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Fysisk aktivitet kan reducere depressive symptomer

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Depression is a common mental health disorder that can have a major impact on individual wellbeing and daily functioning (Kessler, 2012). According to the World Health Organization, depression affects around 300 million people and is now the leading cause of disability worldwide (WHO, 2017). Depression is characterised by persistent low mood, dysphoria, impaired motivation and several other symptoms, ranging from psychomotor to cognitive impairments (American Psychiatric Association, 2013). Depression is also associated with serious physical health comorbidities including cardiovascular disease (Correll et al., 2017; Hare et al., 2014), metabolic risk factors such as adiposity (Capuron et al., 2017), premature mortality (Correll et al., 2017; Walker et al., 2015) and a large financial cost to society (Chisholm et al., 2016). The treatment and prevention of depression remains a public health priority (Cuijpers et al., 2012; Jorm et al., 2017).

Depression is a complex condition, its heterogeneity exemplified by the fact that two people can be diagnosed with depression and not share a single symptom (Fried and Nesse, 2015). This poses considerable challenges for traditional treatments, which include pharmacotherapy, psychotherapy, or a combination of both. These forms of therapy have provided invaluable benefits for the treatment of depression. For example, the widespread use of antidepressant medications demonstrates their scalability and accessibility (Kantor et al., 2015). Treatment effects tend to be small-to-modest for pharmacotherapy (Cipriani et al., 2018) and psychotherapy (Cuijpers et al., 2019), with a third of people with depression remaining non-responsive to treatment (Rush et al., 2006). Pharmacotherapy can also cause several adverse side-effects, such as headaches and nausea (Anderson et al., 2012). A substantial minority of people with depression do not seek treatment at all (Hasin et al., 2018). Pharmacotherapy and psychotherapy are also unable to address the physical comorbidities associated with depression (Correll et al., 2017). Both pharmacotherapy and psychotherapy will continue to play an important role in the treatment of depression in the future. But evidence suggests that the increased provision of these treatments for common mental health disorders has had little impact on prevalence and novel methods of treating and preventing these conditions are still needed (Jorm et al., 2017).

Physical activity is consistently reported as having antidepressant effects (Schuch et al., 2018). Physical activity refers to any bodily movement by the skeletal muscles that requires energy expenditure (Caspersen et al., 1985). A recent meta-analysis of 49 prospective cohort studies including 1,837,794 person-years found that people with high levels of physical activity had 17% lower odds of depression (OR = 0.83, CI = 0.79, 0.88) than people with low physical activity (Schuch et al., 2018). Other meta-analyses have also found that low physical activity is associated with a greater risk of depression (Mammen and Faulkner, 2013; Teychenne et al., 2010). Other meta-analyses found that low cardiorespiratory fitness (CRF), an indicator of physical inactivity, was associated with a 64% higher risk of depression (HR = 1.64, CI = 1.29, 2.08) than high CRF across at least 3,540,450 person-years of data (Kandola et al., 2019; Schuch et al., 2016a).

The benefits of physical activity for depression extend beyond risk reduction. Exercise refers to a subset of physical activity that is planned and structured towards improving physical fitness (Caspersen et al., 1985), such as running or weight training. Several systematic reviews have found that exercise can reduce the symptoms of depression with a moderate-to-large effect size and can be a useful addition to pharmacotherapy and psychotherapy (Bridle et al., 2012; Cooney et al., 2013; Josefsson et al., 2014; Kvam et al., 2016; Schuch et al., 2016b). In people with depression, CRF is inversely correlated with symptom severity (Papasavvas et al., 2016). Including exercise in the treatment of depression also has several additional benefits. For example, exercise can reduce the risk of cardiovascular disease (Cornelissen and Smart, 2013), which is elevated in people with depression (Correll et al., 2017).

Despite extensive research on the efficacy of exercise and physical activity, the mechanisms through which they produce antidepressant effects remain unclear. An attempt has been made to understand the psychosocial and biological mechanisms of physical activity in the mental health of young people (Lubans et al., 2016). But little has been done to summarise these mechanisms in adults and focussing on depression.

This review will provide a comprehensive summary of the key biological and psychosocial mechanisms through which physical activity produces an antidepressant effect. We conducted non-systematic literature searches to identify possible mechanisms that are influenced by physical activity and may also play a role in the pathophysiology of depression. We primarily included mechanisms based on the strength of the underlying evidence. But there is a paucity of direct, high-quality evidence in this area, particularly within the psychosocial domain. To avoid omitting potentially important but understudied mechanisms, we also considered other factors such as their conceptual plausibility or their role in other forms of depression treatment.

Much of this review will focus on exercise specifically, as clinical research typically utilises this form of activity. Structured exercise plans are an efficient method to operationalise and standardise physical activity within a clinical trial. It is also possible that other characteristics of exercise are conducive to depression treatment. For example, exercise is typically performed during leisure time, which is associated with mental health benefits, unlike other domains such as activity during work (White et al., 2017).

We will also detail how furthering our understanding of these mechanisms can help to identify other factors that moderate or confound the relationship between physical activity and depression. For simplicity, we will assume a fundamental overlap in the mechanisms through which physical activity and exercise influence mental health.

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Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity

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Depression is a common mental health disorder that can have a major impact on individual wellbeing and daily functioning (Kessler, 2012). According to the World Health Organization, depression affects around 300 million people and is now the leading cause of disability worldwide (WHO, 2017).

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s. 9-10

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Inaktivitet og immobilitet i tværfagligt perspektiv

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Bog: Inaktivitet og immobilitet- i et tværfagligt perspektiv 

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Bog: Inaktivitet og immobilitet- i et tværfagligt perspektiv 

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kapitel 3- immobilitet og psykiske konsekvenser

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For stor fysisk aktivitet = samme effekt som inaktivitet på det mentale helbred = risiko for depression, angst og spiseforstyrrelser

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For stor fysisk aktivitet = samme effekt som inaktivitet på det mentale helbred = risiko for depression, angst og spiseforstyrrelser

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Fysisk inaktivitet - konsekvenser, årsaker og symptomer / symptomer | Alternativ medisin og metoder for behandling av sykdommer. (tso-stockholm.com)

Fysisk inaktivitet kan påvirke kreativiteten samt føre til selvisolation

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Alternativ medisin og metoder for behandling av sykdommer.

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Fysisk inaktivitet er et fenomen av postindustrielle samfunn. Bare noen få generasjoner siden måtte folk bevege seg med mindre de var blant de få privilegerte menneskene som la andre gjøre det fysiske arbeidet.

innhold

Dismembered habitat

Psykiske konsekvenser

Kultur raskere enn evolusjon

Kroppen tilpasser seg

Bare de som beveger seg, føler sine kjedler

Første tegn

Mangel på trening blant ungdom

Mangel på trening gjør deg feit

immobilitet

Hva forårsaker mangel på trening??

stresset

For mye av en god ting

Hva å gjøre?

I dag gjøres det meste av arbeidet sittende, på kontoret foran datamaskinen. Mange tenåringer leker med smartphones i stedet for å sette på gummistøvler og gå i skogen, foreldrene deres sitter foran datamaskinen etter åtte timer på kontoret og bestiller pizza i stedet for å kjøpe ferske ingredienser og tilberede seg selv.

Fysisk inaktivitet: årsak til mange sykdommer. Bilde: rynket korn - fotolia

Barn har mindre og mindre mulighet til å engasjere seg i fysisk aktivitet: bilstopp i byene, overfylte boligblokker og veier slutter på mulighetene for å slippe av damp. TV, datamaskin, Facebook og Appens app erstatter nesten eventyrene i omverdenen, i stedet for klicken, barna i nettsamfunn.

Våre forfedre hadde beundret de tekniske hjelpemidler i dagens samfunn, men: Hvis musklene er for lite belastning i det lange løp, snakker vi om mangel på mosjon. Det har konsekvenser fordi vi må bruke alle organene slik at de blir sunne.

Forskere ved Pennington Biomedical Research Center ved Louisiana State University fant at personer som bruker mer enn tre timer om dagen, dør omtrent tre år tidligere.

Dismembered habitat

Det er billig, folk som ikke får nok å antyde latskap, tro mot den nyliberalistiske mantra: Alle har ansvar for seg selv. Friheten til å handle fysisk, spesielt i store byer, er begrenset.

Veier kutter barnets handlingsradius på en slik måte at de knapt kan unngå åpne plasser utenfor boligen uten fare. Foreldre frykter for barna sine på vei til skolen, og med rette. Når barn står opp i sitt spill, er de i reell fare for å bli spilt over.

Folk i storbyer kan sjelden ha råd til store hager. I to-roms leiligheten med utsikt over parkeringsplassen på penny markedet, er det knapt noen muligheter til å delta i fysisk aktivitet.

Det er færre og færre åpne områder. Tenåringer som lager brann, leir vilt, bygger en flåte eller løper utenfor banket spor i skogen, betraktes nesten som kriminelle.

Felt sprøytet med plantevernmidler og overbefruktet med gjødsel gjør selv landlige områder uattraktivt for barn.

Psykiske konsekvenser

Mangel på trening tresko skipene, som et resultat, er hjernen mindre forsynt med blod. Påvirkede lider av mangel på konsentrasjons- og læringshemming. Reduserer ytelsen med mangel på trening, de berørte er ansett som usportslige og deltar ikke lenger i fysisk testing av sine jevnaldrende.

Deres selvbilde er truet, og det får dem raskt til å isolere seg sosialt. Som et resultat kan du skjule enda mer bak Playstation, kompensere for deres frustrasjon av fett og sukkerrik mat og komme inn i en ond sirkel.

Mangel på trening lammer kreativitet. Kreativitet er ikke en rent åndelig prosess. Kreative mennesker bruker materialer fra miljøet og lager noe nytt fra det. Grafikkprogrammer kan ikke erstatte maleri, carving eller keramikk. Vi lærer ved å forstå ting i bokstavelig forstand. Virtuelle realiteter kan ikke erstatte disse tingene.

