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Background Postpartum women are at higher risk of depression compared to the general population. Despite the mental health benefits an active lifestyle can provide, postpartum women engage in low physical activity and high screen time. Very little research has investigated the social ecological (i.e. individual, social and physical environmental) influences on physical activity and screen time amongst postpartum women, particularly amongst those with depressive symptoms. Therefore, this study sought to examine the influences on physical activity and screen time amongst postpartum women with heightened depressive symptoms. Methods 20 mothers (3–9 months postpartum) participating in the Mums on the Move pilot randomised controlled trial who reported being insufficiently active and experiencing heightened depressive symptoms participated in semi-structured telephone interviews exploring their perceptions of the key influences on their physical activity and screen time across various levels of the social ecological model. Strategies for promoting physical activity and reducing screen time were explored with participants. Thematic analyses were undertaken to construct key themes from the qualitative data. Results Findings showed that postpartum women with depressive symptoms reported individual (i.e. sleep quality, being housebound, single income), social (i.e. childcare, social support from partner and friends) and physical environmental (i.e. weather, safety in the local neighbourhood) influences on physical activity. Postpartum women reported individual (i.e. screen use out of habit and addiction, enjoyment) and social (i.e. positive role modelling, social isolation) influences on screen-time, but no key themes targeting the physical environmental influences were identified for screen time. Strategies suggested by women to increase physical activity included mother’s physical activity groups, home-based physical activity programs and awareness-raising. Strategies to reduce screen time included the use of screen time tracker apps, increasing social connections and awareness-raising. Conclusions Amongst postpartum women with heightened depressive symptoms, influences on physical activity encompassed all constructs of the social ecological model. However, screen time was only perceived to be influenced by individual and social factors. Intervention strategies targeting predominantly individual and social factors may be particularly important for this high-risk group. These findings could assist in developing targeted physical activity and screen time interventions for this cohort.

Background Physical activity (PA) is a modifiable risk factor for postnatal depression (PND) and programs are needed to enhance PA amongst women at risk of PND. Key stakeholder involvement in informing development and implementation of such programs is vital. However, little research demonstrates key stakeholder insights to inform the design and delivery of PA programs for improving PND. The aim of this study was to explore key stakeholder perspectives on the design and delivery of a home-based PA program for mothers with PND symptoms to inform future real-world implementation and scale-up. Methods A descriptive qualitative study was undertaken whereby semi-structured interviews were conducted with representatives from various key stakeholder organisations involved in postnatal PA and/or mental health, public health and policy in Australia (n = 11). Interviews were conducted between September to November 2019 and explored stakeholder perceptions on the design and delivery of a home-based PA program for mothers with PND symptoms. The interview schedule was informed by both the Consolidated Framework for Implementation Research (CFIR) and the PRACTical planning for Implementation and Scale-up (PRACTIS) guide. Data were analysed thematically using both deductive and inductive coding. Results The relative priority of PND and PA was high for most organisations involved, although none implemented PA programs supporting women at risk of PND. Most stakeholders perceived the program as appealing due to addressing barriers to postnatal PA, although identified some feasibility issues regarding funding and delivery mechanisms. Suggestions for program adaptations included an equity focus (e.g. providing socioeconomically disadvantaged women with a greater program dose; translating web-app based content into various languages). Planned components of the program were suggested to align (i.e. relative advantage) with existing initiatives (e.g. equipment hire for nurseries scheme) and screening systems for PND (timing of referral). Perceived barriers to scale-up included logistics/cost of equipment, organisational capacity demands and safety risks/liability. Perceived enablers to scale-up included linking the program with ‘adjunct’ programs and services. Conclusions While the program was appealing and most organisations could see a role in endorsing and/or referring to the program, funding and delivery mechanisms still need to be identified.

Background Recent evidence suggests that work-related physical activity may not have the same mental health benefits as leisure-time physical activity. Further, work-related physical activity is likely to include a variety of different behaviours for people with different occupations. As such, the aim of this study was to determine if occupation type moderated the association between work-related physical activity and psychological distress. Methods A randomly selected sample of 1080 women from Melbourne, Australia completed the International Physical Activity Questionnaire (IPAQ) and General Health Questionnaire (GHQ-30), and reported their current occupation. Results Linear regression analyses indicated that occupation significantly moderated the association between work-related walking and psychological distress (F [8, 55] = 2.26, p = .036). Given evidence of moderation, we fitted linear regression models to test the associations between work-related physical activity and psychological distress for three separate groups; professionals, sales and services workers, and tradespersons. Female tradespersons who engaged in a low (B = − 3.81, p = .006) or high amount of work-related walking (B = − 3.23, p = .029), had significantly lower psychological distress symptoms than those who engaged in no work-related walking. There were no significant associations between work-related physical activity of any intensity and psychological distress for professionals, or sales and service workers. Conclusions Given the relationship does not exist across all occupations, work-related physical activity should not be promoted above and beyond leisure-time physical activity. However, walking at work may be important in reducing psychological distress for some people and should therefore, not be discounted.

Background: Research has shown that regular physical activity is key for the prevention and/or treatment of depression. However, epidemiological studies describing the associations between different physical activity modes (i.e., aerobic vs. muscle-strengthening exercise) with depression are limited. Methods: Cross-sectional analyses were conducted on pooled data from four U.S. health surveillance surveys (2011-2017). Validated survey items assessed self-reported moderate-to-vigorous-intensity physical activity (MVPA) and muscle-strengthening activity (MSA). Twenty groups were created, ranging from (a) 'inactive' (0 MVPA min/week & MSA 0 times/week) to (xx) 'most active' (>= 300 MVPA min/week & MSA >= 4 times/week). Poisson regression with a robust error variance was used to assess prevalence ratios (PRs) of self-reported clinically diagnosed depression (outcome variable) across physical activity groups (exposure variables). Results: The sample contained 1,477,981 adults (>= 18 years), of which 286,325 (18.0%) had depression. Compared to the reference group (i.e., no MVPA and no MSA), almost all physical activity combinations were associated with lower depression prevalence. Lowest prevalence of depression was shown for those combining sufficient MVPA-MSA (MVPA >= 300 min/week and MSA >= 2 times/week; adjusted prevalence ratio range: 0.54-0.63). All associations remained after stratification and/or adjustment for sociodemographic (age, sex, income, education), lifestyle characteristics (body mass index, self-rated health, smoking, alcohol), comorbidities (e.g., arthritis, diabetes, hypertension), and year of survey. Conclusions: A physical activity routine that includes both aerobic and MSA is likely to be optimal for the prevention of depression. Public health approaches targeting depression should endorse joint aerobic and MSA as key lifestyle modification strategy.

