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

Compositional associations of 24-h physical activities, sedentary time and sleep with depressive symptoms in urban and rural residents: a cross-sectional study

BACKGROUND

Studies investigating the associations of 24-h movement behaviours (including moderate-to-vigorous-intensity physical activity (MVPA), light-intensity PA (LPA), sedentary time (ST) and sleep) with depressive symptoms are scarce. It is also unclear whether possible associations differ between urban and rural residents. Hence, we aimed to investigate these associations in a population-based sample of middle-aged Finnish adults.

METHODS

The study population consisted of 4295 adults, aged 46 years, from the Northern Finland Birth Cohort 1966. The participants wore a hip-worn accelerometer for 14 days. Time spent in sedentary, LPA and MVPA was obtained from accelerometer data and then combined with self-reported sleep duration to obtain the 24-h composition. The residential environment was classified as urban or rural based on the participants' home addresses. Depressive symptoms were assessed using the Beck Depression Inventory-II (BDI-II). Multivariable adjusted regression analysis using a compositional data analysis approach based on isometric log-ratio transformation was used to determine the associations between movement behaviours and depressive symptoms in urban and rural residential environments.

RESULTS

The 24-h movement behaviour composition was significantly associated with the BDI-II score both in urban and rural residential environment. More time spent in sleep relative to other behaviours was associated with lower BDI-II score in rural residential environments. More time spent in ST among urban residents and in LPA among rural residents was associated with higher BDI-II scores. When modelling pairwise reallocations of time, more MVPA or more sleep at the expense of LPA or ST was associated with lower BDI-II score among rural residents. For urban residents, reallocating time from ST to any other behaviour was associated with lower BDI-II score.

CONCLUSIONS

Our findings showed that more relative time spent in MVPA and sleep was associated with lower levels of depressive symptoms among rural residents, and more relative time spent in any other behaviour at the expense of ST was associated with lower levels of depressive symptoms among urban residents. These differences should be considered in the prevention and treatment of depressive symptoms. Due to the cross-sectional design of this study, causality cannot be inferred, and further research exploring the mechanisms underlying these associations in diverse populations and longitudinal study settings are needed.

Sedentary behavior and physical activity are associated with risk of depression among adult and older populations: a systematic review and dose-response meta-analysis

Background

Depression symptoms are commonly experienced by adults and older people; however, there is uncertainty concerning the associations of lifestyle with the risk of depression. This study systematically reviewed and meta-analyzed observational data to assess the link between instrumented sedentary behavior (i-SB) and physical activity (i-PA) measures and depression risk among adult and older populations.

Methods

A systematic review across four databases was performed up to July 27, 2024, targeting studies linking i-SB, i-PA, and depression. The review included a dose-response meta-analysis, presenting results as odds ratios (OR) and 95% confidence intervals (95% CI).

Results

Fifty-one studies, encompassing 1,318,687 participants, fulfilled the inclusion criteria. The comparison between the most and least sedentary groups yielded a pooled OR of 1.09 (95% CI 1.05-1.13). The comparison between the least and most active participant groups yielded pooled ORs of 0.96 (95% CI 0.93-0.98) for light activity (LPA), 0.91 (95% CI 0.86-0.96) for moderate-to-vigorous activity (MVPA), 0.93 (95% CI 0.90-0.96) for total physical activity (TPA), and 0.87 (95% CI 0.81-0.94) for steps per day. After adjusting i-PA, a lower OR for i-SB did not indicate a significant link to increased depression risk. Meta-regression analyses confirmed a dose-response relationship between SB, MVPA, daily steps, and depression.

Conclusion

The association between i-SB and the risk of depression was not consistent with the results of previous self-reported studies. MVPA linked to the risk of depression was independent of i-SB, whereas the link between i-SB and the risk of depression was not independent of i-PA.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=546666, identifier CRD42024546666.

Methodological Choices on 24-h Movement Behavior Assessment by Accelerometry: A Scoping Review

BACKGROUND

There are no reviews describing current measurement protocols and accelerometer processing decisions that are being used in 24-h MovBeh studies, across the lifespan. We aim to synthesise information on methods for assessing 24-h movement behaviors using accelerometry across all age groups.

