Martina Svensson Experimental Neuroinflammation Laboratory Department of Experimental Medical Science Lund University, Lund, Sweden

Physically Active Lifestyle Linked to Lower Anxiety Risk, but Gender Differences Exist Interview with:

Martina Svensson Experimental Neuroinflammation Laboratory Department of Experimental Medical Science Lund University, Lund, Sweden

Martina Svensson

Martina Svensson
Experimental Neuroinflammation Laboratory
Department of Experimental Medical Science
Lund University, Lund, Sweden What is the background for this study?

Response: We followed almost 200,000 long-distance skiers for up to two decades and investigated how many of these skiers were diagnosed with anxiety disorders compared to people of the same sex and age in the general population. In total, the study included almost 400,000 people. (Previous studies have shown that Vasaloppet skiers are significantly more physically active than the general population.) What are the main findings? 

Response: We found that the group with a more physically active lifestyle had an almost 60% lower risk of developing anxiety disorders over a follow-up period of up to 21 years. This association between a physically active lifestyle and a lower risk of anxiety was seen in both men and women.

What surprised us the most was to discover how the physical performance in the ski race (finishing time among the skiers) impacted the risk of future anxiety differently in physically active men and women. We were surprised to see that physically high-performing women had almost a doubled risk of developing anxiety compared to lower-performing women. However, the total risk of getting anxiety among these high-performing women was still lower compared to the more physically inactive women in the general population. So it seems like both sexes benefit from being physically active, even though the optimal level may differ between men and women. What should readers take away from your report?

Response: That both men and women benefitted from having a physically active lifestyle in terms of the risk of developing anxiety disorders. But also that other factors linked to exercise behaviors may affect mental well-being, and the impact of this may differ between men and women, even though additional studies have to investigate this more in depth.

Our study is important because it is the largest population-based study to date, confirming a long-term association of a physically active lifestyle on the later development of anxiety disorders in both men and women seen in previous studies with shorter follow-up times. In addition, our study reveals an association between physical performance and the risk for anxiety disorders in women specifically has not been reported before. What recommendations do you have for future research as a result of this work?

Response: Our study does not investigate why faster skiing is associated with an increased risk of developing anxiety compared to slower skiers among women. Hence future studies considering the impact of exercise intensity on the risk of developing anxiety disorders in men and women separately are warranted, especially with designs allowing for conclusions about directionality and causality of the association between physical activity and anxiety.

Our results suggest that the relation between symptoms of anxiety and exercise behavior may not be linear. Exercise behaviors and anxiety symptoms are likely to be affected by genetics, psychological factors, and personality traits, confounders that were not possible to investigate in our cohort. Studies investigating the driving factors behind these differences between men and women when it comes to extreme exercise behaviors and how it affects the development of anxiety are needed.

Also, studies investigating molecular and cellular mechanisms behind the proposed beneficial effects are needed. Is there anything else you would like to add?

Response: It is important to note that our study is an epidemiological study, where you can find interesting associations, but you cannot really scientifically prove the causation. Therefore, randomized intervention trials, as well as long-term objective measurements of physical activity in prospective studies, are required to assess the validity and causality of the association we reported.

In addition, our study investigate a physically active lifestyle as a whole. This may also include other habits, like better diet, less smoking, etc, which may affect the result.

Physical Activity Is Associated With Lower Long-Term Incidence of Anxiety in a Population-Based, Large-Scale Study
Svensson Martina, Brundin Lena, Erhardt Sophie, Hållmarker Ulf, James Stefan, Deierborg Tomas
Front. Psychiatry, 10 September 2021 |



The information on is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.


Last Updated on September 13, 2021 by Marie Benz MD FAAD