Abstract
BackgroundPrevious studies have reported an additive effect of moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) on depressive symptoms. However, no studies have been conducted in rural community settings. This cross-sectional study investigated whether the additive effect of MVPA and ST was associated with depressive symptoms in rural Japanese adults.MethodsWe identified 2,814 participants from health examinations conducted in Shimane, rural Japan, in 2012 and analyzed data from 1,958 participants. We assessed depressive symptoms using the Zung Self-Rating Depression Scale and measured the total time spent on MVPA and ST using a Japanese short version of the International Physical Activity Questionnaire. Poisson regression analysis examined the prevalence ratios (PR) of depressive symptoms in nine category combinations of MVPA level (no, insufficient, or sufficient MVPA) and ST level (high, moderate, or low ST).ResultsA total of 117 (6.0%) participants had depressive symptoms. Compared with the reference category (no MVPA/high ST), multivariate analysis showed that the likelihood of depressive symptoms was significantly lower in the sufficient MVPA/low ST category (PR 0.23; 95% confidence intervals [CI], 0.08–0.66), insufficient MVPA/low ST category (PR 0.37; 95% CI, 0.16–0.86), and insufficient MVPA/moderate ST category (PR 0.39; 95% CI, 0.17–0.90).ConclusionAnalysis of the additive effect of MVPA and ST showed that the combinational category of sufficient MVPA and low ST had the lowest prevalence of depressive symptoms in rural Japanese adults. Moderate ST and low ST showed significantly lower likelihoods of depressive symptoms, regardless of insufficient MVPA.
Highlights
Depression was the third leading contributor to the global burden of disease in 2004 and is projected to be the leading contributor globally in 2030.1 The prevalence of depression has increased in the United States during the last 2 decades.[2,3] In Japan, the number of patients with mood disorders, including depression, has increased from 433,000 in 1996 to 1,116,000 in 2014.4 Depression is a known risk factor for cardiovascular disease,[5] stroke,[6] type 2 diabetes,[7] and mortality.[8]
The prevalence of depressive symptoms was significantly different among the no moderate-to-vigorous physical activity (MVPA) (10.1%), insufficient MVPA (5.8%), and sufficient MVPA (4.8%) groups (P = 0.03)
There was a significant difference in the prevalence of depressive symptoms for Body mass index (BMI) (P < 0.01), city=town of residence (P = 0.03), having enough sleep (P < 0.001), current smoking (P < 0.01), low back pain (P < 0.01), and history of heart disease (P < 0.01)
Summary
Depression was the third leading contributor to the global burden of disease in 2004 and is projected to be the leading contributor globally in 2030.1 The prevalence of depression has increased in the United States during the last 2 decades.[2,3] In Japan, the number of patients with mood disorders, including depression, has increased from 433,000 in 1996 to 1,116,000 in 2014.4 Depression is a known risk factor for cardiovascular disease,[5] stroke,[6] type 2 diabetes,[7] and mortality.[8]. Several risk factors for depressive symptoms have been identified, including socioeconomic factors,[9] poor health conditions,[10] and lifestyle factors.[11] Previous reviews have shown that physical activity (PA) is independently associated with the onset of depressive symptoms.[12,13] Sedentary behavior (SB), which is related to PA, has been a subject of great interest. Previous studies have reported an additive effect of moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) on depressive symptoms. No studies have been conducted in rural community settings. This cross-sectional study investigated whether the additive effect of MVPA and ST was associated with depressive symptoms in rural Japanese adults
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