Effects of high-intensity interval training on depressive and anxiety symptoms in healthy individuals: A systematic review and meta-analysis of randomized clinical trials.

Although evidence regarding the effects of high-intensity interval training (HIIT) on mental health has increased in recent years, there is still no consensus regarding the effects of HIIT on the symptoms of depression and anxiety in a healthy population. Therefore, this systematic review aimed to investigate the effects of HIIT on depressive and/or anxiety symptoms in healthy individuals. The following four databases were searched: PubMed, Scopus, Embase, and PsycINFO. Only randomized clinical trials (RCTs) were included. We performed a random-effects meta-analysis based on standardized mean difference (SMD). The risk of bias was assessed using the RoB 2.0 tool, and the certainty of the evidence was evaluated based on recommendations GRADE. Eight RCTs evaluating 471 participants (81% female) were considered eligible for inclusion. The results of the meta-analysis showed that HIIT-based interventions had no significant effect on reducing anxiety (SMD = -0.17; 95% CI: -0.53, 0.19; p = 0.27) and depressive symptoms (SMD = -0.38; 95% CI: -1.06, 0.30; p = 0.17) compared with the passive control group. In conclusion, HIIT does not improve symptoms of depression and anxiety in healthy individuals. This finding is based on evidence of very low certainty. Therefore, the evidence is still not consistent enough to support HIIT as a viable strategy to reduce both outcomes because of the limited number of included studies and the overall quality of evidence.

Effects of high-intensity interval training and its different protocols on lipid profile and glycaemic control in type 2 diabetes: A meta-analysis.

This meta-analysis of randomised clinical trials aimed to compare the effects of high-intensity interval training (HIIT) and its different protocols versus moderate-intensity continuous training (MICT) and/or control on total cholesterol, HDL, LDL, triglycerides, HbA1c levels, and fasting glucose in individuals with type 2 diabetes mellitus (T2DM). The search strategy was performed in PubMed/MEDLINE, Cochrane CENTRAL, EMBASE, Web of Science, Sport DISCUS, and PEDro, until January 2023. A total of 31 studies (1092 individuals) were included. When compared to control, HIIT decreased total cholesterol by -0.31 mmol/L (95% CI -0.49; -0.12), LDL by -0.31 mmol/L (95% CI -0.49; -0.12), triglycerides by -0.27 mmol/L (95% CI -0.33; -0.2), HbA1c by -0.75% (95% CI -0.97; -0.53), fasting glucose by -1.15 mmol/L (95% CI -1.44; -0.86), and increased HDL by 0.24 mmol/L (95% CI 0.06; 0.42). No difference was found in the comparison between HIIT versus MICT for any of the outcomes analysed, however subgroup analysis showed that a moderate-interval (>30s to < 2 min) and moderate-term (>4 to < 12 weeks) HIIT protocol reduced total cholesterol, when compared to MICT. HIIT is able to improve lipid profile and glycaemic control in T2DM individuals, and specific protocols can be recommended for improving total cholesterol levels.

Effects of the combination of vitamins C and E supplementation on oxidative stress, inflammation, muscle soreness, and muscle strength following acute physical exercise: meta-analyses of randomized controlled trials.

Background:The combined supplementation of vitamins C and E potentially can mitigate oxidative stress (OS) and accelerate recovery following exercise. However, there is little evidence and a lack of consensus on the effects of these vitamins for this purpose. The objective of this systematic review was to summarize the evidence on the effects of the combined supplementation of vitamins C and E in OS, inflammatory markers, muscle damage, muscle soreness, and musculoskeletal functionality following acute exercise. Methods: The search was carried out from inception until March 2021, on MEDLINE, EMBASE, Cochrane CENTRAL, Web of Science, and SPORT Discus. We included placebo-controlled randomized clinical trials (RCTs) that evaluated the effects of combined supplementation of vitamins C and E in OS, inflammatory markers, muscle damage, muscle soreness, and muscle strength following a single bout of exercise. Random-effect meta-analyses were used to compare pre to post-exercise mean changes in subjects who received supplementation with vitamins C and E or placebo versus controls. Data are presented as standard mean difference (SMD) and 95% confidence interval (95% CI). Results: Eighteen RCTs, accounting for data from 322 individuals, were included. The use of vitamins attenuated lipid peroxidation (SMD= -0.703; 95% CI= -1.035 to -0.372; p < 0.001), IL-6 (SMD= -0.576; 95%CI= -1.036 to -0.117; p = 0.014), and cortisol levels (SMD= -0.918; 95%CI= -1.475 to -0.361; p = 0.001) immediately, and creatine kinase levels 48 h following exercise (SMD= -0.991; 95%CI= -1.611 to -0.372; p = 0.002). Supplementing the combination of vitamins had no effects on protein carbonyls, reduced/oxidized glutathione ratio, catalase, interleukin-1Ra, C-reactive protein, lactate dehydrogenase, muscle soreness, and muscle strength. Conclusion: Prior supplementation of the combination of vitamins C and E attenuates OS (lipid peroxidation), the inflammatory response (interleukin-6), cortisol levels, and muscle damage (creatine kinase) following a session of exercise.

