Epidemiology of physical activity and sedentary behavior levels among patients entering treatment for substance use disorder in the United States: a descriptive study.

Introduction: Little is known about physical activity behaviors among people with SUD. This study aimed to (a) describe self-reported moderate-to-vigorous physical activity (MVPA) and sedentary (SED) behaviors of adults with SUD initiating treatment (b), determine the potential contributions of drug of choice (DOC) on these behaviors, and (c) determine the potential contributions of level of care and demographic variables on these behaviors. Methods: Secondary data that was collected via surveys including demographic information, psychological health, drug of choice, MVPA (categorized as inactive, insufficiently active, meets guidelines, exceeds guidelines) and SED (<4 h/day, 4-<6 h/day, 6-8 h/day, >8 h/day) were analyzed from 1,293 patients in inpatient/outpatient treatment facilities across the United States. Results: On average, over half (51%) of patients entering treatment reported not meeting guidelines, but sitting time was generally low (median= 360 min/day). MVPA levels differed based on level of care (p<0.001) with 48% of patients in detox facilities reporting inactivity compared to 37% in residential and 29% in outpatient programs. MVPA and SED levels differed by sex with women less likely to report sitting <4 h/day (27.9% vs. 38.2%, p<0.001) and more likely to report sitting for >8 h/day (31.5% vs. 21.8%, p<0.001) compared to men. SED differed by race (p=0.01), with 54% of Black patients reporting <4 h/day compared to 33% of White patients. Discussion: Understanding activity behavior patterns among individuals entering SUD treatment provides opportunities for identifying the extent of lifestyle behavior needs and opportunities to develop personalized treatment strategies.

Feasibility and preliminary efficacy of a theory-informed resistance exercise training single-arm intervention for major depression.

Many adults with major depressive disorder (MDD) do not receive effective treatment. The potential benefits of resistance exercise training (RET) are understudied and may be mechanistically related to cerebral blood flow changes. PURPOSE: To assess feasibility, acceptability, and preliminary efficacy of a 16-week, theory-informed RET trial for the treatment of MDD and explore changes in cerebral blood flow. METHODS: Ten adults with DSM-5-diagnosed MDD were enrolled in a single-arm, 16-week, twice-weekly, whole-body RET intervention, consistent with US and WHO Physical Activity resistance exercise guidelines. To build intrinsic motivation and develop exercise-preparatory habits, motivators and commitment were discussed weekly. Screening, enrollment, and intervention attendance and compliance rates documented feasibility. At baseline and weeks 8, 16, and 26, current MDD diagnosis, clinician-rated, and self-reported symptom severity were evaluated along with cerebral blood flow which was assessed as middle cerebral artery (MCA) mean blood velocity, conductance, and pulsatility. RESULTS: Nine participants completed the intervention. Strong feasibility and acceptability (98 % adherence, 93 % compliance, and 90 % retention) were found. MDD remission was reached by 8/9 participants at week 16 and persisted through week 26. There were large decreases in clinician-rated and self-reported symptoms at each assessment (Hedges' g = 0.84-2.13). There were small-to-moderate increases in MCA velocity (g = 0.32-0.57) and conductance (g = 0.20-0.76) across time, with minimal changes in pulsatility (all g < 0.21). CONCLUSIONS: Preliminary results suggest RET for MDD treatment is feasible and plausibly efficacious, finding large antidepressant effects. A sufficiently powered randomized controlled trial to assess RET's efficacy for treating MDD via potential cerebrovascular mechanisms is warranted.

Psychological correlates of physical activity among adults living in rural and urban settings.

Middle-aged and older adults living in rural settings have been consistently less likely to report regular physical activity (PA) than those living in urban settings. While past literature has identified sociodemographic and environmental correlates of PA that may contribute to these differences, consideration of psychological correlates has been limited. A total of 95 rural and urban adults ≥50 years old provided self-reported sociodemographic information, PA level, and psychological correlates of PA including measures assessing motivation, self-efficacy, social support, and attitudes related to PA. The average participant age was 68.6 years, and most were female (62.1%) and married (70.5%). While PA level did not differ significantly between the rural and urban groups, different psychological correlates contributed significantly to separate rural and urban linear regression models considering PA status. Among rural adults, more positive attitudes toward PA, and greater PA self-efficacy and social support were associated with greater amounts of PA while for urban adults, no psychological correlates were significantly associated with PA. Psychosocial factors may be key considerations in developing more effective PA interventions in middle-aged and older adults living in rural areas.

