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Rethorst CD, Leonard D, Barlow CE, Willis BL, Trivedi MH, DeFina LF. Effects of depression, metabolic syndrome, and cardiorespiratory fitness on mortality: results from the Cooper Center Longitudinal Study. Psychol Med 2017; 47:2414-2420. [PMID: 28414015 PMCID: PMC6036919 DOI: 10.1017/s0033291717000897] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression and metabolic syndrome (MetS) are frequently comorbid disorders that are independently associated with premature mortality. Conversely, cardiorespiratory fitness (CRF) is associated with reduced mortality risk. These factors may interact to impact mortality; however, their effects have not been assessed concurrently. This analysis assessed the mortality risk of comorbid depression/MetS and the effect of CRF on mortality in those with depression/MetS. METHODS Prospective study of 47 702 adults in the Cooper Center Longitudinal Study. Mortality status was attained from the National Death Index. History of depression was determined by patient response (yes or no) to a standardized medical history questionnaire. MetS was categorized using the American Heart Association/National Heart, Lung, and Blood Institute criteria. CRF was estimated from the final speed/grade of a treadmill graded exercise test. RESULTS 13.9% reported a history of depression, 21.4% met criteria for MetS, and 3.0% met criteria for both MetS and history of depression. History of depression (HR = 1.24, p = 0.003) and MetS (HR = 1.28, p < 0.001) were independently associated with an increased mortality risk, with the greatest mortality risk among individuals with both a history of depression and MetS (HR = 1.59, p < 0.001). Higher CRF was associated with a significantly lower risk of mortality (p < 0.001) in all individuals, including those with MetS and/or a history of depression. CONCLUSIONS Those with higher levels CRF had reduced mortality risk in the context of depression/MetS. Interventions that improve CRF could have substantial impact on the health of persons with depression/MetS.
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Affiliation(s)
- C. D. Rethorst
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | | | | | - M. H. Trivedi
- Department of Psychiatry, Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas, TX, USA
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Kleinstäuber M, Reuter M, Doll N, Fallgatter AJ. Rock climbing and acute emotion regulation in patients with major depressive disorder in the context of a psychological inpatient treatment: a controlled pilot trial. Psychol Res Behav Manag 2017; 10:277-281. [PMID: 28860880 PMCID: PMC5566792 DOI: 10.2147/prbm.s143830] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Major depressive disorder is characterized by deficits in emotion regulation. This study examined associations between rock climbing and acute emotion regulating effects in patients with major depression. PATIENTS AND METHODS In a nonrandomized, controlled study, 40 major depressive disorder inpatients were assigned to either a climbing session (n=20) or a relaxation session (n=20). Positive and negative affect, depressiveness, and coping emotions were assessed immediately before and after the session. RESULTS Mixed analyses of variance and covariance revealed significant time × group interaction effects for all assessed outcomes (p≤0.012): positive affect and coping emotions significantly increased and negative affect and depressiveness significantly decreased after the climbing session (1.04≤ Cohen's d ≤1.30), in contrast to a relaxation session (0.16≤ Cohen's d ≤0.36). CONCLUSION The results show that rock climbing is associated with acute emotion regulatory effects. These findings have to be replicated with a randomized design, and future research should pay attention to possible mechanisms of rock climbing in regard to emotion regulation.
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Affiliation(s)
- Maria Kleinstäuber
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, Philipps University, Marburg, Germany.,Department of Psychological Medicine, School of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Merle Reuter
- Department of Educational Psychology, Faculty of Psychology, Eberhard Karls University, Tübingen, Germany
| | - Norbert Doll
- Department of General Psychiatry and Psychotherapy, University Hospital for Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany
| | - Andreas J Fallgatter
- Department of General Psychiatry and Psychotherapy, University Hospital for Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany
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Avila-Palencia I, de Nazelle A, Cole-Hunter T, Donaire-Gonzalez D, Jerrett M, Rodriguez DA, Nieuwenhuijsen MJ. The relationship between bicycle commuting and perceived stress: a cross-sectional study. BMJ Open 2017; 7:e013542. [PMID: 28645948 PMCID: PMC5541523 DOI: 10.1136/bmjopen-2016-013542] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 03/29/2017] [Accepted: 04/07/2017] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Active commuting - walking and bicycling for travel to and/or from work or educational addresses - may facilitate daily, routine physical activity. Several studies have investigated the relationship between active commuting and commuting stress; however, there are no studies examining the relationship between solely bicycle commuting and perceived stress, or studies that account for environmental determinants of bicycle commuting and stress. The current study evaluated the relationship between bicycle commuting, among working or studying adults in a dense urban setting, and perceived stress. METHODS A cross-sectional study was performed with 788 adults who regularly travelled to work or study locations (excluding those who only commuted on foot) in Barcelona, Spain. Participants responded to a comprehensive telephone survey concerning their travel behaviour from June 2011 through to May 2012. Participants were categorised as either bicycle commuters or non-bicycle commuters, and (based on the Perceived Stress Scale, PSS-4) as either stressed or non-stressed. Multivariate Poisson regression with robust variance models of stress status based on exposures with bicycle commuting were estimated and adjusted for potential confounders. RESULTS Bicycle commuters had significantly lower risk of being stressed than non-bicycle commuters (Relative Risk; RR (95% CI)=0.73 (0.60 to 0.89), p=0.001). Bicycle commuters who bicycled 4 days per week (RR (95% CI)=0.42 (0.24 to 0.73), p=0.002) and those who bicycled 5 or more days per week (RR (95% CI)=0.57 (0.42 to 0.77), p<0.001) had lower risk of being stressed than those who bicycled less than 4 days. This relationship remained statistically significant after adjusting for individual and environmental confounders and when using different cut-offs of perceived stress. CONCLUSIONS Stress reduction may be an important consequence of routine bicycle use and should be considered by decision makers as another potential benefit of its promotion.
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Affiliation(s)
- Ione Avila-Palencia
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Audrey de Nazelle
- Centre for Environmental Policy, Imperial College of London, London, United Kingdom
| | - Tom Cole-Hunter
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - David Donaire-Gonzalez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Physical Activity and Sports Sciences Department, Fundació Blanquerna, Ramon Llull University, Barcelona, Spain
| | - Michael Jerrett
- Department of Environmental Health Sciences, University of California, Los Angeles, California, USA
| | - Daniel A Rodriguez
- Department of City and Regional Planning, University of California, Berkeley, California, USA
| | - Mark J Nieuwenhuijsen
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Veronese N, Stubbs B, Trevisan C, Bolzetta F, De Rui M, Solmi M, Sartori L, Musacchio E, Zambon S, Perissinotto E, Baggio G, Crepaldi G, Manzato E, Maggi S, Sergi G. Poor Physical Performance Predicts Future Onset of Depression in Elderly People: Progetto Veneto Anziani Longitudinal Study. Phys Ther 2017; 97:659-668. [PMID: 28201628 DOI: 10.1093/ptj/pzx017] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 02/10/2017] [Indexed: 02/09/2023]
Abstract
BACKGROUND Reduced physical performance is predictive of deleterious outcomes in older adults. Data considering objective physical performance and incident depression are sparse. OBJECTIVE The objective of this study was to investigate during a 4-year study whether objective physical performance can predict incident depression among older adults who do not have depression at the baseline. DESIGN This was a longitudinal study. METHODS From 3,099 older people initially enrolled in the Progetto Veneto Anziani study, 970 participants without depression at the baseline were included (mean age = 72.5 years; 54.6% women). Physical performance measures included the Short Physical Performance Battery, 4-m gait speed, Five-Times Sit-to-Stand test, leg extension and flexion, handgrip strength, and 6-minute walk test, categorized in sex-specific tertiles. Depression was classified on the basis of the Geriatric Depression Scale and a diagnosis from a geriatric psychiatrist. Area under the curve and logistic regression analyses were conducted. RESULTS At the baseline, participants developing depression during the follow-up (n = 207) scored significantly worse across all physical performance measures than those who did not develop depression. The area under the curve and predictive power were similar for all of the physical performance tests assessed. In the logistic regression analysis, after adjustment for 14 potential confounders, worse physical performance across all tests increased the risk of depression. Participants in the lowest tertile of the Short Physical Performance Battery were at notable odds of developing depression (odds ratio = 1.79; 95% CI = 1.18-2.71). The association between poor physical performance and depression was typically stronger in women than in men, except for 4-m gait speed. LIMITATIONS No gold standard was used for a depression diagnosis; oxidative stress and inflammatory markers were not included; and there was a high rate of missing data at the follow-up. CONCLUSIONS Low physical performance appeared to be an independent predictor of depression over a 4-year follow-up in a sample of elderly people.
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Affiliation(s)
- Nicola Veronese
- Geriatrics Division, Department of Medicine, University of Padova, Via Giustiniani, 2-35128 Padova, Italy
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; and Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
| | | | | | - Marina De Rui
- Geriatrics Division, Department of Medicine, University of Padova
| | - Marco Solmi
- Department of Neurosciences, University of Padova
| | | | | | - Sabina Zambon
- Clinica Medica I, Department of Medicine, University of Padova, and National Research Council, Neuroscience Institute, Padova, Italy
| | - Egle Perissinotto
- Biostatistics, Epidemiology, and Public Health Unit, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padova
| | | | | | - Enzo Manzato
- Geriatrics Division, Department of Medicine, University of Padova, and National Research Council, Neuroscience Institute
| | | | - Guiseppe Sergi
- Geriatrics Division, Department of Medicine, University of Padova
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Ohrnberger J, Fichera E, Sutton M. The dynamics of physical and mental health in the older population. JOURNAL OF THE ECONOMICS OF AGEING 2017; 9:52-62. [PMID: 28580276 PMCID: PMC5446314 DOI: 10.1016/j.jeoa.2016.07.002] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Mental and physical aspects are both integral to health but little is known about the dynamic relationship between them. We consider the dynamic relationship between mental and physical health using a sample of 11,203 individuals in six waves (2002-2013) of the English Longitudinal Study of Ageing (ELSA). We estimate conditional linear and non-linear random-effects regression models to identify the effects of past physical health, measured by Activities of Daily Living (ADL), and past mental health, measured by the Centre for Epidemiological Studies Depression (CES-D) scale, on both present physical and mental health. We find that both mental and physical health are moderately state-dependent. Better past mental health increases present physical health significantly. Better past physical health has a larger effect on present mental health. Past mental health has stronger effects on present physical health than physical activity or education. It explains 2.0% of the unobserved heterogeneity in physical health. Past physical health has stronger effects on present mental health than health investments, income or education. It explains 0.4% of the unobserved heterogeneity in mental health. These cross-effects suggest that health policies aimed at specific aspects of health should consider potential spill-over effects.
