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Impact of replacing sedentary behaviour with other movement behaviours on depression and anxiety symptoms: a prospective cohort study in the UK Biobank

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A. A. Kandola, B. del Pozo Cruz, D. P.J. Osborn, B. Stubbs, K. W. Choi, J. F. Hayes

Original languageEnglish
Article number133
JournalBMC Medicine
Issue number1
PublishedDec 2021

Bibliographical note

Funding Information: Aaron Kandola is supported by the ESRC (ES/P000592/1). Brendon Stubbs is supported by a Clinical Lectureship (ICA-CL-2017-03-001) jointly funded by Health Education England (HEE) and the National Institute for Health Research (NIHR). Brendon Stubbs is part funded by the NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust. Brendon Stubbs also holds active grants with the Medical Research Council and Guys and St Thomas Charity (GSTT). Brendon Stubbs has received consultancy fees from ASICS Europe BV. Joseph Hayes is supported by the Wellcome Trust (211085/Z/18/Z). David Osborn and Joseph Hayes are supported by the UCLH NIHR Biomedical Research Centre, are also part supported by the NIHR Collaboration for Leadership in Applied Health Research and Care North Thames at Bart’s Health NHS Trust. No funding body had any influence on the conception, design, analysis, or production of this manuscript and the views it expresses are not necessarily those of any funding organisations. Funding Information: The UK Biobank is funded by the Wellcome Trust, Medical Research Council, Department of Health, Scottish government, Northwest Regional Development Agency, Welsh Assembly government, and British Heart Foundation. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Background: Sedentary behaviour is potentially a modifiable risk factor for depression and anxiety disorders, but findings have been inconsistent. To assess the associations of sedentary behaviour with depression and anxiety symptoms and estimate the impact of replacing daily time spent in sedentary behaviours with sleep, light, or moderate to vigorous physical activity, using compositional data analysis methods. Methods: We conducted a prospective cohort study in 60,235 UK Biobank participants (mean age: 56; 56% female). Exposure was baseline daily movement behaviours (accelerometer-assessed sedentary behaviour and physical activity, and self-reported total sleep). Outcomes were depression and anxiety symptoms (Patient Health Questionnaire-9 and Generalised Anxiety Disorders-7) at follow-up. Results: Replacing 60 min of sedentary behaviour with light activity, moderate-to-vigorous activity, and sleep was associated with lower depression symptom scores by 1.3% (95% CI, 0.4–2.1%), 12.5% (95% CI, 11.4–13.5%), and 7.6% (95% CI, 6.9–8.4%), and lower odds of possible depression by 0.95 (95% CI, 0.94–0.96), 0.75 (95% CI, 0.74–0.76), and 0.90 (95% CI, 0.90–0.91) at follow-up. Replacing 60 min of sedentary behaviour with moderate-to-vigorous activity and sleep was associated with lower anxiety symptom scores by 6.6% (95% CI, 5.5–7.6%) and 4.5% (95% CI, 3.7–5.2%), and lower odds of meeting the threshold for a possible anxiety disorder by 0.90 (95% CI, 0.89–0.90) and 0.97 (95%CI, 0.96–0.97) at follow-up. However, replacing 60 min of sedentary behaviour with light activity was associated with higher anxiety symptom scores by 4.5% (95% CI, 3.7–5.3%) and higher odds of a possible anxiety disorder by 1.07 (95% CI, 1.06–1.08). Conclusions: Sedentary behaviour is a risk factor for increased depression and anxiety symptoms in adults. Replacing sedentary behaviour with moderate-to-vigorous activity may reduce mental health risks, but more work is necessary to clarify the role of light activity.

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