Lifestyle behaviors such as healthy diet and some forms of physical activity have been linked to lower risk of depressive symptoms in the general population. However, little is known regarding their associations with postnatal depressive symptoms. Given that postnatal women (particularly those living in socioeconomically disadvantaged neighborhoods) are more likely to have poorer diet quality, lower physical activity levels and greater risk of depressive symptoms, this study sought to determine the associations between diet quality, total and domain specific physical activity and depressive symptoms amongst postnatal women from socioeconomically disadvantaged neighborhoods. It was hypothesized that higher diet quality and levels of leisure-time physical activity would be associated with lower depressive symptoms. In 2007–2008, cross-sectional data were collected from 246 women living in socioeconomically disadvantaged neighborhoods in Victoria, Australia. Participants completed self-report measures of diet (using a 17 item dietary questionnaire), domain specific physical activity (International Physical Activity Questionnaire), and depressive symptoms (Centre for Epidemiologic Studies Depression Scale). Linear regression analyses were used to determine the associations between diet quality, physical activity and postnatal depressive symptoms. There was a significant inverse association between total physical activity (B, −0.009; 95% CI, −0.016 to −0.001; P = .023) and postnatal depressive symptoms. No association was found between other domain-specific physical activity (i.e. leisure-time, domestic or transport-related physical activity), or diet quality and postnatal depressive symptoms. Acknowledging the cross-sectional nature of this study, these findings suggest that total physical activity may play a more important role than diet quality in the relationship with postnatal depressive symptoms.

Indecisiveness and negative thinking regarding career pathways can hinder university students’ career planning, motivation, and mental health. Students intending to enter the workforce after graduation therefore need to develop skills related to career adaptability (i.e. career planning, decision-making, problem solving/confidence and exploration), particularly since career planning and construction is linked to gaining employment. This study aimed to test the effectiveness of an online career planning module on students’ career adaptability. The career-focussed online module, based on the constructs of Savickas’ (2005) theory of career construction, and tailored to students’ skills and interests, was developed and embedded into the University curriculum of a second-year exercise and public health-related unit. In 2018, 80 students completed the online module, along with pre- and post-intervention questionnaires assessing career adaptability elements including career planning, decision making, problem solving/confidence, and exploration. Dependent t-tests were conducted to assess differences in these measures pre- and post-intervention. Post-intervention, significant increases in career-planning strategies used (t(69)=5.45, p

For the prevention and management of chronic diseases, global physical activity guidelines state that an adult should engage in regular moderate-to-vigorous aerobic physical activity (MVPA; e.g. walking, cycling, running) and muscle-strengthening exercise (MSE; e.g. strength/resistance training). However, the associations between combined MVPA-MSE with chronic health conditions are rarely examined in large population studies. In particular, little is known associations between combined MVPA-MSE with depressive disorders, one of the leading causes of disability worldwide. The aim of this study is to describe the associations between MVPA and MSE with depressive symptom severity among a large sample of U.S. adults. Data were drawn from the U.S. 2015 Behavioral Risk Factor Surveillance System. During phone interviews, MVPA, MSE and depressive symptom severity were assessed by validated questionnaires. Poisson regression with a robust error or variance were used to assess prevalence ratios (PR) of depressive symptom severity (mild, moderate, moderately severe/severe) across categories of physical activity guideline adherence (met neither [reference]; MSE only; MVPA only; met both), adjusting for a set of potential cofounders. Data were available on 17,839 adults (18-85 years). When compared with those meeting neither guideline, for mild, moderate and moderately severe/severe depressive symptoms, the PRs were lowest among meeting both guidelines (range: 0.26-0.54), followed by MVPA only (range: 0.36-0.62) and MSE only (range: 0.49-0.84). Among a large sample of U.S. adults, compared to other guideline adherence categories, meeting both MVPA-MSE guidelines was associated with a lowest likelihood of reporting depressive symptoms.

Background: Socioeconomically disadvantaged women are at an increased risk of sedentary behaviors including television (TV) viewing and computer use, so identifying determinants of these behaviors is important. Methods: Women (n = 4349) self-reported weekly TV and computer time (in minutes per week), sociodemographic, and health data at 3 time points (2007–2013). Mixed-effect negative binomial regression was used to determine the baseline determinants of TV viewing and computer use over time, adjusting for confounders. Results: Over 5 years, median TV viewing decreased while median computer time increased. Cross-sectionally TV viewing was highest among participants classified as obese, with poorer health, current smokers, with lower education, not working, with no income, without partners and with no children and computer time was greater among younger women, living in urban areas, working full time, with higher education, without partners and with no children. Average computer time per year increased among those not working (7%), with lower education (5%), and with children (5%) but decreased among those with higher education (1%). However, no factors were associated with a change in TV viewing over time. Conclusion: Among socioeconomically disadvantaged women, interventions aimed at preventing increases in computer time should consider women with lower education, not working, and with children in their design.

Background Physical activity is often associated with better mental health. However, there is evidence that the domain of physical activity influences the strength and direction of this association. Therefore, this study aimed to examine the associations between different domains of physical activity and depression among a large sample of adults living in the European Union. Methods Cross-sectional analyses were conducted on 261,121 adults, recruited in the European Health Interview Survey (wave 2). Validated items were used to assess physical activity domains (i.e., work-related, transport-related, leisure-time aerobic, and muscle-strengthening) and depression symptom severity (8-item personal health questionnaire). Generalized linear models with Poisson regressions provided adjusted prevalence ratios (APR) of depressive symptom severity categories across the physical activity domains. Results Compared to doing no physical activity, any physical effort at work (APR: 0.82-0.86), moderate, high, and very high levels of transport-related (APR: 0.69-0.83) and aerobic leisure-time activity (APR: 0.78-0.87), and 3 days/week of muscle-strengthening (APR: 0.93) were associated with a lower prevalence of mild depressive symptom severity. Moreover, doing any level of physical activity in any domain was mostly associated with a lower prevalence of moderate (APR: 0.43-0.80), moderate-severe (APR: 0.34-0.82), and severe (APR: 0.26-0.56) depressive symptoms. Conclusion Favorable associations were seen between any domain (leisure-time, transport- and work-related) of physical activity and depressive symptom severity. The more severe the symptoms, the stronger the associations. Both modalities of leisure-time physical activity (aerobic and muscle-strengthening) demonstrated beneficial associations with depression, but slightly more so for aerobic physical activity.