MAIN BODY

PubMed, PsycINFO, SPORTDiscus, and EMBASE were searched until December 2022. Observational or intervention reports describing accelerometry methods in studies on combinations of movement behaviors, with a 24-h protocol across all ages, were included. This review included 102 studies: three studies in toddlers, 15 in preschoolers, 17 in children, 23 in adolescents and 44 in adults and older adults. The Actigraph GT3X was the most commonly used device; the majority of the included reports collected data for seven days, including three weekdays and one weekend day, with a ≥ 16 h/day per 24-h period for valid data. The criteria for non-wear time varied between ≥ 20 and  ≥ 90 min of consecutive zero counts, depending on the age group. The most common epoch used was 15 or 60 s for youth and adults, respectively. The choice of sleep algorithms and SB/PA cut-points, of the included reports, depended on age and the original validation/calibration study. To deal with non-compliant participants, exclusion of non-compliant participants from the analysis was most frequently used. Most studies used diaries/logs to complement the accelerometer data.

CONCLUSIONS

Accelerometer protocols and methodological decisions varied considerably between reports. Therefore, consensus on methodological decisions is needed to improve precision and comparability between studies, which is challenging given the complexity of the procedures, the number of available brands and types of accelerometers, and the plethora of programming options.

Association between 24-hour movement behavior and depression in college students: A compositional data analysis

BACKGROUND

Evidence strongly suggests that moderate-to-vigorous physical activity (MVPA) can help reduce symptoms of depression. However, the relationship between 24-h movement behaviors and depressive symptoms, as well as the potential substitution effects between different behaviors, remains unclear. Therefore, this study seeks to investigate how the time spent in one behavior relative to others is associated with depressive symptoms.

METHODS

The study recruited 366 participants, who had their levels of MVPA, light PA (LPA), and sedentary behavior (SB) recorded using tri-axial accelerometers over 7 consecutive days. Participants also self-reported their sleep duration (SLP). Depression scores were measured using the Center for Epidemiological Studies Depression Scale (CESD). Using compositional linear regression, the study explored the connections between different compositions of time spent in movement behaviors and depression symptom scores.

RESULTS

Spending more time on LPA and MVPA relative to other behaviors were associated with lower depression scores, whereas a higher proportion of SB relative to other activities was linked to increased depression scores. Reallocating time spent on SB to LPA and MVPA was associated with decreased depression scores.

LIMITATION

This study is a cross-sectional research design, and causality cannot be inferred. In addition, the sampling method of this study may have imposed some limitations on the representativeness of the sample. Further longitudinal studies could be conducted by selecting a large, representative sample.

CONCLUSION

Within the spectrum of 24-h movement behaviors, increasing the duration of LPA and MVPA emerges as advantageous for reducing depression scores, suggesting a potential benefit in reallocating SB to PA, especially MVPA.

A systematic review of research reporting practices in observational studies examining associations between 24-h movement behaviors and indicators of health using compositional data analysis

Background

Compositional data analysis (CoDA) techniques are well suited for examining associations between 24-h movement behaviors (i.e., sleep, sedentary behavior, physical activity) and indicators of health given they recognize these behaviors are co-dependent, representing relative parts that make up a whole day. Accordingly, CoDA techniques have seen increased adoption in the past decade, however, heterogeneity in research reporting practices may hinder efforts to synthesize and quantify these relationships via meta-analysis. This systematic review described reporting practices in studies that used CoDA techniques to investigate associations between 24-h movement behaviors and indicators of health.

Methods

A systematic search of eight databases was conducted, in addition to supplementary searches (e.g., forward/backward citations, expert consultation). Observational studies that used CoDA techniques involving log-ratio transformation of behavioral data to examine associations between time-based estimates of 24-h movement behaviors and indicators of health were included. Reporting practices were extracted and classified into seven areas: (1) methodological justification, (2) behavioral measurement and data handling strategies, (3) composition construction, (4) analytic plan, (5) composition-specific descriptive statistics, (6) model results, and (7) auxiliary information. Study quality and risk of bias were assessed by the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies.