Resistance exercise for anxiety and depression: efficacy and plausible mechanisms.

Anxiety and depressive symptoms and disorders are prevalent and poorly treated. The salutary benefits of resistance exercise training (RET), a potential alternative therapy, are well established, but mental health effects are understudied. This forum article summarizes the most rigorous evidence regarding efficacy of resistance exercise and provides a primer for putative psychobiological mechanisms.

Epidemiology of engagement in physical activity behaviors in people with epilepsy from National Health Interview Survey 2017.

OBJECTIVE: Physical activity (PA) participation may be beneficial for people with epilepsy (PWE) but has been discouraged due to a fear that it may induce seizures. Using data from the 2017 National Health Interview Survey, we aimed to describe current rates of PA sufficient to meet US PA Aerobic and Strength Training Guidelines (Aim #1), compare the average time PWE spend on aerobic activity and strength training activity (Aim #2), and compare rates of engagement with various types of PA (e.g., moderate, vigorous, strength training, and mind-body activities) among PWE to the general population (Aim #3). METHODS: Cross-sectional data (n = 26,728) were analyzed via logistic and zero-inflated Poisson regression models. PA participation was analyzed based on the US PA Guidelines (neither, strength training [≥2 times/wk], moderate to vigorous physical activity [MVPA; ≥ 150 min/wk], or both; Aim #1), time spent on activity/week (Aim #2), and activity participation (yes/no; Aim #3). Epilepsy status was coded as active epilepsy (doctor-diagnosed and either taking antiepileptic medication or had at least one seizure in 12 months; n = 335), inactive epilepsy (doctor-diagnosed, not taking antiepileptic medication nor had a seizure in 12 months; n = 213), and no history of epilepsy (n = 26,180). RESULTS: People with active epilepsy were more likely to report meeting neither (68 %, 95 % CI = 63-74 %) of the PA Guidelines compared to people with no history of epilepsy (59 %, 58-60 %). The mean duration of time reported on vigorous activity for people with inactive epilepsy was significantly higher than people with no history of epilepsy (p = 0.01). People with active epilepsy were 32-39 % less likely to report participating in any moderate or vigorous activity compared to people with no history of epilepsy. SIGNIFICANCE: This study highlights activity disparities among PWE and the general population, indicating substantially lower activity and higher likelihood of inactivity in PWE, particularly active epilepsy.

Effects of resistance exercise training on depressive symptoms among young adults: A randomized controlled trial.

Evidence supports the antidepressant effects of resistance exercise training (RET); however, findings among young adults at-risk for elevated depressive symptoms are limited. This randomized controlled trial examined the effects of eight weeks of ecologically-valid, guidelines-based RET, compared to a wait-list control, on depressive symptoms among 55 young adults (26±5y; 36 female) with and without subclinical, or analogue, Generalized Anxiety Disorder (AGAD; Psychiatric Diagnostic Screening Questionnaire GAD subscale ≥6 and Penn State Worry Questionnaire ≥45) and Major Depressive Disorder (AMDD). Following a three-week familiarization period, participants completed one-on-one, twice-weekly RET sessions. The 16-item, self-reported Quick Inventory of Depressive Symptomatology (QIDS) assessed depressive symptoms. RM-ANCOVAs examined between-group differences, and significant interactions were decomposed with simple effects analysis. Hedges' d effect sizes (95%CI) quantified the magnitude of differences in change between groups across time. Stratified analyses were conducted among subsamples with AMDD and AGAD. There were no baseline depressive symptom differences between groups. Attendance was 83%, and compliance was 80%. RET induced statistically significant, clinically-meaningful, large-magnitude reductions in depressive symptoms from baseline to week eight in the total (d = 1.01; [95%CI: 0.44-1.57]), AMDD (d = 1.71; [95%CI: 0.96-2.46]), and AGAD (d = 1.39; [95%CI: 0.55-2.24]) samples. These findings support guidelines-based RET as a promising treatment for mild depression.

Dose-response effects of acute exercise intensity on state anxiety among women with depression.