People with mental illness are twice as likely to develop cardiovascular, respiratory, infectious and metabolic diseases compared with the general population.1This disparity in health occurs from the earliest presentation of mental ill health and affects people across the life span,1 reducing life expectancy by 15–30 years compared with the general population.2 This poor physical health, as well as the associated widening mortality gap,3 has been described as a ‘human rights scandal’.2 This problem led to a Lancet Psychiatry Commission1 on protecting the physical health of people living with mental illness, with a focus on prevention and early intervention across all levels of treatment. The Lancet Psychiatry Commission outlines advances in our understanding of the link between physical and mental health, summarising findings from over 100 systematic reviews and meta-analyses, providing a practical blueprint towards protecting the physical health of this vulnerable population.1 Importantly, the blueprint recommends that all people living with mental illness have access to exercise and dietary interventions as part of routine mental healthcare. For people living with mental illness, higher rates of smoking, sleep disturbance, physical inactivity and …

Background Postnatal women are commonly physically inactive, and, when coupled with depressive symptoms, barriers to physical activity can be heightened. This study aimed to 1) examine the feasibility and acceptability of a multi-component home-based physical activity intervention delivered to mothers at risk of postnatal depression, and 2) examine changes in health behaviours (physical activity, sedentary behaviour, sleep, diet) and indicators of mental health. Methods Sixty-two mothers (3 – 9 months postpartum) who at baseline were insufficiently active and experiencing heightened depressive symptoms were recruited into a 12-week randomised controlled trial in 2018. Participants were randomised into either a) Intervention group (receiving a theoretically underpinned multi-component program including free exercise equipment at home, access to smartphone web-app, and an online forum); or b) Control group (usual routine). Primary outcomes were program feasibility and acceptability. Secondary outcomes included self-reported and accelerometer-assessed physical activity and sedentary behavior, sleep, diet, determinants of physical activity, and mental health (depressive and anxiety symptoms), measured at baseline and follow-up (12-weeks), with self-reported physical activity, sedentary behaviour and depressive symptoms also measured at weeks 4 and 8. Qualitative data was analysed following inductive content analysis, and quantitative data using linear mixed models. Results Exercise equipment use in the home was shown to be a feasible strategy to re-engage postnatal women in physical activity. Other components of the program (e.g. web-app, online forum) had low compliance. The program had high acceptability, predominately due to its accessibility, flexibility and ability to overcome key barriers to physical activity. The program resulted in improvements in short-term self-reported physical activity (increased 162min/week at 4 weeks, 95% CI: 37.7, 286.2), behavioural skills (B=0.4, 95% CI: 0.0, 0.8) and perceived barriers to physical activity. However, accelerometer measured physical activity decreased in the intervention group, compared to control group at week 12 (B=-1.3, 95% CI:-2.5, -0.1). There were no changes in other outcomes. Conclusions A home-based physical activity program involving free exercise equipment is acceptable and feasible amongst women experiencing heightened postnatal depressive symptoms. Such programs may be effective in increasing engagement in physical activity, yet additional strategies may be needed to enhance maintenance of physical activity and improvements in mental health.

Physical activity (PA) is beneficial for the prevention and management of psychological distress. However, no studies have investigated which combination/s of PA prescribed in the current global guidelines (i.e. aerobic moderate-to-vigorous PA [MVPA] and muscle-strengthening exercise [MSE]) are most strongly linked to reduced psychological distress. This study aimed to examine how PA guidelines adherence is associated with psychological distress. Using cross-sectional data of adults (n = 14,050) who participated in the 2012–2016 Health Survey for England, four categories of self-reported PA guidelines adherence were created: meeting none, only MSE, only aerobic MVPA, meeting both (exposure variables). Psychological distress (outcome) was measured using the General Health Questionnaire-12. The likelihood of experiencing high levels of psychological distress (cut-point of ≥4) across guidelines adherence categories was examined using logistic regression models adjusted for sociodemographic and lifestyle factors. About 17% of adults experienced high levels of psychological distress; 37.5% did not adhere to any PA guidelines (category 1), 1.3% met only MSE (category 2), 35.5% met only aerobic MVPA (category 3), and 25.7% met both guidelines (category 4). Compared to category 1, the likelihood of experiencing high psychological distress was lowest in category 4 (OR = 0.65, 95% CI: 0.54–0.77) followed by category 3 (OR = 0.78, 95% CI: 0.67–0.90), while it did not differ in category 2 (OR = 1.24, 95% CI: 0.75–2.05). This is the first study to identify the association between PA guidelines adherence and psychological distress in a large population sample. Findings suggest that meeting both aerobic MVPA and MSE guidelines might be most beneficial for mental health.

Clint T Miller,1 Megan Teychenne,2 Jaimie-Lee Maple2 1School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia; 2Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia Background: Exercise training is an essential component of falls prevention strategies, but they do not fully address components of physical function that leads to falls. The training approaches to achieve this may not be perceived as appropriate or even feasible in older adults. This study aims to assess the perceived feasibility and acceptability of novel exercise training approaches not usually prescribed to older adults. Patients and methods: Fourteen adults were exposed to conceptually and physically demanding exercises. Interviews were then conducted to determine perceptions and acceptability of individual exercise tasks. Qualitative thematic analysis was used to identify themes. Results: Safety and confidence, acceptability, and population participation were the key themes identified. Staff knowledge, presence, program design, and overt safety equipment were important for alleviating initial apprehension. Although physically demanding, participants expressed satisfaction when challenged. Prior disposition, understanding the value, and the appeal of novel exercises were perceived to influence program engagement. Conclusion: Given the evidence for acceptability, this type of training is feasible and may be appropriate as part of an exercise training program for older adults. Further research should be conducted to confirm that the physical adaptations to exercise training approaches as presented in this study occur in a similar manner to that observed in younger adults, and to also determine whether these adaptations lead to prolonged independence and reduced falls in older adults compared to usual care. Keywords: falls, balance, qualitative analysis, thematic analysis, exercise/physical activity, power training, over-speed training

Students enrolled in university courses often lack knowledge of potential jobs and career paths they can take, which can inhibit their ability to plan, job seek and make decisions about their careers, and negatively impact on their ability to gain employment. To address this problem we developed and piloted a tailored, career-focused interactive online learning tool for public health and exercise science students, based on constructs of Savickas’ (2005) theory of career construction. This paper reports a mixed-methods study to understand student experiences of using that tool, and their perception of how well it prepared them for career planning. Twenty-two second-year students completed an online survey using both qualitative and quantitative methods to assess the perceived feasibility and acceptability of the interactive online learning tool. Descriptive (for quantitative data) and inductive content analyses (for qualitative data) were performed. Most students (86%) indicated that they would use the tool again. All students reported that the tool was user-friendly, engaging and informative and provided them with jobs that matched their personal and work-related skills and strengths. Qualitative data reflected these findings and identified seven key themes, including: value, career exploration, design, and tailoring, with themes partly reflecting components of Savicka’s theory. The tailored, career-focused interactive online learning tool was perceived to be a feasible and effective strategy to support university students in their career planning and job seeking behaviours prior to graduation. These findings can be used to inform and refine the development of career-focussed tools for students undertaking other University courses.