Results

102 studies met our inclusion criteria. Reporting practices varied considerably across areas, with most achieving high standards in methodological justification, but inconsistent reporting across all other domains. Some items were reported in all studies (e.g., how many parts the daily composition was partitioned into), whereas others seldom reported (e.g., definition of a day: midnight-to-midnight versus wake-to-wake). Study quality and risk of bias was fair in most studies (85%).

Conclusions

Current studies generally demonstrate inconsistent reporting practices. Consistent, clear and detailed reporting practices are evidently needed moving forward as the field of time-use epidemiology aims to accurately capture and analyze movement behavior data in relation to health outcomes, facilitate comparisons across studies, and inform public health interventions and policy decisions. Achieving consensus regarding reporting recommendations is a key next step.

Supplementary Information

The online version contains supplementary material available at 10.1186/s44167-024-00062-8.

Effects of a digital intervention on physical activity in adults: A randomized controlled trial in a large-scale sample

Background

Physical inactivity is associated with health risks, contributing to various diseases and all-cause mortality. Despite recommendations for regular physical activity (PA), many adults remain inactive, influenced by socioeconomic and environmental factors. Digital interventions, particularly web-based PA programs, offer promising possibilities to promote PA across populations. These programs vary in their effectiveness, reflecting differences in design, user engagement, and behavior change techniques employed.

Objective

This study evaluates the effectiveness of the 12-week multimodal web-based TKFitnessCoach. The PA online program is part of the TK-HealthCoach. This study investigates the program's impact on self-reported PA levels, goal attainment, healthrelated quality of life, body weight, and eating behavior, comparing an interactive personalized web-based intervention and non-interactive web-based health information.

Methods

In a randomized controlled trial (RCT), participants were allocated to either the intervention group (IG), receiving access to the interactive TK-FitnessCoach, or the control group (CG) that was provided a static website with evidence-based information on PA. The study targeted a German-speaking adult population interested in improving health behavior. Data was assessed at T0 (beginning of the study), T1 (postintervention), T2, 6 months, and T3, 12 months follow-ups, focusing on self-reported PA at T3 and on various secondary outcomes.

Results

We achieved equally distributed sociodemographics in both the IG and the CG with a mean age of 42.8 (IG), resp. 43.1 years (CG), and female participants of 76.1 % (IG), resp. 74.7 % (CG). PA at baseline was 277.9 min/week in the IG and 273.3 min/week in the CG. Both, the IG (n = 1153 in the Intention-to-treat (ITT) dataset) and CG (n = 1177 in the ITT dataset) exhibited significant increases in PA over time (IG(T3-T0) = 72.92 min/week; CG(T3-T0) = 74.12 min/week).However, the study did not find significant differences in the effectiveness of the interactive TK-FitnessCoach compared to the non-interactive control in terms of improving PA and related health outcomes. The intensity of using the TK-FitnessCoach was not associated with PA.

Conclusions

Both programs were effective in promoting PA among adults, with no significant differences observed between the two RCT groups. This highlights the potential of digital interventions in addressing physical inactivity, suggesting that the effectiveness of such programs may not solely depend on their interactivity but also on the quality and relevance of the information provided. Further research is needed to explore optimization strategies for such interventions, especially for persons with low PA, including user engagement, behavior change techniques, and the integration of objective PA tracking methods.

Trial registration

German Clinical Trials Register DRKS00020249; https://drks.de/search/en/trial/DRKS00020249.

Temporal Relationship between HbA1c and Depressive Symptom Trajectories in a Longitudinal Cohort Study: The Mediating Role of Healthy Lifestyles

