Associations between aerobic and muscle-strengthening exercise with depressive symptom severity among 17,839 U.S. adults

Impact of leisure physical activity and resistance exercise on the prevalence of depressive symptoms in Korean adults: Analysis of the Korean National Health and Nutrition Examination Survey

BACKGROUND

Various physical activity (PA) guidelines recommend leisure PA and resistance exercise (RE). However, the impact of PA and RE on the prevalence of depressive symptoms remains unclear. We investigated whether meeting PA and RE guidelines is associated with the prevalence of depressive symptoms using nationally representative samples.

METHODS

We analyzed data from 11,829 (5111 male and 6718 female) participants aged 19+ years in the Korean National Health and Nutrition Examination Survey (2016 and 2018). Those with doctor's diagnosis of depression or with a cut-off score of ≥11 on the Patient Health Questionnaire-9 were defined as having depressive symptoms. PA and RE were measured using a validated Global PA Questionnaire. Logistic regression analysis was used to examine the association between participating in leisure PA, simultaneously meeting RE guidelines, and experiencing depressive symptoms.

RESULTS

Those who participated in leisure PA and met RE guidelines had a lower prevalence of depressive symptoms than those who did not (p for trend <0.001). After adjusting for covariates, those who participated in leisure PA and met RE guideline were significantly less likely to have depressive symptoms in male (OR = 0.52, 95 % CI 0.32-0.84) and female (OR = 0.71, 95 % CI 0.48-1.06), compared with those who did not participate in leisure PA but also did not meet RE guideline.

LIMITATIONS

The cross-sectional nature of the data prevented causal claims.

CONCLUSIONS

Participation in leisure PA and RE was associated with a lower prevalence of depressive symptoms. This suggests both leisure PA and RE should be encouraged as effective means for preventing depression.

Incorporating Physical Activity Assessments and Behavior Change Techniques Into Geriatrics

Ninety-one percent of adults 65 years and older do not perform the recommended levels of physical activity (PA), resulting in increased risk of disability, morbidity, and mortality. Despite knowing the benefits of PA and acknowledging the importance of assessing and addressing inadequate PA levels, 50%-75% of health care providers do not incorporate behavior change techniques into clinical practice. This clinical gap can be explained by a lack of knowledge or confidence in (1) assessing PA levels; (2) addressing inadequate PA levels; and (3) justifying the time needed to use these techniques in clinical practice. In this special communication, we address this gap by providing a 3-step theoretical-based clinical decision pathway that guides health care providers on how to identify older adults with inadequate PA levels, determine readiness to increase PA, and empower patents to develop an action plan that will increase their PA levels. We also provide a conceptual model that supports the use of techniques that assess and address inadequate PA by tying PA to the Age-Friendly Health System's 4Ms (ie, What Matters to the older adult, Mentation, Mobility, and Medications).

Online Circuit Training Increases Adherence to Physical Activity: A Randomized Controlled Trial of Men with Obesity

PURPOSE

This study aimed to examine adherence to the weekly physical activity guidelines (≥150 min of aerobic activities at moderate-to-vigorous intensity and two or more sessions of strength training (yes or no)) and health outcomes during the COVID-19 pandemic for men living with obesity, 46 wk after being offered an online muscle-strengthening circuit program for 12 wk.

METHODS

Sixty men (age ≥19 yr) living with obesity (body fat percentage ≥25%) were randomly assigned to the intervention group ( n = 30) or the control condition ( n = 30) for 12 wk. The intervention group was offered an online circuit training, three sessions per week, whereas the control group received a website helping them to reach the physical activity guidelines. Adherence to the weekly physical activity guidelines was evaluated 46 wk after enrolling in the program using a heart rate tracker (Fitbit Charge 3) and an exercise log. Health outcomes (e.g., anthropometrics, body composition) were measured at baseline and after 12, 24, and 46 wk.

RESULTS

The intervention group had higher adherence to physical activity guidelines at 46 wk (36.8%) than the control group (5.3%; P = 0.02). However, no difference in health outcomes was observed between participants in the intervention group compared with the control group after 12, 24, and 46 wk.

CONCLUSIONS

Increasing adherence to exercise in men living with obesity is challenging. The proposed program increased adherence to the physical activity guidelines after about a year for men living with obesity; however, more studies are needed to understand how to improve health outcomes when following an online delivery exercise program in this population.

Effect of exercise intervention on depression in children and adolescents: A systematic review and network meta-analysis

OBJECTIVES

To evaluate the effect of different exercise interventions on depressive symptoms in children and adolescents.

METHODS

Randomized controlled trials (RCT) published until May 2023 were screened in four databases. The Cochrane collaboration tool was used to assess the risk of bias for quality evaluation. Stata 16.0 software was used for both a pairwise meta-analysis and a series of frequentist network meta-analyses (NMA).

RESULTS

A total of 35 RCTs and 5393 participants were included. Aerobic exercise had the most significant effect on depressive symptoms (66.2 %), followed by group training (62.5 %), resistance exercise (59.0 %), and aerobic combined with resistance exercise (57.9 %). Furthermore, children and adolescents younger than 15 years showed significant improvement in depressive symptoms (SMD = -0.41, 95 % CI (-0.63, -0.19), P < 0.01). The study also found a significant improvement in depression among healthy, obesity, and depressed populations (SMD = -0.25, 95 % CI (-0.41, -0.08), P < 0.01); SMD = -0.15, 95 % CI (-0.31, -0.00), P < 0.01; SMD = -0.75, 95 % CI (-1.32, -0.19), P < 0.01). Additionally, 30 min of exercise had a significant effect (SMD = -0.14, 95 % CI (-0,81, -0.01), P < 0.01), and 40-50 min of exercise had the best effect (SMD = -0.17, 95 % CI (-0,33, -0.02), P < 0.01). Lastly, exercise frequency of three times per week was significant in children and adolescents (SMD = -0.42, 95 % CI (-0,66, -0.18), P < 0.01).

CONCLUSION

Exercise significantly improves depressive symptoms in children and adolescents, with aerobic exercise having the most significant effect. A 12-week, three-times-a-week, 40-50-min exercise intervention was found to be more effective in younger children and adolescents.

Effect of exercise intervention on depression in children and adolescents: a systematic review and network meta-analysis

OBJECTIVES

To evaluate the effect of different exercise interventions on depressive symptoms in children and adolescents.

METHODS

Randomized controlled trials (RCT) published until May 2023 were screened in four databases. The Cochrane collaboration tool was used to assess the risk of bias for quality evaluation. Stata 16.0 software was used for both a pairwise meta-analysis and a series of frequentist network meta-analyses (NMA).

