusion criteria (22 effect sizes; total n = 70,425). Pooled mean effects were computed using inverse-variance weighted random effects meta-analysis and moderation by study and population characteristics were tested using random effects meta-regression.

EVIDENCE SYNTHESIS

Sedentary behaviour was associated with an increased risk of anxiety for non-adjusted effect sizes (k = 7, OR = 1.33 [95% CI: 1.14, 1.55]) and effect sizes adjusted for sociodemographic and health-related factors (k = 11, OR = 1.48 [95% CI: 1.25, 1.75]). There was no evidence of publication bias in the results. The regression models showed that effect sizes were not moderated by age or gender. However, there was some evidence of moderation by study quality and measurement of sedentary behaviour and anxiety. Measures of sitting time showed larger associations than measures of screen time, and measures of anxiety symptoms showed larger associations than measures of anxiety disorders.

CONCLUSION

The research synthesis provides evidence that sedentary behaviour has a small positive association with anxiety, after controlling for sociodemographic and other health-related factors. Study limitations include low statistical power in meta-regression models and heterogeneity in measures of anxiety and sedentary behaviour. Findings might be of interest to health care professionals developing health care initiatives to reduce risk of anxiety.

Exercise and cardiorespiratory fitness on subjective memory complaints

The purpose of this study was to examine the association between exercise and estimated cardiorespiratory fitness on subjective memory complaints in young adults. Four-hundred and 64 young adult college students (18-35 yrs) completed an online survey. Exercise behavior was assessed from the Physical Activity Vital Signs Questionnaire. Cardiorespiratory fitness was evaluated from an algorithm that included an assessment of age, gender, body mass index, waist circumference, resting heart rate, habitual physical activity behavior, and smoking status. Subjective memory complaints were assessed using the Prospective-Retrospective Memory Questionnaire. Subjective memory complaints were common among this young adult sample. However, exercise was not statistically significantly associated with prospective (β = -0.002, P = 0.25) or retrospective (β = -0.001, P = 0.26) memory complaints. Results were similar for cardiorespiratory fitness. In conclusion, we did not observe an association between exercise and estimated cardiorespiratory fitness on subjective memory complaints in young adults.

Athletes with neurologic disease

Neurologic disease does not discriminate, even among athletes. Common neurologic diseases among athletes include multiple sclerosis, seizures, headaches, and sleep disorders. Although concrete guidelines for sport participation among athletes with neurologic diseases do not exist, evidence-based and consensus statements can aid healthcare providers in determining whether and to what extent such athletes should participate in sports. Moreover, sport participation is important, since multiple studies indicate that exercise improves disease-specific symptoms, manifestations, and overall quality of life. Although some risk is involved for athletes with neurologic disease, risk is mitigated with proper supervision and neurologic oversight, disease-specific accommodations, and counseling of the athletic staff and the athletes. Neurologic oversight entails an initial comprehensive neurologic assessment by a neurologist followed by regular follow-up. Preparation for environmental conditions encountered by athletes with neurologic disease will further improve safety during their participation in sport. With sound recommendations, neurologic oversight, and proper supervision, most athletes with neurologic disease can participate in athletics. The health benefits that they will gain from participation in athletics outweigh the risks.

Associations between TV viewing, sitting time, physical activity and insomnia among 100,839 Brazilian adolescents

Our aim was to examine the relationship between insomnia and levels of physical activity (PA) and time spent sitting and TV viewing among Brazilian adolescents. Data from the Brazilian Scholar Health Survey, a nationally representative survey of 9th grade adolescents [mean: 14.28 years (range: 11-18 years)] conducted in 2015 (n = 100,839) were used. Self-reported insomnia, TV viewing, sitting time and total PA (adapted International PA Questionnaire) were collected. Chronological age, race, type of city (capital or interior) country region, goodies ingestion and ultra-processed foods ingestion were covariates. Logistic regression analyses were conducted to assess the associations. A higher sitting time and TV viewing (≥8 h/day) was associated with a higher risk of insomnia among boys [sitting time: OR = 2.39 (95%CI = 1.88-3.04); TV:OR = 2.49(95%CI = 1.92-3.22) and girls [sitting time: OR = 2.17(95%CI = 1.84-2.57; TV:OR = 1.72(95%CI = 1.44-2.04)]. More than 4 h of sitting time per day was associated with higher risk of insomnia in adolescents who comply [boys: OR = 1.43(95%CI = 1.19-1.73); girls: OR = 1.66(95%CI = 1.41-1.94)] and who do not comply with the 300 min/week of physical activity recommendation [boys = OR = 1.35(95%CI = 1.13-1.60); girls: OR = 1.38(95%CI = 1.20-1.57)]. Our data suggest that higher levels of TV viewing or sitting are associated with sleep difficulties in this large cohort of adolescents, irrespective of their physical activity behavior.