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Affiliation(s)
- Julius Ohrnberger
- Manchester Centre for Health Economics, Institute of Population Health, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester M13 9PL, UK
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106
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Isotemporal Analysis of the Association of Objectively Measured Physical Activity With Depressive Symptoms: Results From Hispanic Community Health Study/Study of Latinos (HCHS/SOL). J Phys Act Health 2017; 14:733-739. [PMID: 28422609 DOI: 10.1123/jpah.2016-0648] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND The burden of depression among Hispanics/Latinos indicates the need to identify factors related to depressive symptoms. This paper examines the relationship of physical activity (PA) and sedentary behavior (SB) with depressive symptoms in Hispanic/Latinos. METHODS The Hispanic Community Health Study / Study of Latinos (HCHS/SOL) is a population-based, cohort study of Hispanic/Latinos in 4 United States metropolitan areas. Objectively measured PA was coded into: sedentary behavior (SB), light-intensity (LPA), moderate-intensity (MPA), and vigorous-intensity (VPA); and the Center for Epidemiological Studies Depression Scale-10 assessed depressive symptoms. Multiple regression analysis utilizing isotemporal substitution, adjusted for relevant covariates, examined PA as predictors of depressive symptoms. RESULTS Substitution of 1 hour of SB with VPA resulted in a significant decrease in depressive symptoms (β = -1.215, P = .021). Similar decreases were observed when VPA replaced LPA (β = -1.212, P = .021) and MPA (β = -1.50 P = .034). MPA and LPA were not associated with lower depressive symptoms. CONCLUSIONS Previous research has focused on the relationship of MVPA on depressive symptoms. Our results suggest these constructs should be examined separately as they may have unique relationships with depressive symptoms. The association of SB with greater depressive symptoms confirms previous reports.
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107
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Baheiraei A, Hamzehgardeshi Z, Mohammadi MR, Mohammadi E, Nedjat S. Iranian adolescents' insufficient physical activity: a mixed methods explanatory sequential study. Int J Adolesc Med Health 2016; 28:79-89. [PMID: 25781519 DOI: 10.1515/ijamh-2014-0076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 01/31/2015] [Indexed: 01/22/2023]
Abstract
BACKGROUND Adolescents' physical activity decreases from the stage of childhood to adulthood. This study was addressed to explain adolescents' insufficient physical activity (IPA) and its related factors. The subjects were 1201 adolescents in the quantitative phase and 25 adolescents in the quantitative phase. METHODS An explanatory sequential mixed methods design with follow-up explanations variant was used, which involved collecting quantitative data (1201 adolescents) first and then explaining the quantitative results with in-depth interviews and written narrative (25 adolescents) during a qualitative study. RESULTS The quantitative results showed that 98.8% of adolescents did not have the recommended physical activity. Five themes were extracted in the qualitative phase including the inhibitory effect of the school environment and peers, as well as the inhibitory effect of the family environment, lack of availability and cultural barriers for the presence of girls in the community, the effect of self-feeling and self-understanding, and physical and mental exhaustion and permutation. According to the qualitative findings of the study, physical and mental exhaustion expressed the fact that, although adolescents had an unfavorable sense of IPA, they were under the effects of the intrinsic and extrinsic factors. CONCLUSION The comparison of these themes indicates that this behavior is imposable but not optional.
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108
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Orpana H, Vachon J, Pearson C, Elliott K, Smith M, Branchard B. Correlates of well-being among Canadians with mood and/or anxiety disorders. Health Promot Chronic Dis Prev Can 2016; 36:302-313. [PMID: 27977085 PMCID: PMC5387797 DOI: 10.24095/hpcdp.36.12.04] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Our objective was to examine variables associated with well-being as measured by high self-rated mental health (SRMH) and life satisfaction (LS), among Canadian adults (aged 18+) living with a mood and/or an anxiety disorder. METHODS We used nationally representative data from the 2014 Survey on Living with Chronic Diseases in Canada-Mood and Anxiety Disorders Component (SLCDC-MA) to describe the association between well-being and self-management behaviours (physical activity, sleep and meditation) as well as perceived stress, coping and social support. We used multivariate logistic regression to model the relationship between these factors and measures of well-being. RESULTS Approximately one in three individuals with mood and/or anxiety disorders reported high SRMH. The logistic regression models demonstrated that several characteristics such as being older, and reporting higher self-rated general health, fewer functional limitations, lower levels of perceived life stress, higher levels of perceived coping and higher levels of perceived social support were associated with higher levels of wellbeing. Self-management behaviours (including starting physical activity, meditation, adopting good sleep habits and attaining a certain number of hours of nightly sleep) were not significantly associated with measures of well-being in our multivariate model. CONCLUSION Canadian adults with mood and/or anxiety disorders who reported lower levels of perceived stress and higher levels of social support and coping were more likely to report high levels of well-being. This study contributes evidence from a representative population-based sample indicating well-being is achievable, even in the presence of a mood and/or an anxiety disorder.
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Affiliation(s)
- H Orpana
- Public Health Agency of Canada, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - J Vachon
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - C Pearson
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - K Elliott
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - M Smith
- Manitoba Centre for Health Policy, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - B Branchard
- Public Health Agency of Canada, Ottawa, Ontario, Canada
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Alves AJ, Viana JL, Cavalcante SL, Oliveira NL, Duarte JA, Mota J, Oliveira J, Ribeiro F. Physical activity in primary and secondary prevention of cardiovascular disease: Overview updated. World J Cardiol 2016; 8:575-583. [PMID: 27847558 PMCID: PMC5088363 DOI: 10.4330/wjc.v8.i10.575] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 07/14/2016] [Accepted: 08/18/2016] [Indexed: 02/06/2023] Open
Abstract
Although the observed progress in the cardiovascular disease treatment, the incidence of new and recurrent coronary artery disease remains elevated and constitutes the leading cause of death in the developed countries. Three-quarters of deaths due to cardiovascular diseases could be prevented with adequate changes in lifestyle, including increased daily physical activity. New evidence confirms that there is an inverse dose-response relationship between physical activity and cardiovascular disease and mortality risk. However, participation in moderate to vigorous physical activity may not fully attenuate the independent effect of sedentary activities on increased risk for cardiovascular diseases. Physical activity also plays an important role in secondary prevention of cardiovascular diseases by reducing the impact of the disease, slowing its progress and preventing recurrence. Nonetheless, most of eligible cardiovascular patients still do not benefit from secondary prevention/cardiac rehabilitation programs. The present review draws attention to the importance of physical activity in the primary and secondary prevention of cardiovascular diseases. It also addresses the mechanisms by which physical activity and regular exercise can improve cardiovascular health and reduce the burden of the disease.
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111
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Marques A, Peralta M, Martins J, Catunda R, Matos MGD, Saboga Nunes L. Associations between physical activity and self-rated wellbeing in European adults: A population-based, cross-sectional study. Prev Med 2016; 91:18-23. [PMID: 27471019 DOI: 10.1016/j.ypmed.2016.07.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/12/2016] [Accepted: 07/23/2016] [Indexed: 01/24/2023]
Abstract
Although self-rated wellbeing is an indicator of health status, it has been receiving little attention; its relationship with physical activity among adults remains inconclusive. The purpose of this study was to analyse the relationship between physical activity and several dimensions of self-rated wellbeing in European adults. This cross-sectional study was based on data from the European Social Survey round 6, 2012, comprising 40,600 European adults (18,418 men, 22,186 women) from 27 countries, with mean age 42.1±13.3. Meeting physical activity guidelines was assessed using World Health Organization criteria. Six dimensions of the self-rated wellbeing were assessed (evaluative wellbeing, emotional wellbeing, functioning, vitality, community wellbeing, supportive wellbeing). Men and women who attained physical activity recommended levels had better evaluative wellbeing (men, p=0.009; women, p<0.001), emotional wellbeing (men, p<0.001; women, p<0.001), functioning (men, p<0.001; women, p<0.001), vitality (men, p<0.001; women, p<0.001), supportive relationships (men, p<0.001; women, p<0.001), and wellbeing total score (men, p<0.001; women, p<0.001). Physical activity frequency was linearly associated with self-rated wellbeing in the 6 dimensions as well as the wellbeing total score (p<0.001). Attaining recommended physical activity levels is related to better self-rated wellbeing, and more frequent physical activity is linearly associated with better self-rated wellbeing in its 6 dimensions.
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Affiliation(s)
- Adilson Marques
- Centro Interdisciplinar de Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002 Cruz Quebrada, Portugal; Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal.
| | - Miguel Peralta
- Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002 Cruz Quebrada, Portugal
| | - João Martins
- Laboratório de Pedagogia, Faculdade de Motricidade Humana e UIDEF, Instituto de Educação, Universidade de Lisboa, Estrada da Costa, 1499-002 Cruz Quebrada, Portugal
| | - Ricardo Catunda
- Centro de Ciências da Saúde, Universidade Estadual do Ceará, Avenida Dr. Silas Muguba, 1700 - Campus do Itaperi, Fortaleza, CE 60740-000, Brazil
| | - Margarida Gaspar de Matos
- Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002 Cruz Quebrada, Portugal; William James Center for Research, Instituto Superior de Psicologia Aplicada, R. Jardim do Tabaco, 1149-041 Lisboa, Portugal
| | - Luís Saboga Nunes
- Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade Nova de Lisboa, Av. Padre Cruz, 1600-560 Lisboa, Portugal
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Pedersen BK, Saltin B. Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 2016; 25 Suppl 3:1-72. [PMID: 26606383 DOI: 10.1111/sms.12581] [Citation(s) in RCA: 1637] [Impact Index Per Article: 204.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2015] [Indexed: 12/12/2022]
Abstract
This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.