Å flytte for lite begrenser selvstendig næringsdrivende og hindrer selvbestemmelse. Hvem er i full besittelse av hans fysiske evner, kan i alle fall forestille seg hvordan han bygger en leir i skogen, når leiligheten hans brenner ned, eller hvordan hun sliter seg uten å ha Internett.

Nysgjerrighet og glede av funn har mye å gjøre med bevegelse. Når vi går rundt, ser vi noe nytt, vi oppdager ting på dørstokken, når vi går til inngangsdøren. Men mangel på mosjon fremmer behovet for falsk sikkerhet: som drar seg bare fra sofaen til seng, overraskelser vises etter hvert som en trussel. Livet mister sin sjarm, terroren til den helt og holdende tar stedet for eventyret.

Trening er morsomt, det føles godt å føle kroppen vår. Når vi slipper av damp, frigir organismen hormoner, adrenalin og dopamin, endorfiner som frigjør følelser av lykke.

Kultur raskere enn evolusjon

Folk er i naturen løpere som jakter og samler. Vi beveger oss på to ben og brukte mye av vår tid på planeten for å streife å se i hule trær i Honeycomb å grave røtter ut av bakken, nærme oss på hjort å forfølge, å hale byttet i leiren å forberede seg til å sole seg, eller å sy klærne.

Da vi ble bosatte bønder, betydde de fleste av våre liv over tusen år også hardt fysisk arbeid og trening. Mangel på mosjon var lidelse som bøndene dyrket på marken, korn såing, bringe i avling høyet i skur vedlagte eller Shepherds som beveges med sin sauer og geiter i all slags vær gjennom fjellet.

måtte knapt bevege ble en luksus for prester og adelsmenn som levde av andres arbeid: Så i Italia i tidlig moderne tid var blek hud av kvinner som posh samt lange negler, fordi det viste hadde at denne privilegerte arbeidet ikke er fysisk , Fedme viste også at noen tilhørte de herskende klassene, for det første hadde mye å spise og for det andre måtte ikke fysisk utøve.

Håndverkere, byggearbeidere, skogbrukere, postmenn eller gartnere lider ikke i dag av mangel på mosjon. Men fysisk arbeid har mistet betydning generelt. Det meste av arbeidet er gjort på datamaskinen i dag, selv med tidligere klassisk kroppsarbeid.

Det forblir ikke uten konsekvenser. Kroppsmasseindeksen, forholdet mellom høyde og kroppsvekt har skiftet de siste 50 årene.

Vi må forberede maten selv eller kjøpe bare de enkelte bestanddeler, fisken vi ikke lenger fiske, men få ham ut av fryseren, og eplene vi ikke rykke fra treet, men kaste dem i kurven.

Takket være Amazon trenger vi ikke engang å gå til bokhandel, takket være nettbanken ikke lenger til sparebanken, i stedet for å skrive et brev og i hvert fall til postkassen for å kjøre, skriver vi e-post.

Med appeller til den dårlige samvittigheten er det ikke gjort, for selv tidligere generasjoner, som ikke kjente fristelsene fra Internett, kalte vanligvis ikke kroppen sin frivillig.

På lang sikt vil evolusjonen tilpasse kroppen vår til mangel på mosjon og industri, for eksempel ved å endre bekkenets posisjon. Men vår biologi ligger bak vår kultur.

Men en organisme som er programmert til å trene, lider når den ikke er nødvendig. På langt sikt mangler bevegelse skade alle organer.

Sportsforsker Veit Wang sier, "Når kroppen vår ikke beveger seg, utvikler noen ting seg tilbake. La oss ta skjelettsystemet: Leddbrusk støtter demping og gliding. Det tillater den mekaniske bevegelsen i leddene å løpe jevnt. Hvis dette systemet fungerer bra, trenger det litt forandring av bevegelse og gjenoppretting. Men hvis vi ikke beveger seg, blir dette vevet dannet tilbake. Resultatet kan være en smertefull leddgikt hvor knogler i leddene gni mot hverandre. "

Kroppen tilpasser seg

Ofte merker vi ikke konsekvensene av manglende bevegelse fordi vårt behov for å gjøre noe av det, retter seg mot vår evne til å gjøre det. En ung kropp kan kompensere for mangel på trening bedre enn en gammel, og det er derfor vi ofte skylder vår alder for forringelse av ytelsen. Våre fallende ferdigheter er knapt eldre, i hvert fall ikke før fylte 40 år, men er en langvarig følge av mangel på trening. Kroppen selv regenererer når vi alder.

Men betyr alder at virkningene av mangel på mosjon er klar: Hvis jeg med 30 noen år for lite flyttet, kan jeg jogge ikke lenger bare gjennom parken - hvis jeg har nesten ikke beveget meg mer med 50 tjue år er muligens alvorlige sykdommer resultat.

I tillegg flytter mange mennesker i 20-årene generelt mer enn i 40-årene eller 50-årene. Bevegelse er ikke bare klassikere av en "sunn livsstil" som fotturer, men også "å reise gjennom verdenshistorien," på jakt etter et sted å sove uten penger med ryggsekken på Schuler, pakking bokser fra en by til å dra den andre, på en fest nettene Danse gjennom, markere stasjonen med gjengen på stasjonens torg, eller rusle gjennom nettene på jakt etter seksuelle partnere, forhindrer mangel på trening.

I mange år føler vi oss ikke syke når vi kommer ut av pusten raskere og klatrer trappene, og radiusen fortsetter å krympe. I tillegg er det vanskelig å fortelle om vi ubevisst tilpasser seg våre synkende evner eller bare velg den mer komfortable måten. La oss handle på 40 med bil fordi vi bare hadde en sykkel på 20 eller kjempet å ri for mye?

Bare de som beveger seg, føler sine kjedler

Ofte merker vi ikke konsekvensene av mangel på trening før vi ikke krever kroppen vår. Hvem jogs foran fjernsynet etter år, får sideutskrifter; de som supplerer banen fra kontoret til sofaen og derfra til puben med ukentlig vektopplæring, føler første gang smerten i muskler som han ikke engang visste eksisterte før.

Som et problem er det mest mangel på trening bare når de trenger å se legen, fordi de lider av høyt blodtrykk eller ryggsmerter. Alarmklokka ringte mye tidligere.

Første tegn

1) Det er vanskelig for oss å klatre trapper.

2) Hvis vi går ned en trapp, må vi fortsette.

3) Fjellturer plager oss, som sykler på bakkene.

4) En kort sprint tar oss ut av pusten.

5) Vi klarte ikke å få handlekurven inn i bilen.

6) Graving av en seng, kutting av hekken eller hacking av tre er overstrengende.

7) For byturer shimmy vi fra en bistro til den neste.

8) Vi har problemer med å binde skoene våre mens de står.

9) Når vi står opp fra en stol, støtter vi oss selv.

10) Hvis vi står på ett ben i mer enn noen sekunder, støtter vi oss selv.

11) Selv om vi går lenge, må vi hvile.

Vi bør avklare om vi kan lide en alvorlig sykdom. Men hvis det ikke er tilfelle, og vår hverdag består av å sitte, enten på kontoret, på kaffe, ser på TV eller i bilen, så blir det annonsert.

Alder er ingen unnskyldning. Selv om den fysiske ytelsen øker på 20-tallet og reduseres fra rundt 40 år, men dette betyr bare at vi må ta vare på kroppen vår med økende alder.

Med litt trening kan vi også kjøre 50 tre kilometer på 30 minutter, klatre til tredje etasje uten å ta en pause, og slå på skulderleddet 360 grader.

Mangel på trening blant ungdom

Et nytt fenomen er mangel på bevegelse av tenåringer av generasjonen smarttelefon. Idrettsforskere anslår at tre fjerdedeler av 13- til 15-åringene beveger seg for lite. Også ansvarlig er "helikopterforeldre" som vil se etter sine avkom under alle forhold.

Men hvis mor og far kjører til skolen og henter dem, og hvem tilbringer ettermiddagen mellom SMS, Playstation og lekser, spør han ikke om kroppen sin. Mange unge mennesker i dag virker ikke lenger på en måte som var tydelig på 1980-tallet.

Som barn rømmer i gjørmen, bygge trehus, kjør som en tenåring på en sykkel til nabobyen for å møte klicket er det for noen storbybarn i dag en historie fra utlandet.

Programmer i skole og samfunn kan motvirke mangel på trening blant unge mennesker. Det ville være mulig, for eksempel for å inkludere fysisk utagering sterkere i skolen: frittgående utflukter i biologi klasser, Living History i historien, som arbeider med tre, stein eller leire i kunst - det er mange muligheter.

Mangel på trening gjør deg feit

Våre genetikk er ikke forberedt på å velge mellom Big Mäc og frossen pizza når som helst. Som jæger-samler slo vi noen ganger så mye bytte at vi kunne konsumere det i flere uker, så igjen fant vi lang tid bortsett fra noen få bær og røtter ingenting.

Innskudd i arteriene på grunn av mangel på trening. Bilde: psdesign1 - fotolia

Selv om genetikk har tilpasset seg gjennom årtusenene til bønnens diett, men ikke til stadig tilgjengelig hurtigmat. Vår kropp skaper reserver som å overleve de magre tider.

Hvis vi beveger oss for lite med et sammenhengende overskudd av kalorier, fett og karbohydrater, skaper kroppen fettreserver, men forbruker dem ikke. Dette overbelaster det kardiovaskulære systemet. Konsekvensene er høyt blodtrykk, diabetes og hjerteinfarkt.

immobilitet

Ikke bare vår moderne boligmiljø fører til mangel på trening, men også nevrologiske sykdommer og fysiske funksjonshemminger, ulykker og fedme.

Alle som lider av leddgikt eller hoftefrakturer, vender seg til en mild holdning og unngår bevegelser. De berørte menneskene blir svakere fysisk, og det er derfor de beveger seg mindre og mindre.