Brief aerobic exercise immediately enhances visual attentional control and perceptual speed. Testing the mediating role of feelings of energy

While the effects of acute exercise on mood and cognitive functions have been separately documented over the last decade, recent findings have pointed to a possible connection between affective responses to exercise and cognitive performance. The main objective of this study was to test whether the effects of acute exercise on cognition were mediated by changes in feelings of energy. One-hundred-and-one undergraduate students were randomized into one of two experimental conditions: 15 min of jogging at "moderate" intensity, or 15 min of relaxation/concentration (control condition). Perceptual speed, visual attentional control, working memory, and cognitive flexibility were assessed pre- and post-intervention in both groups via the Trail Making Test. Self-rated feelings of energy were also recorded pre- and post-intervention. Only completion time for the TMT-A significantly improved from pre- to post-intervention in participants who exercised compared with participants who practiced relaxation/concentration. No Group × Time interaction was found with regard to the other TMT variables. Finally, changes in feelings of energy were found to fully mediate the relationship between exercise and perceptual speed/visual attentional control. Taken together, our data suggest that a brief bout of moderate intensity exercise can improve the efficiency of certain cognitive processes through increases in feelings of energy, but further research is required to evaluate the duration of benefits and to determine whether these apply to other populations.

Experimentally investigating the joint effects of physical activity and sedentary behavior on depression and anxiety: A randomized controlled trial

OBJECTIVE

To experimentally examine whether increasing sedentary behavior, among a young adult active population, for one week is still associated with increased depression and anxiety symptomology even when allowing for a moderate engagement in physical activity (PA).

METHODS

Participants were confirmed as active via self-report and accelerometry during baseline and randomly assigned to one of three experimental groups. The No Exercise Group (n = 19) was instructed to reduce steps to less than 5000/day and were not allowed to exercise for one-week; the Reduced MVPA (moderate-to-vigorous PA) Group (n = 18) was instructed to reduce steps to less than 5000/day but exercised for 50% of their previously reported vigorous PA for one-week; and the Control Group (n = 20) maintained normal activity for one-week. PA, depression, and anxiety levels were assessed at baseline, post-intervention, and after one week of resumed normal activity for the intervention groups.

RESULTS

The experiment was successful in altering physical activity levels among the intervention groups and maintaining activity habits in the control group (F_Interaction = 16.053, P < 0.001, η²_p = 0.391). Anxiety and depression symptomology remained constant across the two time periods in the control group. For both intervention groups (No Exercise Group and Reduced MVPA Group), depression statistically significantly increased during the inactive week and then resumed back to baseline levels after a week of resumed activity. However, there were no differential trends in anxiety (F_Interaction = 0.073, P = 0.897, η²_p = 0.002) or depression (F_Interaction = 0.276, P = 0.760, η²_p = 0.008) among these two intervention groups.

CONCLUSION

We provide experimental evidence that reducing habitual physical activity causes an increase in depression symptomology among young active adults. We did not, however, observe a joint effect of sedentary behavior and exercise on changes in anxiety and depression. At this point, it is still uncertain as to whether reduced MVPA or increased sedentary behavior were driving the observed changes in psychological function. Future research may help determine if these negative effects are from increased sedentary behavior or a reduction in MVPA.

The Influence of Daily Stress on Sedentary Behavior: Group and Person (N of 1) Level Results of a 1-Year Observational Study

OBJECTIVE

The purpose of this study, which used mobile technologies to continuously collect data for 1 year, was to examine the association of psychological stress with objectively measured sedentary behavior in adults at both the group (e.g., nomothetic approach) and individual (e.g., idiographic approach) level.

METHODS

Data were collected in an observational study of healthy adults (n = 79) residing in the New York City metro area who were studied for 365 days from 2014 to 2015. Sedentary behavior was objectively measured via accelerometry. A smartphone-based electronic diary was used to assess level of stress ("Overall, how stressful was your day?" 0-10 scale) and sources of stress.

RESULTS

The end-of-day stress rating was not associated with total sedentary time (B = -1.34, p = .767) at the group level. When specific sources of stress were evaluated at the group level, argument-related stress was associated with increased sedentariness, whereas running late- and work-related stress were associated with decreased sedentariness. There was a substantial degree of interindividual variability in the relationship of stress with sedentary behavior. Both the level and sources of stress were associated with increased sedentariness for some, decreased sedentariness for others, and had no effect for many (within-person variance p < .001).

