In the general population it appears that physical activity is inversely correlated with incidence of anxiety disorders. The world health survey suggests that not meeting the guidelines of 150 mins of moderate-vigorous physical activity increases the odds of anxiety disorder by 32% (1). One meta-analysis of 13 cohort studies (N = 75,831, median males = 50.1%) demonstrated that high levels of self-reported physical activity (versus low PA) were at reduced odds of developing anxiety (adjusted odds ratio = 0.74) and also demonstrated that completing the recommendation of 150 mins of moderate / vigorous physical activity per week resulted in a lower risk of incident anxiety (AOR =0.71, 95% CI = 0.54, 0.94) (2). One further systematic review of 24 prospective cohort studies with median follow up of 4.75 years of over 80,000 individuals demonstrated reduced odds of anxiety symptoms (OR = 0.8742, 95% CI = 0.7731, 0.9886, n=9) any anxiety disorder (OR =0.6626, 95% CI =0.5337, 0.8227, n=3) and generalised anxiety disorder (OR = 0.5438, 95% CI=0.3231, 0.9153, n=3) were significantly lower after physical activity exposure (3).
Quality of evidence
A – Consistent evidence from meta-analysis and systematic reviews.
Strength of recommendation
1 – significant benefit, low risk of PA.
1) Stubbs B, Koyanagi A, Hallgren M, Firth J, Richards J, Schuch F, Rosenbaum
S, Mugisha J, Veronese N, Lahti J, Vancampfort D. Physical activity and anxiety:
A perspective from the World Health Survey. J Affect Disord. 2017 Jan
15;208:545-552. doi: 10.1016/j.jad.2016.10.028. Epub 2016 Oct 25. PMID:
2) Schuch FB, Stubbs B, Meyer J, Heissel A, Zech P, Vancampfort D, Rosenbaum S, Deenik J, Firth J, Ward PB, Carvalho AF, Hiles SA. Physical activity protects from incident anxiety: A meta-analysis of prospective cohort studies. Depress Anxiety. 2019 Sep;36(9):846-858. doi: 10.1002/da.22915. Epub 2019 Jun 17. PMID: 31209958.
3) McDowell CP, Dishman RK, Gordon BR, Herring MP. Physical Activity and Anxiety: A Systematic Review and Meta-analysis of Prospective Cohort Studies. Am J Prev Med. 2019 Oct;57(4):545-556. doi: