Association between Depression, Anemia And Physical activity Using Isotemporal Substitution Analysis

Abstract

Abstract Background: Depression is a leading cause of disability and mortality, with estimated number of deaths exceeding 2.2 million worldwide. We examined depression in relation to anemia and physical activity, both of which have an impact on depression mechanisms. Methods: This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey was utilized including 18622 participants. Depression was measured by The Patient Health Questionnaire-9, and physical activity was assessed by the Global Physical Activity Questionnaire. Anemia was defined by World Health Organization criteria for blood hemoglobin levels. Isotemporal substitution model for physical activity was used to assess the effect of replacing each intensity level of physical activity. Logistic regression was applied to estimate the effects on depression. Results: Replacing sedentary behavior with moderate or vigorous physical activity was associated with a lower risk of depression in the anemic (OR: 0.875, 95% CI: 0.782–0.978) and non-anemic groups (OR: 0.943, 95% CI: 0.919–0.967). Depression risk was significantly reduced by replacing walking with moderate to vigorous physical activity in both anemic (OR: 0.877, 95% CI: 0.784–0.982) and non-anemic groups (OR: 0.951, 95% CI: 0.927–0.976). Conclusions: Moderate to vigorous physical activity had a protective effect against depression in both anemic and non-anemic groups. Physical activity should be performed to prevent depression in individuals with anemia.