CONCLUSIONS

These findings suggest that the influence of stress on sedentary behavior varies by source of stress and from person to person. A precision medicine approach may be warranted to target reductions in sedentary time, although further studies are needed to confirm the observed findings in light of study limitations including a small sample size and enrollment of participants from a single, urban metropolitan area.

Sedentary behavior and depressive symptoms among 67,077 adolescents aged 12-15 years from 30 low- and middle-income countries

BACKGROUND

Depression is common and burdensome in adolescents. Understanding modifiable environmental risk factors is essential. There is evidence that physical activity is protective of depression. However, the impact of sedentary behavior (SB) on depression is relatively under-researched especially in low- and middle-income countries (LMICs). In this cross-sectional study, we explored the association between SB and depressive symptoms in adolescents from 30 LMICs, controlling for confounders including physical activity.

METHOD

Data from the Global school-based Student Health Survey were analyzed in 67,077 adolescents [mean (SD) age 13.8 (0.9) years; 50.6% girls). Self-report measures assessed depressive symptoms during the past 12 months, and SB, which was a composite variable assessing time spent sitting and watching television, playing computer games, talking with friends during a typical day excluding the hours spent sitting at school and doing homework. Multivariable logistic regression analysis was conducted and a countrywide meta-analysis undertaken.

RESULTS

The prevalence of depressive symptoms and ≥ 3 h/day of SB were 28.7 and 30.6%, respectively. There was a linear increase in the prevalence of depressive symptoms with increasing sedentary time beyond ≥3 h/day (vs. < 1 h/day). Among boys, 1-2 h/day of SB was associated with lower odds for depression (vs. < 1 h/day). Countrywide meta-analysis demonstrated that spending ≥3 h/day versus < 3 h/day was associated with a 20% increased odds for depressive symptoms (OR = 1.20; 95% CI = 1.16-1.24) with low between-country heterogeneity (I2 = 27.6%).

CONCLUSION

Our data indicate that being sedentary for ≥3 h/day is associated with increased odds for depressive symptoms in adolescence. Future longitudinal data are required to confirm/refute the findings to inform public interventions which aim to limit the time spent being sedentary in adolescents.

Randomized controlled trial investigating the experimental effects of reduced habitual physical activity on cardiometabolic profile

OBJECTIVE

Previous work suggests that reduced habitual physical activity is unfavorably associated with cardiometabolic health. Fewer lifestyle-based, experimental studies on this topic have been conducted. Thus, the purpose of this study was to experimentally reduce habitual physical activity over a one-week period to evaluate its potential effects on cardiometabolic profile.

METHODS

Young physically active adults (M_age = 21 yrs) were randomized into a Reduced Activity Group (N = 19) or a Control Group (N = 20). The Reduced Activity group engaged in baseline week of normal activity, then reduced their activity for one week (from approximately 9000 steps/day to approximately 6000 steps/day), followed by resumption of habitual activity for a week. The Control Group maintained their normal active lifestyle for two-weeks. At all time points, the following cardiometabolic parameters were assessed: systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), atherogenic index of plasma (AIP), TC/HDL-C, LDL-C/HDL-C, TG/HDL-C, non-HDL-C, and glucose.

RESULTS

The Reduced Activity Group, compared to the Control Group, had an unfavorable change in TG/HDL-C (F_Interaction = 4.995, P = 0.03, η²_p = 0.14). No other biomarkers were altered CONCLUSION: A one-week period of reduced activity among a young adult, active population, increased TG/HDL-C levels, with no changes observed in any of the other evaluated cardiometabolic parameters. Thus, a temporary lapse in habitual physical activity does not considerably change cardiometabolic outcomes in young, healthy physically active adults.

Correlates of physical activity among community-dwelling individuals aged 65 years or older with anxiety in six low- and middle-income countries

ABSTRACTBackground:Given the important health benefits of physical activity (PA) and the higher risk for physical inactivity in people with anxiety, and the high prevalence of anxiety and low PA among the elderly, there is a need for research to investigate what factors influence PA participation among anxious older individuals. We investigated PA correlates among community-dwelling adults aged ≥ 65 years with anxiety symptoms in six low- and middle-income countries.