This study analyzed China Health and Retirement Longitudinal Study data to explore the HbA1c-depression link, including depressive trajectories, while considering the mitigating impact of healthy lifestyles. Cross-lagged panel models and group-based trajectory modeling were performed to investigate the temporal relationship between HbA1c levels and depressive symptoms, as well as the depressive trajectories. Structural equation models were used to assess the mediating effects of healthy lifestyles. The mean age of the participants was 57.66 ± 9.04 years, with 53.68% being female. Analyzing 8826 participants across three waves, we observed a significant prediction of subsequent depressive symptoms by the preceding HbA1c levels (β = 0.296; p < 0.001). Four distinct trajectories of depressive symptoms were distinguished: stable low, stable moderate, increasing, and stable high. Elevated HbA1c levels were associated with a higher risk of developing stable high (OR 1.12 and 95% CI 1.02-1.23), increasing (OR 1.21 and 95% CI 1.11-1.32), and stable moderate depressive symptoms (OR 1.07 and 95% CI 1.01-1.13). Engaging in two healthy life behaviors reduced stable high and increasing depressive pattern risks by 32% and 30%, respectively. Adherence to a healthy lifestyle lessened 7.2% of the impact of high HbA1c levels on the subsequent depressive symptoms. These findings highlight the potential benefits of incorporating adequate sleep and light physical activities, which might reduce the adverse impact of elevated HbA1c levels on depressive symptoms.

The mediating effect of 24-h time-use behaviors on the relationship between depression and mortality: A compositional mediation analysis for survival outcomes

BACKGROUND

A compositional mediation model of survival outcomes was established to explore whether 24-h time-use behaviors mediate the relationship between depression and mortality.

METHODS

4137 adults from the National Health and Nutrition Examination Survey (NHANES 2005-2006) were followed up to 2019. Cox proportional hazards regression model was used to estimate the total effect of depression on mortality. Compositional data analysis was used to examine the relationship between 24-h time-use compositions and mortality. Furthermore, we constructed a compositional mediation model for survival outcomes to investigate the mediating effect of 24-h time-use behaviors on depression and mortality.

RESULTS

Compared with participants without depression, depressive patients had a significantly higher risk of overall mortality (HR = 1.49, 95 % CI: 1.25,1.79), cardiovascular disease -specific mortality (HR =1.89, 95 % CI: (1.37,2.63)) and mortality from causes other than cardiovascular disease or cancer (HR = 1.62, 95 % CI: (1.25,2.08)). Physical activity, especially moderate-to-vigorous physical activity, significantly mediated the relationship between depression and all-cause and CVD-specific mortality.

LIMITATIONS

Despite being a cohort study, the exposure and mediatiors were measured at the baseline. Further research is necessary to require a temporal order between the exposure and mediating variables.

CONCLUSIONS

Our findings indicate that 24-h time-use behaviors link depression to mortality. In particular, increasing the time spent on physical activity can reduce the risk of death in patients with depression. This finding provides potential interventions for reducing the risk of death in patients with depression.

Associations between 24-h movement behaviors and indicators of mental health and well-being across the lifespan: a systematic review

Researchers have adopted a variety of analytical techniques to examine the collective influence of 24-h movement behaviors (i.e., physical activity, sedentary behaviors, sleep) on mental health, but efforts to synthesize this growing body of literature have been limited to studies of children and youth. This systematic review investigated how combinations of 24-h movement behaviors relate to indicators of mental ill-being and well-being across the lifespan. A systematic search of MEDLINE, PsycINFO, Embase, and SPORTDiscus was conducted. Studies were included if they reported all three movement behaviors; an indicator of mental ill-being or well-being; and were published in English after January 2009. Samples of both clinical and non-clinical populations were included. A total of 73 studies (n = 58 cross-sectional; n = 15 longitudinal) met our inclusion criteria, of which 47 investigated children/youth and 26 investigated adults. Seven analytical approaches were used: guideline adherence (total and specific combinations), movement compositions, isotemporal substitution, profile/cluster analyses, the Goldilocks method and rest-activity rhythmicity. More associations were reported for indicators of mental ill-being (n = 127 for children/youth; n = 53 for adults) than well-being (n = 54 for children/youth; n = 26 for adults). Across the lifespan, favorable benefits were most consistently observed for indicators of mental well-being and ill-being when all three components of the 24-h movement guidelines were met. Movement compositions were more often associated with indicators of mental health for children and youth than adults. Beneficial associations were consistently observed for indicators of mental health when sedentary behavior was replaced with sleep or physical activity. Other analytic approaches indicated that engaging in healthier and more consistent patterns of movement behaviors (emphasizing adequate sleep, maximizing physical activity, minimizing sedentary behaviors) were associated with better mental health. Favorable associations were reported less often in longitudinal studies. Collectively, these findings provide further support for adopting an integrative whole day approach to promote mental well-being and prevent and manage mental ill-being over the status quo of focusing on these behaviors in isolation. This literature, however, is still emerging-for adults in particular-and more longitudinal work is required to make stronger inferences.

