The impact of sitting time and physical activity on mental health during COVID-19 lockdown

Sport Sciences for Health - Tập 18 Số 1 - Trang 179-191 - 2022
Matthew Pears1, Susanna Kola‐Palmer1, Liane B. Azevedo2
1Department of Psychology, University of Huddersfield, Huddersfield, HD1 3DH, West Yorkshire, UK
2Department of Allied Health Professionals, Sports, and Exercise, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, West Yorkshire, UK

Tóm tắt

Abstract Objective The primary aim of this study was to investigate the association between physical activity (PA) and sitting time on adults’ mental health (i.e., depression, anxiety and wellbeing) and the influence of mediators and confounders. Methods An online survey was disseminated in the UK between May and June 2020. A total of 284 participants (33.5 ± 12.4 years) self-reported their PA, sitting time and mental health through validated questionnaires. Results Multiple stepwise regression analysis revealed that being of younger age, female, on a lower income, with one or more comorbid health conditions, with a previous diagnosis of mood disorder and increased sitting time independently correlated with higher depression scores (F (13,219) = 12.31, p < 0.001), and explained 42% of the variance. Similar results were found for wellbeing where socio-demographic, health outcomes and sitting time influenced the subjective wellbeing (F (14,218) = 5.77, p < 0.001, 27% variance), although only socio-demographic and health outcomes contributed to the variation in anxiety score (F (13,219) = 7.84, p < 0.001, 32% variance). PA did not explain variation when sitting time was taken into account in any of the models. Combined analysis revealed that participants with lower sedentary time (< 8 h) and with both low or moderate and high PA presented a significantly lower depression score [low PA: (B = −2.7, 95% CI −4.88, −0.52); moderate and high PA (B = −2.7, −4.88, −0.52)]. Conclusion Sitting time was strongly associated with adverse mental health during COVID-19 lockdown and should be considered in future public health recommendations.

Từ khóa


Tài liệu tham khảo

Rothan HA, Byrareddy SN (2020) The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun 109:102433

Public Health England (2020) [Withdrawn] Guidance on social distancing for everyone in the UK. https://www.gov.uk/government/publications/covid-19-guidance-on-social-distancing-and-for-vulnerable-people/guidance-on-social-distancing-for-everyone-in-the-uk-and-protecting-older-people-and-vulnerable-adults. Accessed 4 Aug 2020

Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y (2020) A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatry. https://doi.org/10.1136/gpsych-2020-100213

Liu S, Yang L, Zhang C et al (2020) Online mental health services in China during the COVID-19 outbreak. Lancet Psychiatry 7(4):e17–e18. https://doi.org/10.1016/S2215-0366(20)30077-8

Wang C, Pan R, Wan X et al (2020) Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health 17(5):1729. https://doi.org/10.3390/ijerph17051729

Altena E, Baglioni C, Espie CA, Ellis J, Gavriloff D, Holzinger B, Schlarb A, Frase L, Jernelöv S, Riemann D (2020) Dealing with sleep problems during home confinement due to the COVID-19 outbreak: Practical recommendations from a task force of the European CBT-I Academy. J Sleep Res 29(4):e13052. https://doi.org/10.1111/jsr.13052

Clay JM, Parker MO (2020) Alcohol use and misuse during the COVID-19 pandemic: a potential public health crisis? Lancet Public Health 5(5):e259. https://doi.org/10.1016/S2468-2667(20)30088-8

World Health Organisation (2020) Depression. https://www.who.int/news-room/fact-sheets/detail/depression . Accessed 8 Oct 2020

Bandelow B, Michaelis S (2015) Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci 17(3):327

Mushtaq R, Shoib S, Shah T, Mushtaq S (2014) Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. JCDR 8(9):WE01

Beutel ME, Klein EM, Brähler E et al (2017) Loneliness in the general population: prevalence, determinants and relations to mental health. BMC Psychiatry 17(1):1–7

Valtorta NK, Kanaan M, Gilbody S, Ronzi S, Hanratty B (2016) Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart 102(13):1009–1016

Elovainio M, Hakulinen C, Pulkki-Råback L et al (2017) Contribution of risk factors to excess mortality in isolated and lonely individuals: an analysis of data from the UK Biobank cohort study. Lancet Public Health 2(6):e260–e266

Leigh-Hunt N, Bagguley D, Bash K et al (2017) An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health 152:157–171

Kiecolt-Glaser JK, Glaser R (2002) Depression and immune function: central pathways to morbidity and mortality. J Psychosom Res 53(4):873–876

Hawkley LC, Cacioppo JT (2010) Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med 40(2):218–227

Qin C, Zhou L, Hu Z et al (2020) Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis 71:762–728

Nguyen HC, Nguyen MH, Do BN et al (2020) People with suspected COVID-19 symptoms were more likely depressed and had lower health-related quality of life: the potential benefit of health literacy. J Clin Med 9(4):965

Pelletier L, Shamila S, Patten Scott B, Demers A (2017) Self-management of mood and/or anxiety disorders through physical activity/exercise. Health Promot Chronic Dis Prev Can 37(5):27

Kandola A, Vancampfort D, Herring M et al (2018) Moving to beat anxiety: epidemiology and therapeutic issues with physical activity for anxiety. Curr Psychiatry Rep 20(8):63

Parker AG, Hetrick SE, Jorm AF et al (2016) The effectiveness of simple psychological and physical activity interventions for high prevalence mental health problems in young people: a factorial randomised controlled trial. J Affect Disord 196:200–209

Mammen G, Faulkner G (2013) Physical activity and the prevention of depression: a systematic review of prospective studies. Am J Prev Med 45(5):649–657. https://doi.org/10.1016/j.amepre.2013.08.001

Rosenbaum S, Tiedemann A, Sherrington C, Curtis J, Ward PB (2014) Physical activity interventions for people with mental illness: a systematic review and meta-analysis. J Clin Psychiatry 75(9):964–974

BBC news (2020) Coronavirus: Strict new curbs on life in UK announced by PM. https://www.bbc.co.uk/news/uk-52012432. Accessed 24 Oct 2020

Government Digital Service GOV. UK (2020) Staying at home and away from others (social distancing). https://www.gov.uk/government/publications/full-guidance-on-staying-at-home-and-away-from-others/full-guidance-on-staying-at-home-and-away-from-others. Accessed 9 Oct 2020

Ammar A, Brach M, Trabelsi K et al (2020) Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 international online survey. Nutrients 12(6):1583

Lesser IA, Nienhuis CP (2020) The impact of COVID-19 on physical activity behavior and well-being of Canadians. Int J Environ Res Public Health 17(11):3899

Stanton R, To QG, Khalesi S et al (2020) Depression, anxiety and stress during COVID-19: associations with changes in physical activity, sleep, tobacco and alcohol use in Australian adults. Int J Environ Res Public Health 17(11):4065

Meyer J, McDowell C, Lansing J et al (2020) Changes in physical activity and sedentary behavior in response to COVID-19 and their associations with mental health in 3,052 US adults. Int J Environ Res Public Health 17:6469

Callow DD, Arnold-Nedimala NA, Jordan LS et al (2020) The mental health benefits of physical activity in older adults survive the COVID-19 pandemic. Am J Geriatr Psych 28:1046–1057

Jacob L, Tully MA, Barnett Y et al (2020) The relationship between physical activity and mental health in a sample of the UK public: a cross-sectional study during the implementation of COVID-19 social distancing measures. Ment Health Phys Activity 19:100345

Edwards MK, Loprinzi PD (2016) Effects of a sedentary behavior-inducing randomized controlled intervention on depression and mood profile in active young adults, vol 91. Elsevier, Amsterdam, pp 984–998

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP (2008) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol 61(4):344–349. https://doi.org/10.1016/j.jclinepi.2007.11.008

Qualtrics (2020) Leading experience management & survey software.  https://www.qualtrics.com/uk/. Accessed 5 Aug 2020

International physical activity questionnaire (2020) IPAQ Scoring Protocol. https://sites.google.com/site/theipaq/scoring-protocol. Accessed 8 Oct 2020

Craig CL, Marshall AL, Sjöström M et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35(8):1381–1395

Helmerhorst HHJ, Brage S, Warren J, Besson H, Ekelund U (2012) A systematic review of reliability and objective criterion-related validity of physical activity questionnaires. Int J Behav Nutr Phys Act 9(1):103

National Health Service (2018) Exercise. https://www.nhs.uk/live-well/exercise/. Accessed 9 Oct 2020

Davis KA, Coleman JR, Adams M et al (2020) Mental health in UK Biobank–development, implementation and results from an online questionnaire completed by 157 366 participants: a reanalysis. BJPsych Open 6(2):e18

Cameron IM, Crawford JR, Lawton K, Reid IC (2008) Psychometric comparison of PHQ-9 and HADS for measuring depression severity in primary care. Br J Gen Pract 58(546):32–36

Kroenke K, Spitzer RL, Williams JBW (2001) The PHQ-9. J Gen Intern Med 16(9):606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Kim YE, Lee B (2019) The psychometric properties of the patient health questionnaire-9 in a sample of Korean University students. Psychiatry Investig 16(12):904–910. https://doi.org/10.30773/pi.2019.0226

Plummer F, Manea L, Trepel D, McMillan D (2016) Screening for anxiety disorders with the GAD-7 and GAD-2: a systematic review and diagnostic metaanalysis. Gen Hosp Psychiatry 39:24–31. https://doi.org/10.1016/j.genhosppsych.2015.11.005

National Collaborating Centre for Mental Health (UK) (2011) Common mental health disorders: identification and pathways to care. British Psychological Society, Leicester

Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B (2007) Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med 146(5):317–325

Yoo W, Mayberry R, Bae S, Singh K, Peter He Q, Lillard JW (2014) A study of effects of multicollinearity in the multivariable analysis. Int J Appl Sci Technol 4(5):9–19

O’brien RM (2007) A caution regarding rules of thumb for variance inflation factors. Qual Quant 41(5):673–690. https://doi.org/10.1007/s11135-006-9018-6

Tabachnick BG, Fidell LS, Ullman JB (2007) Using multivariate statistics, vol 5. Pearson, Boston

Aguinis H, Gottfredson RK, Joo H (2013) Best-practice recommendations for defining, identifying, and handling outliers. Organ Res Methods 16(2):270–301

Killgore WD, Cloonan SA, Taylor EC, Miller MA, Dailey NS (2020) Three months of loneliness during the COVID-19 lockdown. Psychiatry Res 293:113392

Diamond R, Byrd E (2020) Standing up for health-improving mental wellbeing during COVID-19 isolation by reducing sedentary behaviour. J Affect Disord 277:232–234

Zhai L, Zhang Y, Zhang D (2015) Sedentary behaviour and the risk of depression: a meta-analysis. Br J Sports Med 49(11):705–709

Okely JA, Čukić I, Shaw RJ et al (2019) Positive and negative well-being and objectively measured sedentary behaviour in older adults: evidence from three cohorts. BMC Geriatr 19(1):28

Atkin AJ, Adams E, Bull FC, Biddle SJ (2012) Non-occupational sitting and mental well-being in employed adults. Ann Behav Med 43(2):181–188

Teychenne M, Costigan SA, Parker K (2015) The association between sedentary behaviour and risk of anxiety: a systematic review. BMC Public Health 15(1):1–8

Allen MS, Walter EE, Swann C (2019) Sedentary behaviour and risk of anxiety: a systematic review and meta-analysis. J Affect Disord 242:5–13

Faulkner J, O’Brien W, McGrane B et al (2020) Physical activity, mental health and well-being of adults during early COVID-19 containment strategies: a multi-country cross-sectional analysis. medRxiv 24:320–326

Asiamah N, Opuni FF, Mends-Brew E, Mensah SW, Mensah HK, Quansah F (2020) Short-term changes in behaviors resulting from COVID-19-related social isolation and their influences on mental health. Community Ment Health 57:79–92

Martinez EZ, Silva FM, Morigi TZ et al (2020) Physical activity in periods of social distancing due to COVID-19: a cross-sectional survey. Cien Saude Colet 25:4157–4168

Zheng C, Huang WY, Sheridan S, Sit CH-P, Chen X-K, Wong SH-S (2020) COVID-19 pandemic brings a sedentary lifestyle in young adults: a cross-sectional and longitudinal study. Int J Environ Res Public Health 17(17):6035

