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Wiklund CA, Lindwall M, Ekblom Ö, Nyberg J, Åberg MI, Paulsson S, Ekblom-Bak E. Change in cardiorespiratory fitness and risk of depression, anxiety, and cerebrovascular disease. Am J Prev Med 2024:S0749-3797(24)00252-6. [PMID: 39032520 DOI: 10.1016/j.amepre.2024.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION High cardiorespiratory fitness (CRF) has been associated with a lower risk of depression, anxiety, and cerebrovascular disease. The aim was to explore CRF changes over time associated with these outcomes. METHODS This large-scale prospective cohort study, using data from Swedish population-wide registries and databases (during 1972-2020), included men (n=131,431), with measures of estimated CRF (estCRF) in late adolescence (maximal cycle test) and adulthood (sub-maximal cycle test) (mean years between 24.6, SD 8.8). The study explored how change in estCRF was associated with incident depression, anxiety, and cerebrovascular disease using Cox proportional hazards models. Analyses were performed in 2023. RESULTS Higher estCRF in late adolescence and adulthood were associated with a lower risk of incident depression, anxiety, and cerebrovascular disease later in life. For all three outcomes, an increase in estCRF (ml/min/kg and z-score) between the two time points was associated with a lower risk. Further, decreasing from moderate or high estCRF in adolescence to low estCRF in adulthood, compared to staying at a moderate or high level, was associated with a higher risk of depression and anxiety (HR:1.24 95%CI 1.07-1.45 and 1.25 95%CI 1.06-1.49, respectively). Conversely, increasing from moderate to high estCRF was associated with a lower risk of incident anxiety (HR:0.84 95%CI 0.71-0.99). CONCLUSIONS The findings indicate that there is a longitudinal association between negative change in estCRF and increased risk of depression, anxiety, and cerebrovascular disease later in life. Decreasing levels of estCRF could be a helpful indicator when identifying these disorders at a population level.
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Affiliation(s)
- Camilla A Wiklund
- The Swedish School of Sport and Health Sciences, Department of Physical Activity and Health, Box 5626, 114 86 Stockholm, Sweden.
| | - Magnus Lindwall
- The Swedish School of Sport and Health Sciences, Department of Physical Activity and Health, Box 5626, 114 86 Stockholm, Sweden; Department of Psychology, University of Gothenburg, Box 500, 40530 Gothenburg, Sweden
| | - Örjan Ekblom
- The Swedish School of Sport and Health Sciences, Department of Physical Activity and Health, Box 5626, 114 86 Stockholm, Sweden
| | - Jenny Nyberg
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Neurology Clinic, Gothenburg, Sweden
| | - Maria I Åberg
- School of Public Health and Community Medicine/Primary Health Care, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Region Västra Götaland, Regionhälsan, Gothenburg, Sweden
| | - Sofia Paulsson
- Research department, HPI Health Profile Institute, Box 35, 182 11 Danderyd, Sweden
| | - Elin Ekblom-Bak
- The Swedish School of Sport and Health Sciences, Department of Physical Activity and Health, Box 5626, 114 86 Stockholm, Sweden
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Havnen A, Zotcheva E, Bjerkeset O, Sui X, Ernstsen L. Cardiorespiratory fitness and incident use of anxiolytics and antidepressants in adults. A linkage study between HUNT and the Norwegian Prescription Database. J Affect Disord 2023; 339:111-117. [PMID: 37437717 DOI: 10.1016/j.jad.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/11/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND We investigated the association between cardiorespiratory fitness (CRF) and incident use of antidepressants or anxiolytics in the general adult population. METHODS A non-exercise prediction model was used to estimate CRF in 32,603 participants in the third wave of the Trøndelag Health Study (HUNT3; 2006-08). Data on first purchase of antidepressants and anxiolytics were obtained from the Norwegian Prescription Database. Cox regression was used to estimate hazard ratios (HRs). RESULTS Each 1- metabolic equivalent of task (MET) increase in CRF was associated with 4 % reduced risk of purchasing antidepressant or anxiolytic medication during follow-up (HR 0.96, 95 % Confidence interval [CI] 0.94-0.98). Compared to the low CRF tertile, participants in intermediate (HR 0.93, 95 % CI 0.87-0.98) and high (HR 0.92, 95 % CI 0.86-0.98) CRF tertiles had reduced risk of medication purchase. Men in intermediate and high CRF tertile had lower risk of medication purchase (intermediate HR 0.87, 95 % CI 0.79-0.96; high HR 0.87, 95 % CI 0.78-0.96). Intermediate and high CRF tertiles were associated with reduced risk of medication use for younger adults (20 to <30 years old; intermediate HR 0.74, 95 % CI 0.61-0.91, high HR 0.78, 95 % CI 0.64-0.95) and middle-aged adults (30 to <65 years old; intermediate HR 0.90, 95 % CI 0.83-0.97, high HR 0.90, 95 % CI 0.84-0.98), but not in older adults (≥65 years old). LIMITATIONS Only information about medication purchase and not actual use was available. CONCLUSION Increased CRF is associated with reduced risk of anxiolytics and antidepressants purchase, with stronger effects for men and younger adults.