Hvis depresjon og tap av appetitt blir tilsatt, så påvirker de som er berørt, ikke i det hele tatt.

Hva forårsaker mangel på trening??

Det vanligste resultatet av mangel på mosjon er kronisk ryggsmerter. Mangel på trening er en av de store tre, som forårsaker sivilisasjonssykdommer i tillegg til røyking og usunt kosthold, det går sammen med de to andre ofte.

Begrenset bevegelse fremmer hypertensjon, diabetes mellitus, koronar hjertesykdom og allergier. Han øker også risikoen for Alzheimers sykdom. Risikoen for død fra kronisk mangel på trening øker med 56% innen 20 år, noe som er 4% mer enn risikoen for røyking.

Hvis du beveger deg for lite, begynner du å miste fett. Forholdet mellom muskler og fett i kroppen endres, med fett som reduserer utholdenhet og styrke, øker risikoen for metabolske problemer.

Mangel på mosjon svekker kroppens immunsystem. Folk som beveger seg for lite, blir ofte syke: virus og bakterier er mer sannsynlig å invadere og de berørte blir utsatt for allergier.

Hvem mister strømmen på grunn av mangel på mosjon kan holde ryggraden hans mindre tid oppreist, leddene er ustabil, blir skadet risikoen for svekket hjertemuskelen øker risikoen for å lide et hjerteinfarkt.

Sitter i samme stilling hele dagen fører til dårlig stilling, de mulige konsekvensene er ikke bare ryggsmerter, men også en herniated plate.

Når vi sitter mye og beveger seg litt, blir nakke og nakke spent. Spenningen trekker opp til hodet og vi har hodepine.

Hvis vi ikke stresser hjertet, svekker vi hjertemuskelen. Gjennom sport overbelaster vi nå dette svekkede hjertet.

Når vi beveger oss, belaster vi de indre organene for å sikre deres sirkulasjon. Mangel på mosjon, derimot, fører til tarmlyder, forstoppelse og andre fordøyelsesproblemer.

Fedme er først og fremst forårsaket av dårlig kosthold og for det andre av for lite trening. Når vi knapt beveger oss, bruker vi mer energi enn kroppen bruker. Resultatet er en konstant sans for treghet - vi føler impulsiv og ofte mistenker mentalt stress, selv om årsaken er fysisk.

Diabetes 2, påvirker diabetes også flere og flere unge mennesker. Hovedårsakene er overvekt og mangel på trening.

Benatrofi bryter ned benstoffet. De berørte lider frakturer oftere. Ben bygger opp stoffet når musklene er stresset. Derfor er mangel på mosjon også en av utløserne her.

Slidgikt oppstår når brusk returnerer og leddene slites ut. Dette skjer igjen hvis vi beveger oss for lite.

stresset

Mangel på trening er ikke en årsak til stress, men bevegelse er det naturlige svaret på en stressende situasjon. Stress er en nødstilfelle i hjernekjemien vår og er nødvendig for å motvirke farer. Hormoner er i full gang, og vi kan gjøre mer enn vanlig.

Ufordelaktig kombinasjon av mangel på mosjon og stress. Bilde: Focus Pocus LTD - fotolia

I vår naturlige historie, for eksempel, brøt hjernen ut da plutselig sto et løve overfor oss. I et blunk bestemte oss vårt ubevisste om vi kjempet eller flyktet. Som et resultat ble hormonene nedbrytet igjen.

I dag er vi under stress fordi vi ikke kan betale regninger, avtaler overlapper, irriterer utleier eller nabo viser oss til politiet. Men hjernen vet det ikke, og stresshormonene bestemmer ikke mellom det angripende løven og det regulerende byrået.

Derfor hjelper det å reagere på stresset vi gjorde i våre tidligste tider - fysisk. Kjører gjennom skogen, brølende, hakkende tre eller en time med styrketrening, reduserer hormonene.

For mye av en god ting

Tidligere Couchpotatoes, men også ex-junkies og tørre alkoholikere ligner noen ganger konvertitter som opptrer radikalt motsatt av deres tidligere livsstil.

Ikke bare for mye, men for lite trening er skadelig. Kroppen ønsker å bli utfordret, men ikke overbelastet. Han trenger jobb og tid til å regenerere.

Den som tror at etter år på sofaen mellom sigaretter, chips og alkohol, må de gå ti kilometer hver morgen uten å ha forberedt kroppen for det, skader kroppen sin for en gang.

Selv de som stadig må dra tungt på jobb, ødelegger beinene, leddene og stoffskiftet.

Hvis symptomer på mangel på mosjon kunngjør, uten alvorlig sykdom er årsaken, bør vi ta det enkelt.

I stedet for å gå rett med byens maraton, er det nok å gå en time to ganger i uken eller å sykle to ganger i uken. Hvor mye og hvor lenge lys sport gjør oss bra, forteller kroppen oss. Så lenge vi har det bra, er alt bra.

Hvis mangel på trening kombinert med høy overvekt, bør vi gjøre det uten å kjøre fordi vi bruker det så mye til leddene. Svømming, derimot, reduserer vekten, og i stedet for å gå gjennom skogen for en time i uka, kan vi tilbringe tid med å gjøre vanns aerobic.

Hva å gjøre?

Hvis du jobber for åtte timer om dagen på skrivebordet, er rådene ikke mye å jogge. Men mange øvelser kan også enkelt legges inn mens du arbeider.

For eksempel kan du løfte føttene og utvide kneet. Hvis du gjør dette regelmessig, kaller de for lårmusklene dine.

Du kan stå på tuppet i mellom og deretter heve og senke kroppen og deretter fortsette å tippe. Slik trener de sine kalver.

Når du sitter på stolen og holder ryggen rett, trekker du knærne til du kommer over kanten av stolen og bukene strammer.

Fungerer du på et åpent kontor eller trenger du å gå til en offentlig myndighet? Bare gå opp en etasje og tilbake igjen. Dette kan også gjentas, for eksempel hvis du må vente på det offentlige kontoret.

Sett hendene i fanget ditt som om du var be. Trykk deretter hendene fra hverandre. Dette vil trene brystmusklene dine, biceps og triceps.

Trykk på håndflatene mot undersiden av pulten.

Stram muskler i rumpene, slapp av musklene og spenne igjen. Under lunsjpause kan du ta en spasertur. (Dr. Utz Anhalt)
Spesialtilsyn: Barbara Schindewolf-Lensch (lege)

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Fysisk inaktivitet - konsekvenser, årsaker og symptomer / symptomer

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Fysisk inaktivitet er et fenomen av postindustrielle samfunn. Bare noen få generasjoner siden måtte folk bevege seg med mindre de var blant de få privilegerte menneskene som la andre gjøre det fysiske arbeidet.

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-Øger risikoen for depression
-Øger risikoen for angst
-Øger risikoen for stress
- Fysisk aktivitet nedsætter angst
- Manglende bevægelse går både ud over humør og energiniveau
- Øger apetiten og risiko for overvægt

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Fysisk inaktivitet – hvad konsekvenser har det - Powerperformance

Fysisk aktivitet påvirker humøret- frigiver endorfiner
Træning er godt for folk med depression.

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Er det farligt at bevæge sig for lidt? | Sygeforsikringen

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Vi skal være fysisk aktive i mindst 30 minutter dagligt, men hvad sker der, hvis du ikke er det? Kan du kompensere for manglende motion ved at spise sundt, undgå rygning og alkohol? Nyt og Sundt har talt med professor Bente Klarlund om fysisk inaktivitet.

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How Does Physical Activity Impact Academic Performance?

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The answer to the question, how does physical activity impact academic performance depends upon the physical activity & the subject area.

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Metode: 286 patienter fra Sverige deltog i studiet. De blev delt i to hold, hvor det ene hold fik et 12 ugers træningsprogram med hhv. kardiorespiratorisk (aerob) og styrketræning. Det andet hold fik ikke noget program.

Resultaterne: Der var tydelig udvikling for holdet med træning, da deres angst og depressive symptomer blev markant bedre ift. kontrolgruppen.

Link til selve studiet: https://reader.elsevier.com/reader/sd/pii/S0165032721010739?token=060E609FEFF9E64C2BA7322AA9D1F1FAF448F8F62B00B4ADB5418DF0B10043A5492CA20EAC66A51319B460BE6ED2B599&originRegion=eu-west-1&originCreation=20220519091521

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Et nyt svensk lodtrækningsstudie har undersøgt, om 12 ugers guidet træning med forskellige træningsintensiteter kan reducere angstsymptomer hos patienter med angstlidelser, og studiet viser et fald i den gennemsnitlige angstscore.

I studiet deltog 223 patienter i alderen 18-65 år med angstlidelser set i almen praksis i Sverige. Ved lodtrækning blev deltagerne fordelt på tre grupper, to med guidet gruppebaseret kredsløbs- og styrketræning af forskellig intensitet og en kontrolgruppe, der modtag en rådgivningssession om fysisk aktivitet.

Resultaterne viste, at både træning af lav og moderat/høj intensitet gav et større gennemsnitligt fald i angstscoren sammenlignet med indsatsen i kontrolgruppen, og mod forventning så træningsintensiteten ikke ud til at have betydning for effektstørrelsen.

Deltagerne i træningsgrupperne gik fra moderat/høj angstscore til lav angstscore efter 12 de uger.

Der er flere mulige forklaringer på den gavnlige effekt af fysisk aktivitet i forhold til reduktion af angstsymptomer. Ud over neurobiologiske teorier, der omfatter de systemer, der både er involveret i udvikling af angstlidelser og i, hvordan fysisk aktivitet påvirker hjernen, kan det i dette studie ikke udelukkes, at alene det at være en del af en gruppe og modtage støtte fra en fysioterapeut kan have en terapeutisk effekt. Det er relevant af foretage flere undersøgelser af effekten af guidet fysisk aktivitet ved specifikke angstlidelser og med fokus på betydning af træningsintensiteten.

