Increased Vigorous Exercise and Decreased Sedentary Activities are associated with Decreased Depressive Symptoms in United States Adults: Analysis of the National Health and Nutrition Examination Survey (NHANES) 2017-2020. (Preprint)

Abstract

Depression affects over 4% of the global population and new lifestyle recommendations are needed to combat this major public health concern.

The objective of this study was to examine the association between active and sedentary activities and depressive symptoms.

We used data from the most recent National Health and Nutrition Examination Surveys (NHANES 2017-2020). A total of 8,091 adults (≥18 years old) who answered the PHQ-9 and Physical Activities questionnaires were selected for this study. Depressive symptoms were assessed through the validated 9-item Patient Health Questionnaire (PHQ-9). Per literature, patients with PHQ-9 scores ≥10 were considered as having clinically relevant depression. Univariable and multivariable logistic regression was used to investigate the effect of both active and sedentary activities and clinical depression as ascertained by PHQ-9.

After controlling for potential confounders (age, race, education, sex, income, and work schedule), we observed that increased vigorous exercise was associated with decreased rates of depression (each extra day of exercise was associated with 11% decreased odds of depression (OR: 0.89, CI: 0.83-0.96, p<0.01) while increased sedentary activity was associated with increased depression (each extra hour per day of sedentary activity was associated a 6% increase in odds of depression (OR: 1.06, (1.02-1.10, p<0.01)).

To conclude, exercise appears to be protective against depressive symptoms; however, further prospective studies are required to ascertain whether exercise causes decreased depressive symptoms.