RESULTS

A total of 35 RCTs and 5393 participants were included. Aerobic exercise had the most significant effect on depressive symptoms (66.2%), followed by group training (62.5%), resistance exercise (59.0%), and aerobic combined with resistance exercise (57.9%). Furthermore, children and adolescents younger than 15 years showed significant improvement in depressive symptoms (SMD=-0.41, 95% CI (-0.63, -0.19), P < 0.01). The study also found a significant improvement in depression among healthy, obesity, and depressed populations (SMD=-0.25, 95% CI (-0.41, -0.08), P < 0.01); SMD=-0.15, 95% CI (-0.31, -0.00), P < 0.01; SMD=-0.75, 95% CI (-1.32, -0.19), P < 0.01). Additionally, 30 min of exercise had a significant effect (SMD=-0.14, 95% CI (-0,81, -0.01), P < 0.01), and 40-50 min of exercise had the best effect (SMD=-0.17, 95% CI (-0,33, -0.02), P < 0.01). Lastly, exercise frequency of three times per week was significant in children and adolescents (SMD=-0.42, 95% CI (-0,66, -0.18), P < 0.01).

CONCLUSION

Exercise significantly improves depressive symptoms in children and adolescents, with aerobic exercise having the most significant effect. A 12-week, three-times-a-week, 40-50-minute exercise intervention was found to be more effective in younger children and adolescents.

Association Between Depressed Mood Changes and Physical Activity Among Adolescents Post COVID-19 Pandemic

Objectives

Following the coronavirus disease 2019 (COVID-19) pandemic, adolescents have experienced decreased physical activity and a decline in mental health. This study analyzed the association between changes in depressed mood after the COVID-19 pandemic and physical activity among adolescents.

Methods

The analysis was based on the results of the 17th Youth Health Behavior Online Survey conducted in 2021, which included 54848 middle and high school students in South Korea. Information on physical activity included low-intensity physical activity lasting >60 min/day, high-intensity physical activity, and strength training exercises. A logistic regression analysis was performed to evaluate the association between physical activity and changes in depression after the COVID-19 pandemic.

Results

After adjusting for sociodemographic characteristics and previous depression, adolescents who performed strength training exercises more than once per week had a 0.95-fold lower risk (odds ratio [OR]=0.948, 95% confidence interval [CI]=0.905-0.994, p= 0.027) of increasing depression after the COVID-19 pandemic, while the risk of decreasing depression increased by 1.22-fold (OR=1.215, 95% CI=1.131-1.305, p<0.001). The results were not significant for low-intensity physical activity for >60 min/day and high-intensity physical activity.

Conclusion

Strength-training exercises are significantly associated with the prevention of depression among adolescents following the COVID-19 pandemic.

Resistance Training Behavior Is Enhanced With Digital Behavior Change Coaching: A Randomized Controlled Trial With Novice Adults

BACKGROUND

Approximately a third of US adults meet the physical activity guidelines of engaging in resistance training 2 times per week, yet few studies have examined how to increase participation rates. The present randomized control trial compared a remotely delivered coaching intervention with an education only control group.

METHODS

Eligible participants completed 2 remotely delivered Zoom-based personal training sessions during a 1-week run-in period. Participants randomized to the intervention group received synchronous weekly behavioral video coaching sessions over Zoom, whereas the control group received no further contact. Days of resistance training completed were assessed at baseline (pre), 4 weeks (post), and 8 weeks (follow-up). Linear mixed models were used to examine group differences at each time point and within-group differences over time.

RESULTS

There were significant between-group differences favoring the intervention, at posttest for both the previous week (b = 0.71, SE = 0.23; P = .002) and the previous 4 weeks (b = 2.54, SE = 0.87; P = .003) but not at the follow-up period for either the last week (b = 0.15, SE = 0.23; P = .520) or the last 4 weeks (b = 0.68, SE = 0.88; P = .443).

CONCLUSION

The present study showed that by providing participants with equipment, skill, and in the case of the intervention group, a remote coaching intervention, resistance training participation increased.

Comparison of Functional Outcomes between Supervised Rehabilitation and Telerehabilitation in Female Patients with Patellofemoral Pain Syndrome during the COVID-19 Pandemic

Patellofemoral pain syndrome (PFPS) is a common cause of anterior knee pain, and therapeutic exercises are recommended. During the COVID-19 pandemic, despite recommendations on the importance of telerehabilitation, insufficient studies have investigated functional outcomes between supervised rehabilitation and telerehabilitation in patients with PFPS. This study aimed to compare the muscle strength, muscle activation time, and patient-reported outcomes between supervised rehabilitation and telerehabilitation in female patients with PFPS. A total of 61 patients (supervised, n = 30; telerehabilitation, n = 31) participated. Muscle strength and activation time of the quadriceps and hamstrings were measured using an isokinetic device. Hip muscle strength was evaluated using a hand-held dynamometer. Patient-reported outcomes were measured using the visual analog scale (VAS) for pain, Kujala Anterior Knee Pain Scale (AKPS) for functional ability, and Tampa scale for kinesiophobia (TSK-11). No significant differences were found in muscle strength, muscle activation time, or patient-reported outcomes of the involved knees between the two groups (p > 0.05). In addition, the rate of change in all parameters did not significantly differ between the two groups (p > 0.05). Telerehabilitation, such as a home-exercise program supervised by physical therapists, may be as effective as supervised rehabilitation in improving functional outcomes in female patients with PFPS.

Does wing use and disuse cause behavioural and musculoskeletal changes in domestic fowl (Gallus gallus domesticus)?

Domestic chickens may live in environments which restrict wing muscle usage. Notably, reduced wing activity and accompanying muscle weakness are hypothesized risk factors for keel bone fractures and deviations. We used radio-frequency identification (RFID) to measure duration spent at elevated resources (feeders, nest-boxes), ultrasonography to measure muscle thickness (breast and lower leg) changes, radiography and palpation to determine fractures and deviations, respectively, following no, partial (one-sided wing sling) and full (cage) immobilization in white- and brown-feathered birds. We hypothesized partially immobilized hens would reduce elevated resource usage and that both immobilization groups would show decreased pectoralis thickness (disuse) and increased prevalence of fractures and deviations. Elevated nest-box usage was 42% lower following five weeks of partial immobilization for brown-feathered hens but no change in resource usage in white-feathered birds was observed. Fully immobilized, white-feathered hens showed a 17% reduction in pectoralis thickness, while the brown-feathered counterparts showed no change. Lastly, fractures and deviations were not affected in either strain or form of wing immobilization; however, overall low numbers of birds presented with these issues. Altogether, this study shows a profound difference between white- and brown-feathered hens in response to wing immobilization and associated muscle physiology.