Kilde

Henriksson, M. et al. (2022). "Effects of exercise on symptoms of anxiety in primary care patients: A randomized controlled trial". Journal of Affective Disorder.
https://doi.org/10.1016/j.jad.2021.10.006

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Fysisk aktivitet kan mindske angstsymptomer

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Et nyt svensk lodtrækningsstudie har undersøgt, om 12 ugers guidet træning med forskellige træningsintensiteter kan reducere angstsymptomer hos patienter med angstlidelser, og studiet viser et fald i den gennemsnitlige angstscore.

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Abstract

Physical activity may play an important role in the management of mild-to-moderate mental health diseases, especially depression and anxiety. Although people with depression tend to be less physically active than non-depressed individuals, increased aerobic exercise or strength training has been shown to reduce depressive symptoms significantly. However, habitual physical activity has not been shown to prevent the onset of depression. Anxiety symptoms and panic disorder also improve with regular exercise, and beneficial effects appear to equal meditation or relaxation. In general, acute anxiety responds better to exercise than chronic anxiety. Studies of older adults and adolescents with depression or anxiety have been limited, but physical activity appears beneficial to these populations as well. Excessive physical activity may lead to overtraining and generate psychological symptoms that mimic depression. Several differing psychological and physiological mechanisms have been proposed to explain the effect of physical activity on mental health disorders. Well controlled studies are needed to clarify the mental health benefits of exercise among various populations and to address directly processes underlying the benefits of exercise on mental health.

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Acknowledgements

The authors would like to thank the following people for their encouragement in the preparation of this manuscript: Samuel E. Romano, Ph.D. and Marian Cohen, ACSW, The University of Michigan Department of Family Medicine, Ann Arbor, Michigan; Nancy McElwain, Ph.D., The University of North Carolina Center for Developmental Science, Chapel Hill, North Carolina.

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Affiliations

1. Rex Sports Medicine Institute, Cary, North Carolina, USA

Scott A. Paluska

2. Department of Family Medicine, University of Michigan Medical Center, Ann Arbor, Michigan, USA

Thomas L. Schwenk

Corresponding author

Correspondence to Scott A. Paluska.

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Paluska, S.A., Schwenk, T.L. Physical Activity and Mental Health. Sports Med 29, 167-180 (2000). https://doi.org/10.2165/00007256-200029030-00003
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Keywords

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Physical Activity and Mental Health - Sports Medicine

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Physical activity may play an important role in the management of mild-to-moderate mental health diseases, especially depression and anxiety. Although people with depression tend to be less physically active than non-depressed individuals, increased aerobic exercise or strength training has been shown to reduce depressive symptoms significantly.

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 Inaktivitet kan også have konsekvenser for de unges mentale sundhed og trivsel.  

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Det at være inaktiv under corona-nedlukningen kan således forstærke følelsen af at være socialt isoleret, og kan få store konsekvenser for de unges mentale sundhed.

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Den 11. marts 2020 lukkede Danmark ned grundet en hastigt spredende global corona-pandemi. Vi fik i Danmark forbud mod at samles, og skoler, arbejdspladser, foreninger, klubber og fitnesscentre blev lukket for fysisk adgang. Vi blev i det øjeblik kastet ud i en radikalt forandret hverdag, som angiveligt ville påvirke vores bevægelsesadfærd og hermed befolkningens sundhedstilstand.

I april 2020, under den første bølge i corona-pandemien, gennemførte vi derfor på Institut for Idræt og Biomekanik, Syddansk Universitet en undersøgelse, som skulle afdække, hvordan danskernes bevægelsesadfærd påvirkes, når det meste af samfundet lukkes ned. Undersøgelsen bestod af 1.802 spørgeskemabesvarelser fra danskere i alderen 15-85 år samt interviews med 10 familier. Svarene fra spørgeskemaundersøgelsen viste, at danskerne bevægede sig 16,1% mindre under den første corona-bølge sammenlignet med tiden før corona-pandemien. Særligt bekymrende var imidlertid resultaterne for de 142 unge i alderen 15-18 år, som deltog i undersøgelsen. Denne aldersgruppe oplevede det største fald i fysisk aktivitet med 36,6%. Blandt disse unge steg andelen af inaktive desuden med hele 71,8%. Et italiensk studie fandt, i lighed med vores resultater, at unge (under 21 år) reducerede deres fysiske aktivitet med 34,4% under corona-nedlukningen (Maugeri et al., 2020). At de unges fysiske aktivitet faldt betydeligt mere end gennemsnitsdanskerens fysiske aktivitet under corona-nedlukningen kan tyde på, at de unge har sværere ved at kompensere for restriktionerne.

Social isolation har store konsekvenser for unges bevægelsesadfærd

Særligt forsamlingsforbuddet, som har gjort det vanskeligt at være fysisk aktiv sammen med venner, synes at være en afgørende forklaring på den markant faldende fysiske aktivitet under corona-nedlukningen. Næsten hver tredje af de unge i undersøgelsen (28,9%) svarede, at de under nedlukningen savnede nogen at være aktiv sammen med. I undersøgelsen finder vi også, at de unge primært var fysisk aktive alene (57,7%) under nedlukningen og kun 1,4% svarede, at de var fysisk aktive sammen med venner, hvorimod hele 83,5% af de unge normalvis er fysisk aktive sammen med venner. At social isolation har alvorlige konsekvenser for unges bevægelsesadfærd, er ikke overraskende. Andre studier viser ligeledes, at social interaktion med venner er en stærk prædiktor for unges fysisk aktivitet (Macdonald-Wallis, Jago, & Sterne, 2012; Montgomery et al., 2020). Restriktionerne har desuden forårsaget, at mange unge ikke har kunne lave de fysiske aktiviteter som de plejer. Hver tredje af de unge i undersøgelsen (33,1%) svarede, at de savnede at lave de fysiske aktiviteter, som de plejer at lave. I tråd med det har en tidligere dansk undersøgelse, omhandlende danskernes motions- og sportsvaner, fundet, at unge 16-19-årige foretrækker et hverdagsliv med rutiner og stabilitet frem for fleksibilitet (Pilgaard & Rask, 2016). Således synes det, at de unge ikke har kunne lave de fysiske aktiviteter, som de plejer at lave, også at være en forklaring på de unges reducerede fysiske aktivitet under nedlukningen.

Nedsat bevægelse kan få sundhedsmæssige konsekvenser

Det er bekymrende, når unge reducerer deres fysiske aktivitet, og særligt når de helt stopper med at være fysisk aktive, da det er i denne livsfase, man som oftest danner den sundhedsmæssige livsstil, som føres med ind i voksenlivet (Telama, 2009). Tilmed viser et dansk studie, at blot to ugers markant reduktion i fysisk aktivitet hos unge raske mænd resulterer i metaboliske forandringer i kroppen, som kan forårsage en række betydelige sundhedsmæssige konsekvenser (Olsen, Krogh-Madsen, Thomsen, Booth, & Pedersen, 2008). Inaktivitet kan også have konsekvenser for de unges mentale sundhed og trivsel. Et stort nyere brasiliansk studie fandt, at 14-19-årige unge, som er inaktive i fritiden og som ikke deltager i idrætsundervisning, føler sig langt mere ensomme end jævnaldrende, som er fysisk aktive (Pinto et al., 2019). Det at være inaktiv under corona-nedlukningen kan således forstærke følelsen af at være socialt isoleret, og kan få store konsekvenser for de unges mentale sundhed. Set i det perspektiv, hvor det danske samfund nu har haft restriktioner i adskillige måneder, må det forventes, at de unges sundhed er udfordret foranlediget af den stigende forekomst i fysisk inaktivitet.

Hvordan får vi de unge på sporet igen?

Danmark er nu så småt ved at åbne samfundet op igen. Gymnasierne er delvist åbnet op, og nogle unge kan igen lave de fysiske aktiviteter som de gjorde før corona-nedlukningen, mens andre må vente lidt endnu. Det formodes at langt de fleste unge vil vende tilbage til den bevægelsesadfærd, som de havde før corona-nedlukningen. Dog viser erfaringer fra idrætsforeningerne, at det kan være vanskeligt at fastholde særligt de unge i foreningsidrætten, hvis de af en eller anden årsag har været væk fra idrætten i noget tid (Carlsen, 2018). I tråd med det viser de seneste medlemstal fra blandt andet DGI's foreninger et faldende medlemstal (Andersen, 2021), hvilket indikerer, at det kommer til at kræve en særlig indsats at få alle unge tilbage til en mere aktiv hverdag igen. Og det er tvivlsomt, om foreningerne kan løfte opgaven selv. Interviewdelen af vores undersøgelse viser, at særligt dem som arbejder professionelt med idræt og fysisk aktivitet kan være nøglen. I undersøgelsen fandt vi, at de unge, som var i dialog med en idrætslærer under nedlukningen, oplevede det som en stor støtte i forhold til at opretholde en fysisk aktiv hverdag. Anden forskning har ligeledes vist, at idrætslærere er vigtige rollemodeller, som med deres engagement og motivation kan påvirke de unges bevægelsesadfærd positivt (Andersen, 1993; Harman, 2013). For at undgå langsigtede sundhedsmæssige konsekvenser af den reducerede fysiske aktivitet forårsaget af corona-nedlukningen, er det således vigtigt nu, at vi alle løfter i flok - foreninger såvel som forældre, lærere og andre fagprofessionelle - for at motivere de unge til at finde vejen tilbage til en mere aktiv hverdag.

Læs mere om undersøgelsen i følgende artikel:
Schmidt T, Pawlowski CS. (2021) 'Physical activity in crisis. The impact of COVID-19 on Danes physical activity behavior. Front. Sports Act. Living 2:610255

Referencer:

Andersen, M. L. (2021). 64.582 færre medlemmer i DGI's foreninger i 2020. Hentet fra: https://www.dgi.dk/om/presse/presserum/seneste-nyt/64582-faerre-medlemmer-i-dgi-s-foreninger-i-2020

Andersen, N. (1993). Perception of physical education classes among young adolescents: do physical education classes provide equal opportunities to all students? Health Educ Res, 8(2), 167-179.