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Affiliation(s)
- B K Pedersen
- The Centre of Inflammation and Metabolism and The Center for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - B Saltin
- The Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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113
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Patten CA, Bronars CA, Vickers Douglas KS, Ussher MH, Levine JA, Tye SJ, Hughes CA, Brockman TA, Decker PA, DeJesus RS, Williams MD, Olson TP, Clark MM, Dieterich AM. Supervised, Vigorous Intensity Exercise Intervention for Depressed Female Smokers: A Pilot Study. Nicotine Tob Res 2016; 19:77-86. [PMID: 27613946 DOI: 10.1093/ntr/ntw208] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/06/2016] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Few studies have evaluated exercise interventions for smokers with depression or other psychiatric comorbidities. This pilot study evaluated the potential role of supervised vigorous exercise as a smoking cessation intervention for depressed females. METHODS Thirty adult women with moderate-severe depressive symptoms were enrolled and randomly assigned to 12 weeks of thrice weekly, in person sessions of vigorous intensity supervised exercise at a YMCA setting (EX; n = 15) or health education (HE; n = 15). All participants received behavioral smoking cessation counseling and nicotine patch therapy. Assessments were done in person at baseline, at the end of 12 weeks of treatment, and at 6 months post-target quit date. Primary end points were exercise adherence (proportion of 36 sessions attended) and biochemically confirmed 7-day point prevalence abstinence at Week 12. Biomarkers of inflammation were explored for differences between treatment groups and between women who smoked and those abstinent at Week 12. RESULTS Treatment adherence was high for both groups (72% for EX and 66% for HE; p = .55). The Week 12 smoking abstinence rate was higher for EX than HE (11/15 [73%] vs. 5/15 [33%]; p = .028), but no significant differences emerged at 6-month follow-up. Interleukin-6 levels increased more for those smoking than women abstinent at Week 12 (p = .040). CONCLUSIONS Vigorous intensity supervised exercise is feasible and enhances short-term smoking cessation among depressed female smokers. Innovative and cost-effective strategies to bolster long-term exercise adherence and smoking cessation need evaluation in this population. Inflammatory biomarkers could be examined in future research as mediators of treatment efficacy. IMPLICATIONS This preliminary study found that vigorous intensity supervised exercise is feasible and enhances short-term smoking cessation among depressed female smokers. This research addressed an important gap in the field. Despite decades of research examining exercise interventions for smoking cessation, few studies were done among depressed smokers or those with comorbid psychiatric disorders. A novel finding was increases in levels of a pro-inflammatory biomarker observed among women who smoked at the end of the intervention compared to those who did not.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN;
| | - Carrie A Bronars
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | - Michael H Ussher
- Population Health Research Institute, St. George's University of London, London, UK
| | | | | | | | | | - Paul A Decker
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Ramona S DeJesus
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Mark D Williams
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Thomas P Olson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
| | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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Trivedi MH, Greer TL, Grannemann BD, Church TS, Galper DI, Sunderajan P, Wisniewski SR, Chambliss HO, Jordan AN, Finley C, Carmody TI. TREAD: TReatment with Exercise Augmentation for Depression: study rationale and design. Clin Trials 2016; 3:291-305. [PMID: 16895046 DOI: 10.1191/1740774506cn151oa] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Despite recent advancements in the pharmacological treatment of major depressive disorder (MDD), over half of patients who receive treatment with antidepressant medication do not achieve full remission of symptoms. There is evidence that exercise can reduce depressive symptomatology when used as a treatment for MDD. However, no randomized controlled trials have evaluated exercise as an augmentation strategy for patients with carefully diagnosed MDD who remain symptomatic following an adequate acute phase trial of antidepressant therapy. Purpose TReatment with Exercise Augmentation for Depression (TREAD) is an NIMH-funded, randomized, controlled trial designed to assess the relative efficacy of two doses of aerobic exercise to augment selective serotonin reuptake inhibitor (SSRI) treatment of MDD. Methods The TREAD study includes 12 weeks of acute phase treatment with a 12-week post-treatment follow-up. In addition to looking at change in depressive symptoms as a primary outcome, it also includes comprehensive assessment of psychosocial function and treatment adherence. Results This paper reviews the rationale and design of TREAD and illustrates how we address several key issues in contemporary patient-oriented research on MDD: 1) the use of augmentation strategies in the treatment of depressive disorders in general, 2) the use of non-pharmacological strategies in the treatment of depressive disorders, 3) the considerations of designing a well-controlled trial using two active treatment groups, and 4) the implementation of an adherence program for the use of exercise as a treatment strategy. Conclusions The TREAD study is uniquely designed to overcome sources of potential bias and threats to internal and external validity that have limited prior research on the mental health effects of exercise. The study is facilitated by the development of a multidisciplinary research team that includes experts in both depression treatment and exercise physiology, as well as other related fields.
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Affiliation(s)
- Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
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115
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Suterwala AM, Rethorst CD, Carmody TJ, Greer TL, Grannemann BD, Jha M, Trivedi MH. Affect Following First Exercise Session as a Predictor of Treatment Response in Depression. J Clin Psychiatry 2016; 77:1036-42. [PMID: 27561137 PMCID: PMC5673095 DOI: 10.4088/jcp.15m10104] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 10/06/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Remission rates are low with first-step or even second-step antidepressant treatments. Furthermore, despite extensive investments from National Institutes of Health and from industry, novel treatments are not yet available in clinical care for depression. Predictors of treatment response very early in the course of treatment can avoid unnecessarily lengthy trials with ineffective treatments and reduce the trial and error process. This article examines the expression of positive affect immediately following an acute exercise session at the end of the first exercise session as a predictor of treatment response in the National Institute of Mental Health-funded TREAD (Treatment with Exercise Augmentation for Depression) study, which was conducted from April 2003 to August 2007. METHODS 122 subjects with DSM-IV-diagnosed major depressive disorder were randomized to public health dose (16 kcal/kg/wk) or low dose (4 kcal/kg/wk) of exercise for 12 weeks. Affect following the first exercise session was assessed using the Positive and Negative Affect Scale (PANAS), and depressive symptoms were assessed weekly using the Inventory of Depressive Symptomatology, Clinician Rating (IDS-C) (primary outcome measure). RESULTS The PANAS composite affect score (positive-negative total) predicted change in IDS-C score (P < .05), as well as treatment response (P < .02) and remission (P < .03) for those in the high-dose group but not in the low-dose group. CONCLUSIONS These findings suggest that the composite positive affect following the first exercise session has clinical utility to predict treatment response to exercise in depression and match the "right patient" with the "right" treatment. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT00076258.
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Affiliation(s)
| | | | | | - Tracy L. Greer
- University of Texas Southwestern Medical Center, Dallas, TX
| | | | - Manish Jha
- University of Texas Southwestern Medical Center, Dallas, TX
| | - Madhukar H Trivedi
- Comprehensive Center for Depression, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-9119. .,University of Texas Southwestern Medical Center, Dallas, Texas, USA
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116
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Kear BM, Guck TP, McGaha AL. Timed Up and Go (TUG) Test: Normative Reference Values for Ages 20 to 59 Years and Relationships With Physical and Mental Health Risk Factors. J Prim Care Community Health 2016; 8:9-13. [PMID: 27450179 DOI: 10.1177/2150131916659282] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE The Timed Up and Go (TUG) test is a reliable, cost-effective, safe, and time-efficient way to evaluate overall functional mobility. However, the TUG does not have normative reference values (NRV) for individuals younger than 60 years. The purpose of this study was to establish NRV for the TUG for individuals aged between 20 and 59 years and to examine the relationship between the TUG and demographic, physical, and mental health risk factors. METHODS Two hundred participants, 50 per decade (ages 20-29, 30-39, 40-49, 50-59 years) were selected at their primary care visit, and timed as they performed the TUG by standing up out of a chair, walking 3 m, turning around, walking back to the chair, and sitting down. Information regarding the risk factors socioeconomic status, body mass index, an index of multimorbidities, perceptions of overall physical and mental health was obtained and used as predictors of TUG time independent of age. RESULTS TUG times were significantly different among the decades ( F = 6.579, P = .001) with slower times occurring with the 50-year-old decade compared with the 20s ( P = .001), 30s ( P = .001), and 40s ( P = .020). Slower TUG times were associated with lower SES, higher body mass index, more medical comorbidities, and worse perceived physical and mental health. Regression results indicated that perceived physical and mental health accounted for unique variance in the prediction of TUG time beyond age, gender, and socioeconomic status. CONCLUSIONS This study provided TUG NRV for adults in their 20s, 30s, 40s, and 50s. The TUG may have utility for primary care providers as they assess and monitor physical activity in younger adults, especially those with physical and mental health risk factors.
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Affiliation(s)
- Breelan M Kear
- 1 Creighton University School of Medicine, Omaha, NE, USA
| | - Thomas P Guck
- 1 Creighton University School of Medicine, Omaha, NE, USA
| | - Amy L McGaha
- 1 Creighton University School of Medicine, Omaha, NE, USA
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117
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Hartman L, van Dongen JM, Hildebrandt VH, Strijk JE. The Role of Vitality in the Relationship Between a Healthy Lifestyle and Societal Costs of Health Care and Lost Productivity: A Mediation Analysis. Am J Health Promot 2016; 30:465-74. [PMID: 27445327 DOI: 10.1177/0890117116658182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the mediating effect of vitality in the relationship between healthy lifestyle characteristics and health-care and productivity-related costs. DESIGN Observational prospective cohort study with 2 measurements. Online questionnaires were filled out in 2013 (T0) and 2014 (T1). SETTING A random sample of a Dutch online interview panel was obtained. SUBJECTS Data of 4231 Dutch adults who had complete data at T0 and T1 were used in the present study. Participants were representative for the Dutch adult population in terms of age, gender, and having chronic disease(s). MEASURES Healthy Lifestyle Index (HLI), vitality, and health-care and productivity-related costs. The HLI consisted of the sum of 6 healthy lifestyle characteristics, including a healthy BMI (yes/no), meeting physical activity, fruit, vegetable, and alcohol consumption guidelines (yes/no), and smoking status (yes: non or former smoker/no: current smoker). Health-care and productivity-related costs were measured using a utilization questionnaire. ANALYSIS Linear regression analysis. RESULTS The HLI was related to vitality. In addition, vitality was related to health-care costs and productivity-related costs. Furthermore, vitality was found to transmit 28.4% of the effect of HLI on health-care costs and 39.4% of the effect of HLI on productivity-related costs. CONCLUSION Lifestyle was related to vitality and vitality to health-care and productivity-related costs. Vitality mediated the relationship between lifestyle and health-care and productivity-related costs. Therefore, we recommend to sustain and improve both vitality and lifestyle.
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Affiliation(s)
- L Hartman
- Netherlands Organisation for Applied Scientific Research TNO, Expertise Center Life Style, Leiden, the Netherlands
| | - J M van Dongen
- Department of Health Sciences & EMGO+ Institute for Health and Care Research, Faculty of Earth & Life Sciences, VU University Amsterdam, Amsterdam, the Netherlands
| | - V H Hildebrandt
- Netherlands Organisation for Applied Scientific Research TNO, Expertise Center Life Style, Leiden, the Netherlands
| | - J E Strijk
- Netherlands Organisation for Applied Scientific Research TNO, Expertise Center Life Style, Leiden, the Netherlands
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118
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Zoeller RF. Physical Activity: Depression, Anxiety, Physical Activity, and Cardiovascular Disease: What's the Connection? Am J Lifestyle Med 2016. [DOI: 10.1177/1559827607300518] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Depression and anxiety are major public health problems and have been shown to be associated with increased risk for cardiovascular disease. The prevalence and incidence of depression and anxiety are lower in those who are regularly active. Regular physical activity has also been shown to reduce symptoms of depression and anxiety in those who already suffer from these disorders. Depression and anxiety may increase the risk for cardiovascular disease by a number of mechanisms, including hypertension and reduced vascular function, autonomic nervous system dysfunction, and increased platelet activity and aggregation. Regular physical activity has been demonstrated to lower blood pressure and improve nitric oxide— mediated vascular function, increase heart rate variability and baroreflex sensitivity, increase fibrinolysis, and, possibly, decrease platelet activity. Little or no work has been done to determine the optimal amount or intensity of exercise to prevent or reduce the symptoms of depression and anxiety. Based on the limited data available, a physical activity routine consistent with the 1996 Surgeon General's Report on Physical Activity and Health is appropriate—specifically, at least 30 minutes of moderate-intensity activity on most days, if not every day, of the week. Little evidence supports a dose-response relation between physical activity and depression or any of the physiological mechanisms discussed here. This is not to say that there is no such relationship but, rather, that well-controlled studies are lacking. Studies on anxiety, especially, are lacking. This includes the link with cardiovascular disease, physiological mechanisms, and the effects of regular physical activity.