A Trend Analysis of Adherence to the Muscle Strengthening Exercise Guidelines in US Adolescents

Objectives: This study aimed to describe the trends of the muscle-strengthening exercise (MSE) guidelines adherence in adolescents and factors associated with the adherence. Methods: Using the Youth Risk Behavioural Survey data, this study assessed the trends of adhering to the MSE guidelines in adolescents. The survey-year-based trends of MSE guidelines adherence was assessed with logistic regression. Binary logistic regression was used to identify the correlates (i.e., sex, grade, race/ethnicity) of the guidelines' adherence. Results: 73,074 study participants (female = 36,497, male = 36,108; mean age = 16.04 years) were included for analysis. An overall declining trend of the MSE guidelines in adolescents was found (55.6% in 2011 → 49.5% in 2019, p < 0.001), and similar trends were observed in both sexes. The declining trends varied by sociodemographic factors (e.g., grade). Boys and younger adolescents were more likely to adhere to the MSE guidelines. Conclusion: The declining trend of adhering to MSE guidelines in US adolescents would be a health concern in this population. Girls and older adolescents should be targeted as intervention priorities.

Associations of muscle-strengthening exercise with overweight, obesity, and depressive symptoms in adolescents: Findings from 2019 Youth Risk Behavior Surveillance system

Background

Previous studies have focused on the opposite relation between muscle strength, obesity, and depression in adults. Moreover, the evidence has indicated that obesity and depression in adults might be significantly decreased with Muscle Strength Exercise (MSE) albeit it might be insufficient. Therefore, the current study aimed to investigate the association between MSE, adiposity, and depression among United States adolescents.

Materials and methods

This cross-sectional study used the Youth Risk Behavioral Survey (YRBS) data. In YRBS, a cluster sample was used, and the investigation was divided into three stages. The study surveyed 13,677 high school students and conducted self-reported questionnaires on sex, grade, race/ethnicity, MSE days, overweight, obesity, and depressive symptoms. The study got the nationally representative population of American students in Grade 9 to 12 (around 12–18 years).

Results

A total of 13,677 participants (female = 6,885, male = 6641) were included in the final analysis. The participants meeting the guidelines’ requirements seemed more likely to be obese than those not meeting (OR = 1.28, 95% CI = 1.06–1.55). There was no statistical significance in the relations between the MSE guidelines and overweight and depression (OR = 0.86, 95% CI = 0.73–1.01: OR = 0.94, 95% CI = 0.83–1.06). For all the participants, the prevalence of those conforming to MSE was 30.1%. One-fifth of the participants reported no MSE per week, 7.8% reported 3 days of MSE per week, and 7.7% reported 7 days.

Conclusion

The main finding of this study indicated a positive relationship between the normative MSE required in guidelines and low-level obesity. Beyond that, the evidence was insufficient to confirm the positive links between MSE and depression among American adolescents. Our study could offer evidence for future MSE interventions in adolescents.

Muscle-strengthening exercise and positive mental health in children and adolescents: An urban survey study

Background

Much evidence has indicated that physical activity is associated with mental health benefits, such as fewer depression symptoms. Psychological resilience captures a broader mental health phenomenon that may be influenced by other factors as well. Yet, there are few studies examining the association between muscle-strengthening exercises (MSEs) with mental health outcomes, especially positive outcomes (e.g., subjective wellbeing). The study aimed to test the association between MSE with subjective wellbeing and resilience among a large sample of Chinese adolescents.

Materials and methods

A cross-sectional study was conducted among primary and middle school students in Shenzhen, China. MSE frequency, subjective wellbeing, and resilience were measured. Data from a total of 67,281 children and adolescents aged 10–17 years (51.9% men and 48.1% women) were included in the analysis. Mixed effect models were performed to assess how weekly MSE frequency (0–7 days) related to the levels of subjective wellbeing and resilience, adjusting for potential confounding variables (e.g., sex and grade). Sensitivity analyses were also conducted.

Results

Compared to participants with no MSE, the levels of subjective wellbeing were higher in those with higher MSE frequencies [range of β: 0.29 (1 day per week) to 1.98 (7 days per week)]. The frequency of MSE was also positively correlated to better resilience [range of β: 0.50 (1 day per week) to 4.40 (7 days per week)]. All associations remained significant in sensitivity analyses.

Conclusion

More frequent MSE was associated with superior subjective wellbeing and resilience of Chinese children and adolescents. Increasing MSE may be beneficial for promoting positive mental health outcomes among children and adolescents.

Mental Health and Physical Activity of Female Higher Education Students during the COVID-19 Pandemic: A Comparative Cross-Sectional Study from Lithuania

During emerging adulthood (EA), higher education medical students undergo a higher risk of anxiety and depression compared to the general population. The aim of this comparative cross-sectional study was to compare the proportions of three mental disorders, namely anxiety, depression and somatisation in terms of their symptoms and self-reported physical activity (PA) levels across the cohorts of biomedical and non-biomedical female students as well as to assess the association between the mental health outcomes and PA use. Between September 2021 and January 2022, a total of 1231 female higher education students aged between 18 and 29 years old were recruited for the study. Severe symptoms of anxiety and depression, as well as unexplained somatic complaints, were suffered by 51.9%, 11% and 23% of female students, respectively. Non-biomedical female students, compared to medicine and health sciences students, were more vulnerable due to the increased prevalence of negative mental health outcomes. The relationship between increased sports activity as a potential trigger for mental well-being and decreased severity of depressive symptoms was identified in the cohorts of both biomedical (adjusted odd ratio (OR_adj) 0.4; 95% confidence interval (CI): 0.1-1.0) and non-biomedical (OR_adj 0.4; 95% CI: 0.2-0.9) female students. The current research highlights the importance of increasing sports activity by involving students in regular physical exercise of specific types for decreasing the severity of depressive symptoms in student-aged female populations.

Aerobic or Muscle-Strengthening Physical Activity: Which Is Better for Health?

ABSTRACT

The Physical Activity Guidelines recommend performing 150 min of moderate- to vigorous-intensity aerobic physical activity (MVPA) per week. These guidelines also recommend muscle-strengthening physical activity (MSPA) on ≥2 d·wk-1 for additional benefits including muscular fitness and bone health. The majority of the scientific evidence supporting the PA recommendations for health comes from studies of MVPA while the possible contributions of MSPA in these findings have been overlooked historically. Emerging evidence suggests that MSPA can independently protect against major cardiometabolic risk factors, chronic diseases, and mortality. Additional data from clinical trials indicate that many of the well-known health benefits of exercise, like improvements in cardiovascular disease risk factors, are more robust with combined MVPA and MSPA. This review will clarify the relative benefits of MSPA versus MVPA on health-related outcomes to determine the best type of PA for health.

