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Depress Anxiety. 2019 Sep;36(9):846-858. doi: 10.1002/da.22915. Epub 2019 Jun 17.

Physical activity protects from incident anxiety: A meta-analysis of prospective cohort studies.

Author information

1
Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil.
2
Postgraduate Program in Health and Human Development, La Salle University, Canoas, Brazil.
3
Physiotherapy Department, South London and Maudsley National Health Services Foundation Trust, London, UK.
4
Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
5
Department of Kinesiology, Iowa State University, Ames, Iowa.
6
Department of Sports and Health Sciences, University of Potsdam, Potsdam, Brandenburg, Germany.
7
Department of Rehabilitation Sciences, KU Leuven - University of Leuven, Leuven, Belgium.
8
University Psychiatric Centre (UPC) KU Leuven, University of Leuven, Kortenberg, Belgium.
9
School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.
10
Black Dog Institute, Prince of Wales Hospital, Sydney, Australia.
11
GGz Centraal, Amersfoort, The Netherlands.
12
School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
13
NICM Health Research Institute, Western Sydney University, Sydney, Australia.
14
Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
15
Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, Australia.
16
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
17
Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
18
Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.

Abstract

BACKGROUND:

Prospective cohorts have suggested that physical activity (PA) can decrease the risk of incident anxiety. However, no meta-analysis has been conducted.

AIMS:

To examine the prospective relationship between PA and incident anxiety and explore potential moderators.

METHODS:

Searches were conducted on major databases from inception to October 10, 2018 for prospective studies (at least 1 year of follow-up) that calculated the odds ratio (OR) of incident anxiety in people with high PA against people with low PA. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was conducted and heterogeneity was explored using subgroup and meta-regression analysis.

RESULTS:

Across 14 cohorts of 13 unique prospective studies (N = 75,831, median males = 50.1%) followed for 357,424 person-years, people with high self-reported PA (versus low PA) were at reduced odds of developing anxiety (adjusted odds ratio [AOR] = 0.74; 95% confidence level [95% CI] = 0.62, 0.88; crude OR = 0.80; 95% CI = 0.69, 0.92). High self-reported PA was protective against the emergence of agoraphobia (AOR = 0.42; 95% CI = 0.18, 0.98) and posttraumatic stress disorder (AOR = 0.57; 95% CI = 0.39, 0.85). The protective effects for anxiety were evident in Asia (AOR = 0.31; 95% CI = 0.10, 0.96) and Europe (AOR = 0.82; 95% CI = 0.69, 0.97); for children/adolescents (AOR = 0.52; 95% CI = 0.29, 0.90) and adults (AOR = 0.81; 95% CI = 0.69, 0.95). Results remained robust when adjusting for confounding factors. Overall study quality was moderate to high (mean NOS = 6.7 out of 9).

CONCLUSION:

Evidence supports the notion that self-reported PA can confer protection against the emergence of anxiety regardless of demographic factors. In particular, higher PA levels protects from agoraphobia and posttraumatic disorder.

KEYWORDS:

agoraphobia; anxiety; exercise; incidence; meta-analysis; panic; physical activity; posttraumatic stress disorder; protection

PMID:
31209958
DOI:
10.1002/da.22915
[Indexed for MEDLINE]

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