METHODS

Cross-sectional data from the World Health Organization's Study on Global Ageing and Adult Health were analyzed. PA level was assessed by the Global Physical Activity Questionnaire. 980 participants with anxiety (mean age 73.3 years; 62.4% females) were grouped into those who do and do not (low PA) meet the 150 minutes of moderate-to-vigorous PA per week recommendation. Associations between PA and the correlates were examined using multivariable logistic regressions.

RESULTS

The prevalence of low PA was 44.9% (95% CI = 39.2-50.7%). Older age, male gender, less consumption of alcohol, mild cognitive impairment, pain, a wide range of somatic co-morbidities, slow gait, weak grip strength, poor self-rated health, and lower levels of social cohesion were identified as significant positive correlates of low PA.

CONCLUSIONS

Our data illustrate that a number of sociodemographic and health factors are associated with PA levels among older people with symptoms of anxiety. The promotion of social cohesion may increase the efficacy of public health initiatives, while from a clinical perspective, somatic co-morbidities, cognitive impairment, pain, muscle strength, and slow gait need to be considered.

Memorcise and Alzheimer's disease

Alzheimer's disease (AD) is a debilitating disease influencing a multitude of outcomes, including memory function. Recent work suggests that memory may be influenced by exercise ('memorcise'), even among those with AD. The present narrative review details (1) the underlying mechanisms of AD; (2) whether exercise has a protective effect in preventing AD; (3) the mechanisms through which exercise may help to prevent AD; (4) the mechanisms through which exercise may help attenuate the progression of AD severity among those with existing AD; (5) the effects and mechanisms through which exercise is associated with memory among those with existing AD; and (6) exercise recommendations for those with existing AD. Such an understanding will aid clinicians in their ability to use exercise as a potential behavioral strategy to help prevent and treat AD.

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

BACKGROUND

Sedentary behavior (SB) is associated with diabetes, cardiovascular disease and low mood. There is a paucity of multi-national research investigating SB and depression, particularly among low- and middle-income countries. This study investigated the association between SB and depression, and factors which influence this.

METHODS

Cross-sectional data were analyzed from the World Health Organization's Study on Global Ageing and Adult Health. Depression was based on the Composite International Diagnostic Interview. The association between depression and SB (self-report) was estimated by multivariable linear and logistic regression analyses. Mediation analysis was used to identify influential factors.

RESULTS

A total of 42,469 individuals (50.1% female, mean 43.8 years) were included. People with depression spent 25.6 (95%CI8.5-42.7) more daily minutes in SB than non-depressed participants. This discrepancy was most notable in adults aged ≥ 65y (35.6min more in those with depression). Overall, adjusting for socio-demographics and country, depression was associated with a 1.94 (95%CI1.31-2.85) times higher odds for high SB (i.e., ≥ 8h/day). The largest proportion of the SB-depression relationship was explained by mobility limitations (49.9%), followed by impairments in sleep/energy (43.4%), pain/discomfort (31.1%), anxiety (30.0%), disability (25.6%), cognition (16.1%), and problems with vision (11.0%). Other health behaviors (physical activity, alcohol consumption, smoking), body mass index, and social cohesion did not influence the SB-depression relationship.

CONCLUSION

People with depression are at increased risk of engaging in high levels of SB. This first multi-national study offers potentially valuable insight for a number of hypotheses which may influence this relationship, although testing with longitudinal studies is needed.

Effects of Sedentary Behavior, Physical Activity, Frequency of Protein Consumption, Lower Extremity Strength and Lean Mass on All-Cause Mortality

Background

No study has evaluated the potential independent and cumulative effects of physical activity, sedentary behavior, daily frequency of protein consumption, lean mass and muscular strength on mortality risk.

Methods

Data from the 1999–2002 NHANES were utilized (N = 1,079 adults 50–85 yr), with follow-up through 2011. Leg lean mass was estimated from DXA scans. Knee extensor strength was assessed using the Kin Com MP dynamometer. Physical activity and sedentary behavior were assessed via questionnaire, with the number of meals/day of ≥30 g of protein/meal assessed via a “multiple pass” 24-hour dietary interview. An index score was created (range = 0–5) indicating the number of these health characteristics each participant had.

Results

Only less sedentary behavior was independently associated with reduced mortality risk (HR_adjustment = 0.46; 0.32–0.66). After adjustments, and compared to those with an index score of 0, those with an index score of 1, 2 and 3+, respectively, had a 34%, 49%, and 57% reduced risk of all-cause mortality.

Conclusion

While considering physical activity, sedentary behavior, daily protein frequency consumption, lean mass and muscular strength, only sedentary behavior was independently associated with mortality risk among older adults.