Effect of Leisure-Time Physical Activity on Psychological Distress and Well-Being and Its Mediators

Prajapati, Nisha; Swami, Mukesh Kumar

doi:10.1097/psy.0000000000001138

Psychosom Med

2022

DOI: 10.1097/psy.0000000000001138

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Effect of Leisure-Time Physical Activity on Psychological Distress and Well-Being and Its Mediators

Nisha Prajapati

Mukesh Kumar Swami

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“…Finally, we again thank Prajapati and Swami (1) for the opportunity to clarify some points on our study and to raise the discussion on methodological issues that still need to be addressed for a better understanding of the causality between physical activity, well-being, and psychological distress.…”

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confidence: 99%

“…Prajapati and Swami (1) requested adjustment for other potential mediators such as cognition, body mass index (BMI), disability, and pain during the first (2004) wave (at 34 years). Although of relevance, it was unfortunately not possible to adjust for cognition, disability, and pain given that these were not measured during this first wave.…”

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confidence: 99%

“…However, one should acknowledge that BMI at 34 years is highly correlated with BMI at 42 years, presenting a multicollinearity problem for the models. Even though the temporal time sequence is lost when using BMI at 34 years as the mediator, we repeated the mediation models now considering BMI at age 34 years, to address the comment of Prajapati and Swami (1). We found that BMI at 34 years indeed mediated the association between leisure-time physical activity and subsequent well-being both considering frequency (pure indirect effect = 0.015; 95% confidence interval = 0.007–0.025) and total leisure-time physical activity (pure indirect effect = 0.004; 95% confidence interval = 0.001–0.007).…”

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confidence: 99%

“…We would like to thank Prajapati and Swami (1) for their letter commenting on our recent article, in which we investigated the association between leisure-time physical activity and future psychological distress and well-being, as well as potential mediators of these associations (2).…”

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Effect of Leisure-Time Physical Activity on Psychological Distress and Well-Being and Its Mediators—Authors’ Reply

et al. 2022

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We have read with interest the recent article by Werneck et al. (1) regarding the prospective associations of leisure-time physical activity (LTPA) with psychological distress and well-being. The authors reported that there is an association of higher LTPA intensity and frequency with low psychological distress and increased psychological well-being and that the body mass index (BMI) partially mediates this association. The results of this study offer some novel insights; however, we would like to draw attention to some additional points worth consideration.Although the authors have adjusted for several covariates at baseline (34 years), the effect of other variables like family activities, social participation, and social support, Self-esteem, life skills, friends and social behavior, self-perceived skills, and emotional support is not examined. Many of these variables were recorded during earlier follow-ups of the cohort (2). Studies have reported the associations of these confounding variables with LTPA and psychological distress and well-being (3,4). Thereby, not adjusting them can influence the outcome. In addition, the reverse causation of psychological well-being and distress remains a concern, given that the psychological correlates may discourage people from engaging in physical activities, which cannot be ruled out in the present analysis.The authors analyzed mediators as a secondary aim, but the selection of cognition, BMI, disability, and pain is not substantiated theoretically. Existing literature suggests that these variables can influence the level of physical activity and psychological wellbeing. Therefore, the possibility of these variables as confounders cannot be ruled out, especially in the absence of baseline data for these variables. There is a possibility that BMI and cognition can influence the level of physical activities, and having their baseline assessment could have provided clarity regarding change over time. The basic assumption for the mediation model is a casual chain of effect, where one variable affects the later occurring variable (no reverse causality) (5). In addition, while using longitudinal mediation analysis, the reason for choosing the three specific time points in the cohort is not explained. Consistency of LTPA over different time points is also not reported, which could have substantiated the findings (6). Moreover, for cognition, the only verbal recall was measured and the reason for the same is unexplained. It is unlikely that verbal recall can represent global cognition.Examining the mediators for the effect of physical activity on psychological well-being is an important domain for future research, and a robust mediation model can address these issues for clear interpretation of findings.

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Effect of Leisure-Time Physical Activity on Psychological Distress and Well-Being and Its Mediators—Authors’ Reply

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Effect of Leisure-Time Physical Activity on Psychological Distress and Well-Being and Its Mediators

Cited by 1 publication

References 6 publications

Effect of Leisure-Time Physical Activity on Psychological Distress and Well-Being and Its Mediators—Authors’ Reply

Effect of Leisure-Time Physical Activity on Psychological Distress and Well-Being and Its Mediators—Authors’ Reply

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