Background Depression is the single largest contributor to global disability. There is growing evidence that a healthy diet is associated with reduced depression risk. However, beyond the Mediterranean diet, few longitudinal studies have explored the relationship between adherence to national dietary guidelines and depression. Hence, this study investigates the relationship between adherence to Australian Dietary Guidelines and depressive symptoms. Methods Data was drawn from the READI longitudinal study, a prospective cohort study of socioeconomically disadvantaged Australian women. This analysis includes a sub-sample of 837 women. A generalized linear model was used to explore whether baseline diet (assessed using the Dietary Guideline Index (DGI-2013; score range 0 to 85)) was associated with risk of developing depressive symptoms (measured by the Centre for Epidemiologic Studies Depression (CES-D)) at 5 years follow-up, whilst adjusting for potential confounders. A fixed-effects model was used to assess associations between concurrent changes in diet quality and depressive symptoms from baseline to 5 years follow-up. Results An association between baseline diet quality and risk of developing depressive symptoms at follow-up was observed, where a 10 unit increase in DGI-2013 score was associated with an estimated 12% lower risk of developing heightened depressive symptoms (RR = 0.875, 95%CI 0.784 to 0.978, p = 0.018). The fixed-effects model indicated that an increase in DGI score over 5 years follow-up was associated with a lower (improved) CES-D score (B = -0.044, 95% CI − 0.08 to − 0.01, p = 0.024). Conclusions Our results provide evidence that better adherence to the Australian Dietary Guidelines may result in improved depressive symptoms. The growing high-quality evidence regarding the diet-depression relationship provides us with a rationale for developing strategies for supporting dietary behaviour change programs to lower depression rates.

Background : There is strong epidemiological evidence that physical activity is associated with lower likelihood of depression. Yet, most existing large population studies have investigated aerobic physical activity (e.g. walking/running), with few epidemiological studies examining the association between muscle-strengthening exercise (MSE; push ups, using weight machines) with depression. The aim of this study is to examine associations between MSE and depressive symptoms among a representative sample of German adults. Methods : Cross-sectional analyses were conducted on the 2014 German Health Update. Validated questionnaires were used to assess MSE and depression symptom severity (eight-item Personal Health Questionnaire Depression Scale). Generalized linear models with Poisson regression with a robust error variance were used to assess prevalence ratios of depression symptom severity (mild, moderate, moderately severe/severe) across weekly MSE frequency (None [reference]; 1, 2, 3–4 and ≥5), adjusting for potential cofounders (e.g. age, sex, socioeconomic status, self-rated health, smoking, hazardous alcohol consumption, aerobic exercise). Results : Data were available on 23,635 adults (≥18 years). When compared with those reporting no MSE, for all levels of depressive symptom severity, there were reduced prevalence ratios across all MSE frequencies. Compared to the higher MSE frequency groups (3-≥5 times/week), the prevalence ratios (range: 0.53–0.85) were similar among lower frequency groups (1–2 times/week) (range: 0.46–0.85). All associations remained after adjustment for sociodemographic, lifestyle characteristics and aerobic physical activity. Limitations : Findings may be biased by the self-reporting of MSE and depressive symptom severity. Conclusion : Any increase in MSE at the population-level may be beneficial for the prevention and treatment of depression

ObjectivesExercise can be used as a treatment for depressive symptoms in the general population. However, little is known as to whether exercise has mental health benefits for adults experiencing chronic low back pain (CLBP). The aim of this study was to examine the feasibility of two intervention protocols commonly used in clinical practice for treating chronic low back pain, but with differing exercise dose, on depressive symptoms.MethodsForty men and women (mean age = 35) experiencing chronic persistent (>3 months), non-specific low back pain were recruited into a randomised clinical trial during 2015-2016. Participants were randomised to receive motor control (low-dose exercise) and manual therapy (n = 20), or general strength and conditioning training (moderate-dose exercise) (n = 20). Depressive symptoms were assessed fortnightly throughout a 6-month follow-up period using the Centre for Epidemiologic Studies Depression Scale (CES-D 10). Linear mixed models were used to examine within-group and between-group changes in depressive symptoms.ResultsMean CES-D 10 score at baseline was 9.17 (SD = 4.32). There was evidence of a small decrease in average depressive symptoms over time (β -0.19 per fortnight, 95% CI = -0.34, -0.02). However, there was no evidence that change over time was dependent on treatment group.ConclusionsReduction in depressive symptoms amongst adults with CLBP occurred with both treatment methods (motor control [low-dose exercise] and manual therapy; or general strength and conditioning [moderate-dose exercise]). Further interventions including a true control group are needed to draw conclusions as to the effectiveness of each of these treatment methods on depressive symptoms amongst adults with CLBP.Trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12615001270505. Registered on 20 November 2015.

Background Emerging evidence shows sedentary behaviour may be associated with mental health outcomes. Yet, the strength of the evidence linking sedentary behaviour and stress is still unclear. This study aimed to synthesise evidence regarding associations between time spent in sedentary behaviour and stress in adults. Methods A systematic search was conducted (January 1990 – September 2019). Following PRISMA guidelines, an evaluation of methodological quality, and best-evidence synthesis of associations between time in sedentary behaviour (including sitting time, TV viewing, computer use) and stress were presented. Twenty-six studies reporting on data from n = 72,795 people (age 18-98y, 62.7% women) were included. Results Across the studies (n = 2 strong-, n = 10 moderate- and n = 14 weak-quality), there was insufficient evidence that overall time spent in sedentary behaviour and sitting time were associated with stress, particularly when using self-report measures of sedentary behaviour or stress. There was strong evidence of no association between TV viewing, or computer use and stress. Amongst studies using objective measures of sedentary behaviour and/or stress there was also strong evidence of no association. Conclusion Although previous research suggested sedentary behaviour may be linked to mental health outcomes such as depression and anxiety, the evidence for an association between various types of sedentary behaviour and stress is limited in quality, and associations are either inconsistent or null. High-quality longitudinal/interventional research is required to confirm findings and determine the direction of associations between different contexts (i.e. purpose) and domains (i.e. leisure, occupational, transport) of sedentary behaviour and stress.