Association between Walking Habit and Physical Frailty among Community-Dwelling Older Adults

The aim of this cross-sectional study was to determine whether older adults who practice walking have a lower risk of physical frailty than those who do not. The study subjects were 846 older adults and were not certified as needing support or nursing care. The subjects were classified as being physically frail or pre-frail or being robust, according to the revision of the Cardiovascular Health Study criteria. We classified the subjects by questionnaire into a no-exercise group, walking-only group, walking plus other exercise group, and exercise other than walking group. In logistic regression analyses, the odds ratio (OR) and 95% confidence interval (95%CI) were shown. Compared to the no-exercise group, the OR (95%CI) for physical frailty was 0.85 (0.48–1.49) for the walking-only group, 0.54 (0.36–0.83) for the walking plus other exercise group, and 0.67 (0.47–0.97) for the exercise other than walking group. In the components of physical frailty, the walking plus other exercise group and the exercise other than group had significantly lower ORs for exhaustion. Older adults who only practiced walking as an exercise do not have lower risks of physical frailty and pre-frailty. Older adults who combine walking with other exercises or practice non-walking exercises have lower risks of them.

Increases in Muscle-Strengthening Activities Among Latinas in Seamos Saludables

BACKGROUND

Only 17% of Latinas meet national physical activity (PA) guidelines for both moderate-to-vigorous aerobic and muscle-strengthening PA. Additional health benefits are derived from the combination of aerobic and muscle-strengthening PA (vs. aerobic alone), yet there is paucity in research on muscle-strengthening activity in Latinas. The aim of this study was to examine changes in muscle-strengthening activity from baseline to 6 and 12 months in Seamos Saludables, a 12-month PA randomized controlled trial for Latinas.

METHODS

A secondary data analysis was conducted among 131 Latinas ages 18-65 years, who were randomized to either a PA Intervention or a Wellness Control. Self-reported muscle-strengthening exercise was measured at baseline, 6 months, and 12 months via adapted muscle-strengthening questions from the Behavioral Risk Factor Surveillance System.

RESULTS

There was a 16-minute/week difference in median minute/week of muscle-strengthening activity between Intervention and Wellness at 6 months (SE = 7.91, p = .04) and 45-minute/week difference at 12 months (SE = 25.80, p = .06) adjusting for baseline. Significantly more PA Intervention participants met muscle-strengthening guidelines of 2 or more days/week at 6 months versus Wellness Control participants (odds ratio [OR] = 4.29, 95% confidence interval [CI] = [1.03, 17.84]).

CONCLUSION

Results from the current study showed that Latinas engaged in muscle-strengthening activity in an intervention that emphasized primarily aerobic PA outcomes, suggesting they may be interested in engaging in muscle-strengthening activities. Future interventions targeting both aerobic and muscle-strengthening activity could achieve greater health improvements and help more Latinas reach the full national PA guidelines.ClinicalTrials.gov Identifier. NCT01583140.

Do Adults Who Practice Aerobic Physical Activities Have Different Influencing Factors for Depression: A Secondary Data Analysis

Practice in aerobic activities can positively impact depression. This study aimed to identify differences between adults who do and do not practice aerobic activities in terms of general, physical, and psychological factors that influence depression. This study comprised a secondary analysis of data from the 6th (year 2) and 7th (years 1, 3) editions of the Korea National Health and Nutrition Examination Survey. Data from 12,891 adults were analyzed, of whom 7148 reported no practice in aerobic physical activities and 5743 reported practicing such activities. Data were analyzed using SPSS 25. Among those who did not perform aerobic activities, gender, family income, marital status, obesity, frequency of drinking, subjective health, subjective body weight, and stress were found to influence the level of depression. For those who practiced aerobic activities, gender, age, family income, education level, marital status, blood pressure, hypercholesterolemia status, frequency of drinking, subjective health, subjective body weight, and stress influenced the level of depression. This study found that the factors affecting depressive symptoms differ depending on whether individuals practice aerobic activities. Thus, to reduce depressive symptoms among adults, it is necessary to consider their level of physical activity and target the influencing factors associated with this level.

Integrating physical activity into the treatment of depression in adults: A qualitative enquiry

Around 246 million people globally suffer from depression. Physical activity (PA) can reduce the risk of depression by 30% and is recognised as an effective treatment for mild-to-moderate depression (MMD). However, a high proportion of patients with MMD are currently inactive and the implementation of PA as an adherent treatment for MMD is not well understood. This study contributes to a growing body of research exploring how to support people who are experiencing MMD to increase their PA levels (i.e. initiation and maintenance). It investigated which factors individuals with MMD perceived to be important for integrating PA into the treatment of depression in adults. In-depth interviews were carried out with individuals with MMD (N = 6), and data were analysed using thematic analysis. Two main theories of social capital that of Bourdieu and Putnam informed the discussion of findings. The initiation and maintenance of PA were linked to individual factors including health (i.e. nature of depression; comorbidities); abilities and tastes; socioeconomic status (e.g. financial position) and positive encouragement. In addition, maintenance emerged as dependent upon the choice, enjoyment, and meaningfulness of PA itself, and, for those who engaged in group PA, on social capital. PA interventions need to be personalised. This goes beyond a simple exercise prescription based on functional ability, but instead takes into account the needs, desires and capabilities of the whole person. The nature of MMD, the wider physical and socio-economic context and the social capital that is available to the individual also need to be harnessed.

Physical Activity Trends in Korean Adults from Korea National Health and Nutritional Examination Survey from 2014 to 2019

The current study aimed to examine the adherence trend for aerobic and muscle-strengthening physical activity (PA) guidelines among Korean adults using the Korea National Health and Nutritional Examination Survey from 2014 to 2019. Korean adults (N = 2642) were included in the current study to examine the trend of PA adherence from 2014 to 2019. The PA guidelines are: (a) aerobic activity (a minimum of 150 min moderate to vigorous PA weekly) and (b) muscle-strengthening activity (a minimum of two days weekly). Self-report questionnaires in the survey measured both activities. The adherence to PA guidelines by survey year was examined using a multivariable logistic regression analysis adjusted for covariates. There was a significant decreasing trend in which the adherence rate to aerobic PA guidelines changed from 57.0% in 2014 to 45.6% in 2019 (p < 0.001). On the other hand, the trend in adherence rate to muscle-strengthening activity was not significant (p = 0.976). The adherence rate to muscle-strengthening activity guideline was slightly increased but still low from 20.8% to 23.3% during 2014−2019. The aerobic PA guidelines are significantly decreasing, and more than half of the Korean adults in 2019 have not followed the guidelines. In addition, there has been a slight increase in muscle-strengthening activity; however, the adherence rate is meager. Therefore, this study suggests that Korean adults’ aerobic and muscle-strengthening PA participation is necessary for their low adherence rate and decline tendency.

Resistance training for Black men with depressive symptoms: a pilot randomized controlled trial to assess acceptability, feasibility, and preliminary efficacy

BACKGROUND

Depression is under-recognized in Black men, who are less likely to seek or have access to psychiatric treatment. Resistance training (RT; i.e., weight lifting) can improve depressive symptoms and may be more acceptable to Black men, but its effects have not been examined for Black men with depressive symptoms.

