Background: Depression escalating public health concern and the modest efficacy of currently available treatments have prompted efforts to identify modifiable risk factors associated with depression symptoms. Physical inactivity, poor nutrition, or other lifestyle behaviors are among the potentially modifiable risk factors most consistently linked with depression. Past evidence regarding the single effect of physical activity (PA) or dietary quality (DQ) on reducing the risk of depression symptoms has been well-documented. However, the association of the joint effect of PA and DQ on depression symptoms has never been investigated in a representative sample of adults. Objective: This study investigates the association between PA and depression symptoms and between DQ and depression symptoms, and their combined effects on US adults. Methods: Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007 to 2018 cycles. The primary exposures were DQ and PA, measured using the Healthy Eating Index (HEI)-2015 and the metabolic equivalent (MET) minutes per week reported in questionnaires, respectively. Depression symptoms were defined as a 9-item Patient Health Questionnaire (PHQ-9) score of ≥10. We created 4 lifestyle categories: healthy diet and active individuals, unhealthy diet but active individuals, healthy diet but inactive individuals, and unhealthy diet and inactive individuals. Participants were considered to have a healthy diet if they fell within the 60th percentile of the HEI-2015 or to be active if they met the current guidelines for PA. A survey-multivariable logistic regression approach was used to model adjust the variables relevant to the associations, and an age-adjusted prevalence for depression symptoms was calculated following the NHANES guidelines. Results: In total, 19,295 participants represented a weighted number of 932.5 million adults aged 20 to 80 years in the noninstitutionalized US population. The total age-adjusted prevalence of depression symptoms among all respondents was 7.08% (1507/19,295). Of the respondents, 81.97% (15,816/19,295) met the PA recommendation and 26.79% (5170/19,295) scored at or above the 60th percentile on the HEI-2015. Depression symptoms were inversely associated with a higher level of PA (adjusted odds ratio [AOR] 0.819, 95% CI 0.716-0.938) and healthy DQ (AOR 0.809, 95% CI 0.701-0.931), respectively. A healthy diet combined with recommended PA was associated with a significantly lower risk of depression symptoms (AOR 0.658, 95% CI 0.538-0.803) than those who consumed an unhealthy diet but were physically active (AOR 0.890, 95% CI 0.765-1.038) or consumed a healthy diet but were physically inactive (AOR 1.077, 95% CI 0.817-1.406). Conclusions: Our findings indicate that people with a healthy diet and recommended PA have a lower risk of depression symptoms than those with an unhealthy diet and a low level of PA. A healthy dietary habit and regular PA are potential precautions against depression.

Objective: Mild cognitive impairment (MCI) is a preclinical and transitional stage between healthy ageing and dementia. The purpose of our study was to investigate the recent pooled global prevalence of MCI.Methods: This meta-analysis was in line with the recommendations of Cochrane’s Handbook and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. We conducted a comprehensive search using the PubMed, Embase, Web of Science, CNKI, WFD, VIP, and CBM from their inception to March 1, 2023. Quality assessment was guided by the Agency for Healthcare Research and Quality (AHRQ) methodology checklist. The pooled global prevalence of MCI was synthesized using meta-analysis via random effect model. Subgroup analyses were performed to examine considered factors potentially associated with MCI prevalence.Results: We identified 233 studies involving 676,974 individuals aged above 50 years. All the studies rated as moderated-to-high quality. The overall prevalence of MCI was 19.7% [95% confidence interval (95% CI): 18.3–21.1%]. Subgroup analyses revealed that the global prevalence of MCI increased over time, with a significant rise [32.1% (95% CI: 22.6–41.6%)] after 2019. Additionally, MCI prevalence in hospitals [34.0% (95% CI: 22.2–45.7%)] was higher than in nursing homes [22.6% (95% CI: 15.5–29.8%)] and communities [17.9% (95% CI: 16.6–19.2%)], particularly after the epidemic of coronavirus disease 2019 (COVID-19).Conclusion: The global prevalence of MCI was 19.7% and mainly correlated with beginning year of survey and sample source. The MCI prevalence increased largely in hospitals after 2019 may be related to the outbreak of COVID-19. Further attention to MCI is necessary in the future to inform allocation of health resources for at-risk populations.