Schuch FB, Bulzing RA, Meyer J et al (2020) Associations of moderate to vigorous physical activity and sedentary behavior with depressive and anxiety symptoms in self-isolating people during the COVID-19 pandemic: a cross-sectional survey in Brazil. Psychiatry Res 292:113339

Werneck AO, Silva DR, Malta DC et al (2020) Changes in the clustering of unhealthy movement behaviors during the COVID-19 quarantine and the association with mental health indicators among Brazilian adults. Transl Behav Med 11:323–331

Ekelund U, Steene-Johannessen J, Brown WJ et al (2016) Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. Lancet 388(10051):1302–1310

Ekelund U, Tarp J, Steene-Johannessen J et al (2019) Dose-response associations between accelerometry measured physical activity and sedentary time and all cause mortality: systematic review and harmonised meta-analysis. BMJ 366:l4570

Wijndaele K, Duvigneaud N, Matton L et al (2009) Sedentary behaviour, physical activity and a continuous metabolic syndrome risk score in adults. Eur J Clin Nutr 63(3):421–429

Biswas A, Oh PI, Faulkner GE et al (2015) Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med 162(2):123–132

Janssen I, Clarke AE, Carson V et al (2020) A systematic review of compositional data analysis studies examining associations between sleep, sedentary behaviour, and physical activity with health outcomes in adults. Appl Physiol Nutr Metab 45(10):S248–S257

Chastin SF, Palarea-Albaladejo J, Dontje ML, Skelton DA (2015) Combined effects of time spent in physical activity, sedentary behaviors and sleep on obesity and cardio-metabolic health markers: a novel compositional data analysis approach. PLoS ONE 10(10):e0139984

McGregor DE, Carson V, Palarea-Albaladejo J, Dall PM, Tremblay MS, Chastin SF (2018) Compositional analysis of the associations between 24-h movement behaviours and health indicators among adults and older adults from the canadian health measure survey. Int J Environ Res Public Health 15(8):1779

Hamer M, Coombs N, Stamatakis E (2014) Associations between objectively assessed and self-reported sedentary time with mental health in adults: an analysis of data from the Health Survey for England. BMJ Open 46:718–723

Peeters G, van Gellecum YR, van Uffelen JG, Burton NW, Brown WJ (2014) Contribution of house and garden work to the association between physical activity and well-being in young, mid-aged and older women. Br J Sports Med 48(12):996–1001

Theodorou A, Panno A, Carrus G, Carbone GA, Massullo C, Imperatori C (2021) Stay home, stay safe, stay green: The role of gardening activities on mental health during the Covid-19 home confinement. Urban For Urban Green 61:127091

White RL, Babic MJ, Parker PD, Lubans DR, Astell-Burt T, Lonsdale C (2017) Domain-specific physical activity and mental health: a meta analysis. Am J Prev Med 52(5):653–666

Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C (2013) A systematic review of studies of depression prevalence in university students. J Psychiatr Res 47(3):391–400

Sassarini J (2016) Depression in midlife women. Maturitas 94:149–154

McLean CP, Asnaani A, Litz BT, Hofmann SG (2011) Gender differences in anxiety disorders: prevalence, course of illness, comorbidity and burden of illness. J Psychiatr Res 45(8):1027–1035

González-Sanguino C, Ausín B, ÁngelCastellanos M et al (2020) Mental health consequences during the initial stage of the 2020 coronavirus pandemic (COVID-19) in Spain. Brain Behav Immun 87:172–176

Dyrstad SM, Hansen BH, Holme IM, Anderssen SA (2014) Comparison of self-reported versus accelerometer-measured physical activity. Med Sci Sports Exerc 46(1):99–106

Hallgren M, Owen N, Stubbs B, Zeebari Z, Vancampfort D, Schuch F, Bellocco R, Dunstan D, Trolle Lagerros Y (2018) Passive and mentally-active sedentary behaviors and incident major depressive disorder: a 13-year cohort study. J Affect Disord 241:579–585

Werneck AO, Hoare E, Stubbs B, van Sluijs EMF, Corder K (2021) Associations between mentally-passive and mentally-active sedentary behaviours during adolescence and psychological distress during adulthood. Prev Med 145:106436

Curtin R, Presser S, Singer E (2000) The effects of response rate changes on the index of consumer sentiment. Public Opin Q 64(4):413–428