Effects of vitamin C on oxidative stress, inflammation, muscle soreness, and strength following acute exercise: meta-analyses of randomized clinical trials.

BACKGROUND: Vitamin C (ascorbic acid) seems to attenuate the overproduction of reactive species during and after exercises. Yet, no meta-analysis has summarized the magnitude of this effect. The objective of this study was to systematically review the effects of vitamin C supplementation on oxidative stress, inflammatory markers, damage, soreness, and the musculoskeletal functionality after a single bout of exercise. METHODS: Major electronic databases were searched, from inception to September 2019, for placebo-controlled randomized clinical trials (RCTs) that evaluated the effects of vitamin C supplementation on oxidative stress parameters, inflammation markers, muscle damage, muscle soreness, and muscle functionality after a single bout of exercise in healthy volunteers. Random-effects modelling was used to compare mean changes from pre- to postexercise in participants that were supplemented with vitamin C versus placebo. Data were reported as standard mean difference (SMD) and 95% confidence interval (CI). RESULTS: A total of 18 RCTs, accounting for 313 participants (62% males, median age = 24 years) were included. Vitamin C supplementation reduced lipid peroxidation immediately (SMD = - 0.488; 95% CI = - 0.888 to - 0.088), 1 h (SMD = - 0.521; 95% CI = - 0.911 to - 0.131) and between 1 and 2 h (SMD = - 0.449; 95% CI = - 0.772 to - 0.126) following exercise. Exercise induced interleukin-6 (IL-6) response was attenuated 2 h (SMD = - 0.764; 95% CI = - 1.279 to - 0.248) and between 1 and 2 h (SMD = - 0.447; 95% CI = - 0.828 to - 0.065) after exercise. No effects of vitamin C supplementation were found on creatine kinase (CK), C-reactive protein (CRP), cortisol levels, muscle soreness, and muscle strength. CONCLUSION: Vitamin C supplementation attenuates the oxidative stress (lipid peroxidation) and inflammatory response (IL-6) to a single bout of exercise. REGISTRATION: PROSPERO (CRD42018094222).

Physical Activity, Quality of Life and Global Functioning an Early Stages of Psychosis.

BACKGROUND: Regular practice of physical activity is associated with better quality of life and functioning in people with bipolar disorder, schizophrenia and depression. However, to the best of our knowledge, there is no evidence of the association between physical activity and quality of life and global functioning among people in the initial stages of psychosis. The aim to explore the association of the level of physical activity with quality of life and global functioning among patients in early stages of psychosis. SUBJECTS AND METHODS: Cross-sectional study carried out in an early intervention program in 2016. The socio-demographic and clinical variables were assessed via a form; the adherence through the Measurement of Treatment Adherence; the global functioning through the Global Assessment of Functioning (GAF) scale; the level of physical activity through the International Physical Activity Questionnaire (IPAQ) and quality of life through the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). The Mann-Whitney test was used for analysis. RESULTS: A total of eighty-five participants (mean age=32, 57.6% were men) were assessed. Of the 85, 46 (54.1%) were classified as physically active. The physically active patients presented higher values, on average (standard deviation), in relation to the SF-36 domain of physical functioning (active patients: 87.1 (20.9) vs. inactive patients 80.1 (20.5) inactive; p=0.016), and global functioning when compared to the physically inactive group (active patients: 71.5 (17.6) vs. inactive patients 60.1 (20.9); p=0.011). CONCLUSION: Higher levels of physical activity are associated with better quality of life and higher global functioning in patients in early stages of psychosis.

The Role of Exercise in Preventing and Treating Depression.