Background: Sedentary behavior (SB) and physical activity (PA) are modifiable risk factors for cardiovascular disease (CVD); however, previous research on the effects of PA and SB on CVD has been relatively homogeneous. Our study investigated the association between PA, SB, and CVD-related outcomes.Methods: A comprehensive search strategy was conducted in the MEDLINE, Embase, Cochrane Library, and Web of Science databases from their inception to September 2022. We identified eligible studies according to PICOS: the populations comprised healthy adults, the interventions or exposures were PA or SB, the outcomes were CVD-related outcomes, and the study designs were randomized controlled trials (RCTs) and longitudinal studies (LS). Outcomes were pooled using fixed or random effects models, and the quality of individual studies was assessed by the Cochrane Risk of Bias Instrument and the Newcastle Ottawa Scale.Results: A total of 148 RCTs and 36 LS were included, comprising a total of 75,075 participants. The study quality was rated as low to moderate. We found an increased hazard ratio (HR) for CVD in the population with SB (HR = 1.34; 95% confidence interval [CI]: 1.26 to 1.43; I² = 52.3%; P_{heterogeneity} < 0.001, random model) and a decreased HR for CVD in those who performed long-term PA (HR = 0.71; 95% CI: 0.66 to 0.77; I² = 78.0%, P_{heterogeneity} < 0.001, random model). Long-term PA improved the lipid profiles in healthy adults; participants in this group exhibited increased high-density lipoprotein (weighted mean difference [WMD] = 2.38; 95% CI: 1.00 to 3.76; I² = 84.7%; P_{heterogeneity} < 0.001, random model), decreased triglycerides (WMD = −7.27; 95% CI: −9.68 to −4.87; I² = 0%, P_{heterogeneity} = 0.670, fixed model), and lower total-cholesterol (WMD = −6.84; 95% CI: −9.15 to −4.52; I² = 38.4%, P_{heterogeneity} < 0.001, random model).Conclusions: Long-term SB increases the risk of CVD in healthy adults, whereas PA reduces the risk of CVD and improves indicators associated with CVD. However, the ability of PA to improve blood lipids appeared to be limited. The detailed association of SB and PA on CVD needs to be further investigated in the future.

Insufficient physical activity (PA) and excessive sedentary behavior (SB) are detrimental to physical and mental health. This systematic review and meta-analysis aimed to identify whether e-health interventions are effective for improving PA and SB in college students. Five electronic databases, including Medline, Web of Science, Embase, Cochrane Library, and ProQuest, were searched to collect relevant randomized controlled trials up to 22 June 2022. In total, 22 trials (including 31 effects) with 8333 samples were included in this meta-analysis. The results showed that e-health interventions significantly improved PA at post-intervention (SMD = 0.32, 95% CI: 0.19, 0.45, p < 0.001) compared with the control group, especially for total PA (SMD = 0.34, 95% CI: 0.10, 0.58, p = 0.005), moderate to vigorous PA (SMD = 0.17, 95% CI: 0.01, 0.32, p = 0.036), and steps (SMD = 0.75, 95% CI: 0.23, 1.28, p < 0.001. There were no significant effects for both PA at follow-up (SMD = 0.24, 95% CI: – 0.01, 0.49, p = 0.057) and SB (MD = −29.11, 95% CI: −70.55, 12.32, p = 0.17). The findings of subgroup analyses indicated that compared to the control group, interventions in the group of general participants (SMD = 0.45, 95% CI: 0.27, 0.63, p < 0.001), smartphone apps (SMD = 0.46, 95% CI: 0.19, 0.73, p = 0.001), and online (SMD = 0.23, 95% CI: 0.04, 0.43, p < 0.001) can significantly improve PA at post-intervention. Moreover, the intervention effects were significant across all groups of theory, region, instrument, duration, and female ratio. At follow-up, interventions in groups of developing region (SMD = 1.17, 95% CI: 0.73, 1.62, p < 0.001), objective instrument (SMD = 0.83, 95% CI: 0.23, 1.42, p = 0.007), duration ≤ 3-month (SMD = 1.06, 95% CI: 0.72, 1.39, p < 0.001), and all female (SMD = 0.79, 95% CI: 0.02, 1.56, p = 0.044) can significantly improve PA. The evidence of this meta-analysis shows that e-health interventions can be taken as promising strategies for promoting PA. The maintenance of PA improvement and the effect of interventions in reducing SB remain to be further studied. Educators and health practitioners should focus on creating multiple e-health interventions with individualized components.

