Sedentary behaviors and risk of depression in the Seguimiento Universidad de Navarra cohort: the SUN Project

Pimenta, Adriano Marçal; Mendonça, Raquel de Deus; Lahortiga-Ramos, Francisca; Fernandez-Lazaro, Cesar I.; Martínez-González, Miguel Angel; Sánchez-Villegas, Almudena

doi:10.1590/0102-311X00076621

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ARTIGO • Cad. Saúde Pública 38 (2) • 2022 • https://doi.org/10.1590/0102-311X00076621 copy

Sedentary behaviors and risk of depression in the Seguimiento Universidad de Navarra cohort: the SUN Project

Comportamientos sedentarios y riesgo de depresión en la cohorte de Seguimiento Universidad de Navarra: el Proyecto SUN

Comportamentos sedentários e risco de depressão na coorte Seguimiento Universidad de Navarra: o Projeto SUN

Authorship SCIMAGO INSTITUTIONS RANKINGS

The study aimed to prospectively examine the association between different sedentary behaviors and the risk of depression. We included 12,691 Spanish university graduates (mean age: 36.7 year; SD: 11.5), participants of the Seguimiento Universidad de Navarra cohort (the SUN Project), initially free of depression who were followed-up for a median of 10.9 years. Based on items presented in our baseline questionnaire, time spent in four sedentary behaviors (hours/day) were evaluated: overall sitting time; TV-viewing; computer use; and driving. Participants were classified as incident cases of depression if they reported a physician diagnosis of depression in at least one of the follow-up assessments conducted after the first two years of follow-up. Cox regression models were used to assess the relationship between sedentary behaviors and depression. A total of 560 incident cases of depression were identified during follow-up. We found no significant association between overall sitting time, TV-viewing or driving and risk of depression. On the other hand, computer use was directly associated with the risk of developing depression during the follow-up (p-value for trend = 0.020), with the participants in the highest quartile of computer use (3.64 to 10 hours/week) having a higher risk of developing depression (HR = 1.33; 95%CI: 1.05-1.70) than those in the lowest quartile (0 to 0.25 hours/week) after adjusting for potential confounders. Prolonged use of computer was independently associated with an increased risk of developing depression among young middle-aged adult university graduates from a Spanish cohort.

Keywords:
Depression; Sedentary Behavior; Computers; Adult; Cohort Studies

Characteristics	Overall sitting time (hours/day)		Computer use (hours/day)
Characteristics	1st quartile (0.00 to 3.71)	4th quartile (7.21 to 10.00)	1st quartile (0.00 to 0.25)	4th quartile (3.64 to 10.00)
n	3,253	3,101	3,027	2,982
Age (years) [mean (SD)] ^,*	38.2 (11.4)	34.3 (10.8)	36.3 (12.1)	34.2 (9.5)
Female [%] ^,*	67.2	53.9	74.5	54.5
Marital status [%] ^,*
Single	38.2	56.7	45.7	53.3
Married	58.2	41.5	51.0	44.7
Other ***	3.5	1.8	3.3	1.9
University education (years) [mean (SD)] ^,*	4.9 (1.3)	5.2 (1.6)	4.7 (1.2)	5.3 (1.6)
Living alone [%]	2.0	2.1	2.0	2.2
Sitting time (hours/day) [mean (SD)] ^,*	2.4 (1.0)	8.6 (0.8)	4.4 (2.5)	7.3 (1.9)
TV viewing (hours/day) [mean (SD)] ^,*	1.4 (1.3)	1.7 (1.2)	1.6 (1.3)	1.7 (1.5)
Computer use (hours/day) [mean (SD)] ^,*	1.0 (1.5)	3.7 (2.5)	0.1 (0.1)	5.5 (1.4)
Driving (hours/day) [mean (SD)] ^,*	0.9 (1.4)	0.8 (1.0)	0.8 (1.2)	1.1 (1.5)
Working hours (hours/week) [mean (SD)] ^,*	36.5 (16.7)	38.8 (18.4)	31.8 (19.4)	42.2 (13.9)
Hanging out with friends (hours/week) [mean (SD)] **	1.4 (1.3)	1.4 (1.1)	1.4 (1.2)	1.6 (1.4)
Current smokers [%]	20.5	23.8	23.7	23.1
Leisure-time physical activity (METs-hours/week) [mean (SD)] *	23.4 (24.2)	21.0 (19.4)	21 (20.9)	22.0 (21.4)
Total energy intake (Kcal/day) [mean (SD)]	2,356 (611)	2,361 (609)	2,341 (594)	2,356 (623)
Mediterranean diet score (0 to 9 points) [mean (SD)] ^,*	4.2 (1.7)	3.9 (1.7)	4.0 (1.7)	3.9 (1.6)
Psychological traits (0 to 10 points) [mean (SD)] ^#
Competitiveness ^,*	6.9 (1.7)	7.1 (1.7)	6.7 (1.8)	7.2 (1.7)
Anxiety/Tension ^,*	5.8 (2.2)	6.0 (2.2)	5.8 (2.2)	5.9 (2.2)
Dependency	3.6 (2.9)	3.5 (2.8)	3.6 (2.8)	3.5 (2.9)
BMI (kg/m²) [mean (SD)] ^,*	23.3 (3.4)	23.6 (3.5)	23.0 (3.4)	23.4 (3.8)
Insomnia [%] *	9.0	7.5	7.4	7.2
Use of anxiolytics or tranquilizers [%] **	1.2	0.9	1.4	0.8
Sleeping hours (hours per day) [mean (SD)] ^,*	7.2 (1.2)	7.5 (0.8)	7.4 (1.1)	7.3 (0.9)