Depression is a leading cause of global burden. The mainstay of treatment is pharmacological and psychological interventions. While effective, not all people will respond to those treatments and alternative approaches for preventing and treating depression are required. Recent literature has demonstrated that higher physical activity (PA) levels and exercise confer protective effects on incident depression. Also, exercise has demonstrated efficacy on reducing symptoms for people with depression. Despite its effectiveness, similar to other treatments, some people may benefit more from exercise and identifying these potential predictors of response is necessary to deal with patients' and professionals' expectations. Dropout from exercise interventions is comparable to dropout from other treatments for depression and similar to dropout from exercise in other clinical populations. However, some strategies to increase adherence are important. In the present article, we provide an updated overview of the use of PA and exercise for the prevention and treatment of depression.

A critical review of exercise as a treatment for clinically depressed adults: time to get pragmatic.

OBJECTIVE: Although considerable evidence supports the efficacy of exercise as an antidepressant treatment, critical reviews informing routine practice and future research directions are scarce. METHODS: We critically reviewed exercise studies for clinically depressed adults, focussing on the PICOS criteria referred to participants, interventions, comparisons, outcomes, and study designs. RESULTS: Most studies have not screened their samples for symptom heterogeneity. Also, they have employed heterogeneous exercise interventions and control groups that may lead to an underestimation of the benefits of exercise. In addition, pragmatic trials allowing scalable replication and implementation in routine practice are scarce. Future studies, can consider the research domain criteria as a diagnostic framework, and conduct moderator analyses to identify depressed subgroups with symptomatology and biopsychosocial characteristics associated with differential responses to exercise interventions. The search for biomarkers of the antidepressant responses to exercise should be prioritised. Further, non-physically active comparison groups should be used to minimise treatment cross-overs and thus the underestimation of the effects of exercise interventions. Finally, the use of outcome measures that maintain their validity at low and moderate levels of symptom severity and the development of trials with a pragmatic design are essential. CONCLUSION: The current evidence base is fraught with methodological considerations that need to be taken into account in order to increase further our understanding on the impact of exercise as medicine in depression. Future research should include moderator analyses, incorporate biomarker assays, use appropriate control and comparison groups, assess outcomes with psychometrically sensitive measures, and prioritise pragmatic trials towards transition to routine practice.

The effects of exercise on oxidative stress (TBARS) and BDNF in severely depressed inpatients.

Exercise can be an effective treatment for depression. Although the efficacy of exercise is well established, little is known concerning the biological changes associated with the antidepressant effects of exercise. A randomized, controlled trial was conducted to evaluate the effects of adding exercise to the usual treatment on the thiobarbituric acid-reactive substances (TBARS) and brain-derived neurotrophic factor (BDNF) serum levels of severely depressed inpatients. Twenty-six participants were randomized to an exercise group (n=15, exercise+treatment as usual) or a control group (n=11, treatment as usual). The participants in the exercise group completed a targeted dose of 16.5 kcal/kg/week of aerobic exercise, three times per week, throughout their hospitalizations. The control group did not exercise during their hospitalizations. The mean hospitalization length was of 21.63 (4.5)×23.82 (5.7) days for exercise and control groups, respectively. The exercise group performed a median of nine sessions. After adjusting for previous tobacco use, a significant group×time interaction was found for TBARS serum levels (p=0.02). A post hoc Bonferroni test revealed differences between the exercise and control groups at discharge. A significant time effect (p<0.001) but no group×time interaction was found (p=0.13) for BDNF serum levels. Adding exercise to the usual treatment of severely depressed inpatients decreases the TBARS serum levels of severely depressed inpatients after 3 weeks. Adding exercise had no additional effects on BDNF serum levels.

Water-based exercise and quality of life in women: the role of depressive symptoms.

Several studieshave evaluated the relation of exercise to quality of life (QoL). To our knowledge, no study has evaluated the relation of water-based exercise to depressive symptoms and QoL, or the association between improvement in QoL and depressive symptoms in healthy women. The purpose of this study was to evaluate the association of water-based exercise with changes in QoL. Forty-seven women performed water-based combined exercise for 12 weeks. All participants improved in the physical and psychological domains of QoL. Decreases in depressive symptoms and improvements in maximal strength and aerobic capacity were found for all participants. A regression model revealed that depressive symptoms were associated with improvements in physical and psychological domains of QoL. The results showed that moderate intensity, water-based exercise improved physical and psychological domains of QoL, depressive symptoms, aerobic capacity, and muscular strength of women. Furthermore, the improvement in physical and psychological domains of QoL appeared to be mediated by the antidepressant effects of exercise, but not by changes in aerobic capacity or muscular strength.