Background Mental health disorders are a leading cause of disability worldwide, including in first-time mothers. Understanding the associations between diet and depressive symptoms could assist in improving mental health status in this group. Objective Our aim was to determine the association between diet quality, fruit, vegetable, and fish consumption and depressive symptoms in first-time mothers aged 19 to 45 years. Design We analyzed cross-sectional, baseline data (3 months postpartum) from the Melbourne InFANT (Infant Feeding, Activity, and Nutrition Trial) Extend Program. Participants/setting Participants were first-time Australian mothers aged 19 to 45 years from the Geelong and Melbourne regions of Victoria, Australia (n=457). Main outcome measures A self-administered, 137-item food frequency questionnaire assessed dietary intake over the past year. Adherence to the 2013 Australian Dietary Guidelines was assessed using the Dietary Guideline Index as a measure of diet quality. Depressive symptoms were determined using the Center for Epidemiologic Studies Depression Scale. Statistical analysis performed Relationships between diet quality, fruit, vegetable, and fish intake and depressive symptoms were investigated using linear regression adjusted for relevant covariates (age, smoking status, sleep quality, education, physical activity status, and body mass index). Results Better diet quality, as indicated by a higher score on the Dietary Guideline Index, was associated with lower depressive symptoms after adjusting for relevant covariates (β=−.034; 95% CI −.056 to −0.012). There were no other associations between dietary intake and depressive symptoms. Conclusions Adherence to the Australian Dietary Guidelines was associated with better mental health status among first-time mothers. Further research, including longitudinal and intervention studies, are required to determine causality between dietary intake and depressive symptoms, which might help inform future public health nutrition programs for this target group.

Pregnancy is often cited as a time in a woman’s life when motivation towards having a healthy lifestyle increases, including a desire to pursue physical activities and improve physical fitness. There is also a growing body of evidence which demonstrates the potential for physical activity to positively influence psychological well-being during pregnancy. However, pregnancy is also a period of intense physical and psychological change. Alongside the many established social and cultural beliefs associated with pregnancy, these changes contribute significant complexities to women’s adoption and maintenance of exercise during this time. In this chapter we will examine the current evidence surrounding the psychosocial aspects of an active pregnancy and provide recommendations for providing psychological and behavioural support to women to become or remain active throughout their pregnancy.

Background The World Health Organization’s ‘Global Recommendations on Physical Activity for Health’ state that adults should engage in regular moderate-to-vigorous intensity aerobic physical activity (MVPA; e.g. walking, running, cycling) and muscle-strengthening activity (MSA; e.g. strength/resistance training). However, assessment of both MVPA and MSA is rare in physical activity surveillance. The aim of this study is to describe the prevalence, correlates and chronic health conditions associated with meeting the combined MVPA-MSA guidelines among a population representative sample of U.S. adults. Methods In this cross-sectional study, data were drawn from the U.S. 2015 Behavioral Risk Factor Surveillance System. During telephone interviews, MVPA and MSA were assessed using validated questionnaires. We calculated the proportions meeting both the global MVPA and MSA physical activity guidelines (MVPA ≥150 min/week and MSA ≥2 sessions/week). Poisson regressions with a robust error variance were used to assess: (i) prevalence ratios (PR) for meeting both guidelines across sociodemographic factors (e.g. age, sex, education, income, race/ethnicity); and (ii) PRs of 12 common chronic health conditions (e.g. diabetes, coronary heart disease, hypertension, depression) across different categories of physical activity guideline adherence (met neither [reference]; MSA only; MVPA only; met both). Results Among 383,928 adults (aged 18–80 years), 23.5% (95% CI: 20.1, 20.6%) met the combined MVPA-MSA guidelines. Those with poorer self-rated health, older adults, women, lower education/income and current smokers were less likely to meet the combined guidelines. After adjustment for covariates (e.g. age, self-rated health, income, smoking) compared with meeting neither guidelines, MSA only and MVPA only, meeting the combined MVPA-MSA guidelines was associated with the lowest PRs for all health conditions (APR range: 0.44–0.76), and the clustering of ≥6 chronic health conditions (APR = 0.33; 95% CI: 0.31–0.35). Conclusions Eight out of ten U.S. adults do not meet the global physical activity guidelines. This study supports the need for comprehensive health promotion strategies to increase the uptake and adherence of MVPA-MSA among U.S. adults. Large-scale interventions should target specific population sub-groups including older adults, women, those with poorer health and lower education/income. Electronic supplementary material The online version of this article (10.1186/s12966-019-0797-2) contains supplementary material, which is available to authorized users.

The aims of this commentary are to (1) examine the current global physical activity recommendations for adults and its relation to mental health, based on findings from meta-analyses primarily of prospective studies, and (2) determine whether there is a need to extend the scope/focus of existing guidelines to ensure they are mental health informed.

Limited longitudinal evidence of the predictors of physical activity (PA) patterns over time exists, particularly among high-risk groups such as women living in socioeconomically disadvantaged areas. This study aimed to: 1) describe leisure-time PA (LTPA) and transport-related PA (TRPA) patterns over time; and 2) identify individual, social and physical environmental predictors of LTPA and TRPA patterns over five years. Baseline (2007–08) data were collected and analysed (2016–18) from n = 4349 women (18–46 years) from disadvantaged areas of Victoria, Australia. Three- and five-year follow-up data were collected in 2010–11 (n = 1912) and 2012 (n = 1560). LTPA and TRPA were self-reported using the International Physical Activity Questionnaire, and patterns categorised as consistently low, persistently increasing, persistently decreasing, or inconsistent. Compared to a consistently low LTPA pattern, greater family support predicted both persistent decreases (odds ratio [OR] 1.20, 95% CI 1.05–1.36) and persistent increases (OR 1.17, 95% CI 1.04–1.32) in LTPA, while access to childcare predicted inconsistent LTPA patterns (OR 1.66, 95% CI 1.03–2.65). For both LTPA and TRPA, PA enjoyment predicted persistent increases (LTPA: OR 1.05, 95% CI 1.02–1.10; TRPA: OR 1.03, 95% CI 1.00–1.07), persistent decreases (LTPA: OR 1.04, 95% CI 1.00–1.08; TRPA OR 1.04, 95% CI 0.99–1.08), and inconsistent patterns (LTPA: OR 1.04, 95% CI 1.02–1.07; TRPA: OR 1.03, 95% CI 1.01–1.06). Although directionality was inconsistent, and the magnitude of effects were small, PA enjoyment, family social support for PA and access to childcare warrant further investigation and consideration as potentially key factors impacting PA patterns among women living in socioeconomically disadvantaged areas.

Background\ud Most postnatal women are inactive. Since new mothers, particularly those with heightened depressive symptoms experience several challenges to being active such as lack of time and childcare, home-based programs using hired exercise equipment may help overcome these barriers. This study tested the feasibility and acceptability of a home based treadmill intervention among postpartum women with heightened depressive symptoms.\ud \ud Methods\ud Participants were 11 new mothers (3–9 months postpartum) who at baseline were insufficiently active and experiencing heightened depressive symptoms (based on the Edinburgh Postnatal Depression Scale). Following participation in a 12-week physical activity support program (which included free treadmill hire and access to a purposely designed smartphone web-app), semi-structured interviews were conducted with participants. Depressive symptoms were assessed at weeks 4 and 8 and change in depressive symptoms was analysed using repeated-measures analysis of variance (ANOVA). Thematic analyses were used to identify key themes in qualitative data.\ud \ud Results\ud Quantitative data showed that there was a significant change over time with depressive symptoms decreasing from weeks 0–4 (mean difference = −5.9, 95% CI = −8.7, −5.5) and overall from weeks 0–8 (mean difference = −7.6, 95% CI = −9.8, −3.1). Postpartum women perceived the program to be convenient, flexible and acceptable. Women suggested that the program was useful in overcoming key barriers to physical activity and perceived that the program increased their physical activity and improved psychological health.\ud \ud Conclusion\ud A home-based physical activity program involving cost-free exercise equipment hire was feasible and well accepted by postpartum women. The effectiveness of this program for increasing physical activity and improving mental health in this population should be further tested.