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Affiliation(s)
- Robert F. Zoeller
- Department of Exercise Science & Health Promotion, Florida Atlantic University, Davie, Florida,
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119
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Oudghiri DE, Ruiz-Cabello P, Camiletti-Moirón D, Fernández MDM, Aranda P, Aparicio VA. Influence of weight status on physical and mental health in Moroccan perimenopausal women. Pan Afr Med J 2016; 23:153. [PMID: 27303571 PMCID: PMC4894727 DOI: 10.11604/pamj.2016.23.153.8208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 03/18/2016] [Indexed: 11/30/2022] Open
Abstract
Introduction There is a lack of information about fitness and other health indicators in women from countries such as Morocco. This study aims to explore the association of weight status with physical and mental health in Moroccan perimenopausal women. Methods 151 women (45-65 years) from the North of Morocco were analyzed by standardized field-based fitness tests to assess cardiorespiratory fitness, muscular strength, flexibility, agility and balance. Quality of life was assessed by means of the Short-Form-36 Health Survey. Resting heart rate, blood pressure and plasma fasting glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were also measured. Results Blood pressure (P=0.001), plasma triglycerides (P=0.041) and the prevalence of metabolic syndrome (P<0.001) increased as weight status increased. Levels of cardiorespiratory fitness, upper-body flexibility (both, P<0.001), static balance (P<0.05) and dynamic balance (P<0.01) decreased as weight status increased. Pairwise comparisons showed differences mainly between normal-weight and overweight vs. obese groups. No differences between groups were observed on quality of life. Conclusion Cardiovascular and lipid profile and fitness, important indicators of cardiovascular disease risk, worsened as weight status increased, whereas quality of life appears to be independent of weight status. Exercise and nutritional programs focus on weight management may be advisable in this under studied population.
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Affiliation(s)
- Dia Eddine Oudghiri
- Department of Physiology and Pathophysiology, University AbdelmalekEssaadi, Tetouan, Morocco
| | - Pilar Ruiz-Cabello
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy and School of Sport Sciences, University of Granada, Granada, Spain
| | - Daniel Camiletti-Moirón
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy and School of Sport Sciences, University of Granada, Granada, Spain
| | - María Del Mar Fernández
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy and School of Sport Sciences, University of Granada, Granada, Spain
| | - Pilar Aranda
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy and School of Sport Sciences, University of Granada, Granada, Spain
| | - Virginia Ariadna Aparicio
- Department of Physiology and Institute of Nutrition and Food Technology, Faculty of Pharmacy and School of Sport Sciences, University of Granada, Granada, Spain; Department of Public and Occupational Health, VU University and EMGO+ Institute for Health and Care Research, Amsterdam, The Netherlands
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Xiang X. History of major depression as a barrier to health behavior changes after a chronic disease diagnosis. J Psychosom Res 2016; 85:12-8. [PMID: 27212664 DOI: 10.1016/j.jpsychores.2016.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 04/02/2016] [Accepted: 04/04/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine whether changes in smoking, drinking, and physical activity after a chronic disease diagnosis differ between middle-aged and older adults with and without a history of major depression. METHODS Individual-level data came from 1996 to 2010 waves of the U.S. Health and Retirement Study. Chronic disease diagnosis was ascertained from self-reports of physician diagnosed diseases. Major depression was assessed by the short-form Composite International Diagnostic Interview. Mixed-effects logistic regressions were performed to estimate the potential moderating effect of a history of major depression. RESULTS Baseline major depression was associated with a more than 3-fold increase (OR=4.48, 95% CI=2.27-8.86) in the odds of smoking and 37% decrease (OR=0.63, 95% CI=0.52-0.75) in the odds of staying physically active, but not with odds of excessive drinking. After a chronic disease diagnosis, the odds of smoking was reduced by 75% (OR=0.25, 95% CI=0.20-0.32), the odds of excessive drinking was reduced by 47% (OR=0.53, 95% CI=0.47-0.61), and the odds of staying physically active was reduced by 30% (OR=0.70, 95% CI=0.63-0.78). There was a significant interaction effect for smoking such that the decline in the odds of smoking was smaller among adults with a history of major depression. CONCLUSION Chronic disease diagnosis may be an important teachable moment for health behavior change, but the behavior changing effect may be smaller for those with a history of major depression especially when it comes to smoking.
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Affiliation(s)
- Xiaoling Xiang
- Center for Education in Health Sciences, Feinberg School of Medicine, Northwestern University, 633 North St. Clair, 20th floor, Chicago, IL 60611, United States.
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121
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Goracci A, Rucci P, Forgione RN, Campinoti G, Valdagno M, Casolaro I, Carretta E, Bolognesi S, Fagiolini A. Development, acceptability and efficacy of a standardized healthy lifestyle intervention in recurrent depression. J Affect Disord 2016; 196:20-31. [PMID: 26897454 DOI: 10.1016/j.jad.2016.02.034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 01/15/2016] [Accepted: 02/06/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Research evidence on the effects of integrated multifaceted lifestyle interventions for depression is scanty. The aim of the present study is to report on the development, acceptability and efficacy of a standardized healthy lifestyle intervention, including exercise, eating habits, sleep hygiene and smoking cessation in preventing relapses. METHODS One hundred-sixty outpatients with recurrent unipolar depression or bipolar disorder were recruited after achieving full remission or recovery from the most recent depressive episode. Patients were randomized to 3-months of usual care or to an intervention aimed at promoting a healthy lifestyle (HLI), as an augmentation of pharmacological maintenance treatment. Usual care consisted of clinical management visits. At the end of the intervention, follow-up visits were scheduled at 3,6,9 and 12 months. RESULTS During the intervention phase, 1 relapse occurred in the HLI group and 4 in the control group. Over the 12 months of follow-up, relapses were 5 in the HLI group and 16 in control group. Using an intent-to-treat approach, the overall percentage of relapses was 6/81 (7.4%) in the HLI group vs. 20/79 (25.3%) in the control group.. In a Kaplan-Meier survival analysis the risk of relapse was significantly lower in patients receiving the HLI intervention (log-rank test, p=0.003) over the 60 weeks of observation. The majority of patients assigned to HLI adhered to the program, and were highly motivated throughout the intervention. LIMITATIONS The retention rate was low because patients were recruited during the maintenance phase and the 1-year follow-up was relatively short to detect a long-term effect of HLI. CONCLUSIONS The HLI program proved to be efficacious in preventing relapses. Given the absence of contraindications and its cost-effectiveness in routine practice, the use of HLI should be encouraged to promote the well-being of patients with recurrent depression.
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Affiliation(s)
- A Goracci
- Department of Molecular and Developmental Medicine, University of Siena, Italy
| | - P Rucci
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Italy.
| | - R N Forgione
- Department of Molecular and Developmental Medicine, University of Siena, Italy
| | - G Campinoti
- Department of Molecular and Developmental Medicine, University of Siena, Italy
| | - M Valdagno
- Department of Molecular and Developmental Medicine, University of Siena, Italy
| | - I Casolaro
- Department of Molecular and Developmental Medicine, University of Siena, Italy
| | - E Carretta
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - S Bolognesi
- Department of Molecular and Developmental Medicine, University of Siena, Italy
| | - A Fagiolini
- Department of Molecular and Developmental Medicine, University of Siena, Italy
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Ellingson LD, Meyer JD, Cook DB. Wearable Technology Reduces Prolonged Bouts of Sedentary Behavior. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2016. [DOI: 10.1249/tjx.0000000000000001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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123
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Unhjem R, Flemmen G, Hoff J, Wang E. Maximal strength training as physical rehabilitation for patients with substance use disorder; a randomized controlled trial. BMC Sports Sci Med Rehabil 2016; 8:7. [PMID: 27042312 PMCID: PMC4818502 DOI: 10.1186/s13102-016-0032-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 02/29/2016] [Indexed: 12/30/2022]
Abstract
Background Patients with substance use disorder (SUD) suffer from multiple health and psychosocial problems. Because poor physical capacities following an inactive lifestyle may indeed contribute to these problems, physical training is often suggested as an attractive supplement to conventional SUD treatment. Strength training is shown to increase muscle strength and effectively improve health and longevity. Therefore we investigated the feasibility and effect of a maximal strength training intervention for SUD patients in clinical treatment. Methods 16 males and 8 females were randomized into a training group (TG) and a control group (CG). The TG performed lower extremities maximal strength training (85-90 % of 1 repetition maximum (1RM)) 3 times a week for 8 weeks, while the CG participated in conventional clinical activities. Results The TG increased hack squat 1RM (88 ± 54 %), plantar flexion 1RM (26 ± 20 %), hack squat rate of force development (82 ± 29 %) and peak force (11 ± 5 %). Additionally, the TG improved neural function, expressed as voluntary V-wave (88 ± 83 %). The CG displayed no change in any physical parameters. The TG also reduced anxiety and insomnia, while the CG reduced anxiety. Conclusion Maximal strength training was feasible for SUD patients in treatment, and improved multiple risk factors for falls, fractures and lifestyle related diseases. As conventional treatment appears to have no effect on muscle strength, systematic strength training should be implemented as part of clinical practice. Trial regestration ClinicalTrials.gov Identifier: NCT02218970 (August 14, 2014).