The association of changes in leisure-time physical activity on depressive symptoms during Covid-19 in German adults: A longitudinal study.

This longitudinal survey assessed preventive and curative antidepressant effects of at least 75 min/week of leisure-time physical activity (LTPA) at different timepoints of the Covid-19 pandemic. We further investigated if high self-regulation skills were associated with higher odds of initiating or maintaining LTPA during the pandemic. Data was collected online from 4253 participants (age: m = 33.65 years, SD = 0.79; 79 % female) during the first quarantine measures in Germany (T1), as well as 4 weeks (T2), and 8 months (T3) later. We performed linear mixed models with changes (T2-T1, T3-T1) in LTPA and baseline major depressive disorder (MDD) as predictors (main effects and interaction effect) and depressive symptoms (at T2, T3) as the primary outcome. We found significant interaction effects of baseline depression and change in LTPA on depressive symptoms at T2 and T3 (p < 0.001). For probable cases of MDD an increasing LTPA to ≥75 min/week (vs. no change, <75 min/week) was associated with less depressive symptoms at T2 and T3 (p = 0.003, d = 0.28). For absence of depression at baseline, remaining at ≥75 min/week of LTPA was associated with less depressive symptoms at T2 and T3 compared to remaining at <75 min/week (p = 0.006, d = 0.11) or decreasing LTPA to <75 min/week (p = 0.018, d = 0.11). Reporting high self-regulation at T1 was associated with higher odds of performing ≥75 min/week of LTPA at T2/T3 (OR = 1.74, p < 0.001). In general, studies report reduced LTPA during Covid-19. To benefit from the reported preventive and interventional effects, further interventions should focus on improving physical activity related self-regulation to identify and overcome barriers for LTPA.

Effectiveness of short sprint interval training in women with major depressive disorder: a proof-of-concept study.

Background: High-intensity intermittent training has emerged as an option for treating major depressive disorder (MDD). However, short sprint training (sSIT), an efficient HIIT modality, has not been tested yet for this purpose. The sSIT has been proven to induce the same metabolic adaptations, with the advantage of promoting lower muscle fatigue than other HIIT protocols. Methods: Seventeen adult women diagnosed with moderate/severe MDD were randomly allocated into a sSIT group (n=9) or a control condition (n=8). The sSIT group completed, over two weeks, six 6-10-min sessions which consisted of 3-12 "all out" sprints of 5 s interspersed with low-intensity recovery of 30-45 s. The week before and after the intervention, both groups were evaluated with the Hamilton Depression Rating Scale of 21-itens (HAM-D21), and for physical fitness and incidental physical activity. Results: The sSIT group exhibited significant improvements for HAM-D21 scores (24.6±8.2 vs. 16.8±10.1), maximum aerobic power (140±15 vs. 155±15 W), countermovement jump (13.0±3.4 vs. 14.9±3.1 cm), % of body fatness (32.4±4.4 vs. 29.3±3.8%), and 4-days number of steps (13,626±11,309 vs. 16,643±15,371) after the training period when compared to the control group. Conclusion: Less than 1 hour of a sSIT protocol over two weeks have demonstrated to reduce depressive symptoms, while improving aerobic fitness and body composition, and increasing incidental physical activity in a sample of women diagnosed with MDD.

Physical activity and sedentary behavior levels among individuals with mental illness: A cross-sectional study from 23 countries.

People with mental illness tend to present low levels of physical activity and high levels of sedentary behavior. The study aims to compare these levels in mental illness patients, exploring the role of socioeconomic development and treatment setting. This cross-sectional study used accelerometers and the Simple Physical Activity Questionnaire (SIMPAQ) to assess physical activity and sedentary behavior in mental illness individuals living in 23 countries. Two-way ANOVAs were used to evaluate the interaction between socioeconomic development and the treatment settings on physical activity and sedentary behavior. A total of 884 (men = 55.3%) participants, mean age of 39.3 (SD = 12.8), were evaluated. A significant interaction between socioeconomic development and treatment settings was found in sedentary behavior (F = 5.525; p = 0.019; η2p = 0.009; small effect size). Main effects were observed on socioeconomic development (F = 43.004; p < 0.001; η2p = 0.066; medium effect size) and treatment setting (F = 23.001; p < 0.001; η2p = 0.036; small effect size) for sedentary behavior and physical activity: socioeconomic development (F = 20.888; p < 0.001; η2p = 0.033; small effect size) and treatment setting (F = 30.358; p < 0.001; η2p = 0.047; small effect size), showing that HIC patients were more active, while MIC patients were more sedentary. Moreover, despite of inpatients had presented higher levels of physical activity than outpatients, they also spent more time sitting. Socioeconomic development plays an important role in sedentary behavior in patients with mental disorders, warning the need to develop new strategies to reduce these levels in this population.

