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Prev Med. 2016 Dec;93:159-165. doi: 10.1016/j.ypmed.2016.10.011. Epub 2016 Oct 17.

Are lower levels of cardiorespiratory fitness associated with incident depression? A systematic review of prospective cohort studies.

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Unilasalle, Canoas, Brazil; Hospital de ClĂ­nicas de Porto Alegre, Porto Alegre, Brazil. Electronic address:
KU Leuven - University of Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven - University of Leuven, University Psychiatric Center KU Leuven, Leuven-Kortenberg, Kortenberg, Belgium.
Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
Exercise Physiology Department, School of Medical Sciences, UNSW Australia, Sydney and Black Dog Institute, Randwick, NSW, Australia.
Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom.
School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, Australia.
School of Psychiatry, UNSW Australia, Sydney and Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, Liverpool, Australia.
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.


Physical activity (PA) is protective from future depression, however, the potential impact of cardiorespiratory fitness (CRF) on the development of depression is less clear. We aimed to investigate if lower levels of CRF are associated with a higher risk for depression onset. Major electronic databases were searched, from inception to January 2016 for prospective cohort studies evaluating the association between CRF and incident depression. Pooled hazard ratio (HR) with 95% confidence intervals (CIs) were calculated. Methodological quality was evaluated using the Newcastle-Ottawa scale (NOS). Three prospective studies were identified and data from two studies were pooled. Our data provide preliminary evidence found that people with low CRF and medium CRF were at increased risk of developing depression (n=1,128,290, HR=1.76, 95% CI 1.61-1.91, p<0.001, I2=11.88, and HR=1.23, 95% CI 1.20-1.38, p<0.001, I2=0, respectively). Considered alongside the wider benefits of higher levels of CRF, these findings further support the rationale for interventions specifically targeting fitness, in order to reduce the significant burden associated with depression.


Cardiorespiratory fitness; Depression; Fitness; Prevention; Risk factor

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