Carlsen, H. (2018). Foreningslivet er børn og unges fritidsarena - Det skal det også være i fremtiden. Brøndby: Danmarks Idrætsforbund

Harman, A. (2013). Student's perception of their PE teachers as role models: A retrospective account. Cardiff Metropolitan University, Wales, UK Cardiff School of Sport p. 1-58.

Macdonald-Wallis, K., Jago, R., & Sterne, J. A. C. (2012). Social Network Analysis of Childhood and Youth Physical Activity A Systematic Review. Am J Prev Med, 43(6), 636-642.

Maugeri, G., Castrogiovanni, P., Battaglia, G., Pippi, R., D'Agata, V., Palma, A., et al. (2020). The impact of physical activity on psychological health during Covid-19 pandemic in Italy. Heliyon, 6:e04315.

Montgomery, S. C., Donnelly, M., Bhatnagar, P., Carlin, A., Kee, F., & Hunter, R. F. (2020). Peer social network processes and adolescent health behaviors: A systematic review. Prev Med, 130, 105900.

Olsen, R. H., Krogh-Madsen, R., Thomsen, C., Booth, F. W., & Pedersen, B. K. (2008). Metabolic responses to reduced daily steps in healthy nonexercising men. JAMA, 299(11), 1261-1263.

Pilgaard, M., & Rask, S. (2016). Danskernes motions- og sportsvaner 2016. København: Idrættens Analyseinstitut

Pinto, A. A., Oppong, A. K., Puga, B. R., Nahas, M. V., Dias, D. T., & Pelegrini, A. (2019). Association between loneliness, physical activity, and participation in physical education among adolescents in Amazonas, Brazil. J Health Psychol, 1359105319833741.

Telama, R. (2009). Tracking of physical activity from childhood to adulthood: a review. Obes Facts, 2(3), 187-195.

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Unges bevægelse i krise - et tværsnitstudie af unges bevægelsesadfærd under corona-nedlukningen - Gymnasieskolernes Idrætslærerforening

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Den 11. marts 2020 lukkede Danmark ned grundet en hastigt spredende global corona-pandemi. Vi fik i Danmark forbud mod at samles, og skoler, arbejdspladser, foreninger, klubber og fitnesscentre blev lukket for fysisk adgang. Vi blev i det øjeblik kastet ud i en radikalt forandret hverdag, som angiveligt ville påvirke vores bevægelsesadfærd og hermed befolkningens sundhedstilstand.

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Department of Kinesiology, Université Laval, Québec City, QC, Canada

Department of Physical Education, Université Laval, Québec City, QC, Canada

Centre de Recherche de l'Institut de Cardiologie et de Pneumologie de Québec, Québec City, QC, Canada

Sedentary behavior refers to certain activities in a reclining, seated, or lying position requiring very low energy expenditure. It has been suggested to be distinct from physical inactivity and an independent predictor of metabolic risk even if an individual meets current physical activity guidelines. Over the past decades, a shift in the activity profile of individuals has been observed with vigorous physical activity and sleep being partly replaced by cognitive work, a potential neurogenic stress component considering its hormonal and neurophysiological effects, leading to various impacts on health. Mental work, for instance, may significantly increase glycemic instability leading to an increase in the desire to eat and thus, higher energy intakes. Furthermore, screen-based leisure activities (e.g., television watching) and screen-based work activities (e.g., computer use for work purposes) have often been considered together while they may not trigger the same stress response and/or use of substrate. Thus, the problems of sedentariness may not only be attributed to a lack of movement, but also to the stimulation provided by replacing activities. The objective of this review is to discuss the (1) recent evidence and current state of knowledge regarding the health impact of sedentary behaviors on health; (2) potential neurogenic effects of cognitive work as a sedentary behavior; (3) link between sedentary behaviors and the diet; (4) resemblance between sedentary behaviors and the inadequate sleeper; and (5) potential solutions to reduce sedentary behaviors and increase physical activity.

Introduction

Although the beneficial health effects of physical activity have been well recognized, physical inactivity accounts for 9% of premature mortality worldwide ( 1). The term physical inactivity refers to performing insufficient amounts of moderate to vigorous-intensity activity (i.e., not meeting specific physical activity guidelines) ( 2). Sedentary behavior, on the other hand, has been suggested to be distinct from physical inactivity and an independent predictor of metabolic risk even if an individual meets current physical activity guidelines ( 3). The World Health Organization recommends that adults aged 18 or older participate in at least 150 min of moderate-to-vigorous activity per week or the equivalent of 30 min of daily activity ( 4). Currently, just over 15% of Canadian adults are meeting these guidelines ( 5). However, it is unclear if meeting these guidelines of activity is sufficient to be considered non-sedentary. Daily physical activity levels are evaluated by a person's daily energy expenditure divided by his or her basal metabolic rate ( 6). The prevalence of sedentary behavior, defined as any waking behavior that requires low energy expenditure (≤1.5 MET) such as prolonged sitting, reclining or lying down ( 2), is very high in developed countries. Results from the 2003/2004 National Health and Nutrition Examination Survey (NHANES) demonstrated that children and adults in the United States spend ~7.7 h/day of their waking time engaged in sedentary behaviors such as watching television, playing passive video games, using the computer, prolonged sitting (e.g., at a desk) and motorized transportation ( 7).

Over the last 30 years, overweight and obesity have become characteristic of the majority of Canadians which has led to a concomitant increase in the prevalence of co-morbidities including type 2 diabetes and cardiovascular disease. Sedentary behavior has been a contributing factor to this epidemic and associated with an increased risk of all-cause mortality ( 8, 9). In a 12-year prospective study, a progressively higher risk of mortality was found across higher levels of sitting time from all causes and cardiovascular disease, independent of leisure-time physical activity ( 10). Furthermore, in a meta-analysis of six studies evaluating daily sitting time and all-cause mortality, a 34% higher mortality risk for adults sitting 10 h/day was observed after taking physical activity into account ( 9). Sedentary behavior has also been linked with poor glycemic control including a reduction in insulin sensitivity and glucose uptake ( 11). Several animal studies have shown that insulin-mediated glucose uptake is significantly reduced due to muscular inactivity ( 12, 13). Epidemiological studies have consistently reported that time spent in sedentary tasks that require little muscular activity (low accelerometry counts, computer use or self-reported television time) is negatively associated with insulin action ( 14, 15). In a clinical trial, healthy non-exercising young men who reduced their daily activity levels from normal (10,501 steps/day) to low (1,344 steps/day) levels of ambulatory activity for 2 weeks were found to display metabolic alterations including a 17% decline in their insulin sensitivity ( 16). However, because higher inactivity decreases energy expenditure, if this reduction is not compensated for by a reduction in energy intake it will lead to energy surplus which has been shown to increase insulin resistance ( 17).

In addition to the changes in human activity, globalization and technological changes have favored a progressive switch from physically demanding tasks to knowledge-based work or mental activity soliciting an enhanced cognitive demand. Screen-based leisure activities (e.g., television watching, video games, and internet use) and screen-based work activities (e.g., computer use for work purposes) have often been considered together while they may not trigger the same stress response and/or use of substrate. Furthermore, from a physiological perspective, the biological requirements and effects of physical and cognitive work are not the same. Mental work, for instance, may significantly increase glycemic instability (i.e., wide fluctuations in blood glucose concentrations) leading to an increase in the desire to eat and thus, higher energy intakes ( 18, 19). Thus, the problems of sedentariness may not only be attributed to a lack of movement, but also to the stimulation provided by replacing activities. In a context where there is exposure to cognitive work, novel strategies to increase physical activity and improve energy balance regulation are needed.

Therefore, the objective of this review is to discuss the (1) recent evidence and current state of knowledge regarding the health impact of sedentary behaviors on health; (2) potential neurogenic effects of cognitive work as a sedentary behavior; (3) link between sedentary behaviors and the diet; (4) resemblance between sedentary behaviors and the inadequate sleeper; and (5) potential solutions to reduce sedentary behaviors and increase physical activity.

Epidemiological Observations

The energy cost of various activities, both in work and leisure, has been of great interest to researchers. Regular physical activity has been associated with decreased adiposity ( 20, 21), an increase in muscle oxidative potential ( 22) and resting metabolism ( 21), a decrease in energy intake relative to energy expenditure ( 23) and an increase in beta-adrenergic stimulation ( 21, 24). In a study examining the association between physical activity and weight loss maintenance in a group of individuals who were previously living with obesity, participants in the highest tertile of physical activity (highly active; >1575 kcal/week) experienced a significantly lower weight regain compared to those in the low (< 850 kcal/week) and moderately (850-1575 kcal/week) active groups after a two year follow-up ( 25). This suggests that significant weight loss may be maintained for 2 years when weekly caloric expenditure is greater than 1500 kcal/week; however, success also depending upon the degree of lifestyle changes made. This study also indicated that the increasing the frequency of exercise appeared to be the best method for increasing weekly caloric expenditure and that increased fat utilization post-exercise may be a likely contributor to maintaining a lower body weight long term. Inverse associations have been observed between time spent in moderate-to-vigorous physical activity and indices of adiposity in children, independent of objectively measured sedentary time and other covariates, while sedentary behavior was not linked with any of the adiposity indicators ( 26). However, frequent interruptions in sedentary time have been shown to be associated with a favorable cardiometabolic risk profile in adults ( 27) and among children with parental obesity ( 28). In a cross-sectional study of children with a family history of obesity, examining the associations among moderate-to-vigorous physical activity, fitness, sedentary behavior and insulin sensitivity using two markers of characterization (i.e., accelerometer and screen-time), it was found that physical activity was correlated with indices of insulin sensitivity independent of fitness and sedentary behaviors; however, this association was attenuated when adiposity was considered ( 29). Furthermore, self-reported screen-time was negatively associated with insulin sensitivity in girls, but not boys, after controlling for physical activity, fitness and adiposity ( 29). Although the reason for this is not clear, other factors including dietary habits linked to screen-time were suggested to be involved which may explain its effects on insulin sensitivity ( 29). Additionally, as previously discussed, this suggests that a stress-related biological reality related to screen-time may also promote metabolic dysfunctionality. In a recent meta-analysis of 16 studies, high levels of moderate intensity physical activity (60-75 min/day) appeared to offset the increased risk of mortality associated with high sitting time; however, the high activity did not eliminate the increased risk associated with television viewing suggesting the importance of considering the type of activities while sitting ( 30).

