More minutes spent in moderate-to-vigorous physical activity and a more pronounced circadian rhythm, assessed with actigraphy, are important correlates of better immunometabolic health, while daily life affect variables were not associated with immunometabolic health outcomes.
Key Findings
Results
Higher moderate-to-vigorous physical activity (MVPA) was consistently associated with lower inflammation index, metabolic index, and BMI.
MVPA was associated with lower inflammation index (B = -0.19, p < 0.011)
MVPA was associated with lower metabolic index (B = -0.14, p < 0.011)
MVPA was associated with lower BMI (B = -1.23, p < 0.011)
MVPA was measured continuously using a research-grade actigraphy device worn for 14 days and averaged across that period
Sample consisted of n = 357 participants with and without depression/anxiety from the Netherlands Study of Depression and Anxiety
Results
Higher relative amplitude (a measure of circadian rhythmicity) was consistently associated with lower inflammation index, metabolic index, and BMI.
Relative amplitude was associated with lower inflammation index (B = -0.12, p < 0.011)
Relative amplitude was associated with lower metabolic index (B = -0.15, p < 0.011)
Relative amplitude was associated with lower BMI (B = -1.30, p < 0.011)
Relative amplitude was derived from continuous actigraphy data collected over 14 days
Results
Longer sleep duration was associated with lower BMI, but not with inflammation or metabolic index.
Sleep duration was associated with lower BMI (B = -0.80, p = 0.027)
Sleep duration was not significantly associated with the inflammation index or metabolic index (p's > 0.05)
Sleep duration was measured continuously via actigraphy over 14 days
Results
Daily life affect variables (mean and SD of positive affect and negative affect) were not associated with any immunometabolic health outcomes.
Affect variables examined included mean positive affect (PA), SD of PA, mean negative affect (NA), and SD of NA
None of the four affect variables were significantly associated with the inflammation index, metabolic index, or BMI (all p's > 0.05)
Affect was self-reported 5 times per day over 14 days using an ambulatory assessment protocol
This null finding held across all three immunometabolic outcomes
Results
The associations between behavioral variables and immunometabolic health outcomes were independent of depression/anxiety diagnostic status.
Moderation analyses tested whether having a current depression/anxiety diagnosis altered the associations between affect/behavior and immunometabolic outcomes
No significant moderation by depression/anxiety diagnosis was found for any association (all p's > 0.05)
Participants included individuals with and without a current depression/anxiety diagnosis from the Netherlands Study of Depression and Anxiety
Methods
The study used an ambulatory assessment design combining ecological momentary assessment of affect with 14-day continuous actigraphy in a mixed sample of individuals with and without depression/anxiety.
n = 357 participants were recruited from the Netherlands Study of Depression and Anxiety (NESDA)
Positive and negative affect were assessed 5 times per day for 14 days via self-report
Physical activity, sleep, and circadian rhythm were measured continuously using a research-grade actigraphy device for 14 days
Immunometabolic outcomes included an inflammation index (based on CRP and IL-6), a metabolic index (based on five metabolic syndrome components), and BMI
Linear regression analyses were used to examine associations between affect/behavioral variables and immunometabolic outcomes
What This Means
This research suggests that how physically active people are in daily life and how regular their daily rhythms of rest and activity are — measured objectively with wrist-worn activity trackers over two weeks — are both strongly linked to better markers of physical health, including lower levels of inflammation, better metabolic health, and lower body weight. Longer sleep was also linked to lower body weight, but not to inflammation or metabolic health. These findings came from a study of 357 adults who were monitored in their everyday lives, some of whom had a diagnosis of depression or anxiety and some of whom did not.
Interestingly, how people felt emotionally from day to day — whether they experienced more or less positive or negative mood — was not connected to these physical health markers. This suggests that it is the behavioral side of daily life (what you do, how active you are, how regular your schedule is) rather than the emotional side (how you feel) that more directly relates to inflammatory and metabolic health. The associations held equally for people with and without depression or anxiety diagnoses, suggesting these behavioral links to physical health are broadly relevant.
This research highlights the value of using wearable devices to objectively capture daily behaviors in real-world settings, rather than relying on self-reported estimates. It suggests that interventions aimed at increasing moderate-to-vigorous physical activity and strengthening regular daily rhythms (such as consistent sleep-wake cycles) could be particularly relevant for improving inflammation and metabolic health, including in people living with mood and anxiety disorders.
van Zwieten N, Aalbers G, Lamers F, Giltay E, Hillegers M, Penninx B. (2026). Daily affect and behavior in relation to inflammatory and metabolic health: An ambulatory assessment study.. Brain, behavior, and immunity. https://doi.org/10.1016/j.bbi.2026.106282