Abstract
Often controlled pharmaceutically despite increasing interest in non-pharmacological methods, anxiety disorders are among the most frequent mental health illnesses around. Promising complementary approaches are lifestyle interventions, including dietary modifications, sleep hygiene, stress reduction, and physical activity. The goal of this methodical review and meta-analysis was to assess how well lifestyle changes helped to alleviate anxiety symptoms across several demographics and environments. Up to 2024, studies assessing the effects of lifestyle changes on anxiety symptoms were found using a systematic literature search across major electronic databases. Forty-four qualified studies were included across many methodologies, populations, and intervention approaches. Of these, 36 studies met quantitative synthesis criteria. Validated scales, including the Hospital Anxiety and Depression Scale, Generalized Anxiety Disorder-7, State-Trait Anxiety Inventory, and Depression Anxiety Stress Scales, were used to measure anxiety results. A random-effects model was use to estimate pooled effect sizes using meta-analysis, and the I2 statistic assessed heterogeneity. Most lifestyle interventions showed statistically significant decreases in anxiety symptoms, according to the qualitative synthesis. Interventions combining physical activity, psychoeducation, mindfulness, and digital platforms showed the most consistent advantages. The meta-analysis found a considerable combined standardized mean difference of 0.18 (95% CI: 0.27-0.08, p = 0.0003) favoring the intervention group, including 3,022 participants in the intervention group and 2,925 in the control group. In particular, in primary care and community health settings, lifestyle treatments constitute a feasible supplement or replacement for traditional therapy and are linked with significant decreases in anxiety symptoms.

Key words: Lifestyle interventions, improvement, anxiety symptoms, primary care, systematic review