Association between physical activity and global functioning in individuals with mental disorders: A systematic review and meta-analysis.

Physical activity is associated with better global functioning in the general population and in people with physical conditions. However, there is no meta-analytic evidence on the associations between daily physical activity levels and global functioning in people with mental disorders. The objective of the present meta-analysis therefore was to evaluate the associations between daily physical activity levels and global functioning in individuals with mental disorders. Pubmed, Embase, PsycINFO and SPORTdiscus were searched from inception to August 1st, 2022. Risk of bias was assessed using the National Institutes of Health Study Quality Assessment Tools. A random-effects meta-analysis was performed. Ten studies were identified and six were meta-analyzed including 251 adults (39.2 ± 11.9 years, 33.6% of women). The pooled results from six studies found a moderate positive correlation (r = 0.39, 95% CI 0.242 to 0.528, p<0.001, I²=49.3%) between daily physical activity and global functioning. Three out of four studies not included in the meta-analysis also found significant associations between physical activity and global functioning. The current meta-analysis demonstrated a moderate association between daily physical activity and global functioning in individuals with mental disorders. However, the evidence is based on cross-sectional studies and a causal relationship cannot be established. High-quality longitudinal studies aiming to address this relationship should be conducted.

The relationship between physical activity and depressive symptoms is domain-specific, age-dependent, and non-linear: An analysis of the Brazilian national health survey.

Although there is consistent evidence of the beneficial effects of leisure physical activity (PA) on mental health, the role of PA in the domestic, transport, and occupational domains is inconclusive. This study aimed to analyze the relationship between domain-specific PA and depressive symptoms and examine whether the association is moderated by age in a representative sample of the Brazilian population. Cross-sectional data of 89,923 (52.4% female) individuals aged ≥15 years were analyzed. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Physical activity (min/week) performed in different domains (domestic, transport, occupation, and leisure) was self-reported. Generalized additive models with penalized splines were used to explore associations. Lower leisure-time PA and higher levels of PA in the domestic, occupational, and transport domains at distinct PA thresholds were associated with higher depressive symptoms. Leisure PA, even at lower levels, was associated with lower depressive symptoms compared to no PA at all. The increase in depressive symptoms as a function of occupational PA was observed only at PA levels higher than 40 h/week. Although non-leisure PA levels were related to higher depressive symptoms among the total sample, higher domestic and transport PA levels were related to lower depressive symptoms among older adults. This study provides insights into the non-linearity and age-group dependence of the relationship between domain-specific PA and depressive symptoms in a middle-income country. The evidence suggests that care should be taken on recommending PA regardless of context or domain.

Exchanging screen for non-screen sitting time or physical activity might attenuate depression and anxiety: A cross-sectional isotemporal analysis during early pandemics in South America.

OBJECTIVES: To examine the theoretical substitutions of screen exposure, non-screen sitting time, moderate and vigorous physical activity with depressive and anxiety symptoms in South American adults during the COVID-19 pandemic. DESIGN: A cross-sectional study during the first months of the COVID-19 pandemic with data from 1981 adults from Chile, Argentina, and Brazil. METHODS: Depressive and anxiety symptoms were assessed using the Beck Depression and Anxiety Inventories. Participants also reported physical activity, sitting time, screen exposure, sociodemographic, and tobacco use data. Isotemporal substitution models were created using multivariable linear regression methods. RESULTS: Vigorous physical activity, moderate physical activity, and screen exposure were independently associated with depression and anxiety symptoms. In adjusted isotemporal substitution models, replacing 10 min/day of either screen exposure or non-screen sitting time with any intensity of physical activity was associated with lower levels of depressive symptoms. Improvements in anxiety symptoms were found when reallocating either screen exposure or non-screen sitting time to moderate physical activity. Furthermore, replacing 10 min/day of screen exposure with non-screen sitting time was beneficially associated with anxiety (B = -0.033; 95 % CI = -0.059, -0.006) and depression (B = -0.026; 95 % CI = -0.050, -0.002). CONCLUSIONS: Replacement of screen exposure with any intensity of physical activity or non-screen sitting time could improve mental health symptoms. Strategies aiming to reduce depressive and anxiety symptoms highlight physical activity promotion. However, future interventions should explore specific sedentary behaviors as some will relate positively while others negatively.