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Affiliation(s)
- Runar Unhjem
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway
| | - Grete Flemmen
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Jan Hoff
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Department of Physical Medicine and Rehabilitation, St. Olav University Hospital, Trondheim, Norway
| | - Eivind Wang
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Division of Psychiatry, Department of Østmarka, St. Olav University Hospital, Trondheim, Norway ; Department of Internal Medicine, University of Utah, Salt Lake City, Utah USA
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Cadenas-Sánchez C, Mora-González J, Migueles JH, Martín-Matillas M, Gómez-Vida J, Escolano-Margarit MV, Maldonado J, Enriquez GM, Pastor-Villaescusa B, de Teresa C, Navarrete S, Lozano RM, de Dios Beas-Jiménez J, Estévez-López F, Mena-Molina A, Heras MJ, Chillón P, Campoy C, Muñoz-Hernández V, Martínez-Ávila WD, Merchan ME, Perales JC, Gil Á, Verdejo-García A, Aguilera CM, Ruiz JR, Labayen I, Catena A, Ortega FB. An exercise-based randomized controlled trial on brain, cognition, physical health and mental health in overweight/obese children (ActiveBrains project): Rationale, design and methods. Contemp Clin Trials 2016; 47:315-24. [DOI: 10.1016/j.cct.2016.02.007] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 02/14/2016] [Accepted: 02/19/2016] [Indexed: 12/30/2022]
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Investigation of the Impact of Sports, Exercise, and Recreation Participation on Psychosocial Outcomes in a Population of Veterans with Disabilities. Am J Phys Med Rehabil 2015; 94:1026-34. [DOI: 10.1097/phm.0000000000000263] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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126
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Lindegård A, Jonsdottir IH, Börjesson M, Lindwall M, Gerber M. Changes in mental health in compliers and non-compliers with physical activity recommendations in patients with stress-related exhaustion. BMC Psychiatry 2015; 15:272. [PMID: 26530329 PMCID: PMC4632342 DOI: 10.1186/s12888-015-0642-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 10/08/2015] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND There is a lack of research regarding the long-lasting effects of a more physically active lifestyle in patients with mental disorders. In the present study, clinical data were analysed to examine if initially physically inactive patients, clinically diagnosed with stress-related exhaustion, taking part in 12-month multimodal treatment (MMT), differ at the 18-month follow-up regarding mental health, depending on whether they did or did not comply with the physical activity (PA) recommendations resembling those of the American College of Sports Medicine. METHODS The study population consisted of 69 patients (65% women) who were referred to a stress clinic due to stress-related exhaustion. All patients received MMT. A major goal was to increase patients' PA levels. The patients received general comprehensive instructions including personal advice regarding the positive effects of PA on mental health and could self-select for an 18-week coached exercise program. Changes in mental health symptoms over an 18-month period were compared between non-compliers (n = 26), mild compliers (n = 22) and strong compliers (n = 21) with the PA recommendations included in the MMT. RESULTS Non-compliers, mild and strong compliers did not differ regarding burnout, depression and anxiety at baseline. Although substantial improvements occurred in all groups, mild and strong compliers reported significantly lower burnout and depression levels at the 18-month follow-up than the non-complying group (p < .05). The general pattern of findings was corroborated, if standard cut-off criteria for clinical burnout were used. CONCLUSIONS Compliance with PA recommendations is associated with decreased levels of burnout and depression in patients with stress-related exhaustion. Thus, the promotion of a more active lifestyle among patients with stress-related exhaustion should be implemented as a part of MMT, to achieve a more sustainable decrease of symptoms of burnout and depression. TRIAL REGISTRATION This is not a clinical trial.
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Affiliation(s)
- Agneta Lindegård
- Institute of Stress Medicine, Carl Skottsbergs gata 22B, Gothenburg, SE-41319, Sweden.
| | - Ingibjörg H. Jonsdottir
- Institute of Stress Medicine, Carl Skottsbergs gata 22B, Gothenburg, SE-41319 Sweden ,Department of Food and Nutrition, and Sport Science, University of Gothenburg, PO Box 300, Gothenburg, SE-40530 Sweden
| | - Mats Börjesson
- The Swedish School of Sport and Health Sciences, University of Stockholm, Lidingövägen 1, Stockholm 1, SE-11433, Sweden. .,Department of Cardiology, Karolinska University Hospital, Stockholm, SE-17176, Sweden.
| | - Magnus Lindwall
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, PO Box 300, Gothenburg, SE-40530, Sweden. .,Department of Psychology, University of Gothenburg, PO Box 500, Gothenburg, SE-40530, Sweden.
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320B, Basel, CH-4052, Switzerland.
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Flemmen G, Wang E. Impaired Aerobic Endurance and Muscular Strength in Substance Use Disorder Patients: Implications for Health and Premature Death. Medicine (Baltimore) 2015; 94:e1914. [PMID: 26554792 PMCID: PMC4915893 DOI: 10.1097/md.0000000000001914] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Although substance use disorder (SUD) patients are documented to have an inactive lifestyle, which is associated with cardiovascular disease, other lifestyle-related diseases and premature death, evidence regarding their aerobic endurance and muscular strength is limited. Therefore, the authors aimed to evaluate directly assessed maximal oxygen consumption, walking efficiency, as well as maximal strength in a group of SUD patients.A total of 44 SUD patients in residential treatment, 31 men (31 ± 8 years) and 13 women (34 ± 10 years), were included and completed the physical testing. The patients were compared with an age- and sex-matched reference group.Male and female SUD patients exhibited a maximal oxygen consumption of 44.6 ± 6.2 and 33.8 ± 6.6 mL· min kg, respectively. This was significantly lower than the reference group, 15% (P = 0.03) for men and 25% (P = 0.001) for women. In addition, the SUD patients had a 13% significantly reduced walking efficiency (P = 0.02), compared with healthy controls. The impairments in aerobic endurance were accompanied by significant reductions in maximal strength of 30% (P = 0.001) and 33% (P = 0.01) for men and women, respectively. In combination, these results imply that SUD patients have impaired endurance and muscular strength compared with what is typically observed in the population, and consequently suffer a higher risk of developing cardiovascular and other lifestyle-related diseases and early death. Effective physical exercise should be advocated as an essential part of the clinical practice of SUD treatment to improve the patient's health and consequently reduce the costs because of the high use of emergency departments, hospital, and medical care.
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Affiliation(s)
- Grete Flemmen
- From the Department of Circulation and Medical Imaging, Faculty of Medicine, the Norwegian University of Science and Technology (GF, EW); and Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway (GF); Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA (EW)
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128
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Depression Symptom Severity and Cardiorespiratory Fitness in Healthy and Depressed Adults: A Systematic Review and Meta-Analysis. Sports Med 2015; 46:219-30. [DOI: 10.1007/s40279-015-0409-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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129
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Determinants of Physical Activity Guideline Attainment in Australian Cardiac Patients: A 12-Month Study. J Cardiopulm Rehabil Prev 2015; 35:399-408. [PMID: 26378492 DOI: 10.1097/hcr.0000000000000137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE Little is known about the type and intensity of physical activity (PA) reported by cardiac patients during the first year after hospitalization and whether patients are meeting recommended PA guidelines. In addition, the achievement of PA guideline over the course of recovery is largely unknown. METHODS A total of 136 patients consecutively admitted to 2 Australian hospitals after acute myocardial infarction (31%), or to undergo bypass surgery (29%) or percutaneous coronary intervention (40%), were interviewed at 6 weeks and at 4 and 12 months after admission. Physical activity at each time point was assessed by the Active Australia PA Survey. Medical and sociodemographic data, self-reported anxiety and depression, and cardiac rehabilitation attendance status were also recorded. Logistic regression was used to identify predictors of PA guideline attainment at each of the 3 time points. RESULTS At all 3 time points, walking was regularly performed by more than 95% of patients, while moderate- and vigorous-intensity PA reached only 40% and 59% participation by 12 months, respectively. Significant predictors of PA guideline attainment at 6 weeks posthospitalization were physical functioning, depression, and mode of PA. As hypothesized, different predictors were found at 4 months (living arrangements, PA mode, and attainment of 6-week PA guidelines) and 12 months (living arrangements, socioeconomic resources, PA mode, and attainment of 6-week PA guidelines). CONCLUSIONS The study highlighted the potential importance of modifying walking behavior in cardiac patients to achieve PA guidelines and the dynamic nature of variables influencing PA at various stages of recovery.
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Goldstein BI, Carnethon MR, Matthews KA, McIntyre RS, Miller GE, Raghuveer G, Stoney CM, Wasiak H, McCrindle BW. Major Depressive Disorder and Bipolar Disorder Predispose Youth to Accelerated Atherosclerosis and Early Cardiovascular Disease: A Scientific Statement From the American Heart Association. Circulation 2015; 132:965-86. [PMID: 26260736 DOI: 10.1161/cir.0000000000000229] [Citation(s) in RCA: 328] [Impact Index Per Article: 36.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In the 2011 "Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents," several medical conditions among youth were identified that predispose to accelerated atherosclerosis and early cardiovascular disease (CVD), and risk stratification and management strategies for youth with these conditions were elaborated. Major depressive disorder (MDD) and bipolar disorder (BD) among youth satisfy the criteria set for, and therefore merit inclusion among, Expert Panel tier II moderate-risk conditions. The combined prevalence of MDD and BD among adolescents in the United States is ≈10%, at least 10 times greater than the prevalence of the existing moderate-risk conditions combined. The high prevalence of MDD and BD underscores the importance of positioning these diseases alongside other pediatric diseases previously identified as moderate risk for CVD. The overall objective of this statement is to increase awareness and recognition of MDD and BD among youth as moderate-risk conditions for early CVD. To achieve this objective, the primary specific aims of this statement are to (1) summarize evidence that MDD and BD are tier II moderate-risk conditions associated with accelerated atherosclerosis and early CVD and (2) position MDD and BD as tier II moderate-risk conditions that require the application of risk stratification and management strategies in accordance with Expert Panel recommendations. In this scientific statement, there is an integration of the various factors that putatively underlie the association of MDD and BD with CVD, including pathophysiological mechanisms, traditional CVD risk factors, behavioral and environmental factors, and psychiatric medications.
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131
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Effects of music aerobic exercise on depression and brain-derived neurotrophic factor levels in community dwelling women. BIOMED RESEARCH INTERNATIONAL 2015; 2015:135893. [PMID: 26075212 PMCID: PMC4446469 DOI: 10.1155/2015/135893] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 04/07/2015] [Accepted: 04/08/2015] [Indexed: 11/17/2022]
Abstract
A randomized clinical trial was utilized to compare the improvement of depression and brain-derived neurotrophic factor (BDNF) levels between community women with and without music aerobic exercise (MAE) for 12 weeks. The MAE group involved 47 eligible participants, whereas the comparison group had 59 participants. No significant differences were recorded in the demographic characteristics between the participants in the MAE group and the comparison group. Forty-one participants in the MAE group and 26 in the comparison group completed a pre- and posttest. The MAE group displayed significant improvement in depression scores (p = 0.016), decreased depression symptoms in crying (p = 0.03), appetite (p = 0.006), and fatigue (p = 0.011). The BDNF levels of the participants significantly increased after the 12-week MAE (p = 0.042). The parallel comparison group revealed no significant changes in depression scores or BDNF levels. In summary, the 12-week MAE had a significant impact on the enhancement of BDNF levels and improvement of depression symptoms. Middle-aged community women are encouraged to exercise moderately to improve their depression symptoms and BDNF levels.
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132
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Clennin MN, Payne JPW, Rienzi EG, Lavie CJ, Blair SN, Pate RR, Sui X. Association between Cardiorespiratory Fitness and Health-Related Quality of Life among Patients at Risk for Cardiovascular Disease in Uruguay. PLoS One 2015; 10:e0123989. [PMID: 25901358 PMCID: PMC4406735 DOI: 10.1371/journal.pone.0123989] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 02/25/2015] [Indexed: 01/07/2023] Open
Abstract
PURPOSE To examine the association between objectively measured CRF and physical and mental components of HRQoL in a Uruguayan cohort at risk for developing CVD. METHODS Patient data records from 2002-2012 at the Calidad de Vida Center were examined. To assess CRF, participants performed a submaximal exercise test. During the evaluation, participants also completed the SF-36, a HRQoL measure comprised of eight dimensions that are summarized by physical and mental component scores (PCS and MCS, respectively). ANCOVA was used to examine the relationship between HRQoL dimensions and CRF. Logistic regression was then used to compare the odds of having a HRQoL component score above the norm across CRF. All analyses were performed separately for males and females with additional stratified analyses across age and BMI conducted among significant trends. RESULTS A total of 2,302 subjects were included in the analysis. Among females, a significant relationship was observed between CRF and vitality, physical functioning, physical role, bodily pain, and general health dimensions. However, for males the only dimension found to be significantly associated with CRF was physical health. After adjusting for potential confounders, a significant linear trend (p<0.001) for PCS scores above the norm across CRF levels was observed for females only. CONCLUSION Among females with one or more risk factors for developing CVD, higher levels of CRF were positively associated with the vitality and physical dimensions of HRQoL, as well as the overall PCS. However, among males the only dimension associated with CRF was physical functioning. Future studies should examine this relationship among populations at risk for developing CVD in more detail and over time.