Overall sitting time (hours/day) [n = 12,691]	1st quartile (0.00 to 3.71)	2nd quartile (3.74 to 5.42)	3rd quartile (5.43 to 7.14)	4th quartile (7.21 to 10.00)	p-value for trend
Cases	144	151	124	141
Persons-year	34,323	36,747	32,877	33,997
Model 2: gender-adjusted [HR (95%CI)]	1.00 (Reference)	0.98 (0.78-1.24)	0.93 (0.73-1.18)	1.05 (0.82-1.33)	0.801
Model 3: multivariable adjusted * [HR (95%CI)]	1.00 (Reference)	1.02 (0.81-1.28)	0.94 (0.74-1.20)	1.04 (0.81-1.32)	0.894
TV viewing (hours/day) [n = 12,314]	1st quartile (0.00 to 0.75)	2nd quartile (0.78 to 1.28)	3rd quartile (1.32 to 2.28)	4th quartile (2.36 to 10.00)	p-value for trend
Cases	160	118	135	127
Persons-year	39,638	31,506	36,927	25,747
Model 2: gender-adjusted [HR (95%CI)]	1.00 (Reference)	0.95 (0.75-1.21)	0.92 (0.73-1.16)	1.18 (0.94-1.49)	0.239
Model 3: multivariable adjusted * [HR (95%CI)]	1.00 (Reference)	0.94 (0.74-1.19)	0.89 (0.71-1.12)	1.11 (0.88-1.41)	0.510
Computer use (hours/day) [n = 11,978]	1st quartile (0.00 to 0.25)	2nd quartile (0.28 to 1.42)	3rd quartile (1.5 to 3.57)	4th quartile (3.64 to 10.00)	p-value for trend
Cases	143	131	98	147
Persons-year	35,08	32,426	30,795	31,628
Model 2: gender-adjusted [HR (95%CI)]	1.00 (Reference)	1.11 (0.88-1.42)	0.91 (0.70-1.18)	1.33 (1.05-1.69)	0.031
Model 3: multivariable adjusted * [HR (95%CI)]	1.00 (Reference)	1.13 (0.89-1.44)	0.92 (0.71-1.20)	1.33 (1.05-1.70)	0.020
Driving (hours/day) [n = 11,898]	1st quartile (0.00 to 0.25)	2nd quartile (0.28 to 0.61)	3rd quartile (0.71 to 1)	4th quartile (1.04 to 10.00)	p-value for trend
Cases	172	113	105	126
Persons-year	41,078	25,384	31,220	31,461
Model 2: gender-adjusted [HR (95%CI)]	1.00 (Reference)	1.17 (0.92-1.48)	0.91 (0.71-1.17)	1.09 (0.86-1.38)	0.687
Model 3: multivariable adjusted * [HR (95%CI)]	1.00 (Reference)	1.15 (0.90-1.47)	0.91 (0.71-1.17)	1.05 (0.83-1.34)	0.905

	Computer use (hours/day) [HR (95%CI)]				p-value for trend
	1st quartile (0.00 to 0.25)	2nd quartile (0.28 to 1.42)	3rd quartile (1.50 to 3.57)	4th quartile (3.64 to 10.00)
Overall (n = 11,978)	1.00 (Reference)	1.13 (0.89-1.44)	0.92 (0.71-1.20)	1.33 (1.05-1.70)	0.020
Including participants with prevalent diabetes, CVD or cancer (n = 13,462)	1.00 (Reference)	1.09 (0.86-1.38)	0.88 (0.68-1.14)	1.30 (1.02-1.64)	0.043
Excluding pregnant women (n = 11,065)	1.00 (Reference)	1.19 (0.92-1.53)	0.88 (0.66-1.18)	1.42 (1.10-1.83)	0.018
Excluding participants who use anxiolytics at baseline (n = 11,862)	1.00 (Reference)	1.08 (0.85-1.38)	0.90 (0.69-1.18)	1.32 (1.04-1.69)	0.029
Excluding participants with prevalent obesity (n = 11,456)	1.00 (Reference)	1.12 (0.87-1.43)	0.91 (0.70-1.20)	1.32 (1.03-1.69)	0.042
Considering medical diagnosis of depression only from 2 until 8 years of follow-up (n = 11,978)	1.00 (Reference)	1.43 (0.98-2.09)	1.17 (0.78-1.77)	1.63 (1.12-2.39)	0.039
Additionally, adjusted for incident CVD during follow-up (n = 11,978)	1.00 (Reference)	1.12 (0.88-1.42)	0.92 (0.70-1.19)	1.33 (1.04-1.69)	0.034

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[1] Correspondence
A. M. Pimenta Departamento de Enfermagem, Setor de Ciências da Saúde, Universidade Federal do Paraná. Av. Prefeito Lothário Meissner 632, Curitiba, PR 80210-170, Brasil. adriano.pimenta@ufpr.br