Extended periods of sedentary behavior results in low energy expenditure and may contribute to weight gain and negative health effects via effects on energy intake. Changes in energy expenditure and energy intake have been attributed to many factors including changes in family dynamics and popular sedentary activities including using computers and television viewing. In a systematic review of observational studies, higher levels of sedentary behavior (e.g., television viewing) were associated with a less healthful diet, such as less fruit and vegetable intake and higher consumption of energy-dense snacks and sugar-sweetened beverages in pre-school and school-aged children and adolescents ( 31). However, the results were less conclusive in adults. Technological development has favored a progressive switch from physically demanding tasks to knowledge-based work, soliciting great cognitive demand ( 32). This may be reflected by activities such as computer "chatting" in children, whereas for adults, it may represent knowledge-based work that appears to be essential from the perspective of economic competitiveness (i.e., labor efficiency and productivity) ( 33).

Effects of Sedentary Behavior vs. Physical Inactivity on Energy Intake, Appetite Control and Metabolism

Over time, a shift in the activity profile of individuals has been observed. Vigorous physical activity and sleep have been, in part, replaced by cognitive work which has also contributed to various health-related effects. Sedentary occupations have become the norm with approximately one in two individuals performing primarily sedentary tasks. In addition to the low energy expenditure from these sedentary tasks, high mental demands at work have been associated with increased food intake suggesting that this may lead to a positive energy balance ( 34- 36). In a study examining the impact of knowledge-based work on spontaneous energy intake, subjective appetite and glucose homeostasis, healthy women students were randomly assigned to one of three 45-min conditions including (1) resting in a seated position; (2) reading a document and writing a summary; or (3) performing a battery of computerized tests followed by an ad libitum buffet meal ( 18). Although no differences in subjective appetite were observed, mean energy intake following the reading-writing and automated test-battery conditions exceeded that measured after rest by 203 kcal and 253 kcal, respectively ( 18). Furthermore, significant variations in plasma glucose and insulin concentrations were observed compared to the seated only position suggesting that this may be considered a risk factor for a positive energy balance leading to overweight in the longer term ( 18). Cortisol concentrations over the 45 min in the two cognitive conditions was also significantly higher compared to the control condition suggesting knowledge-based work as a neurogenic stress component considering its hormonal and neurophysiological effects. Activation of the hypothalamic-pituitary-adrenal (HPA) axis is the primary neuroendocrine response to both psychological and physiological stress and previous studies ( 37, 38) have shown that stress-induced cortisol reactivity is associated with greater food intake which may explain the response to the knowledge-based conditions in this study ( 18). In another study assessing the impact of a major work deadline (high workload) and a quiescent period of work (low workload) on plasma lipids, dietary intake, and self-reported stress in employees, self-reported stress, plasma total cholesterol, energy and dietary fat intakes were higher in the high workload compared to the low workload condition ( 34). Although the association between cognitive work and body weight has been primarily investigated in adults, one study examining the link between homework duration, adiposity indicators, and stress-related levels in school-aged children found that boys with a high workload of homework, when combined with schoolwork-related stress, had unfavorable adiposity indicators (i.e., higher percent body fat) ( 39). As has been previously suggested, from a physiological perspective, the biological requirements of physical and mental work are different because knowledge-based work is a type of activity that relies on the brain which utilizes glucose for the metabolism of energy compared to physical activity which uses skeletal muscle and relies mostly on fat metabolism, depending on the type of physical activity ( 40). For example, frequent interruptions of prolonged sitting with short bouts of activity rely primarily on carbohydrate as fuel. However, in a study by Volkow et al., positron emission tomography was used to examine the impact of methylphenidate medication on the amount of glucose required by the brain to perform a cognitive task ( 41). It was found that methylphenidate reduced the increase in carbohydrate utilization induced by mental work by ~50% ( 41).

Appetite control occurs through a complex interaction between physiology and behavior. Low physical activity levels have been suggested to interact with body fat to dysregulate appetite and be a source of overconsumption ( 42, 43). Hormonal responses to changes in energy intake and structured exercise have been observed; however, few studies have investigated their responses to increased time spent in sedentary activities. In a clinical trial of non-obese adults, only one day of inactivity, long hours of sitting, and minimal walking or standing, decreased insulin sensitivity even when energy intake was reduced to maintain energy balance ( 44). Subjects participated in three study sessions, mostly sitting without matching energy intake (SIT), sitting with matching energy intake (SITBAL), and no sitting (NO-SIT) ( 45). Three meals, breakfast, lunch, and dinner were exactly the same between SIT and NO-SIT. However, the caloric content of the breakfast and lunch were reduced by about 1,000 calories to match the reduction in energy expenditure in SIT-BAL. The next morning insulin action was tested. The results indicate that whole body insulin action was lower in SIT and SIT-BAL compared to NO-SIT (39 and 18% respectively). Therefore, both muscle inactivity and energy surplus contribute to the effect of prolonged sitting on insulin action. Further analyses examining gastrointestinal hormone response showed that SIT-BAL led to an increase in ghrelin in the men, but attenuated the leptin response, reduced ghrelin, increased hunger, and decreased fullness in the women. Because a reduction in energy expenditure was not accompanied by lower appetite, prolonged sitting may promote excess energy intake, leading to weight gain in both men and women. Physical inactivity has also been shown to interact with dietary macronutrient composition to influence energy and fat balance ( 46). Energy intake was not found to be regulated over a 2-day period in response to either imposition of inactivity or a high-fat diet ( 46). It was suggested that physical activity was essential to the avoidance of a significant positive energy balance.

From a practical standpoint, sedentary behavior is frequently associated with activities performed in a seated position. As previously discussed, there are potentially unfavorable stimulations that may be promoted by seated activities. However, these observations also reveal that the main problem of sedentariness in this context is maybe not the seated position, but rather the stressful stimulation that would accompany seated activities. For instance, in the context of usual daily activities seated labor can become stressful because of demanding cognitive effort, an inadequate sitting position, a stressful labor environment, or seated work that may be too long. Up until now, the biological mechanisms underlying stressful sitting activities have not been sufficiently documented; however, as discussed, our research experience suggests that stressful sitting may promote glycemic instability, hypercortisolemia and a reduced parasympathetic activity ( 18), which are all biological adaptations that are contrary to optimal metabolic fitness and body composition. Furthermore, up until now, there is no clear evidence that reading an interesting book in a seated position to relax before going to bed has negative effects (Figure 1).

Figure 1. Sedentary behavior and effects on appetite and glycemic control.

Sedentary Behavior and the Inadequate Sleeper

There is a resemblance between the biological effects of inadequate sleep compared to stressful seated work. In individuals with inadequate sleep habits, for example, glycemic instability has also been documented ( 47) and it is also well-known that short sleepers (< 6 h/night) are more prone to excessive energy intake and thus, weight gain compared to individuals sleep 7-8 h/night ( 48). These observations add to the proof of concept, where it is not so much the nature of the sedentary activity, but the stress-related biological reality that may be related to it.

Potential Solutions to Counteract the Apparent Detrimental Effects of Sedentariness

Clinical and public health guidelines for physical activity have been in place for nearly two decades ( 49); however, no quantitative guidelines exist for sedentary behavior because it is not known how much sedentary behavior is harmful to health. The impact of cognitive work as a sedentary behavior appears to be a stimulus favoring a significant enhancing effect on food intake and very trivial effects on energy expenditure. There is a clear disturbance in the context of modernity because of what we are accustomed to due to evolution. We have been configured to be hunter-gatherers and now we have chosen a modality of labor that is not optimally adapted to what we are used to. It would be difficult to return to the way of living of our grandparents using the "technology" of the past; however potential solutions that consider approaches to counteracting the negative impact of mental work may be possible with the readjustment of daily physical activity schedules.

In the context of a school or work environment, recent data has suggested that combining mental and physical work (e.g., active pauses/meetings), may be one strategy to reduce sedentary time in a context where potential neurogenic stress may be high. Both mental work and physical activity can influence hunger and food intake by producing various physiological changes. For example, an active exercise pause between a session of mental work and a buffet meal on energy intake and energy balance was found to represent a strategy to create a negative energy balance via an increase in energy expenditure and maintenance of energy intake ( 50). Furthermore, an acute bout of interval exercise after mental work was shown to decrease food consumption compared with a non-exercise condition suggesting that it may be used as an approach to offset positive energy balance induced by mental tasks ( 51). The school environment represents a good place for children and adolescents to improve the balance between physical activity and the cognitive demands of mental work. Students registered in a traditional sports studies program in ice hockey (school-related sessions in the morning and hockey-related activities in the afternoon) were found to experience a decrease in their body mass indices and increase in their aerobic and muscular fitness over the academic year without compromising their academic success ( 52). A physical education class prior to mental work was found to reduce blood pressure suggesting that physical education should be more prominent in schools and part of children's daily activities ( 53). Furthermore, elementary school children were found to be more physically active in an activity-permissive school environment up to the conditions of summer vacation conditions compared with a traditional school with chairs and desks and traditional school with desks which encouraged standing ( 54). The possibility of moving and even standing are good examples of modalities of cognitive work in which there is an inclusion of movement. The same scenario could be considered in a professional environment where active meetings could be developed to permit individuals to talk while walking or cycling on relevant machines.

