Associations of objectively-assessed physical activity and sedentary time with depression: NHANES (2005–2006)
Highlights
► This study is the first to examine associations of accelerometer-derived MVPA and sedentary time with depression within a nationally representative population-based sample of adults. ► One of the main findings in this study was a strong association between objectively measured MVPA and depression ► Results suggested that being sedentary for large portions of the day may be more hazardous with respect to depression for adults who are overweight or obese compared with those who have a healthy body weight
Introduction
Depressive disorder is expected to be one of the top three contributors to the burden of disease by 2020 (Murray and Lopez, 1997). Studies have provided conflicting evidence for the protective effects of moderate-to-vigorous intensity physical activity (MVPA) on depression. Some studies indicated a significant protective effect (Strawbridge et al., 2002); others have not (Cooper-Patrick et al., 1997, Weyerer, 1992). However, studies have had methodological limitations, including limited definitions of MVPA (e.g., sports-related physical activity) (Weyerer, 1992), and the use of non-validated self-report physical activity assessments (Strawbridge et al., 2002).
Sedentary behaviors have been inversely associated with premature mortality, type 2 diabetes, cardiovascular disease, and cardio-metabolic biomarkers (Owen et al., 2010). Sedentary behaviors involve low energy expenditure (1.0–1.5 METS) and are characterized by prolonged sitting and the absence of whole-body movement (Owen et al., 2010). A review of seven observational studies found sedentary behaviors were associated with an increased risk of depressive symptoms (Teychenne et al., 2010). With the exception of a single, non population-based study, which utilized accelerometers (Sanchez et al., 2008), all of the remaining studies used self-report measures and only considered a limited set of screen-based sedentary behaviors.
Although most studies have reported an association between obesity and depression risk (Herva et al., 2006, Simon et al., 2006), the potential moderating role of body mass index (BMI) on the associations of MVPA and sedentary time with depression is unknown. To date, no population-based studies have examined associations of objectively-assessed MVPA and sedentary time with depression. The primary objective of this study was to examine the associations of accelerometer-assessed MVPA and sedentary time with depression in a population-based sample of adults. Exploratory secondary objectives were to explore the potential moderating roles of gender, age and overweight/obesity on these associations.
Section snippets
Study sample
The 2005–2006 National Health and Nutrition Examination Survey (NHANES) cycle included a nationally-representative sample of non-institutionalized civilian US citizens, selected with a complex multi-stage design. The survey consisted of a household interview and an examination conducted in a mobile examination centre (MEC). The study complied with the Declaration of Helsinki and protocols were approved by the National Center for Health Statistics Ethics Review Board. Written informed consent
Participant characteristics
Participant characteristics, weighted to the US adult population, are presented in Table 1. The average age was 45.7 (SD = 13.7) years with 50.2% women. The majority (67.7%) were either overweight/obese (n = 2000) with an average BMI of 28.4 (SD = 6.6). Participants wore their accelerometer 4 to 7 days (median = 6) for an average of 14.6 (SD = 1.5) hours per day, of which 8.5 (SD = 2.2) hours per day were spent sedentary. Overall, adults spent on average 25.6 (SD = 18.2) minutes per day [Median = 20.2; from 0
Comment
This study is the first to examine associations of accelerometer-derived MVPA and sedentary time with depression within a nationally representative population-based sample of adults. It extends on previous research by using objective assessments as opposed to self-report (Strawbridge et al., 2002), and by using a nationally representative, general adult population as opposed to a restricted sub-sample of the population (Sanchez et al., 2008).
One of the main findings in this study was a strong
Conflict of interest statement
The authors declare that there are no conflicts of interest.
Acknowledgments
Vallance is supported by a Population Health Investigator Award from Alberta Innovates—Health Solutions and a New Investigator Award from the Canadian Institutes of Health Research. Winkler, Gardiner, Healy, and Owen are supported by a Program Grant (#569940) from the National Health and Medical Research Council of Australia (NHMRC) and by Research Infrastructure funding from Queensland Health. Healy is also supported by a NHMRC (#569861)/National Heart Foundation of Australia (PH 374 08B 3905)
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