METHODS

Fifty Black men with depressive symptoms were randomized to either (a) 12 weeks of RT (coupled with Behavioral Activation techniques to promote adherence) or (b) an attention-control group (Health, Wellness, and Education; HWE). Both groups met twice/week for 12 weeks, and follow-up assessments were done at end-of-treatment (EOT) and 6 months after enrollment. Changes in physical activity and muscular strength were collected as a manipulation check. The primary outcome was interviewer assessed symptoms of depression using the Quick Inventory of Depression Symptomology (QIDS). Secondary outcomes included self-reported depressive symptoms, anxiety, and stress. The association between change in QIDS from baseline to EOT and concurrent changes in physical activity and muscular strength in the RT group were explored as an initial assessment of mechanism. Longitudinal mixed effects regression models with subject-specific intercepts were used to examine intervention effects.

RESULTS

A sample with high rates of medical comorbidities (e.g., 44% HIV positive), substance use (e.g., 34% smoking), and negative social determinates of health (e.g., 50% unemployed) was enrolled. Recruitment, engagement, and retention data indicate that the intervention and design were feasible. The RT group showed greater gains in self-reported exercise (b = 270.94, SE = 105.69, p = .01) and muscular strength (b = 11.71, SE = 4.23, p = .01 for upper body and b = 4.24, SE = 2.02, p = .04 for lower body) than the HWE group. The RT group had greater reductions in QIDS scores at both EOT (b = -3.00, SE = 1.34, p = .01) and 6 months (b = -2.63, SE = 1.81, p = .04). The RT group showed a greater reduction in anxiety at EOT (b = -2.67, SE = 1.06, p = .02). Findings regarding self-reported depressive symptoms and stress were non-significant, but in the expected direction with effect sizes in the small to medium range. In the RT group, improvement on the QIDS between baseline and EOT was associated with concurrent improvements in physical activity (b = 21.03, SE = 11.16, p = .02) and muscular strength (b = 1.27, SE = .44, p = .03 for upper body and b = .75, SE = .14, p = .03 for lower body).

CONCLUSIONS

Results suggest that RT is feasible and may be efficacious for reducing depressive symptoms among underserved urban Black men.

TRIAL REGISTRATION

ClinicalTrial.gov #: NCT03107039 (Registered 11/04/2017).

Health-Enhancing Physical Activity in Europe-Combined Aerobic Physical Activity and Muscle-Strengthening Exercise Guideline Adherence Among 280,605 Adults From 28 European Countries

BACKGROUND

Compared with engaging in aerobic physical activity (aerobic PA; eg, walking, running, cycling) or muscle-strengthening exercise (MSE; eg, weight/resistance training) alone, epidemiological evidence suggests that combining both is linked to better health. However, the assessment of both PA modes is rare in health surveillance. This article provides the first multicountry study on the descriptive epidemiology of combined moderate to vigorous PA-MSE guideline adherence.

METHODS

Data were drawn from the European Health Interview Survey wave 2 (2013-2014), comprising samples from 28 European countries (n = 280,605). Self-reported aerobic PA and MSE were assessed using the validated European Health Interview Survey Physical Activity Questionnaire. The authors calculated the weighted proportions meeting the health-enhancing PA guideline (aerobic PA ≥ 150 min/wk and MSE ≥ 2 sessions/wk). Poisson regression assessed the prevalence ratios for meeting the combined guideline across sociodemographic factors and by country.

RESULTS

A total of 15.0% met the health-enhancing PA guideline. The lowest prevalence was from respondents from Southern and Central European countries (Romania, Poland, and Croatia, range: 0.5%-5.7%). Poorer self-rated health, older age, lower income, being female, and being obese had a lower likelihood of meeting the combined guideline.

CONCLUSIONS

Most European adults do not meet the health-enhancing PA guideline that includes both aerobic PA and MSE.

Is all activity equal? Associations between different domains of physical activity and depressive symptom severity among 261,121 European adults

BACKGROUND

Physical activity is often associated with better mental health. However, there is evidence that the domain of physical activity influences the strength and direction of this association. Therefore, this study aimed to examine the associations between different domains of physical activity and depression among a large sample of adults living in the European Union.

METHODS

Cross-sectional analyses were conducted on 261,121 adults, recruited in the European Health Interview Survey (wave 2). Validated items were used to assess physical activity domains (i.e., work-related, transport-related, leisure-time aerobic, and muscle-strengthening) and depression symptom severity (8-item personal health questionnaire). Generalized linear models with Poisson regressions provided adjusted prevalence ratios (APR) of depressive symptom severity categories across the physical activity domains.

RESULTS

Compared to doing no physical activity, any physical effort at work (APR: 0.82-0.86), moderate, high, and very high levels of transport-related (APR: 0.69-0.83) and aerobic leisure-time activity (APR: 0.78-0.87), and 3 days/week of muscle-strengthening (APR: 0.93) were associated with a lower prevalence of mild depressive symptom severity. Moreover, doing any level of physical activity in any domain was mostly associated with a lower prevalence of moderate (APR: 0.43-0.80), moderate-severe (APR: 0.34-0.82), and severe (APR: 0.26-0.56) depressive symptoms.

CONCLUSION

Favorable associations were seen between any domain (leisure-time, transport- and work-related) of physical activity and depressive symptom severity. The more severe the symptoms, the stronger the associations. Both modalities of leisure-time physical activity (aerobic and muscle-strengthening) demonstrated beneficial associations with depression, but slightly more so for aerobic physical activity.

Assessment of muscle-strengthening exercise in public health surveillance for adults: A systematic review

There is strong scientific evidence that muscle-strengthening exercise (i.e. use of weight machines, push-ups, sit-ups) is independently associated with a reduced risk of multiple chronic diseases (e.g. diabetes, hypertension, cardiovascular disease). However, prevalence rates for meeting the muscle-strengthening exercise guideline (≥2 times/week) are significantly lower (~20%) than those reported to meet the aerobic physical activity guideline (e.g. walking, jogging, cycling) (~50%). It is therefore important to understand public health surveillance approaches to assess muscle-strengthening exercise. The aim of this review was to describe muscle-strengthening exercise assessment in public health surveillance. Informed by the PRISMA guidelines, an extensive keyword search was undertaken across 7 electronic data bases. We identified 86,672 possible articles and following screening (n = 1140 in full-text) against specific inclusion criteria (adults aged ≥18 years, English, studies containing <1000 participants), extracted data from 156 manuscripts. Fifty-eight different survey systems were identified across 17 countries. Muscle-strengthening exercise frequency (85.3%), duration (23.7%) and intensity (1.3%) were recorded. Muscle-strengthening exercise questions varied significantly, with some (11.5%) requiring a singular 'yes' vs 'no' response, while others (7.7%) sought specific details (e.g. muscle groups targeted). Assessments of duration and intensity were inconsistent. Very few studies measured the validity (0.6%) and reliability (1.3%) of muscle-strengthening exercise questions. Discrepancy exists within the current assessment systems/surveys used to assess muscle-strengthening exercise in public health surveillance. This is likely to impede efforts to identify at risk groups and trends within physical activity surveillance, and to accurately assess associations between muscle-strengthening exercise and health-related outcomes.

