Evidence map›Paper›PMID 40534999›Full record

ArticleEClinicalMedicine2025

Association between physical activity and risk of anxiety: a dose-response meta-analysis of 11 international cohorts.

Xuesi Li, Weicong Chen, Zijiao Zhang, Zheng Li, Xianming Fan, Tongyu Ma, Shunjing Ding, Fangyu Yang, Jianbo Lei

Abstract read
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In one paragraph

Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Xuesi LiSchool of Public Health, China Medical University, Shenyang, Liaoning Province, China.
Weicong ChenInformation Center, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China.
Zijiao ZhangSchool of Public Health, Southwest Medical University, Luzhou, Sichuan Province, China.
Zheng LiDepartment of Rehabilitation Medicine & Physical Therapy, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China.
Xianming FanDepartment of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China.
Tongyu MaDepartment of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Shunjing DingDepartment of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Fangyu YangSchool of Nursing, Capital Medical University, Beijing, China.
Jianbo LeiClinical Research Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Anxiety disorders are the world's most common mental disorders and the risk of anxiety may be reduced by physical activity. However, the dose-response relationship between physical activity and the risk of anxiety remains uncertain. Methods: Following Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines, PubMed, Embase, Web of Science, and PsycINFO databases were searched for all prospective cohort studies on physical activity and the risk of anxiety up to 7 February 2025, with no language restrictions. We included prospective cohort studies reporting physical activity at three or more exposure levels and risk estimates for anxiety. Data extraction and article quality assessments were completed independently by two extractors. Data were synthesized using random-effects models, and nonlinear dose-response meta-analyses were performed using restricted cubic spline models. We used the Newcastle-Ottawa Scale (NOS) to assess the risk of bias for the included articles. Egger's test and Begg's test were used to evaluate the publication bias. Findings: 11 studies (I Interpretation: Our research confirmed a dose-response relationship between physical activity and anxiety risk, and increasing physical activity within the range recommended by the World Health Organization (WHO) (10-20 MET-h/week) can significantly reduce anxiety risk. Subgroup analysis showed that this protective effect was most significant during the 5-year follow-up period, with a maximum anxiety risk reduction of 49%. Exceeding the recommended dose, there may be additional smaller benefits between doses 20-30 MET-h/week, and exceeding 50 MET-h/week may become a risk factor. In addition, the protective effect decreases with time and age, and the recommended dose by WHO (10-14.5 MET-h/week) has no statistically significant protection for the elderly, nor has the maximum beneficial dose been found, indicating the need for more relevant research on the elderly in the future. Funding: The National Traditional Chinese Medicine innovation team and talent support projects fund this study.

Indexed as

AnxietyDose-responseMental healthMeta-analysisPhysical activity

Identifiers

PMID40534999
PMCPMC12173747

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.