Anxiety is common in people with major depressive disorder (MDD), yet the anxiolytic effects of acute exercise in MDD are unknown. The purpose of this analysis was to determine a potentially optimal acute exercise intensity for reducing state anxiety in women with MDD, the duration of the response, and the potential influences of depression severity and preferred-intensity exercise. Using a within-subject, randomized, counter-balanced design, 24 participants completed five separate visits including 20 min of steady-state bicycling at prescribed (via RPE) light, moderate, or hard intensities, a preferred/self-selected session, or a quiet rest (QR) session. State anxiety was measured via the State-Trait Anxiety Inventory (STAI-Y1) and anxiety visual analog scale (VAS) at pre-, immediately (VAS only), 10 min, and 30 min post-exercise. Depression was measured via the Beck Depression Inventory (BDI-II) pre-exercise. Moderate exercise resulted in a moderate state anxiety reduction compared to QR 10 min (STAI-Y1: g = 0.59, padj = 0.040) and 30 min post-exercise (STAI-Y1: g = 0.61, padj = 0.032). Pairwise differences indicated each exercise session decreased state anxiety pre to 10 min and 30 min post-exercise (all padj < 0.05) for the STAI-Y1, and for moderate and hard exercise from pre to each time point post-exercise (all padj < 0.05) for the VAS. Depression severity was associated with state anxiety (p < 0.01) but did not influence the overall results. Prescribed moderate intensity exercise led to greater reductions in state anxiety compared to preferred at 30 m (STAI-Y1: g = 0.43, p = 0.04). These findings suggest steady-state prescribed moderate exercise reduces state anxiety in women with MDD for at least 30 min following exercise regardless of their depression severity.

Physical Activity, Sedentary Behavior, and Suicidal Ideation in Major Depressive Disorder.

OBJECTIVE: Identifying risk factors for suicidal ideation (SI) is necessary for suicide prevention. Associations between self-reported physical activity (PA) and sedentary time and SI in the general population have been found. The current study examines these associations in adults with major depressive disorder (MDD) using objective measures of PA and sedentary time. METHOD: Sedentary time and PA were measured with an activPAL inclinometer/accelerometer over 7 days in 52 adults with MDD. Presence and severity of SI was examined with the Mini International Neuropsychiatric Interview. Multinomial logistic regressions examined associations between accelerometer-derived behaviors and SI classification in the full sample and a subsample experiencing a major depressive episode (MDE). RESULTS: Sedentary time and PA measures were not significantly associated with SI in the full sample. In those experiencing an MDE, higher light ambulatory PA was associated with lower odds of reporting Low SI compared to None and for Moderate/High SI compared to None. Sedentary time was not significantly associated with SI severity. CONCLUSION: Sedentary time and PA were not associated with SI severity, although results could be due to the small sample size. The small effect found for the subsample may suggest that low levels of light ambulatory PA may be a modifiable risk factor for SI during an MDE. We also demonstrated the feasibility of collecting objective data with accelerometers in this population. Future studies are needed to replicate findings to determine whether increasing light ambulatory PA could be useful in suicide prevention during an MDE.HighlightsLight physical activity was associated with lower odds of suicidal ideation.Suicidal ideation was not associated with sedentary or moderate-to-high activity.It is possible to collect objective data for adults with depression.

Feasibility of an Exercise and CBT Intervention for Treatment of Depression: A Pilot Randomized Controlled Trial.