The association between prior physical fitness and depression in young adults during the COVID-19 pandemic-a cross-sectional, retrospective study

Background

The COVID-19 pandemic has led to a spike in deleterious mental health. This dual-center retrospective cross-sectional study assessed the prevalence of depression in young adults during this pandemic and explored its association with various physical fitness measures.

Methods

This study enrolled 12,889 (80% female) young adults (mean age 20 ± 1) who performed a National Student Physical Fitness battery from December 1st, 2019, to January 20th, 2020, and completed a questionnaire including Beck’s Depression Inventory in May 2020. Independent associations between prior physical fitness and depression during the pandemic were assessed using multivariable linear and binary logistic regressions accordingly, covariates including age, dwelling location, economic level, smoking, alcohol, living status, weight change, and exercise volume during the pandemic. Sex- and baseline stress-stratified analyses were performed.

Results

Of the study population 13.9% of men and 15.0% of women sampled qualified for a diagnosis of depression. After multivariable adjustment, anaerobic (mean change 95% CI −3.3 [−4.8 to 1.8]) aerobic (−1.5 [−2.64 to −0.5]), explosive (−1.64 [−2.7 to −0.6]) and muscular (−1.7 [−3.0 to −0.5]) fitness were independently and inversely associated with depression for the overall population. These remained consistent after sex- and baseline stress-stratification. In binary logistic regression, the combined participants with moderate, high or excellent fitness also showed a much lower risk compared to those least fit in anaerobic (odd ratio (OR) 95% CI 0.68 [0.55–0.82]), aerobic (0.80 [0.68–0.91]), explosive (0.72 [0.61–0.82]), and muscular (0.66 [0.57–0.75]) fitness.

Conclusions

These findings suggest that prior physical fitness may be inversely associated with depression in young adults during a pandemic.

Effect of Aerobic Exercise on Mental Health in Older Adults: A Meta-Analysis of Randomized Controlled Trials

Introduction: The recommendation of exercise programs in the senior population may benefit inactive and sedentary individuals and improve and help to treat specific health conditions. The purpose of this review is to summarize the published evidence from RCT studies of aerobic exercise interventions for mental health in older adults over the last 20 years. Methods: A literature search was conducted using electronic databases including Web of Science, PubMed/Medline, and ProQuest. Results: A total of 15 studies met the inclusion criteria. The subjects of these studies were aged 60 years or older and had various physical health statuses. In 15 studies, the mean effect size for the experimental outcome was 0.56 ± 0.39 (95%CI: 0.36-0.76). One-way ANOVA indicated no significant differences in the intervention duration [F _(2,15) = 0.919, p = 0.420], subject category [F _(2,15) = 0.046, p = 0.955], or measurement category [F _(3,14) = 0.967, p = 0.436]. However, there were significant differences in exercise frequencies [F _(2,15) = 6.03, p = 0.012]. Conclusion: The available evidence suggests that aerobic exercise is beneficial for improving the mental health of adults aged 60 years and older. The intervention effect can be achieved regardless of the type of subject and the duration of the intervention. Further, the present study indicates that low-frequency, long-term and regular aerobic exercise is more effective for older adults. Therefore, we recommend that older adults to exercise at a low frequency depending on their physical condition.

The Role of Exercise in Management of Mental Health Disorders: An Integrative Review

A large and growing body of evidence suggests that physical activity (PA) may hold therapeutic promise in the management of mental health disorders. Most evidence linking PA to mental health outcomes has focused on the effects of aerobic exercise training on depression, although a growing body of work supports the efficacy of both aerobic and resistance exercise paradigms in the treatment of anxiety and post-traumatic stress disorder. Despite abundant evidence linking PA and mental health, use of exercise training as a mental health treatment remains limited due to three important sources of uncertainty: (a) large individual differences in response to exercise treatment within multiple mental health domains; (b) the critical importance of sustained PA engagement, not always achieved, for therapeutic benefit; and (c) disagreement regarding the relative importance of putative therapeutic mechanisms. Our review of treatment data on exercise interventions and mental health outcomes focuses primarily on depression and anxiety within a health neuroscience framework. Within this conceptual framework, neurobiological and behavioral mechanisms may have additiveor synergistic influences on key cognitive and behavioral processes that influence mental health outcomes. We therefore highlight sources of treatment heterogeneity by integrating the critical influences of (a) neurobiological mechanisms enhancing neuroplasticity and (b) behavioral learning of self-regulatory skills. Understanding the interrelationships between dynamic neurobiological and behavioral mechanisms may help inform personalized mental health treatments and clarify why, and for whom, exercise improves mental health outcomes. The review concludes with recommendations for future studies leveraging individual differences to refine treatment approaches to optimize mental health benefits.

Associations of muscle-strengthening and aerobic exercise with self-reported components of sleep health among a nationally representative sample of 47,564 US adults

OBJECTIVES

Evidence demonstrates that physical activity is favorably associated with indicators of sleep health. However, population-based studies rarely examine the relationship between different physical activity modalities (ie, aerobic exercise vs muscle-strengthening exercise) with components of sleep health.

METHODS

Cross-sectional analyses were conducted on the US 2017 Behavioral Risk Factor Surveillance System. Validated items assessed self-reported moderate-to-vigorous-intensity aerobic physical activity (MVPA), muscle-strengthening exercise (MSE), sleep duration, difficulties and disorders. Poisson regression assessed prevalence ratios (PR) of 5 components of detrimental sleep health (short sleep; long sleep; poor quality sleep; observed snoring; and observed breathing stoppage) separately for adults 18-64 years and ≥65 years, across 4 categories of physical activity guideline adherence (met neither [reference]; MSE only; MVPA only; met both).

RESULTS

The sample comprised 47,564 adults (mean age: 48.4 years; ±1.4; 51.6% female). Among those 18-64 years, with the exception of short sleep (4-6 hours), for all other detrimental sleep health components, the lowest PRs were observed among those meeting both MVPA-MSE guidelines. Among those aged ≥65 years, for all 5 detrimental sleep health components, compared to the other physical activity categories, the lowest PRs were observed among those meeting both MVPA-MSE guidelines. All associations remained after adjusting for potential confounders (sex, education, income, smoking, alcohol, depression, hypertension, diabetes).

CONCLUSION

A physical activity routine that includes both MVPA and MSE is likely to be beneficial for better sleep health. Longitudinal studies are needed to establish the temporal relationships between MVPA/MSE guideline adherence and sleep health.