Background Postpartum weight retention (PPWR) increases the risk for obesity and complications during subsequent pregnancies. Few interventions have been successful in limiting PPWR in mothers. The present study assessed the effectiveness of the mums OnLiNE (Online, Lifestyle, Nutrition & Exercise) intervention with respect to reducing PPWR and improving diet, physical activity and sedentary behaviour. Methods A subsample of first-time mothers enrolled in the Extended Melbourne Infant Feeding Activity and Nutrition Trial (InFANT Extend) completed the nonrandomised mums OnLiNE intervention. Women in the intervention (I) group (n = 28) received access to an online calorie tracking program, smartphone app, three telephone counselling calls with a dietitian and written material. Women in two comparison groups (CI and C2) (n = 48; n = 43) were from the control (C1) and intervention (C2) arms of InFANT Extend and received no additional support. Weight and waist circumference were measured objectively. Written surveys assessed diet and physical activity. Sedentary behaviour was self-reported. Linear and logistic regression assessed changes in outcomes between groups from 9 to 18 months postpartum. Results Mean PPWR decreased in the (I) group (−1.2 kg) and the C2 group (−1.2 kg), although the changes were not significant. Mean waist circumference for all groups exceeded recommendations at baseline but decreased to below recommendations for women in the (I) group (78.3 cm) and significantly for the (I) group (−6.4 cm) compared to C1 (−1.1 cm; P = 0.002) and C2 (−3.3 cm; P = 0.001). Changes in diet, physical activity or sedentary behaviour were not significant. Conclusions The online intervention reported in the present study shows promise with respect to reducing waist circumference in postpartum women. Further evidence of strategies that may improve weight and related behaviours in this target group is needed.

Issue addressed: The aim of this project was to identify effective recruitment and retention strategies used by health-promotion organisations that focus on increasing physical activity and improving nutrition within the local community. Methods: Semistructured telephone or face-to-face interviews with 25 key informants from stakeholder organisations were conducted. Key informants discussed strategies used by their organisation to effectively recruit and retain participants into community-based healthy eating and/or physical activity programs. Transcribed data were analysed with NVivo software. Results: Effective recruitment strategies included word of mouth, links with organisations, dissemination of printed materials, media, referrals, cross-promotion of programs and face-to-face methods. Effective retention strategies included encouraging a sense of community ownership, social opportunities, recruiting a suitable leader and offering flexibility and support. Fees and support for recruiting and retaining participants was also identified. Conclusion: This study provides novel insights to a greatly under researched topic in the field of health promotion. There are two key take-home messages from the present study that are applicable to health practitioners as well as developers and deliverers of community health-promotion programs: (1) it is imperative that all community health organisations report on the effectiveness of their recruitment and retention, both successes and failures; and (2) there is a clear need to tailor the recruitment and retention approach to the target population and the setting the program is occurring in. So what? These findings provide important insights for the development of future community-based healthy eating and physical activity programs.

Context Postnatal depression is highly prevalent in mothers. Although physical activity has been found to reduce the risk of depression in the general population, little is known regarding its link with postnatal depression. This review examined original research investigating the relationship between physical activity and sedentary behavior dose (frequency, intensity, and duration) and domain, and postnatal depressive symptoms. Evidence acquisition A systematic search for original research investigating the relationship between physical activity and sedentary behavior dose and domain, and postnatal depressive symptoms, was performed using several electronic databases in early 2012. A total of ten observational and seven intervention studies were included. Evidence synthesis Most studies (one cross-sectional, two longitudinal, and six intervention studies) found an inverse association between postpartum leisure-time physical activity (LTPA) and postnatal depressive symptoms. One longitudinal study found that occupational physical activity was positively associated with postnatal depressive symptoms. There was inconclusive evidence to suggest an optimal dose of postpartum physical activity for reducing postnatal depressive symptoms. Two longitudinal studies found an inverse association between antenatal LTPA and presence of postnatal depressive symptoms. One of two studies that investigated sedentary behavior found a positive cross-sectional association between sedentary behavior and presence of postnatal depressive symptoms. Conclusions Although studies are limited, on balance, LTPA prior to, during, and after pregnancy may be important for reducing the risk of postnatal depression. Further research is required to determine the optimal dose and domain of physical activity for reducing postnatal depressive symptoms as well as to examine the link between sedentary behavior and postnatal depressive symptoms.

Background This study examined associations between alcohol outlet access and alcohol intake, depressive symptoms score and risk of depression among women residing in disadvantaged neighbourhoods in Victoria, Australia. Methods Data on depressive symptoms, alcohol intake and socio-demographic characteristics were obtained from a sample of 995 adult women from Victoria, Australia who were surveyed as part of the Resilience in Eating and Activity Despite Inequality (READI) study. The location of all licensed alcohol outlets in Victoria was obtained from the Victorian Commission for Gambling and Liquor Regulation. Participant and alcohol outlet addresses were geocoded to calculate individual alcohol outlet access, defined as the number of outlets (all and by sub-type) within 0.4 km and 3 km of participants’ homes. Separate regression models with clustered standard errors were fitted to examine associations between access and alcohol intake according to national recommended limits for short- and long-term harm, frequency of consumption above long-term harm guidelines, depressive symptoms score and risk of depression. Results Odds of consumption within short-term harm guidelines (≤4 drinks on any day) decreased with increasing access within 3 km, irrespective of outlet type. Typically, there was no evidence to support associations between access and consumption above long-term harm guidelines (>2 drinks on any day) unless considering frequency of consumption at this level where results showed decreased odds of ‘don’t drink’ versus frequently drinking above long-term harm guidelines (i.e., >2 drinks at least once per week) with increasing access at either distance. Although there was no evidence of an association between any of the alcohol outlet access measures and depressive symptoms score, odds of being at risk of depression decreased with increasing access within 3 km. Conclusions This study found some evidence to support an association between increasing alcohol outlet densities of all types and harmful levels of alcohol consumption, and the association appears to be dependent on the distance threshold considered, among women residing in socioeconomically disadvantaged neighbourhoods within Victoria, Australia. However, higher numbers of alcohol outlets appear to be associated with a slightly lower risk of depression, with further research needed to identify the direction and mechanisms underlying this unintuitive association.