Depression (DEP) is prevalent and current treatments are ineffective for many people. This pilot study's purpose was to assess the feasibility, acceptability, and plausible efficacy of an 8-week intervention employing 30 min of prescribed moderate intensity exercise ("ActiveCBT") compared to 30 min of usual activities ("CalmCBT") immediately prior to weekly online CBT sessions. Ten adults with DSM-5-diagnosed current DEP were randomized to groups and completed: an intake assessment, eight weekly CBT sessions, final assessment, and 3-month follow-up. ActiveCBT participants were prescribed 30-min of moderate exercise immediately prior to each standardized 50-min CBT session. CalmCBT participants continued with normal activities for 30 min before therapy. Questionnaires regarding DEP symptom severity (Patient Health Questionnaire-9 [PHQ-9]), between-session effectiveness (Behavioral Activation for Depression Survey [BADS], Automatic Thoughts Questionnaire [ATQ]), in-session effectiveness (Working Alliance Inventory-Short Revised [WAI]), and state anhedonia (Dimension Analog Rating Scale [DARS], Visual Analog Scale [VAS]; assessed 3 times: before Active/Calm condition, after, and after therapy) were completed each week. Therapy fidelity ratings were independently coded via a standardized codebook. The Structured Clinical Interview for DSM-5 (SCID) and Hamilton Rating Scale for Depression (HAMD) were used to assess DEP at intake, final, and 3-month follow-up. We found strong feasibility and acceptability (100% adherence, 100% retention at final visit, 74.6% therapy fidelity, and high patient satisfaction ratings). Differences between groups favoring ActiveCBT in anhedonia (DARS, Hedges' g = 0.92; VAS, g = 3.16), within- (WAI, g = 0.1.10), and between-session effectiveness (ATQ g = -0.65; BADS g = -1.40), suggest plausible efficacy of ActiveCBT for enhancing CBT. DEP rates were reduced in both groups from baseline to final (60% MDD SCID remission) and at follow up (Active: 40%; Calm: 25%). Larger and potentially quicker symptom improvement was found favoring the Active condition to the final visit (HAMD, between-group changes g = -1.33; PHQ-9, g = -0.62), with small differences remaining at follow-up (HAMD, g = -0.45; PHQ-9, g = -0.19). Exercise priming appears acceptable and plausibly efficacious for enhancing mechanisms of CBT and overall outcomes, though the present small sample precludes efficacy determinations. It appears feasible to conduct a randomized controlled trial comparing ActiveCBT to CalmCBT. Future trials evaluating this potentially promising treatment approach and mediating mechanisms are warranted.

Bidirectional Associations Between Depressive and Anxiety Symptoms and Loneliness During the COVID-19 Pandemic: Dynamic Panel Models With Fixed Effects.

Background: Understanding the direction and magnitude of mental health-loneliness associations across time is important to understand how best to prevent and treat mental health and loneliness. This study used weekly data collected over 8 weeks throughout the COVID-19 pandemic to expand previous findings and using dynamic panel models with fixed effects which account for all time-invariant confounding and reverse causation. Methods: Prospective data on a convenience and snowball sample from all 50 US states and the District of Colombia (n = 2,361 with ≥2 responses, 63.8% female; 76% retention rate) were collected weekly via online survey at nine consecutive timepoints (April 3-June 3, 2020). Anxiety and depressive symptoms and loneliness were assessed at each timepoint and participants reported the COVID-19 containment strategies they were following. Dynamic panel models with fixed effects examined bidirectional associations between anxiety and depressive symptoms and loneliness, and associations of COVID-19 containment strategies with these outcomes. Results: Depressive symptoms were associated with small increases in both anxiety symptoms (ß = 0.065, 95% CI = 0.022-0.109; p = 0.004) and loneliness (ß = 0.019, 0.008-0.030; p = 0.001) at the subsequent timepoint. Anxiety symptoms were associated with a small subsequent increase in loneliness (ß = 0.014, 0.003-0.025; p = 0.015) but not depressive symptoms (ß = 0.025, -0.020-0.070; p = 0.281). Loneliness was strongly associated with subsequent increases in both depressive (ß = 0.309, 0.159-0.459; p < 0.001) and anxiety (ß = 0.301, 0.165-0.436; p < 0.001) symptoms. Compared to social distancing, adhering to stay-at-home orders or quarantining were not associated with anxiety and depressive symptoms or loneliness (both p ≥ 0.095). Conclusions: High loneliness may be a key risk factor for the development of future anxiety or depressive symptoms, underscoring the need to combat or prevent loneliness both throughout and beyond the COVID-19 pandemic. COVID-19 containment strategies were not associated with mental health, indicating that other factors may explain previous reports of mental health deterioration throughout the pandemic.

High Sitting Time Is a Behavioral Risk Factor for Blunted Improvement in Depression Across 8 Weeks of the COVID-19 Pandemic in April-May 2020.