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Affiliation(s)
- Morgan N. Clennin
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Jonathan P. W. Payne
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Edgardo G. Rienzi
- Especialista en Medicina del Deporte, Centro Calidad de Vida, Asociación Española, Montevideo, Uruguay
| | - Carl J. Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the University of Queensland School of Medicine, New Orleans, Louisiana, United States
- Department of Preventive Medicine, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, United States
| | - Steven N. Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Russell R. Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States
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Wielopolski J, Reich K, Clepce M, Fischer M, Sperling W, Kornhuber J, Thuerauf N. Physical activity and energy expenditure during depressive episodes of major depression. J Affect Disord 2015; 174:310-6. [PMID: 25532078 DOI: 10.1016/j.jad.2014.11.060] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 11/28/2014] [Accepted: 11/29/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND Recent data suggest a substantial association between physical activity and depressive symptoms, but there is a lack of research evaluating the physical activity levels in patients suffering from unipolar depression across different stages of disease in an objective way. The aim of the present pilot study was to objectively examine physical activity levels of this patient group compared to healthy controls. METHODS Physical activity performance of 19 patients with major depressive episode and 19 healthy controls was assessed at three different time points using a multisensory armband device (SenseWear® Pro3 Armband) and was reported as total energy expenditure (TEE), active energy expenditure (EE), metabolic equivalents (METs), physical activity (PA) and time of lying down (LD), in each case over 24h. RESULTS Over all measurements, depressive patients presented a significantly lower mean TEE and EE over 24h. Moreover, the patient group showed significantly shorter duration of PA and lower average MET over 24h. When depressive symptoms abated, physical activity parameters significantly increased in the patient group. Correlation analyses demonstrated a significant relation between depressive status/anhedonia and parameters of physical activity, especially in healthy subjects. LIMITATIONS Results represented valid data for inpatients only. CONCLUSION Acute unipolar depression was associated with a significantly lower level of physical activity and showed a significant increase in parallel to clinical improvement. Electronic monitoring of physical activity may be an additional tool for evaluating and controlling therapeutic effects.
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Affiliation(s)
- Jan Wielopolski
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany
| | - Karin Reich
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany
| | - Marion Clepce
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany
| | - Marie Fischer
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany
| | - Wolfgang Sperling
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany
| | - Norbert Thuerauf
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany.
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134
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Engberg E, Liira H, Kukkonen-Harjula K, From S, Kautiainen H, Pitkälä K, Tikkanen H. Associations of physical activity with self-rated health and well-being in middle-aged Finnish men. Scand J Public Health 2014; 43:190-6. [DOI: 10.1177/1403494814561820] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims: We examined the associations of physical activity (PA) frequency with self-rated health (SRH), self-rated well-being (SRW) and depressive symptoms, in middle-aged men in Finland. Methods: The cross-sectional study comprised 665 men (mean age 41 ± 3 SD years; body mass index (BMI) 26.8 ± 4.2 SD kg/m2), who had completed the screening questionnaire of an intervention for men with cardiovascular risk factors. Their weekly frequency of PA was assessed by a questionnaire, SRH and SRW by visual analog scales (VAS), and depressive symptoms by the Patient Health Questionnaire-2 (PHQ-2). Results: The mean SRH ± SD (range of scale 0–100) by PA frequency categories was 56.2 ± 18.5 for PA sometimes or never, 63.8 ± 16.2 for PA about 1–2 times/week, and 71.1 ± 15.5 for PA at least 3 times/week. The mean SRW ± SD (range of scale 0–100) was 59.0 ± 20.4, 65.6 ± 17.6, and 68.9 ± 17.1, respectively. The mean PHQ-2 score ± SD (range of scale 0–6) by PA categories was 1.83 ± 1.40 for PA sometimes or never, 1.68 ± 1.28 for PA about 1–2 times/week, and 1.60 ± 1.31 for the PA at least 3 times/week group. SRH and SRW improved linearly with increasing PA frequency (both p < 0.001), and the results remained similar after adjustment for BMI, education and smoking status. No association existed between PA frequency and PHQ-2. Conclusions: More frequent PA was linearly associated with better SRH and SRW, but not with depressive symptoms that were measured by a brief depression screening tool.
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Affiliation(s)
- Elina Engberg
- Department of Sports and Exercise Medicine, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
- Foundation for Sports and Exercise Medicine, Clinic for Sports and Exercise Medicine, Helsinki, Finland
| | - Helena Liira
- Department of General Practice and Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland
| | | | - Svetlana From
- Department of General Practice and Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Hannu Kautiainen
- Department of General Practice and Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Kaisu Pitkälä
- Department of General Practice and Helsinki University Central Hospital, Unit of Primary Health Care, University of Helsinki, Helsinki, Finland
| | - Heikki Tikkanen
- Department of Sports and Exercise Medicine, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland
- Foundation for Sports and Exercise Medicine, Clinic for Sports and Exercise Medicine, Helsinki, Finland
- Institute of Biomedicine, School of Medicine, University of Eastern Finland, Kuopio, Finland
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135
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Silverman MN, Deuster PA. Biological mechanisms underlying the role of physical fitness in health and resilience. Interface Focus 2014; 4:20140040. [PMID: 25285199 PMCID: PMC4142018 DOI: 10.1098/rsfs.2014.0040] [Citation(s) in RCA: 201] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Physical fitness, achieved through regular exercise and/or spontaneous physical activity, confers resilience by inducing positive psychological and physiological benefits, blunting stress reactivity, protecting against potentially adverse behavioural and metabolic consequences of stressful events and preventing many chronic diseases. In this review, we discuss the biological mechanisms underlying the beneficial effects of physical fitness on mental and physical health. Physical fitness appears to buffer against stress-related disease owing to its blunting/optimizing effects on hormonal stress responsive systems, such as the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. This blunting appears to contribute to reduced emotional, physiological and metabolic reactivity as well as increased positive mood and well-being. Another mechanism whereby regular exercise and/or physical fitness may confer resilience is through minimizing excessive inflammation. Chronic psychological stress, physical inactivity and abdominal adiposity have been associated with persistent, systemic, low-grade inflammation and exert adverse effects on mental and physical health. The anti-inflammatory effects of regular exercise/activity can promote behavioural and metabolic resilience, and protect against various chronic diseases associated with systemic inflammation. Moreover, exercise may benefit the brain by enhancing growth factor expression and neural plasticity, thereby contributing to improved mood and cognition. In summary, the mechanisms whereby physical fitness promotes increased resilience and well-being and positive psychological and physical health are diverse and complex.
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Affiliation(s)
| | - Patricia A. Deuster
- Consortium for Health and Military Performance, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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136
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Ellingson LD, Kuffel AE, Vack NJ, Cook DB. Active and sedentary behaviors influence feelings of energy and fatigue in women. Med Sci Sports Exerc 2014; 46:192-200. [PMID: 23783259 DOI: 10.1249/mss.0b013e3182a036ab] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The purpose of this study was to determine whether physical activity and sedentary behaviors interact to influence feelings of energy and fatigue in women. METHODS Feelings of energy and fatigue and physical activity and sedentary behaviors were assessed in 73 women (mean ± SD age = 37 ± 10) who were dichotomized based on physical activity status (meets physical activity recommendations [n = 40] vs insufficiently active [n = 33]) and the amount of uninterrupted sedentary time they accumulated (high [n = 38] vs low [n = 35]). Three 2 × 2 ANOVA were conducted to determine the relationships between physical activity and sedentary behaviors and between energy (vigor and vitality) and fatigue. RESULTS Results demonstrated a significant main effect for meeting physical activity recommendations for both vigor (P = 0.004) and vitality (P < 0.001). For fatigue, there was a significant interaction between physical activity and sedentary behaviors (P = 0.005). Analyses of simple main effects demonstrated that in women who were not meeting physical activity recommendations, those who were less sedentary had significantly lower levels of fatigue than their more sedentary peers (P = 0.003). CONCLUSIONS Our results suggest that meeting physical activity recommendations has benefits for energy and fatigue even when combined with an otherwise sedentary lifestyle. Moreover, in women who are insufficiently active, being less sedentary is associated with lower levels of fatigue that are comparable with women who are meeting recommendations.
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Affiliation(s)
- Laura D Ellingson
- 1William S. Middleton Veterans Hospital, Madison, WI; 2Department of Kinesiology, University of Wisconsin-Madison, Madison WI; and 3Waisman Center for Brain Imaging and Behavior, Madison, WI
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137
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Wang DC, Chen TJ, Lin ML, Jhong YC, Chen SC. Exercise prevents the increased anxiety-like behavior in lactational di-(2-ethylhexyl) phthalate-exposed female rats in late adolescence by improving the regulation of hypothalamus-pituitary-adrenal axis. Horm Behav 2014; 66:674-84. [PMID: 25251977 DOI: 10.1016/j.yhbeh.2014.09.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 09/13/2014] [Accepted: 09/15/2014] [Indexed: 11/25/2022]
Abstract
Both the detrimental effects of early life adversity and the beneficial effects of exercise on the hypothalamic-pituitary-adrenal (HPA) axis have been reported. Early life exposure to di-(2-ethylhexyl)-phthalate (DEHP) may impair the development of endocrine system. In this study, we investigated the effects of lactational DEHP exposure on stress responses in late adolescent female rats and examined the protective role of treadmill running. Sprague-Dawley dams were fed with DEHP (10mg/kg per day) or vehicle during lactation. After weaning, the female offspring rats were trained to exercise on a treadmill for 5 weeks and then stressed by exploring on an elevated plus maze. The activities of HPA axis were evaluated by measuring the plasma levels of ACTH and corticosterone, the expressions of adrenal enzymes cholesterol side-chain cleavage enzyme (CYP11A1) and cytochrome P-450 11β-hydroxylase (CYP11B1), and the expression of hypothalamic glucocorticoid receptors (GR). The results demonstrate that DEHP-exposed rats exhibited enhanced anxiety-like behaviors. Increased hypothalamic GR and plasma ACTH levels, but decreased adrenal CYP11A1 and corticosterone levels, were observed in DEHP-exposed animals under stressed condition. Importantly, in DEHP-exposed animals, exercise during childhood-adolescence reduced anxiety-like behaviors by normalizing stress-induced alterations in ACTH level and adrenal CYP11A1 expression. The findings of this study suggest that treadmill running may provide beneficial effects on ameliorating the dysregulation of HPA axis in lactational DEHP-exposed adolescent female rats.