Background maternal postpartum weight retention (PPWR) has implications for short and long term weight-related health of both the mother and child. Little is known about how mothers perceive they may be best supported to achieve a healthy postpartum weight and healthy lifestyle behaviours. Evaluating existing postpartum weight focussed intervention strategies is an important step in the planning of future programs aimed at supporting new mothers. Aim to describe the perspectives of women who completed the mums OnLiNE pilot intervention, regarding the acceptability and effectiveness of a program which aimed to limit PPWR and promote healthy diet and physical activity behaviours in new mothers. Method descriptive qualitative research methods utilising semi-structured interview questions to explore new mothers' views regarding their participation in the mums OnLiNE intervention were used. All women who completed the intervention were invited to participate in one-on-one interviews via telephone. Interviews were digitally recorded and transcribed verbatim. Data were analysed utilising thematic analysis for common, emerging themes. Findings twelve women participated in the interviews. Six main themes including program usefulness, intervention components, walking, self-monitoring, barriers and challenges and future recommendations described women's views of the mums OnLiNE intervention. Women felt well supported being part of the program and their reported awareness of healthy eating increased. Telephone support was the most valued and helpful component of the intervention and the smartphone application for self-monitoring was used more often than the website. Walking was by far the most preferred activity as it was considered enjoyable and achievable and some reported that their incidental walking increased as a result of being part of the program. Lack of time and motivation were the main barriers to participation in the program. Suggestions for future programs included encouraging group support and mother-baby exercise sessions. Conclusion women perceived the mums OnLiNE intervention to be useful in promoting a healthy lifestyle and valued the support provided. Whilst barriers to participation in healthy lifestyle programs exist, well planned interventions which consider time constraints of new mothers, utilize one-on-one support and offer social engagement with other new mothers may further support women in their attainment of healthy postpartum weight and lifestyle behaviours.

Numerous health benefits are associated with achieving optimal diet and physical activity behaviours during and after pregnancy. Understanding predictors of these behaviours is an important public health consideration, yet little is known regarding associations between clinician advice and diet and physical activity behaviours in postpartum women. The aims of this study were to compare the frequency of dietary and physical activity advice provided by clinicians during and after pregnancy and assess if this advice is associated with postpartum diet and physical activity behaviours. First time mothers (n = 448) enrolled in the Melbourne InFANT Extend trial completed the Cancer Council of Australia’s Food Frequency Questionnaire when they were three to four months postpartum, which assessed usual fruit and vegetable intake (serves/day). Total physical activity time, time spent walking and time in both moderate and vigorous activity for the previous week (min/week) were assessed using the Active Australia Survey. Advice received during and following pregnancy were assessed by separate survey items, which asked whether a healthcare practitioner had discussed eating a healthy diet and being physically active. Linear and logistic regression assessed associations of advice with dietary intake and physical activity. In total, 8.6 % of women met guidelines for combined fruit and vegetable intake. Overall, mean total physical activity time was 350.9 ± 281.1 min/week. Time spent walking (251.97 ± 196.78 min/week), was greater than time spent in moderate (36.68 ± 88.58 min/week) or vigorous activity (61.74 ± 109.96 min/week) and 63.2 % of women were meeting physical activity recommendations. The majority of women reported they received advice regarding healthy eating (87.1 %) and physical activity (82.8 %) during pregnancy. Fewer women reported receiving healthy eating (47.5 %) and physical activity (51.9 %) advice by three months postpartum. There was no significant association found between provision of dietary and/or physical activity advice, and mother’s dietary intakes or physical activity levels. Healthy diet and physical activity advice was received less after pregnancy than during pregnancy yet no association between receipt of advice and behaviour was observed. More intensive approaches than provision of advice may be required to promote healthy diet and physical activity behaviours in new mothers. Australian New Zealand Clinical Trials Registry ( ACTRN12611000386932 13/04/2011)

Background Participant adoption and maintenance is a major challenge in strength training (ST) programs in the community-setting. In adults who were overweight or with type 2 diabetes (T2DM), the aim of this study was to compare the effectiveness of a standard ST program (SST) to an enhanced program (EST) on the adoption and maintenance of ST and cardio-metabolic risk factors and muscle strength. Methods A 12-month cluster-randomized controlled trial consisting of a 6-month adoption phase followed by a 6-month maintenance phase. In 2008–2009, men and women aged 40–75 years (n = 318) with T2DM (n = 117) or a BMI >25 (n = 201) who had not participated in ST previously were randomized into either a SST or an EST program (which included additional motivationally-tailored behavioral counselling). Adoption and maintenance were defined as undertaking ≥ 3 weekly gym-based exercise sessions during the first 6-months and from 6–12 months respectively and were assessed using a modified version of the CHAMPS (Community Healthy Activity Models Program for Seniors) instrument. Results Relative to the SST group, the adjusted odds ratio (OR) of adopting ST for all participants in the EST group was 3.3 (95 % CI 1.2 to 9.4). In stratified analyses including only those with T2DM, relative to the SST group, the adjusted OR of adopting ST in the EST group was 8.2 (95 % CI 1.5–45.5). No significant between-group differences were observed for maintenance of ST in either pooled or stratified analyses. In those with T2DM, there was a significant reduction in HbA1c in the EST compared to SST group during the adoption phase (net difference, -0.13 % [-0.26 to -0.01]), which persisted after 12-months (-0.17 % [-0.3 to -0.05]). Conclusions A behaviorally-focused community-based EST intervention was more effective than a SST program for the adoption of ST in adults with excess weight or T2DM and led to greater improvements in glycemic control in those with T2DM. Trial registration Registered at ACTRN12611000695909 (Date registered 7/7/2011).

Objectives Little is known about how health behaviors such as physical activity (PA) and sedentary behaviors (SB) may be associated with psychosocial well-being during the crucial early childhood period. The aim of this study was to undertake a systematic review of associations between PA, SB and psychosocial well-being during early childhood. Methods In February 2013, MEDLINE, PsycINFO, SPORTDiscus and Embase electronic databases were searched. Inclusion criteria were: 1. peer-reviewed publication since 1980 in English; 2. children aged birth–5 years; 3. PA or SB measured during early childhood; 4. an indicator of child psychosocial well-being; and 5. association between PA/SB and psychosocial well-being reported. Studies could be observational or interventions. Data were extracted by one author and entered into a standardized form in February and March 2013. Results 19 studies were identified: four examined PA, 13 examined SB and two examined PA and SB. No interventions met the inclusion criteria; all included studies were observational. In total, 21 indicators of psychosocial well-being were examined, 13 only once with the remaining eight reported in more than one study. Some dose–response evidence was identified suggesting that PA is positively, and SB inversely, associated with psychosocial well-being. Conclusions Too few studies exist to draw conclusions regarding associations. Future high-quality cohort and intervention studies are warranted particularly investigating dose–response associations.