The COVID-19 pandemic has elicited increased sedentary behaviors, decreased moderate-to-vigorous physical activity (MVPA), and worsened mental health, yet the longitudinal impact of these changes and their inter-relations remains unknown. Our purpose was to examine associations between changes in self-reported activity behaviors and mental health over an 8-week period following the COVID-19 outbreak. Participants from all 50 states and the District of Colombia were recruited through convenience and snowball sampling at baseline April 3-10, 2020. Prospective data from 2,327 US adults with ≥2 responses (63.8% female; 74.3% response rate) were collected weekly via online survey for eight consecutive weeks (April 3-June 3, 2020). Primary exposures were self-reported time spent sitting, viewing screens and in MVPA, with primary outcomes being depressive symptoms, anxiety symptoms, and positive mental health (PMH). A significant sitting-by-time interaction (p < 0.05) showed slightly higher marginal effects for depressive symptoms for the 90th-percentile of sitting time than the 10th-percentile at baseline (5.8 [95% confidence interval = 5.5-6.2] vs. 5.7 [5.4-6.1]), with the difference magnifying over time (week 8: 3.5 [3.2-3.9] vs. 2.7 [2.4-2.9]). No other interactions over time were significant. Screen time was negatively associated with PMH and positively associated with depressive and anxiety symptoms (p < 0.05). Sitting time was negatively associated with PMH (p < 0.05). Rapid changes in sitting patterns (e.g., due to a pandemic) may have lasting effects on depressive symptoms. Strategies targeting those most affected (i.e., young adults, females) and/or focused on reducing sitting time may be critical for preventing long-term mental health effects resulting from COVID-19 or other large-scale behavior changes in the general population.

The effect of physical activity on the association between perceived racial discrimination and depression in African Americans.

BACKGROUND: The purpose of this cross-sectional study was to examine the effect of physical activity (PA) on the relationship between perceived racial discrimination and major depressive disorder (MDD) in African Americans. METHODS: 645 African Americans (mean age 45 years) were interviewed on their perceived racial discrimination, PA, and past 12-month MDD. Participants were categorized into tertiles (lower, middle, upper) of racial discrimination as well as "active" or "inactive" groups based on the US PA guidelines. Odds ratios and 95% confidence intervals (CIs) were calculated for MDD prevalence across discrimination tertiles stratified by PA group after adjusting for potential confounders. RESULTS: The upper (higher) discrimination group had 2.99 (95% CIs 1.03-8.67) increased odds of MDD compared with the lower group after adjusting for potential confounders. The stratified analysis indicated that the increased odds of MDD in the upper discrimination group were observed only among the inactive group (5.19 [1.08-24.87]) after adjusting for age and sex. The association between discrimination and MDD was not significant among active participants. LIMITATIONS: Limitations include generalizability since participants were predominantly women and recruited solely from Iowa or Georgia; the low number of MDD cases in some groups; and that causation cannot be inferred from this cross-sectional study. CONCLUSION: Not meeting the PA guidelines may be associated with higher depression among African Americans experiencing higher levels of perceived racial discrimination.

Associations Between Employment Changes and Mental Health: US Data From During the COVID-19 Pandemic.

Objectives: To examine associations of changing employment conditions, specifically switching to working from home (WFH) or job loss, with mental health, using data collected during the COVID-19 pandemic. Methods: Data from 2,301 US adults in employment prior to COVID-19 were collected April 3rd-7th, 2020. Participants reported whether their employment remained unchanged, they were WFH when they had not been before, or they had lost their job due to the pandemic. Outcomes were symptoms of depression, anxiety, stress, loneliness, and positive mental health (PMH) assessed using validated questionnaires. Linear regression quantified associations of employment changes with mental health outcomes, controlling for age, sex, race, BMI, smoking status, screen time, physical activity, marital status, chronic conditions, and current COVID-19 containment strategies being followed. Results: Compared to participants whose employment remained unchanged, those who switched to WFH did not differ in any measures of mental health (all p ≥ 0.200). Participants who had lost their job reported higher symptoms of depression (g = -0.200, 95%CI = -0.333 to -0.067; p = 0.003), anxiety (g = -0.212, -0.363 to -0.061; p = 0.008), and stress (g = -0.348, -0.482 to -0.214; p < 0.001), and lower PMH (g = -0.212, -0.347 to -0.078; p = 0.002). Loneliness did not differ between groups (p = 0.087). Conclusion: This study demonstrates (1) that concerns around potential adverse mental health effects, particularly increases in loneliness, should not preclude WFH in the general population, while considering each individual's personal circumstances, and (2) the acute adverse association of job loss with mental health. Tailored and sensitive interventions may be required to prevent deteriorations in mental health associated with job loss during periods of societal stress.