U-SMILE: a brief version of the Short Multidimensional Inventory on Lifestyle Evaluation.

INTRODUCTION: Lifestyle Medicine comprises six domains: diet, substance use, physical activity, stress management, social connection, and sleep. The comprehensive assessment of lifestyle is challenging, but the "Short Multidimensional Inventory on Lifestyle Evaluation" (SMILE) was developed to fill out this gap. In this paper, we describe the development and the psychometric properties (internal consistency, concurrent and convergent validity) of a shorter version of the SMILE among university students. METHODS: Data from a cross-sectional study including 369 students from 10 Brazilian universities were used. Considering a theoretical nomological net, we performed exploratory factor analysis to obtain the most parsimonious, interpretable and good-fitting model. RESULTS: The final model was called U-SMILE, comprised 24 items, and presented acceptable internal consistency (Cronbach's α = 0.73, McDonald's ω = 0.79). To evaluate the concurrent validity of the U-SMILE, we compared it to the original SMILE and found a high correlation between the instruments (Spearman's r= 0.94). Furthermore, we evaluated convergent validity by examining the U-SMILE correlation with the PHQ-9 (Spearman's r= -0.517), and GAD-7 (Spearman's r= -0.356), two validated instruments to screen for depression and anxiety, respectively. DISCUSSION: Our findings suggest that the U-SMILE is a valid instrument for assessing lifestyle among university students. We recommend that the use of U-SMILE to evaluate overall lifestyle scores rather than individual domain scores. Finally, we discuss the importance of clarifying the definitions of lifestyle and related constructs in future research.

A Rapid Review of Randomized Trials Assessing the Effects of High-Intensity Interval Training on Depressive Symptoms in People with Mental Illness.

OBJECTIVE: to systematically search for randomized controlled trials comparing the effects of high-intensity interval training (HIIT) protocols vs. control without exercise or other exercise protocols, in patients with mental disorders experiencing depressive symptoms, and to provide some guidance based on the current HIIT literature to improve further interventions. METHODS: we searched for relevant studies, published by 18 August 2022 on PubMed, Embase, PsycINFO and SPORTDiscus databases, that used a HIIT protocol, involving adults (≥18 years) with a diagnosis of a mental disorder, participating in a HIIT or a control condition, and assessed for depressive symptoms. RESULTS: Four studies accounting for 108 participants (n HIIT = 55; n comparison groups = 53) met the inclusion criteria. Three out of the four studies included found significant improvements of depressive symptoms after 12 days to 8 weeks of intervention. However, there were no differences to other forms of low-to-moderate continuous exercise in 2/3 studies. CONCLUSIONS: The limited evidence suggests the effectiveness of HIIT interventions for improving depressive symptoms in people with mental illness. However, HIIT was not superior to other exercise treatments, although a trend for its superiority may be recognized. A number of methodological issues should be considered in further interventions to better characterize and identify the most efficient HIIT modalities for the treatment of depressive symptoms in these patients.

Relationship between types of physical activity and depression among 88,522 adults.

BACKGROUND: Physical activity is associated with depression; however, the influence of physical activity type on this association remains poorly explored. We aimed to investigate the association between various types of leisure-time physical activity and depression among a large and representative sample. METHODS: Data from the 2019 Brazilian National Health Survey were used (n = 88,522 adults aged between 18 and 107 years, 53% female). Depression was measured using the Patient Health Questionnaire-9; participants' leisure-time physical activity types were self-reported. A four-step hierarchical regression was applied, and the analyses were adjusted for several confounders. RESULTS: Active individuals had lower odds of depression (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.62-0.81); however, only outdoor walking/running (OR, 0.70; 95% CI, 0.60-0.82), cycling (OR, 0.50; 95% CI, 0.34-0.74), and team sports (OR, 0.52; 95% CI, 0.42-0.66) were associated with lower odds of depression than inactivity. CONCLUSIONS: Physical activity type may be associated with mental health. The qualitative mechanisms of some physical activities seem to have greater capability than others to reduce depression. Causal inferences could not be made, however, our findings suggest that specific physical activities types have additional benefits that can be used in promoting mental health in clinical intervention and at a population level.