Several years ago, our research group began active research meetings and examined its impact on perceived stress in staff and students at Laval University in Quebec City. A beneficial effect on self-reported stress and performance was found among staff and student members of the group suggesting that this may be one way to increase physical activity participation and improve the unfavorable effects of sedentariness on overall health. Computer-related activities which are common in both the school and work environment, for example, represent particular types of sedentary activities that are stressful and biologically demanding and thus, "re-designing" these environments may be essential to promoting more movement ( 54, 55).

Because sitting is widespread among desk-based activities, ergonomic adaptations including sitting-standing desks while working may be an approach that may decrease the negative effects of sedentary activities. Although the effects of sitting and standing on metabolism (e.g., blood pressure, glucose, and lipid metabolism) and cardiovascular risk is almost the same, evidence suggests that breaking up sedentary time with standing may be sufficient to improve productivity, relieve lower back pain and increase movement ( 56). In the workplace, sit-stand desks were found to be effective in decreasing workplace sedentary behavior in office workers with abdominal obesity, with no change in sedentary behavior or physical activity outside of work hours; however, these changes did not alter markers of cardiometabolic risk in these individuals ( 57). Furthermore, the use of sit-stand desks in sedentary office workers was also associated an overall sense of well-being and energy, decreased fatigue, and reduction in appetite, food intake and lower self-perceived levels of hunger ( 58). Introducing sit-stand desks was also shown to increase classroom standing time among university students who reported improvements in engagement, participation, attention and declines in restlessness, fatigue, boredom and cell phone use ( 59).

Conclusion

Based on the available evidence, sedentary behavior may be more than just physical inactivity. Calorie for calorie we deal with a profile of stimulation that may not necessarily have the same effects on appetite control, related peripheral biomarkers, and neuro-messengers. There appears to be a modern version of sedentary behavior that bears a potential neurogenic component leading to hyperphagia, stress, and unfavorable metabolic health outcomes; however, various approaches may help to increase physical activity participation that may possibly counteract the apparent unfavorable effects of sedentary behaviors. In the context of an environment where we are submitted to desk-based and computer-related activities, we must preserve our movement for optimal health and implement some of these strategies to increase physical activity participation in our schools and workplaces. Thus, socio-ecological interventions that consider multiple components are needed to help reduce sedentary behaviors and promote physical activity.

Author Contributions

AT was responsible for the content of the manuscript. SP and AT wrote, read and approved the final manuscript.

Funding

The research of AT is partly funded by the Canada Research Chair in Environment and Energy Balance. SP is the recipient of a Mitacs Accelerate Postdoctoral Fellowship in partnership with Alliance Santé Quebec.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

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# data[].attributes.attachment_link.title
Sedentariness and Health: Is Sedentary Behavior More Than Just Physical Inactivity?

# data[].attributes.attachment_link.description
Sedentary behavior refers to certain activities in a reclining, seated, or lying position requiring very low energy expenditure. It has been suggested to be distinct from physical inactivity and an independent predictor of metabolic risk even if an individual meets current physical activity guidelines.

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People who was not involved with PE during the COVID-19 pandemic had higher anxiety, depression, and stress scores. Based on this, it seems important to advise people to continue PE, following all the recommendations of preventive measures of the pertinent health organizations.

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Lucas Raphael Bento Silva 1,2*, Camila Simões Seguro ², Camila Grasiele Araújo de Oliveira ¹, Paulo Otávio Silva Santos ¹, Jordana Campos Martins de Oliveira 1,2, Luiz Fernando Martins de Souza Filho ², Célio Antônio de Paula Júnior ¹, Paulo Gentil 2,3 and Ana Cristina Silva Rebelo 2,3,4

Department of Physical Education, University Center Araguaia, Goiânia, Brazil

Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, Brazil

Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia, Brazil

Department of Morphology, Institute of Biological Sciences, Federal University of Goiás, Goiânia, Brazil

Objective: To evaluate the levels of anxiety, depression, and stress associated with the practice of physical exercise (PE) during pandemic by COVID-19.

Methods: This study has a cross-sectional characteristic and was carried out between May 12 and 14, 2020. An online questionnaire was applied with questions to assess sociodemographic characteristics and physical exercise during the CoVID-19 pandemic, in addition to depression, anxiety, and stress analysis. The study was approved by the local ethics committee (CAAE: 31521720.8.0000.5082).

Results: One thousand one hundred and fifty four answered the questionnaire (69.84% female). During the isolation period, the number of participants who declared not to exercise was 54.16%. Women generaly presented higher levels of anxiety, depression, and stress when compared to men ( p < 0.0001 for all domains). The risk of having increased anxiety were 118% higher (OR = 2.183; 95% CI = 1.717-2.775), the risk of depression was 152% higher (OR = 2.525; 95% CI = 1.991-3.205), and the risk of stress symptoms increased 75.1% (OR = 1.751; 95% CI = 1.386-2.213) in the participants who did not perform PE when compared to those who maintain regular PE.

Conclusion: People who was not involved with PE during the COVID-19 pandemic had higher anxiety, depression, and stress scores. Based on this, it seems important to advise people to continue PE, following all the recommendations of preventive measures of the pertinent health organizations.

Introduction

In December 2019, the World Health Organization (WHO) officially reported cases of pneumonia with no apparent cause, in the province of Hubei in China, the new disease caused by a type of coronavirus was designated with COVID-19 ( 1). COVID-19 quickly crossed borders, infecting people around the world, and was considered a pandemic in early March ( 2). Currently there are officially 5,438,837 confirmed cases and 340,585 deaths by the new virus. At the moment, Brazil stills in an upward curve of contamination, in May 24, 2020 there were 347,398 cases of infected with 22,013 numbers of deaths ( https://covid.saude.gov.br).

Widespread outbreaks of infectious diseases, such as COVID-19, are associated with emotional and psychological distress and symptoms of mental disorders, with a higher prevalence of anxiety, depression, and stress ( 3- 7). The number of people affected by these symptoms tends to be higher than the number of people affected by the infection ( 8, 9). Limited knowledge about COVID-19, lack of update on COVID-19, duration of home confinement, poor physical health and physical symptoms, lack of access to healthcare, lack of activity, uncertainty regarding the economic scenario and health systems can increase anxiety and depression ( 3, 6, 10, 11). In addition, social isolation-working and studying at home, having dependent children, decreased physical contact with other people-can be a significant psychological stressor ( 12, 13) and cause negative lifestyle changes such as poor diet and physical inactivity ( 14).

Physical exercise (PE) has been associated with improved psychological outcomes ( 15); and its neurobiological effects seem to influence several neural mechanisms related to depressive and anxiety disorders ( 16, 17). The absence or reduction of PE has been associated with an increased risk of mental disorders such as anxiety and depression ( 18- 20). Although there is not yet an ideal dose of exercise for this type of diseases, there is evidence demonstrating that any exercise is better than none on mental disorders ( 15, 20, 21). Studies show that the regular practice of PE can be compared to pharmacological measures for the treatment of mental disorders such as depression ( 22, 23).

However, in the midst of the global public health crisis scenario, little is known about the relationship between PE and the attenuation of symptoms of mental disorderscaused by the current pandemic. Morover, it would be important to know if physcial activity habits would be related to markers of stress, anxiety, and depression. In view of the above, the objective of this study was to evaluate the levels of anxiety, depression, and stress associated with the practice of PE during COVID-19 outbreak.

Methods

Study Design and Participants

This study has a cross-sectional characteristic and was conducted between May 12 and 14, 2020, the invitation to participate in the study was made through social media to reach the largest number of respondents. All participants were informed of the evaluation model to be applied and consented to participate. The study was approved by the local ethics committee (CAAE: 31521720.8.0000.5082).

Procedures

A questionnaire was applied via online platform to all those who showed interest to participate in the survey, using the Google ® forms system. The questionnaire was divided into two parts, the first involved demographic characteristics (age, gender, marital status, and educational level), weight and height for BMI calculation, history of diseases, PE practice before and during COVID-19 outbreak, fear of contamination and prevention measures adopted.

In the second part of the questionnaire, mental health status was assessed using the Depression Anxiety Stress Scale (DASS-21) ( 24), based on previous studies ( 25, 26). The scale consists of 21 self-reports items that assess the leve of anxiety (items 2, 4, 7, 9, 15, 19 e 20), depression (items: 3, 5, 10, 13, 16, 17 e 21) and stress (items 1, 6, 8, 11, 12, 14 e 18), the answers are according to the Likert scale, four points and pass through points 0 (Did not apply to me at all), 1 (Applied to me to some degree, or some of the time), 2 (Applied to me to a considerable degree or a good part of time), and 3 (Applied to me very much or most of the time).

The DASS-21 scale scores are classified by summing the relevant items, and the cutoff points for the anxiety subscale are: normal (<7), mild (8-9), moderate (10-14), severe (15-19), and extremely severe (>20). For depression subscale: normal (<9), mild (10-13), moderate (14-20), severe (21-27), and extremely severe (>28). The cutoff points for the stress subscale are: normal (<14), mild (15-18), moderate (19-25), severe (26-33), and extremely severe (>34).

Statiscal Analysis

The continuous variables of the study are presented in mean ± standard deviation and categorical variables were presented in frequency (percentage). The Shapiro-Wilk was used to assess the normality of the continuous variables. The independent sample t-test was used to compare anxiety, depression, and stress scores between men and women. The Chi-square test was used to verify the differences between categorical variables. The binary logistic regression was used to assess the association between regular physical exercise and levels of anxiety, depression, and stress. The significance level adopted was p < 0.05 and the statistical software used was the Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY, USA) version 21.0.

