The Relationship Between Resistance Exercise Participation And Anxiety In A Nationally Representative Sample

Anxiety symptoms are common and range from mild to highly debilitating. Resistance exercise (RE) may have protective effects for anxiety symptoms. However, the relationships between anxiety symptoms as well as anxiety disorders with RE is unclear. PURPOSE: To assess associations between meeting the US Physical Activity (USPA) guidelines for RE (Aim 1) and frequency of RE (Aim 2) with anxiety severity, and between lifetime anxiety disorder status and RE participation (Aim 3). METHODS: We analyzed cross-sectional data from the 2022 National Health Interview Survey, which includes a nationally representative sample (n = 27,651). We used linear regression models to assess the associations between RE participation (meeting the USPA guidelines for RE [2x/week; n = 7894]/not meeting guidelines [n = 19,757]) and anxiety severity (Aim 1) and continuous frequency of RE (times per week) and anxiety severity (Aim 2). Anxiety severity was measured using the Generalized Anxiety Disorder-7 (GAD-7; higher scores indicate higher anxiety, scored 0-21). In Aim 3 logistic regression modeling assessed the relationship between RE participation and anxiety disorder status (lifetime anxiety disorder diagnosis [n = 4,834]/no diagnosis [n = 22,765]). All models included sex, age, and BMI as covariates. RESULTS: On average, those who met USPA RE guidelines had a GAD-7 score 0.32 points lower compared to those who did not meet the guidelines (p < 0.001; Cohen’s d = 0.11). On average, each additional RE session per week was associated with a .07 lower GAD-7 score (p < 0001). The odds of having a lifetime anxiety disorder diagnosis were 32% higher in those who did not meet USPA RE guidelines compared to those who did meet the guidelines (odds ratio = 1.32, [95% CI = 1.22, 1.43]). CONCLUSIONS: Participating in RE at least two times per week may have protective effects against anxiety disorders, with those not meeting USPA guidelines being 32% more likely to be diagnosed with anxiety at some point in their lives. However, the association between RE and anxiety severity appears weaker in general in this nationally representative sample, likely due to generally low anxiety symptoms. Overall, these results suggest a relationship between RE and anxiety, particularly diagnosed disorders, and interventions in anxious samples may prove fruitful. SS and JM were partially supported via 1R01MH130566-01A1.