Associations Between Change in Outside Time Pre- and Post-COVID-19 Public Health Restrictions and Mental Health: Brief Research Report.

The novel coronavirus disease 2019 (COVID-19) and associated pandemic has resulted in systemic changes to much of life, affecting both physical and mental health. Time spent outside is associated with positive mental health; however, opportunities to be outside were likely affected by the COVID-19 public health restrictions that encouraged people not to leave their homes unless it was required. This study investigated the impact of acute COVID-19 public health restrictions on outside time in April 2020, and quantified the association between outside time and both stress and positive mental health, using secondary analyses of cross-sectional data from the COVID and Well-being Study. Participants (n = 3,291) reported demographics, health behaviors, amount of time they spent outside pre/post COVID-19 public health restrictions (categorized as increased, maintained, or decreased), current stress (Perceived Stress Scale-4), and positive mental health (Short Warwick-Edinburgh Mental Well-being Scale). Outside time was lower following COVID-19 restrictions (p < 0.001; Cohen's d = -0.19). Participants who increased or maintained outside time following COVID-19 restrictions reported lower stress (p < 0.001, 5.93 [5.74-6.12], Hedges' g = -0.18; p < 0.001, mean = 5.85 [5.67-6.02], Hedges' g = -0.21; respectively) and higher positive mental health (p < 0.001, 24.49 [24.20-24.77], Hedges' g = 0.21; p < 0.001, 24.78 [24.52-25.03], Hedges' g = 0.28) compared to those who decreased outside time. These findings indicate that there are likely to be negative stress and mental health implications if strategies are not implemented to encourage and maintain safe time outside during large-scale workplace and societal changes (e.g., during a pandemic).

A qualitative analysis of barriers and facilitators to reducing sedentary time in adults with chronic low back pain.

BACKGROUND: Sedentary time (SED) is associated with many detrimental health outcomes, yet little is known about what factors influence one's ability to reduce SED. Even less is known about these factors in specific patient populations for whom high levels of SED may influence symptoms, such as those with chronic low back pain (cLBP). The purpose of this study was to qualitatively explore participants' perceptions of factors that influenced their ability to reduce SED across an 8-week intervention to reduce SED in adults with cLBP and elevated depressive symptoms. METHODS: Three months after a theory-based intervention to break up and reduce sitting, semi-structured interviews explored factors that influenced reducing SED. Three researchers independently coded each conversation. Codes were charted and mapped with participants reviewing their own transcripts and the merged codes. The research team then defined key themes. Factors that were perceived to either facilitate behavior change or acted as barriers were identified and thematized as positive or negative determinants. RESULTS: Common barriers for reducing SED included environmental constraints, opposing social norms, and productivity; these barriers were frequently encountered in the workplace. Common facilitators for reducing SED included habit development, self-monitoring tools, restructuring the physical environment, and social accountability. Notably, back pain was not a frequently reported barrier or facilitator for reducing SED. CONCLUSION: This sample of patients with cLBP and elevated depressive symptoms had similar determinants for reducing SED as previously reported in non-patient populations and did not appear to need strategies specific to dealing with chronic pain. Since work-related social norms and environmental factors were perceived as significant barriers to sitting less, workplace interventions that provide standing desks, offer standing meetings rooms, and/or institution-wide standing breaks may help reduce SED at work. The use of an activity monitor with sitting reminders and education regarding how to use the reminders as external cues to develop new sitting habits may also aid in adoption and adherence to this behavior change across settings. Developing coping plans and restructuring physical environments were perceived as successful strategies for overcoming social and environmental barriers. Future interventions targeting SED reductions may benefit from incorporating these strategies.

Working From Home and Job Loss Due to the COVID-19 Pandemic Are Associated With Greater Time in Sedentary Behaviors.