The association between reallocations of time and health using compositional data analysis: a systematic scoping review with an interactive data exploration interface

BACKGROUND

How time is allocated influences health. However, any increase in time allocated to one behaviour must be offset by a decrease in others. Recently, studies have used compositional data analysis (CoDA) to estimate the associations with health when reallocating time between different behaviours. The aim of this scoping review was to provide an overview of studies that have used CoDA to model how reallocating time between different time-use components is associated with health.

METHODS

A systematic search of four electronic databases (MEDLINE, Embase, Scopus, SPORTDiscus) was conducted in October 2022. Studies were eligible if they used CoDA to examine the associations of time reallocations and health. Reallocations were considered between movement behaviours (sedentary behaviour (SB), light physical activity (LPA), moderate-to-vigorous physical activity (MVPA)) or various activities of daily living (screen time, work, household chores etc.). The review considered all populations, including clinical populations, as well as all health-related outcomes.

RESULTS

One hundred and three studies were included. Adiposity was the most commonly studied health outcome (n = 41). Most studies (n = 75) reported reallocations amongst daily sleep, SB, LPA and MVPA. While other studies reported reallocations amongst sub-compositions of these (work MVPA vs. leisure MVPA), activity types determined by recall (screen time, household chores, passive transport etc.) or bouted behaviours (short vs. long bouts of SB). In general, when considering cross-sectional results, reallocating time to MVPA from any behaviour(s) was favourably associated with health and reallocating time away from MVPA to any behaviour(s) was unfavourably associated with health. Some beneficial associations were seen when reallocating time from SB to both LPA and sleep; however, the strength of the association was much lower than for any reallocations involving MVPA. However, there were many null findings. Notably, most of the longitudinal studies found no associations between reallocations of time and health. Some evidence also suggested the context of behaviours was important, with reallocations of leisure time toward MVPA having a stronger favourable association for health than reallocating work time towards MVPA.

CONCLUSIONS

Evidence suggests that reallocating time towards MVPA from any behaviour(s) has the strongest favourable association with health, and reallocating time away from MVPA toward any behaviour(s) has the strongest unfavourable association with health. Future studies should use longitudinal and experimental study designs, and for a wider range of outcomes.

Mediterranean-Style Diet and Other Determinants of Well-Being in Omnivorous, Vegetarian, and Vegan Women

Due to the lack of studies comparing the determinants of well-being in omnivores and vegetarians, we examined associations of socio-demographic and lifestyle factors, including adherence to a Mediterranean-style diet, in relation to well-being in omnivorous, vegetarian, and vegan women. Well-being was assessed using a validated WHO-5 Well-Being Index. Adherence to the Mediterranean-style diet was determined using a modified Mediterranean diet score. The study was conducted on 636 women (23.9 ± 5.7 years), of whom 47.3% were omnivores, 33.2% vegetarians, and 19.5% vegans. The good well-being group (WHO-5 Index ≥ 13 points) comprised 30.9% of the omnivores, 46.0% of the vegetarians, and 57.3% of the vegans. The remaining participants were classified as belonging to the poor well-being group (<13 points). Compared to the omnivores, the vegetarians and vegans had a 1.6-fold (95% CI: 1.04-2.42) and a 2.4-fold (95% CI: 1.45-3.99) higher probability of having good well-being, respectively. In omnivores, the predictors of good well-being were adherence to the Mediterranean-style diet (a 1-score increment was associated with a 17% higher probability of good well-being, P-trend = 0.016), higher self-perceived health status, and lower levels of stress. In vegetarians and vegans, it was older age, higher physical activity (≥3 h/week), 7-8 h sleep time, and similarly to omnivores' higher self-perceived health status and lower stress level. Our findings indicate that following a Mediterranean-style diet was associated with better well-being in omnivores. Furthermore, we identified that different determinants were associated with well-being in omnivorous and vegetarian and vegan women.