Objective Although recent cross-sectional research has suggested a positive association between sedentary behaviour and risk of depression, the direction of associations is unclear. This study aimed to investigate prospective associations between sedentary behaviour and risk of depression in both directions in socio-economically disadvantaged women. Methods 1511 women, aged 18–45, completed self-report validated measures of sedentary behaviour (TV viewing, computer use, overall sitting time and screen time) as well as depressive symptoms (CES-D-10) in 2007/08 (T1) and 2010/11 (T2). Linear regression analyses examined associations between sedentary behaviours at T1 and depressive symptoms at T2, and multinomial logistic regression analyses examined associations between depressive symptoms at T1 and sedentary behaviours at T2. Results Although prospective analyses indicated no association between T1 sedentary behaviours and depressive symptoms at T2, results showed that depressive symptoms at T1 were associated with higher levels of TV viewing (adjusted odds ratio: 1.032, 95% CI: 1.00, 1.07) at T2. Conclusions Women's sedentary behaviour may not predict subsequent depressive symptoms; however, women's risk of depression may be predictive of engaging in greater amounts of TV viewing. Confirmation of these findings using further prospective and intervention study designs is required.

Background The high prevalence of depression in women is an increasing public health concern. Although studies have found associations between physical activity (PA) and depression, little is known about the optimal domain, dose and social context of PA for reducing the risk of depression. This study aimed to investigate associations between specific components of PA (domain, dose and social context) and odds of depressive symptoms in women. Methods The sample included 1,501 women, aged 18–65. Analyses were performed using cross-sectional data collected from a mail-out survey in 2004. The survey included self-report measures of PA behaviours and depressive symptoms. Crude and adjusted (age, marital status and physical health) odds ratios (OR) and 95% confidence intervals (CI) were calculated for each component of PA and odds of depressive symptoms using logistic regression analyses. Results Those who reported more than 3.5 hours leisure-time PA per week had lower odds of depressive symptoms when compared to those who undertook less than this. No other domains of PA (eg. work-related, transport-related or domestic activity) were associated with odds of depressive symptoms. Odds of depressive symptoms were lower among women who reported more than 1.5 hours of moderate-intensity (OR = 0.67, CI = 0.45–0.98) or more than 1.75 hours vigorous-intensity (OR = 0.60, CI = 0.42–0.84) leisure-time PA per week. Being discouraged to be active by others was associated with higher odds of depressive symptoms (OR = 2.28, CI = 1.00–5.16), whilst being active with a family member was associated with lower odds of depressive symptoms (OR = 0.61, CI = 0.43–0.87). Conclusion Acknowledging the cross-sectional design, these findings suggest that the domain and social context of PA may be more important for mental health among women than simply the total dose of PA.

Objective This review examines original research which has investigated associations between physical activity (PA) dose (i.e. frequency, intensity and duration) and domain and depression or symptoms of depression in adults. Methods A search of electronic databases and authors' own bibliographic libraries was performed between 2006 and 2007 for original research articles investigating associations between PA and depression in adults. A total of 27 observational and 40 intervention studies were included. Results Of the studies that focused on the association between duration of PA and likelihood of depression, all five observational studies, and five of the seven intervention studies found both shorter and longer durations of PA were associated with reduced likelihood of depression. Of the studies that focused on the association between intensity of PA and likelihood of depression, four of the six observational studies found that vigorous-intensity PA was more strongly associated with decreased likelihood of depression than lower intensities. Most intervention studies showed that both intensities were effective in reducing the likelihood of depression. Two observational studies found a stronger inverse relationship of leisure-time PA with depression than PA in other domains. There is insufficient evidence regarding the importance of the PA setting on depression. Conclusion Although the dose and domain of physical activity varied across studies reviewed, evidence suggests that even low doses of PA may be protective against depression. Further studies examining the optimal domain of PA for reducing the likelihood of depression are needed.

BackgroundMental health conditions are among the leading non-fatal diseases in middle-aged and older adults in Australia. Proximal and distal social environmental factors and physical environmental factors have been associated with mental health, but the underlying mechanisms explaining these associations remain unclear. The study objective was to examine the contribution of different types of physical activity in mediating the relationship of social and physical environmental factors with mental health-related quality of life in middle-aged and older adults.MethodsBaseline data from the Wellbeing, Eating and Exercise for a Long Life (WELL) study were used. WELL is a prospective cohort study, conducted in Victoria, Australia. Baseline data collection took place in 2010. In total, 3,965 middle-aged and older adults (55-65 years, 47.4% males) completed the SF-36 Health Survey, the International Physical Activity Questionnaire, and a questionnaire on socio-demographic, social and physical environmental attributes. Mediation analyses were conducted using the MacKinnon product-of-coefficients test.ResultsPersonal safety, the neighbourhood physical activity environment, social support for physical activity from family or friends, and neighbourhood social cohesion were positively associated with mental health-related quality of life. Active transportation and leisure-time physical activity mediated 32.9% of the association between social support for physical activity from family or friends and mental health-related quality of life. These physical activity behaviours also mediated 11.0%, 3.4% and 2.3% respectively, of the relationship between the neighbourhood physical activity environment, personal safety and neighbourhood social cohesion and mental health-related quality of life.ConclusionsIf these results are replicated in future longitudinal studies, tailored interventions to improve mental health-related quality of life in middle-aged and older adults should use a combined strategy, focusing on increasing physical activity as well as social and physical environmental attributes.

Background Previous research has linked sedentary behaviour (SB) to adverse physical health outcomes in adults and youth. Although evidence for the relationship between SB and mental health outcomes (e.g., depression) is emerging, little is known regarding risk of anxiety. Methods A systematic search for original research investigating the association between SB and risk of anxiety was performed using numerous electronic databases. A total of nine observational studies (seven cross-sectional and two longitudinal) were identified. Methodological quality of studies was assessed and a best-evidence synthesis was conducted. Results One cross-sectional study demonstrated a strong methodological quality, five cross-sectional studies demonstrated a moderate methodological quality and three studies (two cross-sectional one longitudinal) received a weak methodological quality rating. Overall, there was moderate evidence for a positive relationship between total SB and anxiety risk as well as for a positive relationship between sitting time and anxiety risk. There was inconsistent evidence for the relationship between screen time, television viewing time, computer use, and anxiety risk. Conclusion Limited evidence is available on the association between SB and risk of anxiety. However, our findings suggest a positive association (i.e. anxiety risk increases as SB time increases) may exist (particularly between sitting time and risk of anxiety). Further high-quality longitudinal/interventional research is needed to confirm findings and determine the direction of these relationships. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-1843-x) contains supplementary material, which is available to authorized users.