Objectives: Due to the COVID-19 pandemic, major changes to how, or even whether, we work have occurred. This study examines associations of changing COVID-19-related employment conditions with physical activity and sedentary behavior. Methods: Data from 2,303 US adults in employment prior to COVID-19 were collected April 3rd-7th, 2020. Participants reported whether their employment remained unchanged, they were working from home (WFH) when they had not been before, or they lost their job due to the pandemic. Validated questionnaires assessed physical activity, sitting time, and screen time. Linear regression quantified associations of COVID-19-related employment changes with physical activity, sitting time, and screen time, controlling for age, sex, race, BMI, smoking status, marital status, chronic conditions, household location, public health restrictions, and recalled physical activity, sitting time, and screen time prior to the COVID-19 pandemic. Results: Compared to those whose employment remained unchanged, participants whose employment changed (either WFH or lost their job) due to COVID-19 reported higher sitting time (WFH: g = 0.153, 95% CI = 0.095-0.210; lost job: g = 0.212, 0.113-0.311) and screen time (WFH: g = 0.158, 0.104-0.212; lost job: g = 0.193, 0.102-0.285). There were no significant group differences for physical activity (WFH: g = -0.030, -0.101 to 0.042; lost job: g=-0.070, -0.178 to 0.037). Conclusion: COVID-19 related employment changes were associated with greater sitting and screen time. As sedentary time is consistently negatively associated with current and future health and wellbeing, increased sedentary time due to employment changes is a public health concern.

Current and 1-Year Psychological and Physical Effects of Replacing Sedentary Time With Time in Other Behaviors.

INTRODUCTION: Sedentary time is inversely associated with health. Capturing 24 hours of behavior (i.e., sleep, sedentary, light physical activity, and moderate-to-vigorous physical activity) is necessary to understand behavior-health associations. METHODS: Healthy young adults aged 20-35 years (n=423) completed the Profile of Mood States, the Perceived Stress Scale, and dual-energy x-ray absorptiometry and anthropometric measures at baseline and 12 months. Time spent sedentary (total, in prolonged [>30 minutes] and short [≤30 minutes] bouts), in light physical activity (1.5-3.0 METs), moderate-to-vigorous physical activity (>3.0 METs), and asleep, were assessed through SenseWear armband worn 24 hours/day for 10 days at baseline. Isotemporal substitution modeling evaluated cross-sectional and longitudinal psychological and physical health associations of substituting sedentary time with sleep, light physical activity, or moderate-to-vigorous physical activity. Data were collected from 2010 to 2015 and analyzed in 2019. RESULTS: Cross-sectional analyses revealed substituting prolonged sedentary time for sleep was associated with lower stress (standardized ß= -0.11), better mood (-0.12), and lower BMI (-0.10). Substituting total or prolonged sedentary for moderate-to-vigorous physical activity was associated with lower body fat percentage (total, -0.22; prolonged, -0.23) and BMI (-0.40; -0.42). Higher BMI was associated with substituting total or prolonged sedentary for light physical activity (0.15; 0.17); lower BMI with substituting prolonged sedentary for short bouts (-0.09). Prospective analyses indicated substituting total or prolonged sedentary with light physical activity was associated with improved mood (-0.16; -0.14) and lower BMI (-0.15; -0.16); substituting with moderate-to-vigorous physical activity was associated with improved mood (-0.15; -0.15). CONCLUSIONS: Short- and long-term psychological benefits may result from transitioning sedentary time to light physical activity or sleep, whereas increasing moderate-to-vigorous physical activity may be required to influence physical health. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT01746186.

Cardiorespiratory Fitness and Muscular Strength on Arterial Stiffness in Older Adults.

