Device-quantified vigorous intermittent lifestyle physical activity and risk of incident depression and anxiety among non-exercising adults
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Background
Physical activity is a well-established modifiable risk factor of depression and anxiety. However, whether vigorous intermittent lifestyle physical activity (VILPA)—short, sporadic bouts embedded in daily life—confers mental health benefits remains unclear. We aimed to examine the associations of accelerometer-measured VILPA with risks of incident depression and anxiety among non-exercising adults.
Methods
This prospective cohort study included 19,962 non-exercising adults (mean age 62.3 years) from the UK Biobank, free of depression and anxiety at baseline (2013–2015), with 7-day wrist-worn accelerometry data. Cox proportional hazards models and restricted cubic splines were used to examine associations between average daily duration of VILPA bouts (up to 1 or 2 minutes) and these outcomes.
Findings
Over an average follow-up of 7.8 years, 469 participants developed depression and 536 developed anxiety. Approximately 94.6% of participants engaged in VILPA bouts lasting up to 1 minute. Daily VILPA duration exhibited L-shaped associations with both depression and anxiety. Compared with participants who accumulated no VILPA, the whole sample median daily VILPA duration (lasting up to 1 minute) of 4.1 minutes was associated with a hazard ratio of 0.70 (95% confidence interval [CI]: 0.56-0.88) for depression and 0.79 (95% CI: 0.64-0.97) for anxiety. Findings were similar for VILPA bouts lasting up to 2 minutes.
Interpretation
Among non-exercisers, even small amounts of VILPA are associated with substantially lower risks of depression and anxiety, highlighting the potential of high intensity incidental physical activity as a feasible strategy for preventing depression and anxiety, particularly among individuals unable or unwilling to engage in structured exercise.
Research in context
Evidence before this study
We searched PubMed and Web of Science, without language restrictions, using the terms (physical activity OR vigorous intensity OR VILPA) AND (depression OR anxiety OR mental health). Most previous studies on physical activity and mental health have focused on structured leisure-time activity, usually accumulated in bouts of at least 10–15 minutes, and have relied mainly on self-reported physical activity. Few studies have investigated short bouts of vigorous activity embedded within daily living. Research on vigorous intermittent lifestyle physical activity (VILPA) is emerging, but has not specifically focused on mental health outcomes. Thus, evidence directly addressing whether brief intermittent vigorous activity undertaken as part of everyday life is associated with depression, anxiety, or broader mental health remains scarce.
Added value of this study
This study provides prospective evidence that device-measured daily VILPA is associated with lower risks of incident depression and anxiety. We found Daily VILPA duration exhibited L-shaped associations with both depression and anxiety, with small amounts of VILPA were associated with substantially lower risk of depression and anxiety. Compared with no VILPA, the median daily VILPA duration of 4.1 minutes was associated with a 30% lower risk of depression and a 21% lower risk of anxiety.
Implications of all the available evidence
VILPA might represent a feasible and accessible alternative for adults who are unwilling or unable to engage in structured leisure-time exercise, for whom barriers to participation can be substantial. The widespread use of consumer wearable devices also creates new opportunities to capture brief bursts of non-exercise physical activity accumulated across the day. Together, the available evidence and our findings highlight the potential public health importance of brief intermittent vigorous physical activity undertaken as part of daily living, and may help inform future intervention design, target setting, and monitoring.
