High Sedentary Behavior Is Associated with Depression among Rural South Africans

Unhealthy behaviors associated with mental health disorders: a systematic comparative review of diet quality, sedentary behavior, and cannabis and tobacco use

Background

There are well-established literatures documenting the associations between mental disorders and unhealthy behaviors such as poor diet quality, sedentary behavior, and cannabis and tobacco use. Few studies have attempted to understand the respective findings in light of each other, however.

Objective

The purpose of this review was to assemble comparable data for each behavior-disorder association and assess the associations in terms of their overall strength. The review aimed to include a representative, but not exhaustive, range of studies that would allow for explorative comparisons.

Methods

Eligible studies were identified via Pubmed searches and citation searching, restricted to publications no older than 2015 written in English. To obtain comparable data, only studies that reported findings as odds ratios were included, and risk of bias related to study samples, behavioral measurement disparities, and control variables was assessed via sensitivity analyses. Findings for each disorder were compared on the basis of different measures of central tendency.

Results

From 3,682 records, 294 studies were included. The review found evidence of associations between each of the four unhealthy behaviors and psychosis, depression, anxiety, bipolar disorder, attention-deficit/hyperactivity disorder (ADHD), and post-traumatic stress disorder (PTSD), while personality disorder was only investigated in relation to cannabis and tobacco use. In overall comparison, the associations were generally of similar strength, and only the association between cannabis use and personality disorder was exceptional in terms of being significantly stronger than its counterparts across disorders and across behaviors. Analyses of bias risk identified some influence from behavioral measurement disparities and lack of adequate statistical control, but findings were generally robust across a range of sensitivity analyses.

Conclusion

This explorative and comparative review found that poor diet quality, sedentary behavior, and cannabis and tobacco use are about equally strongly associated with a range of different mental disorders. Given the general nature of these associations, we should probably understand them to reflect a general and shared etiology. However, the findings in this review should be regarded as tentative until confirmed by more comprehensive investigations.

Association between dietary diversity, sedentary time outside of work and depressive symptoms among knowledge workers: a multi-center cross-sectional study

BACKGROUND

Low-diversity diets and sedentary status are risk factors for depressive symptoms, while knowledge workers were ignored before. The purpose of this current study was to examine the relationship between dietary diversity, sedentary time spent outside of work, and depressive symptoms among knowledge workers.

STUDY DESIGN AND METHODS

This was a multicenter and cross-sectional design that included 118,723 knowledge workers. Participants self-reported online between January 2018 and December 2020. Demographic information, the Dietary Diversity Scale, the Patient Health Questionnaire-9, dietary habits (which included eating three meals on time, midnight snacking, overeating, social engagement, coffee consumption, sugary drink consumption, smoking and alcohol use), sedentary time spent outside of work and physical activity were investigated.

RESULTS

The relationships between demographic information, dietary habits and dietary diversity, and depressive symptoms were estimated. Compared with the first and second levels of dietary diversity, the third level of dietary diversity (OR: 0.91; 95% CI: 0.84-0.98) reduced the risk of depressive symptoms. Knowledge workers with different degrees of sedentary status (2-4 h (OR: 1.11; 95% CI: 1.07-1.14), 4-6 h (OR: 1.21; 95% CI: 1.17-1.26), and > 6 h (OR: 1.49; 95% CI: 1.43-1.56), presented a progressively higher risk of depressive symptoms.

CONCLUSION

High amounts of sedentary time spent after work and low levels of dietary diversity are risk factors for depressive symptoms. In addition, an irregular diet and overeating are also major risk factors for knowledge workers.

Dose-response association of total sedentary behaviour and television watching with risk of depression in adults: A systematic review and meta-analysis

BACKGROUND

Although sedentary behaviour has been increasingly linked to depression, evidence remains conflicted and meta-analysis of the dose-response associations in adults is lacking. We aimed to explore the quantitative dose-response association of total sedentary behaviour and television watching with depression among adults.

METHODS

We systematically searched PubMed, Embase and Web of Science for articles to identify observational studies that assessed the association of total sedentary behaviour and television watching with depression in adults. Summary risk ratios (RRs) and 95 % confidence intervals (CIs) were estimated for the dose-response association by using a fixed or random-effects model. Restricted cubic splines were used to evaluate the possible linear or non-linear relations.

RESULTS

We included 16 studies with 221,599 participants in this meta-analysis, 10 for total sedentary behaviour and 6 for television watching. The summary RR of depression for the highest versus lowest total sedentary behaviour and television watching were 1.42 (95 % CI: 1.22-1.67) and 1.26 (95 % CI: 1.14-1.40), respectively. We found a non-linear association between total sedentary behaviour and depression. For participants with total sedentary time 8 h/day and 9 h/day, the risk of depression was increased by 20 % (RR 1.20, 95 % CI 1.09-1.29) and 29 % (RR 1.29, 95 % CI 1.20-1.40), respectively. A linear dose-response association was observed between television watching and depression. For each 1 h/day increase in television watching, risk of depression was increased by 5 % (RR: 1.05, 95 % CI: 1.02-1.09).

CONCLUSIONS

Depression may be associated with increased time spent in total sedentary behaviour and television watching.

Cross-sectional associations between mental health indicators and social vulnerability, with physical activity, sedentary behaviour and sleep in urban African young women

BACKGROUND

Relationships between mental health and multiple health behaviours have not been explored in young South African women experiencing social constraints. The aim of this study was to identify associations between mental health indicators and risk factors with physical activity, sedentary behaviour, and sleep, amongst young women living in Soweto, a predominantly low-income, urban South African setting.

METHODS

For this cross-sectional study, baseline measurements for participants (n = 1719, 18.0-25.9 years old) recruited for the Healthy Life Trajectories Initiative were used including: physical activity, sedentary behaviour (sitting, screen and television time), sleep (duration and quality), depression and anxiety indicators, emotional health, adverse childhood experiences, alcohol-use risk; social vulnerability, self-efficacy, and social support.

RESULTS

Multiple regression analyses showed that depression (β = 0.161, p < 0.001), anxiety (β = 0.126, p = 0.001), adverse childhood experiences (β = 0.076, p = 0.014), and alcohol-use risk (β = 0.089, p = 0.002) were associated with poor quality sleep. Alcohol-use risk was associated with more screen time (β = 0.105, p < 0.001) and television time (β = 0.075, p < 0.016). Social vulnerability was associated with lower sitting time (β = - 0.187, p < 0001) and screen time (β = - 0.014, p < 0.001). Higher self-efficacy was associated with more moderate- to vigorous-intensity physical activity (β = 0.07, p = 0.036), better-quality sleep (β = - 0.069, p = 0.020) and less television time (β = - 0.079, p = 0.012). Having no family support was associated with more sitting time (β = 0.075, p = 0.022). Binomial logistic regression analyses supported these findings regarding sleep quality, with anxiety and depression risk doubling the risk of poor-quality sleep (OR = 2.425, p < 0.001, OR = 2.036, p = 0.003 respectively).

CONCLUSIONS

These findings contribute to our understanding of how mental health indicators and risk factors can be barriers to health behaviours of young women in Soweto, and that self-efficacy and social support can be protective for certain of these behaviours for these women. Our results highlight the uniqueness of this setting regarding associations between mental health and behaviours associated with non-communicable diseases risk.