Association Between Physical Activity and Depression among Women: An Analysis of NHANES 2017–2018 Data

Background: Depression is a prevalent mental disorder that affects approximately 5% of adults globally as of 2023. Women are 50% more likely to experience depression than men, making it one of the leading causes of disability among women. Despite the effectiveness of antidepressants, their side effects underscore the need to explore other interventions, such as physical activity (PA). This study aimed to investigate the relationship between PA and depression among women using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018, addressing gaps in understanding the impact of PA intensity and specific lifestyle factors on women with depression. Methods: This exploratory, observational, cross-sectional study included female participants aged 20 years and older from the NHANES 2017-2018 survey. Depressive symptoms were assessed using the 9-item Patient Health Questionnaire (PHQ-9), and PA was categorized into moderate- and vigorous activity. Logistic regression models were used to evaluate the association between PA and depression, controlling for potential confounders, including age, ethnicity, marital status, education, poverty ratio, lifestyle factors, and comorbidities. Results: Overall, 10.45% of participants reported depressive symptoms. Moderate PA was associated with 35% lower odds of depression (OR=0.65, 95% CI: 0.47–0.91, p=0.009). Vigorous PA showed a non-significant trend toward reduced odds of depression (OR=0.76, 95% CI: 0.49–1.19, p=0.243), which became significant in sensitivity analyses. High sugar intake was linked to a higher risk of depression (OR=1.97, 95% CI: 1.24–3.13), while fiber intake was protective. Women with arthritis had 63% higher odds of depression (OR=1.63, 95% CI: 1.17–2.27, p=0.003), and those with chronic bronchitis had more than twice the odds (OR=2.08, 95% CI: 1.38–3.12, p<0.001). Conclusion: This study addresses critical gaps in the literature by focusing on the specific effects of different PA intensities on depression among women. The findings support the inclusion of moderate exercise and a balanced diet in mental health interventions for women, offering valuable insights into non-pharmacological treatment options