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Affiliation(s)
- Dean-Chuan Wang
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
| | - Tsan-Ju Chen
- Department of Physiology, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Ming-Lu Lin
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Yue-Cih Jhong
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Shih-Chieh Chen
- Department of Anatomy, Kaohsiung Medical University, Kaohsiung City, Taiwan
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138
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Gujral S, Manuck SB, Ferrell RE, Flory JD, Erickson KI. The BDNF Val66Met polymorphism does not moderate the effect of self-reported physical activity on depressive symptoms in midlife. Psychiatry Res 2014; 218:93-7. [PMID: 24745471 PMCID: PMC4059542 DOI: 10.1016/j.psychres.2014.03.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 03/05/2014] [Accepted: 03/24/2014] [Indexed: 11/29/2022]
Abstract
The brain-derived neurotrophic factor (BDNF) Val66Met single nucleotide polymorphism may be associated with clinical and subsyndromal depression, but physical activity improves mood and increases BDNF expression. The aim of the study was to examine whether the BDNF polymorphism moderates an effect of physical activity on depressive symptoms. BDNF genotype, physical activity measured by the Paffenbarger Questionnaire, and depressive symptoms using the Center for Epidemiology Depression Scale (CES-D) were collected on 1072 participants (mean age=44). Multiple linear regression was used to examine the association between BDNF genotype, physical activity, and depressive symptoms. After adjusting for family income, age, and education, depressive symptoms were higher in Met carriers compared to Val homozygotes (p=0.03), but this was only significant in men. Physical activity was associated with fewer depressive symptoms, but only in women (p=0.01). BDNF genotype did not moderate the effect of physical activity on depressive symptoms (p=0.94). In midlife, the BDNF Val66Met polymorphism neither attenuates nor magnifies the effect of physical activity on depressive symptoms.
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Affiliation(s)
- Swathi Gujral
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA USA,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA USA
| | - Stephen B. Manuck
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA USA,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA USA
| | - Robert E. Ferrell
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA USA
| | - Janine D. Flory
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY USA
| | - Kirk I. Erickson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA USA,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA USA,Corresponding Author: Kirk I. Erickson, PhD, 3107 Sennott Square, 210 S. Bouquet St., Pittsburgh, PA 15213, , Phone: 412-624-4533, Fax: 412-624-4428
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139
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Saligheh M, Rooney RM, McNamara B, Kane RT. The relationship between postnatal depression, sociodemographic factors, levels of partner support, and levels of physical activity. Front Psychol 2014; 5:597. [PMID: 25071618 PMCID: PMC4095827 DOI: 10.3389/fpsyg.2014.00597] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 05/28/2014] [Indexed: 11/13/2022] Open
Abstract
Background: postnatal depression (PND) is defined as a psychological mood disorder that occurs in a mother within 6 weeks of her giving birth. It refers to an episode that causes mood disturbance and it could begin in, or extend into, the postpartum period. It is thought to have a high impact upon the mother's health as well as the family's functioning and the child's development. Socio-demographic, psych-social, and physical activity factors may all contribute to postpartum mood and ability to cope with responsibilities. The primary aim of this study was to determine which of these factors predicted PND in postpartum women. A secondary aim was to identify the socio-demographic and psycho-social predictors of physical activity in postpartum women. Methods: The study used a cross-sectional correlational design. A sample of 150 postpartum women was sent a package of six standardized questionnaires. Results: There was no association between physical activity and PND; however, older mothers, mothers of younger children, mothers who are less reluctant to ask for help, and mothers who are more satisfied with the help they get experience lower levels of PND. Mothers of older babies, mothers with more children, and less educated mothers are more likely to engage in caregiving activities, whereas mothers with fewer children and higher levels of partner support are more likely to engage in occupational activities. None of the socio-demographic factors or any of the parenting factors predicted levels of sporting activity.
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Affiliation(s)
- Maryam Saligheh
- School of Psychology and Speech Pathology, Curtin University Perth, WA, Australia
| | - Rosanna M Rooney
- School of Psychology and Speech Pathology, Curtin University Perth, WA, Australia
| | - Beverley McNamara
- School of Occupational Therapy and Social Work, Curtin University Perth, WA, Australia
| | - Robert T Kane
- School of Psychology and Speech Pathology, Curtin University Perth, WA, Australia
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140
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An AR, Shin DW, Kim S, Lee CH, Park JH, Park JH, Oh MK, Hwang SH, Kim Y, Cho B. Health behaviors of people with retinitis pigmentosa in the republic of Korea. Ophthalmic Epidemiol 2014; 21:279-86. [PMID: 24968102 DOI: 10.3109/09286586.2014.926939] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To investigate the health behaviors of people with retinitis pigmentosa (RP) in the Republic of Korea. METHODS An online questionnaire was used to survey members of the Korean Retinitis Pigmentosa Society (KRPS), over 3 months from December 2010 to February 2011. Controls were selected from participants of the 4th Korean National Health and Nutrition Examination Survey and were matched with people with RP using the propensity score method to optimize comparative analysis. A semi-structured interview was also conducted with five members of the KRPS to identify potential reasons for physical inactivity and unhealthy diet and to develop effective interventions. RESULTS A total of 194 eligible people with RP responded to the online survey, and 187 individuals were matched with the control population by propensity score matching. RP subjects reported a lower rate of current smoking and greater use of preventive healthcare services. However, people with RP were more physically inactive (50.8% vs 27.3%, p < 0.001) and consumed more fast food (69.5% vs 58.3%, p = 0.024) than the control population. CONCLUSION Physical inactivity and fast food consumption were more frequently reported in people with RP than the general population. Efforts to understand the possible reasons and develop interventions to improve these health behaviors are warranted.
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Affiliation(s)
- Ah Reum An
- Department of Family Medicine, Seoul National University Hospital , Seoul , Republic of Korea
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Sarris J, O’Neil A, Coulson CE, Schweitzer I, Berk M. Lifestyle medicine for depression. BMC Psychiatry 2014; 14:107. [PMID: 24721040 PMCID: PMC3998225 DOI: 10.1186/1471-244x-14-107] [Citation(s) in RCA: 217] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 03/07/2014] [Indexed: 12/16/2022] Open
Abstract
The prevalence of depression appears to have increased over the past three decades. While this may be an artefact of diagnostic practices, it is likely that there are factors about modernity that are contributing to this rise. There is now compelling evidence that a range of lifestyle factors are involved in the pathogenesis of depression. Many of these factors can potentially be modified, yet they receive little consideration in the contemporary treatment of depression, where medication and psychological intervention remain the first line treatments. "Lifestyle Medicine" provides a nexus between public health promotion and clinical treatments, involving the application of environmental, behavioural, and psychological principles to enhance physical and mental wellbeing. This may also provide opportunities for general health promotion and potential prevention of depression. In this paper we provide a narrative discussion of the major components of Lifestyle Medicine, consisting of the evidence-based adoption of physical activity or exercise, dietary modification, adequate relaxation/sleep and social interaction, use of mindfulness-based meditation techniques, and the reduction of recreational substances such as nicotine, drugs, and alcohol. We also discuss other potential lifestyle factors that have a more nascent evidence base, such as environmental issues (e.g. urbanisation, and exposure to air, water, noise, and chemical pollution), and the increasing human interface with technology. Clinical considerations are also outlined. While data supports that some of these individual elements are modifiers of overall mental health, and in many cases depression, rigorous research needs to address the long-term application of Lifestyle Medicine for depression prevention and management. Critically, studies exploring lifestyle modification involving multiple lifestyle elements are needed. While the judicious use of medication and psychological techniques are still advocated, due to the complexity of human illness/wellbeing, the emerging evidence encourages a more integrative approach for depression, and an acknowledgment that lifestyle modification should be a routine part of treatment and preventative efforts.
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Affiliation(s)
- Jerome Sarris
- Department of Psychiatry, The University of Melbourne, 2 Salisbury Street, Richmond 3121 Victoria, Australia
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, Australia
| | - Adrienne O’Neil
- School of Medicine, Deakin University, Geelong, Australia
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Isaac Schweitzer
- Department of Psychiatry, The University of Melbourne, 2 Salisbury Street, Richmond 3121 Victoria, Australia
| | - Michael Berk
- Department of Psychiatry, The University of Melbourne, 2 Salisbury Street, Richmond 3121 Victoria, Australia
- School of Medicine, Deakin University, Geelong, Australia
- Florey Institute for Neuroscience and Mental Health, Parkville, Australia
- Orygen Youth Health Research Institute, Parkville, Australia
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142
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Patel A, Keogh JWL, Kolt GS, Schofield GM. The long-term effects of a primary care physical activity intervention on mental health in low-active, community-dwelling older adults. Aging Ment Health 2014; 17:766-72. [PMID: 23547971 DOI: 10.1080/13607863.2013.781118] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To examine the effect that physical activity delivered via two different versions of the Green Prescription (a primary care physical activity scripting program) had on depressive symptomatology and general mental health functioning over a 12-month period in non-depressed, low-active, community-dwelling older adults. METHOD Two hundred and twenty-five participants from the Healthy Steps study took part in the present study. Healthy Steps participants were randomized to receive either the standard time-based or a modified pedometer-based Green Prescription. Depression, mental health functioning and physical activity were measured at baseline, post-intervention (3 months post-baseline) and at the 9-month follow-up period. RESULTS At post-intervention, a positive association was found between increases in leisure-time physical activity and total walking physical activity and a decrease in depressive symptomatology (within the non-depressed range of the GDS-15) and an increase in perceived mental health functioning, regardless of intervention allocation. These improvements were also evident at the follow-up period for participants in both intervention allocation groups. CONCLUSION Our findings suggest that the standard time-based Green Prescription and a modified pedometer-based Green Prescription are both effective in maintaining and improving mental health in non-depressed, previously low-active older adults.
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Affiliation(s)
- Asmita Patel
- Human Potential Centre, Auckland University of Technology, Auckland, New Zealand.
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143
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High-intensity interval training in patients with substance use disorder. BIOMED RESEARCH INTERNATIONAL 2014; 2014:616935. [PMID: 24724089 PMCID: PMC3958650 DOI: 10.1155/2014/616935] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Revised: 01/22/2014] [Accepted: 01/23/2014] [Indexed: 11/18/2022]
Abstract
Patients with substance use disorder (SUD) suffer a higher risk of cardiovascular disease and other lifestyle diseases compared to the general population. High intensity training has been shown to effectively reduce this risk, and therefore we aimed to examine the feasibility and effect of such training in SUD patients in clinical treatment in the present study. 17 males and 7 females (32 ± 8 yr) in treatment were randomized to either a training group (TG), treadmill interval training in 4 × 4 minutes at 90–95% of maximal heart rate, 3 days a week for 8 weeks, or a conventional rehabilitation control group (CG). Baseline values for both groups combined at inclusion were 44 ± 8 (males) and 34 ± 9 (females) mL · min−1· kg−1, respectively. 9/12 and 7/12 patients completed the TG and CG, respectively. Only the TG significantly improved (15 ± 7%) their maximal oxygen consumption (VO2max), from 42.3 ± 7.2 mL · min−1· kg−1 at pretest to 48.7 ± 9.2 mL · min−1· kg−1 at posttest. No between-group differences were observed in work economy, and level of insomnia (ISI) or anxiety and depression (HAD), but a significant within-group improvement in depression was apparent for the TG. High intensity training was feasible for SUD patients in treatment. This training form should be implemented as a part of the rehabilitation since it, in contrast to the conventional treatment, represents a risk reduction for cardiovascular disease and premature death.