Results

Participants and Demographics Characteristics

A total of 1,154 responded the questionnaire, among them 69.84% were women. Mean age of the participants was 31.15 ± 9.68 and mean BMI was 25.32 ± 5.05. The majority of the participants were single (women: 55.08% and men: 71.83%, with a statistical difference p = 0.042). Only 193 interviewees reported pre-existing diseases, including: cancer (0.49%), diabetes mellitus (1.73%), respiratory diseases (9.61%), and arterial hypertension (5.02).

When asked about PE practice before and during the COVID-19 outbreak, 278 women and 72 men reported not practicing any type of PE before social isolation (30.32% of the participants). During the isolation period the number of participants who stated no PE practicewere 434 women and 191 men representing 54.16% of the total. The other data are presented in Table 1.

Table 1. Characteristics of the participants.

Risk of Contamination and Preventive Measures

A considerable percentage of the participants (96.78% of the women and 85.62% of the men) reported having some fear of contamination by COVID-19. Table 2 presents the measures taken by the participants, all reported taking at least two of the measures mentioned.

Table 2. Percepction of contamination risk and preventive measures taken by respondents.

Anxiety, Depression, and Stress Levels

Women presented higher levels of anxiety, depressoin, and stress when compared to men ( p < 0.0001 for all domains). It was observed that 374 women (46.41%) and 100 men (28.74%) had mild to extremely severe anxiety levels. In the depression domain, 487 women (60.43%), and 142 men (40.81%) showed mild to extremely severe levels. Regarding stress, 417 women (51.74%), and 110 men (31.61%) presented levels from mild to extremely severe. The frequency per domain is shown in Table 3.

Table 3. Number of participants showing psychological symptoms during quarantine by COVID-19, stratified by sex, using DASS-21.

Associations and Influence of Physical Exercise During Quarantine on Anxiety, Depression, and Stress

Table 4 shows the comparison of the general scores of anxiety, depression, and stress among the interviewees according to PE practice during the period of social isolation. Individuals who performed PE had lower levels of anxiety, stress, and depression ( p < 0.0001 in all domains for women p = 0.0103, <0.0001 and 0.0001, respectively, in men) when compared to individuals who were not performing PE during the COVID-19 outbreak.

Table 4. Comparison of anxiety, depression, and stress levels in respondents who do or do not physical exercises during quarantine by COVID-19.

Table 5 shows the association between psychological symptoms and PE practice, adjusted for age, in the total population, between women and men. The risk of having increased anxiety were 118% higher (OR = 2.183; 95% CI = 1.717-2.775), the risk of depression was 152% higher (OR = 2.525; 95% CI = 1.991-3.205) and the risk of stress symptoms increased 75.1% (OR = 1.751; 95% CI = 1.386-2.213) in the participants who did not perform PE when compared to those who maintain regular PE. Among women, the chance of showing symptoms of anxiety and depression was more than two times greater (OR = 2.341; 95% CI = 1.760-3.112 and OR = 2.363; 95% CI = 1.771-3.154, respectively) for those did no perform PE. Absence of PE was related to 60% higher risk of having elevated stress levels (OR = 1.602; 95% CI = 1.212-2.117). In men, there was a greater risk of having higher levels of anxiety, depression, and stress (OR = 2.929; 95% CI = 1.911-4.449; 4.045; 95% CI = 2.657-6.155 and 3.247; 95% CI = 2.147-4.993, all presented p < 0.0001) in those who did not perform PE.

Table 5. Association between physical exercise and mental health status measured by DASS-21, adjusted for age and stratified for sex.

Discussion

A recent scientometric analysis found that the most common research topics include emergency care and surgical, viral pathogenesis, and global responses in the COVID-19 pandemic but there is a lack of research on PE ( 27). Our results showed an increase of 67.14% in the number of people who did not perform PE during the COVID-19 pandemic. Women had higher scores of anxiety, depression, and stress when compared to men. Our analysis showed that thosewho did not practice PE showed higher values in all subscales evaluated (anxiety, depression, and stress). After binary logistic regression, the lack of PE practice was associated with higher values of anxiety, depression, and stress in both men and women.

Our results showed that individuals who performed PE during coronavirus outbreak presented lower levels of anxiety, stress and depression. When considering both sexes, those who did not perform PE had a 118% higher risk of presenting symptoms of anxiety, 152% more chance of having values of depression above normal and 75.1% higher risk of having symptoms of stress. Women who did not perform PE were 134% more likely to have high anxiety scores, 136% more likely to have depressive symptoms and 66% more likely to show high levels of stress. As for men, those who were not involved with PE were 192, 304, and 224% more likely to have high levels of anxiety, depression, and stress, respectively, as shown in Table 5.

Our results are in agreement with previous studies. Fluetsch et al. ( 28) evaluated the "The 2015 Behavioral Risk Factor Surveillance System" and found an inverse relationship between PE and mental health for those who reported being insufficiently active. Teychenne et al. ( 29) reported that sedentary behavior was associated with increased risk of anxiety. A meta-analysis documented that PE interventions significantly improved depressive symptoms among healthy adults ( 30). Moreover, it has been shown that PE have the potential to decrease the self-reported days of mental health problems due to anxiety, depression, and stress ( 28). Schuch et al. ( 31), when performing a meta-analysis with prospective studies (at least 1 year of follow-up), showed that higher levels of self-reported PE are associated with a lower risk of anxiety symptoms and anxiety disorders when compared to lower levels of PE.

The relationship between PE and mental health problems seems to be bidirectional. Exercise reduce the risk of anxiety and/or depression symptoms, but these symptoms may also lead the individual perform PE. Da Silva et al. ( 32), reported that regular PE was associated with a lower probability of depressive symptoms; but in the inverse analysis, participants with symptoms of anxiety and depression were more likely to not reach the recommended levels of PE. However, there are possible mechanisms that might explain the influence of PE on mood. These mechanisms though might involve the release of endorphins ( 33), thermogensis ( 34), the activation of the mTOR axis in specific brain regions ( 35) and neurotransmitters such as dopamine and serotonin ( 36, 37).

In the current scenario, measures aiming to control covid-19 dissemination require social isolation and restrictions that might agravate mood symptoms. However, the present results suggest that PE may decrease the risk of depression, anxiety, and stress. Therefore, it might be advisable to recommend the performance of PE, obviously respecting safety recommendations as part of the behavior therapy ( 38) and health education ( 39) during the COVID-19 pandemic.

The WHO recommends 150 min of PE for asymptomatic people, which can be distributed throughout the week, and for those people with comorbidities who do not present symptoms the recommendation is to continue with active habits ( 40) From a practical standpoint, PE can be performed with numerous possibilities. It is possible to adapt materials, use body weight exercises, elastic bands, exercise with no external loads, calisthenics and others ( 41- 49).

The study has some important limitations. We opted to perform a simple analysis of PE habits (yes or no question). Whist this facilited response, it does not precisely define different levels, so we cannot stablish a dose response relation. Another important limitation is that the mode of delivery (electronic) leaded mostly younger adults that have access to internet to respond; therefore, it might not reflect the situation of groups with different socioechonomical and age status. It might not reflect the situation of groups with different socioechonomical and age status. This study did not explore the use of face mask as preventive measures which was found to be associated with lower prevalence of depression ( 7) but cannot be used during PE.

Conclusion

Based on the present results, it is possible to note a reduction in regular PE during social isolation. Moreover, people who was not involved with PE during the COVID-19 pandemic had higher anxiety, depression, and stress scores. Based on this, it seems important to advise people to continue PE, following all the recommendations of preventive measures of the pertinent health organizations.

Data Availability Statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics Statement

This study involved human participants and was reviewed and approved by the Research Ethics Committee linked to the Center for Excellence in Teaching, Research and Projects Leide das Neves Ferreira of the National Health Council. The patients/participants provided their written informed consent to participate in this study.

Author Contributions

LRBS: concept and study design, collected and analyzed data, wrote, reviewed, and edited the manuscript. CS and CO: collected data, wrote, reviewed, and edited the manuscript. PS, JO, LFMS, and CP: collected data and edited the manuscript. PG and AR: contributed with data analysis, reviewed, and edited the manuscript. All authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

We would like to thank the participants for their effort.

References

14. Roy D, Tripathy S, Kumar S, Sharma N. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19 (2020). The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information.

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Physical Inactivity Is Associated With Increased Levels of Anxiety, Depression, and Stress in Brazilians During the COVID-19 Pandemic: A Cross-Sectional Study

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Objective: To evaluate the levels of anxiety, depression, and stress associated with the practice of physical exercise (PE) during pandemic by COVID-19.Methods: This study has a cross-sectional characteristic and was carried out between May 12 and 14, 2020.

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Find rapporter, notater og analyser om samfundsorienteret idrætsforskning

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Beskriver hvilke goder/konsekvenser der kommer ved fysisk aktivitet hos folk der lider af deprassion, angst, skizofreni og misbrug

Depression: mindre sandsynlighed for at udvikle depression end fysisk inaktive

Angst: kan være med til at påvirke selvbilledet negativt hvis PT ikke informeres om fysioloiske ændringer + kan fremkalde tvansgdforestillinger og hykondre tanker

Skizofreni: færre auditive hallucinatoriske fænomener, mindre aggression og normaliseret fysiologisk funktionskapacitet. Skizofrene patienters sociale kompetence, kontakter, aktivitetsniveau og beskæftigelse synes forøget som følge af fysisk træning

Misbrug: kan dæmpe abstinensreaktionen og tilbagefaldsfrekvensen. Udsfylder det sociale tomrum rusmidler

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Karen Margrethe Jensen , psykiatrisk sygeplejerske Margit Sandberg , klinisk diætist

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Psykisk syge har godt af fysisk aktivitet | Sygeplejersken, DSR

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Kom så. Motion er et godt, billigt og enkelt supplement til den traditionelle psykiatriske behandling ved f.eks. depression, angst og misbrug. Den store udfordring er at motivere og støtte patienterne til fysisk aktivitet.