Joint association of physical activity and overweight with subsequent psychotropic medication: A register-linked follow-up study among employees Health behavior, health promotion and society

Abstract

Background: Physical activity level and overweight have shown associations with mental health problems but it is not known whether the risk of mental health problems due to overweight varies by physical activity. We examined joint association of physical activity and overweight with subsequent psychotropic medication among 40-60-year-old employees. Methods: The questionnaire survey data were derived from Helsinki Health Study baseline postal questionnaires in 2000-02 among employees of the City of Helsinki aged 40-60 years (n∈=∈8960, response rate 67 %). Baseline survey data were linked with prospective register data on prescribed psychotropic medication (ATC-codes N05 and N06, except N06D) among those with written consent (74 %) for such linkage. The analyses included 6169 responders (78 % women, corresponding to the target population). We divided participants into six groups according to their baseline self-reported body mass index and leisure-time physical activity using physically highly active normal-weight participants as a reference group. We used Cox regression analysis adjusted for age, gender, psychotropic medication prior to baseline, and socioeconomic position, marital status, working conditions, limiting long-standing illness, alcohol use, and smoking. Results: At baseline, 49 % were overweight and 23 % were physically inactive. After adjusting for age and gender, inactive normal-weight (hazard ratio (HR) 1.3, 95 % CI 1.1-1.5), moderately active overweight (HR 1.3, 95 % CI 1.1-1.5) and inactive overweight (HR 1.4, 95 % CI 1.2-1.6) had higher risk for any psychotropic medication compared with group of highly active normal-weight. After adjusting for prior medication, only the inactive overweight group had higher risk (HR 1.4, 95 % CI 1.2-1.6). Other covariates made but a minor contribution to the examined associations. For antidepressants the associations were somewhat stronger than for sedatives. Conclusions: Both normal-weight and physical activity help prevent psychotropic medication but physical activity dominates the association over normal-weight.