A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders

There is increasing academic and clinical interest in how "lifestyle factors" traditionally associated with physical health may also relate to mental health and psychological well-being. In response, international and national health bodies are producing guidelines to address health behaviors in the prevention and treatment of mental illness. However, the current evidence for the causal role of lifestyle factors in the onset and prognosis of mental disorders is unclear. We performed a systematic meta-review of the top-tier evidence examining how physical activity, sleep, dietary patterns and tobacco smoking impact on the risk and treatment outcomes across a range of mental disorders. Results from 29 meta-analyses of prospective/cohort studies, 12 Mendelian randomization studies, two meta-reviews, and two meta-analyses of randomized controlled trials were synthesized to generate overviews of the evidence for targeting each of the specific lifestyle factors in the prevention and treatment of depression, anxiety and stress-related disorders, schizophrenia, bipolar disorder, and attention-deficit/hyperactivity disorder. Standout findings include: a) convergent evidence indicating the use of physical activity in primary prevention and clinical treatment across a spectrum of mental disorders; b) emerging evidence implicating tobacco smoking as a causal factor in onset of both common and severe mental illness; c) the need to clearly establish causal relations between dietary patterns and risk of mental illness, and how diet should be best addressed within mental health care; and d) poor sleep as a risk factor for mental illness, although with further research required to understand the complex, bidirectional relations and the benefits of non-pharmacological sleep-focused interventions. The potentially shared neurobiological pathways between multiple lifestyle factors and mental health are discussed, along with directions for future research, and recommendations for the implementation of these findings at public health and clinical service levels.

Adherence to aerobic and muscle-strengthening exercise guidelines and associations with psychological distress: A cross-sectional study of 14,050 English adults

Physical activity (PA) is beneficial for the prevention and management of psychological distress. However, no studies have investigated which combination/s of PA prescribed in the current global guidelines (i.e. aerobic moderate-to-vigorous PA [MVPA] and muscle-strengthening exercise [MSE]) are most strongly linked to reduced psychological distress. This study aimed to examine how PA guidelines adherence is associated with psychological distress. Using cross-sectional data of adults (n = 14,050) who participated in the 2012-2016 Health Survey for England, four categories of self-reported PA guidelines adherence were created: meeting none, only MSE, only aerobic MVPA, meeting both (exposure variables). Psychological distress (outcome) was measured using the General Health Questionnaire-12. The likelihood of experiencing high levels of psychological distress (cut-point of ≥4) across guidelines adherence categories was examined using logistic regression models adjusted for sociodemographic and lifestyle factors. About 17% of adults experienced high levels of psychological distress; 37.5% did not adhere to any PA guidelines (category 1), 1.3% met only MSE (category 2), 35.5% met only aerobic MVPA (category 3), and 25.7% met both guidelines (category 4). Compared to category 1, the likelihood of experiencing high psychological distress was lowest in category 4 (OR = 0.65, 95% CI: 0.54-0.77) followed by category 3 (OR = 0.78, 95% CI: 0.67-0.90), while it did not differ in category 2 (OR = 1.24, 95% CI: 0.75-2.05). This is the first study to identify the association between PA guidelines adherence and psychological distress in a large population sample. Findings suggest that meeting both aerobic MVPA and MSE guidelines might be most beneficial for mental health.

Muscle-strengthening Exercise Epidemiology: a New Frontier in Chronic Disease Prevention

This current opinion provides an overview of the emerging discipline of muscle-strengthening exercise epidemiology. First, we define muscle-strengthening exercise, and discuss its recent addition into the global physical activity guidelines, which were historically mainly focused on aerobic physical activity (walking, running, cycling etc.). Second, we provide an overview of the current clinical and epidemiological evidence on the associations between muscle-strengthening exercise and health, showing a reduced mortality risk, and beneficial cardiometabolic, musculoskeletal, functional and mental health-related outcomes. Third, we describe the latest epidemiological research on the assessment, prevalence, trends and correlates of muscle-strengthening exercise. An overview of recent population estimates suggests that the proportion of adults meeting the current muscle-strengthening exercise guideline (10-30%; ≥ 2 sessions/week) is far lower than adults reporting meeting the aerobic exercise guideline (~ 50%; ≥ 150 min/week). Fourth, we discuss the complexity of muscle-strengthening exercise promotion, highlighting the need for concurrent, coordinated, and multiple-level strategies to increase population-level uptake/adherence of this exercise modality. Last, we explore key research gaps and strategies that will advance the field of muscle-strengthening exercise epidemiology. Our objective is to provide a case for increased emphasis on the role of muscle-strengthening exercise for chronic disease prevention, and most importantly, stimulate more research in this currently understudied area of physical activity epidemiology.

Relationship between different domains of physical activity and positive mental health among young adult men

Background

There is growing evidence on positive effects of physical activity (PA) on mental health. However, the focus of previous research on this relationship has typically been on mental health from the perspective of mental health problems rather than from the perspective of mental wellbeing. Further, previous research has commonly focused rather on leisure time PA without evidence on the role of other domains of PA. The aim of the present cross-sectional study was to investigate the relationship between positive mental health (PMH) and different domains of PA in young Finnish men. The secondary aim was to examine the reasons for physical inactivity among individuals with a low level of PMH.

Methods

Positive mental health (measured with Short Warwick-Edinburgh Mental Wellbeing Scale, SWEMWBS), self-reported leisure time, occupational and commuting PA as well as reasons for physical inactivity were measured using questionnaires (n = 456, mean age 29 years) among young Finnish males. Logistic regression modelling was used to generate odds for low and high levels of positive mental health for different levels of PA and sociodemographic variables.

Results

A weak positive association between leisure time PA and PMH was found in men with a low level of PMH (OR = 0.33, 95% CI 0.13–0.86). No association was found in the domains of commuting and occupational PA. Multivariate logistic regression analysis showed lower level of leisure time PA, unemployment and being single independently predicting low level of PMH. No associations were found between any domains of PA and high level of PMH. The most common reasons for physical inactivity among men with a low level of PMH were lack of interest (28%) and unwillingness to practise sports alone (27%).

Conclusions

The relationship between physical activity and positive mental health seems to vary between different domains of physical activity. The findings highlight the important role of leisure time physical activity, particularly in men with a low level of positive mental health. Strategies aimed at increasing physical activity for mental health benefits should focus particularly on providing opportunities for leisure time physical activity involving social interactions for men with lower mental wellbeing.

Muscular and cardiorespiratory fitness are associated with health-related quality of life among young adult men

Background

Despite numerous studies providing evidence for positive effects of physical activity and physical fitness, evidence for association between physical fitness and health-related quality of life (HRQoL) in young adults is limited. The aim of the present cross-sectional study was to investigate the association of cardiorespiratory and muscular fitness with HRQoL from the perspective of its physical and mental components among young adult Finnish males.

Methods

The sample consisted of 754 men, with the mean age of 26 years (SD 6.7 years), who participated in the military refresher training. HRQoL was measured using the Finnish RAND 36-item health survey. Cardiorespiratory fitness was determined by a bicycle ergometer test, and muscular fitness by various tests measuring maximal strength and muscular endurance. Logistic regression modelling was used to compare low, moderate and high physical and mental component of HRQoL scores to the respective levels of muscular and cardiorespiratory fitness.

Results

The findings of the adjusted (age, educational level, marital status, employment status, smoking, use of alcohol and BMI) analysis showed that cardiorespiratory and muscular fitness are positively associated with both physical and mental components of HRQoL. In terms of the physical component of HRQoL, even a moderate fitness level was positively associated with better HRQoL. In terms of the mental component of HRQoL, the impact was seen only in the group with the highest fitness level.

Conclusions

The findings suggest a positive contribution of physical fitness to mental health and highlight the importance of both muscular and cardiorespiratory fitness in the promotion of HRQoL. Even lighter forms of physical activity that result in moderate physical fitness could contribute to the physical component of HRQoL. In terms of the mental component of HRQoL, higher levels of physical fitness may be needed to gain higher levels of HRQoL among young males.

Muscle-strengthening exercise and prevalent hypertension among 1.5 million adults: a little is better than none

BACKGROUND

Clinical evidence suggests that muscle-strengthening exercise (using weight machines/body weight exercises) may be an important antihypertensive lifestyle therapy. However, epidemiological research on the association between muscle-strengthening exercise and hypertension is limited. We conducted the first population-level study describing the associations between muscle-strengthening exercise and prevalent hypertension among a large sample of US adults.

METHODS

In this cross-sectional study, data were pooled from four US health surveillance surveys (2011-2017) (n = 1 539  309, aged ≥18 years). Muscle-strengthening exercise frequency and self-reported clinically diagnosed hypertension (n = 431 313; 28%) were assessed using the same items across each survey. Generalized linear models using Poisson regression with robust error variance were used to calculate the prevalence ratios of hypertension (outcome variable) across muscle-strengthening exercise [exposure variables: 0 (reference); 1 to ≥7 times/week), adjusting for potential cofounders.

RESULTS

Compared with those doing none, the adjusted prevalence ratios for hypertension were 0.67 (95% CI: 0.66-0.68), 0.67 (95% CI: 0.67-0.68), 0.70 (95% CI: 0.69-0.70), 0.61 (95% CI: 0.60-0.63), 0.62 (95% CI: 0.61-0.64), 0.60 (95% CI: 0.58-0.62) and 0.83 (95% CI: 0.82-0.84) among the groups engaging in muscle-strengthening exercise one, two, three, four, five, six, and at least seven times/week, respectively. Associations remained after stratification for sociodemographic factors (age, sex), lifestyle characteristics (aerobic exercise, BMI, self-rated health, smoking, alcohol) and comorbidities (e.g. arthritis, diabetes, depression).

CONCLUSION

Among over 1.5 million adults, compared with those doing none, any weekly frequency in muscle-strengthening exercise was associated with a lower prevalence of hypertension. Longitudinal studies and large-scale muscle-strengthening exercise interventions with population representative samples are needed to confirm these preliminary cross-sectional observations.

Joint and dose-dependent associations between aerobic and muscle-strengthening activity with depression: A cross-sectional study of 1.48 million adults between 2011 and 2017

BACKGROUND

Research has shown that regular physical activity is key for the prevention and/or treatment of depression. However, epidemiological studies describing the associations between different physical activity modes (i.e., aerobic vs. muscle-strengthening exercise) with depression are limited.

METHODS

Cross-sectional analyses were conducted on pooled data from four U.S. health surveillance surveys (2011-2017). Validated survey items assessed self-reported moderate-to-vigorous-intensity physical activity (MVPA) and muscle-strengthening activity (MSA). Twenty groups were created, ranging from (a) "inactive" (0 MVPA min/week & MSA 0 times/week) to (xx) "most active" (≥300 MVPA min/week & MSA ≥4 times/week). Poisson regression with a robust error variance was used to assess prevalence ratios (PRs) of self-reported clinically diagnosed depression (outcome variable) across physical activity groups (exposure variables).

RESULTS

The sample contained 1,477,981 adults (≥18 years), of which 286,325 (18.0%) had depression. Compared to the reference group (i.e., no MVPA and no MSA), almost all physical activity combinations were associated with lower depression prevalence. Lowest prevalence of depression was shown for those combining sufficient MVPA-MSA (MVPA ≧300 min/week and MSA ≥2 times/week; adjusted prevalence ratio range: 0.54-0.63). All associations remained after stratification and/or adjustment for sociodemographic (age, sex, income, education), lifestyle characteristics (body mass index, self-rated health, smoking, alcohol), comorbidities (e.g., arthritis, diabetes, hypertension), and year of survey.

CONCLUSIONS

A physical activity routine that includes both aerobic and MSA is likely to be optimal for the prevention of depression. Public health approaches targeting depression should endorse joint aerobic and MSA as key lifestyle modification strategy.

Resistance training in addition to aerobic activity is associated with lower likelihood of depression and comorbid depression and anxiety symptoms: A cross sectional analysis of Australian women

The mental health benefits of resistance training (RT) alone or beyond those provided by aerobic physical activity (PA) are unclear. This study aimed to determine the association between meeting recommendations for aerobic PA and/or RT, and symptoms of depression and/or anxiety. Participants were Australian female members of the 10,000 Steps project (n = 5180, 50.0 ± 11.5 years). Symptoms of depression and anxiety were determined using the Depression Anxiety Stress Score. Participants were grouped as 'depression only', 'anxiety only', 'co-occurring depression and anxiety' or 'neither depression nor anxiety' based on relevant subscale score (cut-points: depression≥14 points, anxiety≥10 points). The International Physical Activity Questionnaire-Long Form questionnaire was used to determine PA with an additional item to specify RT frequency. Participants were classified as adhering to 'aerobic PA only' (≥150 min PA/week), 'RT only' (RT ≥ 2 days/week), 'aerobic PA + RT' (≥150 min PA/week+RT ≥ 2 days/week), or 'neither aerobic PA nor RT' (<150 min PA/week+RT < 2 days/week). Adjusted relative risk ratios (RRR [95%CI]) were estimated using multinomial logistic regression models. Relative to the 'neither PA nor RT' (n = 2215), the probabilities of 'depression only' (n = 317) and 'co-occurring depression and anxiety' (n = 417) were lower for the 'aerobic PA only' (n = 1590) (RRR = 0.74 [0.56-0.97] and RRR = 0.76 [0.59-0.97] respectively), and 'both PA + RT' (n = 974) groups (RRR = 0.61 [0.43-0.86] and RRR = 0.47 [0.33-0.67] respectively). There were no associations between adhering to one or both recommendations and 'anxiety only' (n = 317), or between 'RT only' (n = 401) and depression and/or anxiety. Prevention and treatment strategies including both aerobic PA and RT may provide additional benefits for depression with or without comorbid anxiety.