PURPOSE: To evaluate the independent and combined associations of cardiorespiratory fitness (CRF) and muscular strength (MS) with arterial stiffness (AS), a strong predictor of cardiovascular disease, in older adults. METHODS: This cross-sectional study included 405 older adults (mean age, 72 yr). Cardiorespiratory fitness was assessed by time (s) to complete a 400-m walking test and MS by maximal handgrip strength (kg). Carotid-femoral pulse wave velocity was used to assess AS. High AS was defined as a pulse wave velocity of ≥10 m·s, a previously established threshold for increased cardiovascular risk. Poisson regression was used to calculate prevalence ratios (PR) and 95% confidence intervals (CI) of having high AS across sex-specific tertiles of CRF and MS. Muscular strength and CRF were further dichotomized into either "weak" or "unfit" (lower one third for each), or "strong" or "fit" (upper two thirds for each) to investigate the combined associations of CRF and MS with high AS. All analyses were adjusted for potential confounders, including MS for CRF and CRF for MS. RESULTS: Sixty-nine (17%) participants had high AS. Compared with lower CRF, PR (95% CI) of having high AS were 0.53 (0.30-0.95) and 0.69 (0.38-1.23) for middle and upper CRF, respectively. Compared with lower MS, PR (95% CI) of having high AS were 0.81 (0.49-1.34) and 0.52 (0.29-0.92) for middle and upper MS, respectively. In the joint analysis, compared with the "unfit and weak" group, PR (95% CI) of having high AS were 0.72 (0.38-1.35), 0.58 (0.29-1.16), and 0.46 (0.25-0.85) for "unfit and strong," "fit and weak," and "fit and strong" groups, respectively. CONCLUSIONS: Higher levels of CRF and MS were independently associated with lower (healthier) levels of AS in older adults.

Cytokine responses across submaximal exercise intensities in women with major depressive disorder.

BACKGROUND: Major depressive disorder (MDD) is associated with chronic inflammation. Exercise training can treat depression in adults with MDD, potentially through reducing inflammatory activity. This improvement may occur through adaptations to repeated acute inflammatory responses. Cytokine responses to acute steady-state exercise of varying intensities were determined in women with different levels of depression. METHODS: This analysis included 19 women with MDD who each participated in four sessions consisting of 30 â€‹min of quiet rest, light, moderate, or hard intensity exercise. Blood samples were collected pre- and within 10 â€‹min post-session. Changes in the levels of IL-6, IL-8, IL-10, and TNF were evaluated in each session. RESULTS: Serum concentrations of IL-6, IL-8 and TNF were all significantly elevated following vigorous exercise (i.e., hard) compared to the quiet rest session. No changes in cytokine levels occurred after light and moderate exercise. Depression severity did not appear to influence the acute inflammatory response to exercise. LIMITATIONS: The sample size was small, all female, and from a secondary data analysis, which limits the generalizability of the findings. CONCLUSIONS: Repeat, acute increases in inflammatory activity following hard exercise sessions may prompt adaptations and lead to reductions in chronic inflammation over time. This dose-response study identified an exercise intensity threshold to induce acute inflammatory responses in women with MDD.

Serum Endocannabinoid and Mood Changes after Exercise in Major Depressive Disorder.

The endocannabinoid (eCB) system is implicated in the pathophysiology of depression and is responsive to acute exercise in healthy adults. PURPOSE: We aimed to describe acute changes in serum eCB across a prescribed moderate (MOD) and a self-selected/preferred (PREF) intensity exercise session in women with major depressive disorder (MDD) and determine relationships between changes in eCB and mood states. METHODS: Women with MDD (n = 17) exercised in separate sessions for 20 min on a cycle ergometer at both MOD or PREF in a within-subjects design. Blood was drawn before and within 10 min after exercise. Serum concentrations of eCB (anandamide [AEA], 2-arachidonoylglycerol) and related lipids (palmitoylethanolamine, oleoylethanolamine, 2-oleoylglycerol) were quantified using stable isotope-dilution, liquid chromatography/mass spectrometry/mass spectrometry. The profile of mood states and state-trait anxiety inventory (state only) were completed before, 10 min and 30 min postexercise. RESULTS: Significant elevations in AEA (P = 0.013) and oleoylethanolamine (P = 0.024) occurred for MOD (moderate effect sizes: Cohen's d = 0.58 and 0.41, respectively). Significant (P < 0.05) moderate negative associations existed between changes in AEA and mood states for MOD at 10 min (depression, confusion, fatigue, total mood disturbance [TMD] and state anxiety) and 30 min postexercise (confusion, TMD and state anxiety). Significant (P < 0.05) moderate negative associations existed between 2-arachidonoylglycerol and mood states at 10 min (depression and confusion) and 30 min postexercise (confusion and TMD). Changes in eCB or related lipids or eCB-mood relationships were not found for PREF. CONCLUSION: Given the broad, moderate-strength relationships between improvements in mood states and eCB increases after MOD, it is plausible that the eCB system contributes to the mood-enhancing effects of prescribed acute exercise in MDD. Alternative mechanisms are likely involved in the positive mood state effects of preferred exercise.