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145
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Berk M, Sarris J, Coulson CE, Jacka FN. Lifestyle management of unipolar depression. Acta Psychiatr Scand Suppl 2013:38-54. [PMID: 23586875 DOI: 10.1111/acps.12124] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To be used in conjunction with 'Pharmacological management of unipolar depression' [Malhi et al. Acta Psychiatr Scand 2013;127(Suppl. 443):6-23] and 'Psychological management of unipolar depression' [Lampe et al. Acta Psychiatr Scand 2013;127(Suppl. 443):24-37]. To provide clinically relevant recommendations for lifestyle modifications in depression, derived from a literature review. METHOD A search of pertinent literature was conducted up to August 2012 in the area of lifestyle factors and depression. A narrative review was then conducted. RESULTS There is evidence that level of physical activity plays a role in the risk of depression, and there is a large and validated evidence base for exercise as a therapeutic modality. Smoking and alcohol and substance misuse appear to be independent risk factors for depression, while the new epidemiological evidence supports the contention that diet is a risk factor for depression; good quality diets appear protective and poor diets increase risk. CONCLUSION Lifestyle modification, with a focus on exercise, diet, smoking and alcohol, may be of substantial value in reducing the burden of depression in individuals and the community.
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Affiliation(s)
| | | | - C. E. Coulson
- Department of Psychiatry; The University of Melbourne; Melbourne; Vic; Australia
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146
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Malchow B, Reich-Erkelenz D, Oertel-Knöchel V, Keller K, Hasan A, Schmitt A, Scheewe TW, Cahn W, Kahn RS, Falkai P. The effects of physical exercise in schizophrenia and affective disorders. Eur Arch Psychiatry Clin Neurosci 2013; 263:451-67. [PMID: 23873090 DOI: 10.1007/s00406-013-0423-2] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 07/08/2013] [Indexed: 01/23/2023]
Abstract
Affective and non-affective psychoses are severe and frequent psychiatric disorders. Amongst others, they not only have a profound impact on affected individuals through their symptomatology, but also regarding cognition, brain structure and function. Cognitive impairment influences patients' quality of life as well as their ability to work and being employed. While exercise therapy has been implemented in the treatment of psychiatric conditions since the days of Kraepelin and Bleuler, the underlying mechanisms have never been systematically studied. Since the early 1990s, studies emerged examining the effect of physical exercise in animal models, revealing stimulation of neurogenesis, synaptogenesis and neurotransmission. Based on that body of work, clinical studies have been carried out in both healthy humans and in patient populations. These studies differ with regard to homogenous study samples, sample size, type and duration of exercise, outcome variables and measurement techniques. Based on their review, we draw conclusions regarding recommendations for future research strategies showing that modern therapeutic approaches should include physical exercise as part of a multimodal intervention programme to improve psychopathology and cognitive symptoms in schizophrenia and affective disorders.
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Affiliation(s)
- Berend Malchow
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nußbaumstraße 7, 80336, Munich, Germany.
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147
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Linke SE, Ciccolo JT, Ussher M, Marcus BH. Exercise-based smoking cessation interventions among women. ACTA ACUST UNITED AC 2013; 9:69-84. [PMID: 23241156 DOI: 10.2217/whe.12.63] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Although smoking rates are lower among women than men, women are less likely to quit smoking in cessation trials. This is in part due to their tendency to smoke to help prevent or mitigate negative mood/affect, depression and/or postcessation weight gain. Exercise helps to alleviate women's fear of postcessation weight gain and reduces their cessation-related mood symptoms, making it a theoretically ideal smoking cessation intervention for women. In addition, short bouts of exercise decrease cigarette cravings and withdrawal symptoms among temporarily abstinent smokers. However, results from exercise-based smoking cessation interventions to date have been mostly nonsignificant. This paper describes the theoretical mechanisms (psychological, behavioral, physiological and neurobiological) and practical reasons underlying our belief that exercise-based smoking cessation interventions should not yet be abandoned despite their current paucity of supporting evidence. It also presents ideas for modifying future exercise-based smoking cessation interventions to increase adherence and, as a result, more accurately evaluate the effect of exercise on smoking cessation.
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Affiliation(s)
- Sarah E Linke
- Department of Family & Preventive Medicine, University of California, San Diego, 9500 Gilman Drive, Box 0628, La Jolla, CA 92093-0628, USA.
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148
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The association between physical fitness and depressive symptoms among young adults: results of the Northern Finland 1966 birth cohort study. BMC Public Health 2013; 13:535. [PMID: 23731782 PMCID: PMC3679735 DOI: 10.1186/1471-2458-13-535] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 05/30/2013] [Indexed: 12/18/2022] Open
Abstract
Background The effect of physical activity on mental health has been the subject of research for several decades. However, there is a lack of studies investigating the association between physical fitness, including both cardiorespiratory and muscular fitness and depressive symptoms among general population. The aim of this study was to determine the association between physical fitness and depressive symptoms among young adults. Methods The study population consists of 5497 males and females, members of the Northern Finland birth cohort of 1966, who at age 31 completed fitness tests and filled in a questionnaire including questions about depressive symptoms (Hopkins’ Symptom Checklist-25) and physical activity. Cardiorespiratory fitness was measured by a 4-min step test and muscular fitness by tests of maximal isometric handgrip and isometric trunk extension. The odds ratios (OR) with 95% confidence intervals (95% CI) for having depressive symptoms were calculated for quintiles groups of physical fitness using the third, median quintile as reference group, and the results were adjusted for potential confounding variables. Results Depressive symptoms were most common among males and females in the lowest quintile group of trunk extension test (OR 1.58 and 95% CI 1.07-2.32 in males and OR 1.43 and 95% CI 1.03-2.0 in females) and among males in the lowest quintile group of handgrip strength (OR 1.64 95% CI 1.11-2.42) compared to the reference group. Level of self-reported physical activity was inversely associated with depressive symptoms both in males (OR 1.74 95% CI 1.25-2.36) and females (OR 1.36 95% CI 1.05-1.75). The cardiorespiratory fitness was not associated with depressive symptoms (OR 1.01 95% CI 0.68-1.49 in males and 0.82 95% CI 0.57-1.16 in females). Conclusions The results indicate that low level of isometric endurance capacity of trunk extensor muscles is associated with high level of depressive symptoms in both sexes. In males, also poor handgrip strength is associated with increased levels of depressive symptoms. The physical activity level is inversely associated with the prevalence of depressive symptoms among young adults.
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Vankim NA, Nelson TF. Vigorous physical activity, mental health, perceived stress, and socializing among college students. Am J Health Promot 2013; 28:7-15. [PMID: 23470187 DOI: 10.4278/ajhp.111101-quan-395] [Citation(s) in RCA: 151] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine cross-sectional associations between vigorous physical activity, mental health, perceived stress, and socializing among 4-year college students. DESIGN A national cross-sectional sample of 4-year colleges in the United States. SETTING Ninety-four 4-year colleges in the United States. SUBJECTS A total of 14,804 undergraduate students. MEASURES Self-report vigorous physical activity, perceived stress (measured using the Cohen Perceived Stress Scale), mental health (measured using the SF-36), and socializing (assessed using self-report number of friends and hours spent socializing). ANALYSIS Logistic regression models accounting for clustering within schools were estimated to examine the association between vigorous physical activity, mental health, perceived stress, and socializing. Adjusted models included high school vigorous physical activity and sociodemographic characteristics. RESULTS Students who met vigorous physical activity recommendations were less likely to report poor mental health (adjusted odds ratio [OR]: .79; 95% confidence interval [CI]: .69, .90) and perceived stress (adjusted OR: .75; 95% CI: .67, .83) than students who did not meet recommendations. In addition, socializing partially mediated the relationship between vigorous physical activity, mental health, and perceived stress; however, race and sex did not moderate the relationship. CONCLUSION Interventions aiming to improve mental well-being of college students should also consider promoting physical activity. At least some of the positive benefits of physical activity may arise from social interactions.
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Affiliation(s)
- Nicole A Vankim
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South 2nd Street, Suite 300, Minneapolis, MN 55454, USA.
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150
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Lindhom V, Lahti J, Rahkonen O, Lahelma E, Lallukka T. Joint association of physical activity and body weight with subsequent physical and mental functioning: a follow-up study. BMC Public Health 2013; 13:197. [PMID: 23497094 PMCID: PMC3599380 DOI: 10.1186/1471-2458-13-197] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 02/28/2013] [Indexed: 12/26/2022] Open
Abstract
Background Physical inactivity and overweight are major threats to public health. However, it is not well understood to what extent physical activity might counteract the harmful effects of overweight on functioning. Thus, we examined the joint associations of leisure-time physical activity and body mass index (BMI) with subsequent physical and mental functioning over a follow-up of five to seven years. Methods The data were derived from the Helsinki Health Study, which is a cohort study among employees of the City of Helsinki, Finland. The baseline postal survey data were collected among 40-60-year-old employees in 2000–02 (n = 8960, response rate 67%), and the follow-up data in 2007 among all baseline survey respondents (n = 7332, response rate 83%). We divided the participants into six groups according to their amount of physical activity (inactive, moderately active and highly active) and their relative weight (normal weight and overweight). Highly active normal-weight participants were used as a reference group in all the analyses. Poor functioning was defined as the lowest quartile of the Short Form 36 (SF-36) health survey’s physical and mental component summaries, with the follow-up cut-off point also applied at baseline. We used logistic regression analysis adjusted for age, gender, baseline functioning, smoking, alcohol use, marital status, socioeconomic position and working conditions. Results At baseline 48% of the participants were overweight and 11% were inactive. After adjustments inactivity was associated with poor physical functioning at follow-up both among the normal-weight (OR 1.51, 95% CI 1.09-2.10) and overweight (OR 2.02, 95% CI 1.56-2.63) groups. Being overweight regardless of activity level was associated with poor physical functioning. Poor physical functioning was practically equally common among the highly active overweight group and the inactive normal-weight group. After adjustments, for mental functioning, only inactivity among the overweight was associated with poor mental functioning (OR 1.39, 95% CI 1.08-1.80). Conclusions Physical activity is likely to be beneficial for physical and mental functioning among both those with overweight and normal weight. However, maintaining normal weight is also important for good physical functioning. Therefore, efforts should be made to recommend people to engage in physical activity regardless of weight.
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Affiliation(s)
- Vivian Lindhom
- Hjelt Institute, Department of Public Health, University of Helsinki, POB 41, 00014, Helsinki, Finland.
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