Clear association between physical fitness and mental health: Study

‘Physical fitness could be … a modifiable risk factor for common mental disorders in the population.
 
‘Public health approaches to improve physical fitness through combined aerobic and resistance activities could reduce the incidence of common mental disorders and improve physical health outcomes for people with mental health symptoms.’
 
Such are the findings of a new large-scale, seven-year prospective cohort study published in BMC Medicine.
 
For this study, researchers analysed data from a subset of UK Biobank participants, amounting to a total of 152,978 people.
 
At the start of the study, participants underwent tests to measure their cardiorespiratory fitness (CRF) and grip strength, which was used as a proxy for muscle strength.
 
They also completed two standard clinical questionnaires relating to anxiety and depression at that time.
 
Seven years later, the researchers assessed each person’s anxiety and depression again using the same two clinical questionnaires and found a significant association between a participant’s initial fitness and their mental health seven years on.
 
In fact, participants who were classified as having low combined CRF and muscle strength on initial assessment had 98% higher odds of experiencing depression and 60% higher odds of experiencing anxiety.
 
While both CRF and muscle strength individually had an impact on mental health, the authors say that when looking at them as ‘separate exposures, the effect sizes were smaller’.
 
‘We found that compared with high CRF, low CRF was associated with 1.5 times higher odds of a common mental disorder incidence and low grip strength with 1.4 times higher odds,’ the authors wrote.
 
‘We also found that associations with grip strength and anxiety disorders had higher odds ratios for women than men, and for older than younger adults.’
 
Although the study demonstrated a correlation between physical fitness and improved mental health outcomes, it did not show a causative link.
 
Aaron Kandola, a doctoral candidate in the Division of Psychiatry at University College London and lead author of the study says this research provides ‘further evidence’ of a relationship between physical and mental health.
 
‘[S]tructured exercise aimed at improving different types of fitness is not only good for your physical health, but may also have mental health benefits,’ he said.
 
‘Physical activity … can play a key role in preventing mental health disorders.’
 
Dr Tim Jones, a Tasmanian GP with a special interest in mental health, agrees.
 
‘There’s already a fair amount of literature on this topic; this [study] is adding to that,’ he told newsGP.
 
He says there are ‘really strong links’ between physical exercise and mental health and that this relationship occurs for a number of reasons.
 
‘There are definitely chemical and hormonal mechanisms that are activated within our bodies when we exercise, such as dopamine, that are related to our mood or sense of wellbeing,’ he said.

Dr Tim Jones says this research adds further weight to the link between physical fitness and improved mental health.

Dr Jones says that exercise offers additional psychological benefits, such as a sense of achievement as goals are reached.
 
‘That has a psychological flow-on [effect] to then giving us more energy and motivation to assist us in some of the other challenges we have,’ he said.
 
Dr Jones says the benefits of exercise on mental health are even more significant when it is part of a group-based activity, as that offers participants a sense of connection to others, external accountability and improved motivation.
 
‘We can also see an increased sense of community and support in patients as well, which is one of the things I’ve seen in my own patients,’ he said.
 
Dr Jones says such support may ‘be responsible for really significant improvements in people’s wellbeing’.
 
He says community-based exercises ‘with a mental health focus’ such as Go4Fun and the parkrun program target people who are struggling in either their physical or mental health, or both.
 
‘And the initial results of some of the programs that have been running for around 12–18 months have shown really dramatic and sustained improvements,’ he said.
 
Those improvements may relate to the friendships that are formed with other members through such experiences.
 
‘And they then continue doing that sort of work in a more self-guided way, and that’s awesome for us to see because we know that’s going to achieve long-term outcomes that benefit people as well,’ he said.
 
‘So we’re really hoping to see more of these programs get rolled out in a broader context.’
 
Dr Jones hopes this research will further encourage clinicians to recommend physical fitness as part of a treatment plan for people with mental health issues, and to help prevent such issues.
 
While he acknowledges there are barriers to engaging in exercise, especially for patients with mental health issues, he says it is a worthwhile pursuit.
 
Instead of recommending one particular exercise as a blanket measure, Dr Jones says it is important for clinicians to help patients look for ways to incorporate exercise into their day-to-day lives while ‘working in the limits of what their motivation and energy will allow them to do’.
 
‘Every treatment [should be] individualised to the person that we’re working with,’ Dr Jones said.
 
‘But we do know that people recover from mental health issues faster if exercise is a component of their treatment plan.’
 
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