Inadequate physical activity (PA) among university students, a growing concern, hinders their holistic health development and the formation of healthy habits. Current evidence regarding the impact of interventions to promote PA in this group remains inconclusive. Through a systematic review and meta-analysis, this study aims to evaluate the efficacy of PA interventions in promoting PA among university students. A search of six electronic databases up to 30 June 2023 was conducted to identify randomized controlled trials (RCTs) assessing PA interventions in university students. Thirty-one RCTs were included for systematic review and meta-analysis. The eligible studies’ quality was assessed via the Cochrane Collaboration tool for evaluating the risk of bias. The results indicated a significant increase in total PA (TPA), moderate-to-vigorous PA (MVPA), and step counts at post-intervention compared to control groups, with effect sizes approaching large for MVPA and an increase of 19,245 steps per week. TPA also showed significant improvements during follow-up periods from three weeks to 12 months. Subgroup analyses revealed significant intervention effects across all subgroups, with the subgroups of post-COVID and sample sizes ≤100 showing larger effect sizes within their respective group. This review identified that interventions could enhance TPA, MVPA, and step counts among university students, with sustainable effects on TPA, while further research is needed for other outcomes. The university environment is conducive to PA interventions, and future interventions integrating e-health with in-person modes, coupled with matched theories and behavior change techniques, show promise. This review protocol has been registered on the platform of the International Prospective Register for Systematic Reviews (PROSPERO, CRD42023486749).

Background: Existing evidence on the association between sedentary behavior (SB) and cognitive function remains inconclusive. Therefore, this study investigated the association between SB and the risk of cognitive decline (CD) or mild cognitive impairment (MCI) in the elderly.Methods: A comprehensive search was independently conducted by two researchers (XC and GQ) in seven electronic databases, including Medline (via PubMed), China Biology Medicine, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang database, and VIP database for Chinese technical periodicals, covering studies published from the inception of database to June 2023. Studies that investigated the relationship between SB and the risk of CD or MCI in the elderly were included. The quality of the literature was assessed using the Newcastle–Ottawa Scale (NOS) and the Agency for Healthcare Research and Quality (AHRQ) assessment tools. The combined effect size analysis, subgroup analysis, and publication bias assessment were performed using STATA 14.0.Results: A total of 13 cross-sectional and 6 cohort studies involving 81,791 individuals were included, comprising 17 high-quality studies and 2 medium-quality studies. We found that SB was significantly associated with an increased risk of CD [odds ratio (OR) = 1.69, 95% confidence intervals (CI): 1.47–1.94] or MCI (OR = 1.34, 95% CI: 1.14–1.56) among the elderly. Subgroup analysis stratified according to comorbidity, lifestyle, family structure, publication year, and region showed statistical differences between groups, and the consistency of the results revealed the sources of the heterogeneity.Conclusion: This meta-analysis showed that SB is positively associated with the risk of CD or MCI in the elderly, providing a higher level of evidence for the promotion of healthy behaviors by clinicians and health policymakers. Due to the number and quality of the included articles, more high-quality longitudinal studies are needed to further confirm our findings.