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Affiliation(s)
- Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology, Norway; Division of Psychiatry, St. Olavs Hospital, Trondheim, Norway.
| | - Ekaterina Zotcheva
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway; Department of Physical Health and Ageing, Norwegian Institute of Public Health, Norway
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway; Department of Mental Health, Faculty of Medicine and Health Sciences, Norway
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Linda Ernstsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Norway
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Zang W, Fang M, Chen H, Huang X, Li D, Yan J, Shu H, Zhao M. Effect of concurrent training on physical performance and quality of life in children with malignancy: A systematic review and meta-analysis. Front Public Health 2023; 11:1127255. [PMID: 37006540 PMCID: PMC10063894 DOI: 10.3389/fpubh.2023.1127255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
ObjectiveThis study aims to evaluate the intervention effect of concurrent training on children with malignant tumors to provide evidence for prescribing exercise for children with malignant tumors.MethodsTwelve databases were searched from inception to October 15, 2022. Two researchers independently screened the literature, evaluated the quality, extracted the data, and performed the meta-analysis using R.ResultA total of nine randomized controlled trials involving 371 children were included in this study. The meta-analysis revealed that muscle strength was significantly greater in the exercise group compared to the usual care group [SMD = 0.26, 95% CI (0.04, 0.48), P = 0.023], with subgroup analysis showing no significant difference in upper limb [SMD = 0.13, 95% CI (−0.17, 0.43), P = 0.318] and a considerable difference in lower limb strength [SMD = 0.41, 95% CI (0.08, 0.74), P = 0.015]. Physical activity [SMD = 0.57, 95% CI (0.03, 1.1), P = 0.038], timed up and down stairs test [SMD = −1.22, 95% CI (−2.04, −0.4), P = 0.004], 6-min walking ability [SMD = 0.75, 95% CI (0.38, 1.11), P < 0.01], quality of life [SMD = 0.28, 95% CI (0.02, 0.53), P = 0.033], and cancer-related fatigue [SMD = −0.53, 95% CI (−0.86, −0.19), P = 0.002] were significantly better than the usual care group. There were no significant differences in peak oxygen uptake [SMD = 0.13, 95% CI (−0.18, 0.44), P = 0.397], depression [SMD = 0.06, 95% CI (−0.38, 0.5), P = 0.791], and withdrawal rates [RR = 0.59, 95% CI (0.21, 1.63), P = 0.308] between the two groups.ConclusionConcurrent training could improve physical performance for children with malignancy but had no significant effect on mental health. Because the quality level of evidence is mostly very low, future high-quality randomized controlled trials are required to confirm these findings.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=364140, identifier CRD42022308176.
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Affiliation(s)
- Wanli Zang
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Mingqing Fang
- Xiangya Hospital, Central South University, Changsha, China
| | - Haohao Chen
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Xinmeng Huang
- Norman Bethune Health Science Center, Jilin University, Changchun, China
| | - Dong Li
- Department of International Culture Education, Chodang University, Muan-gun, Republic of Korea
| | - Jin Yan
- Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW, Australia
- College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
| | - Heng Shu
- Postgraduate School, University of Harbin Sport, Harbin, China
| | - Mingyuan Zhao
- Winter Olympic School, Harbin Sport University, Harbin, China
- *Correspondence: Mingyuan Zhao
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Roxburgh BH, Cotter JD, Campbell HA, Reymann U, Wilson LC, Gwynne-Jones D, van Rij AM, Thomas KN. Physiological relationship between cardiorespiratory fitness and fitness for surgery: a narrative review. Br J Anaesth 2023; 130:122-132. [PMID: 36529576 DOI: 10.1016/j.bja.2022.10.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/11/2022] [Accepted: 10/24/2022] [Indexed: 12/23/2022] Open
Abstract
Epidemiological evidence has highlighted a strong relationship between cardiorespiratory fitness and surgical outcomes; specifically, fitter patients possess heightened resilience to withstand the surgical stress response. This narrative review draws on exercise and surgical physiology research to discuss and hypothesise the potential mechanisms by which higher fitness affords perioperative benefit. A higher fitness, as indicated by higher peak rate of oxygen consumption and ability to sustain metabolic homeostasis (i.e. higher anaerobic threshold) is beneficial postoperatively when metabolic demands are increased. However, the associated adaptations with higher fitness, and the related participation in regular exercise or physical activity, might also underpin the observed perioperative benefit through a process of hormesis, a protective adaptive response to the moderate and intermittent stress of exercise. Potential mediators discussed include greater antioxidant capacity, metabolic flexibility, glycaemic control, lean body mass, and improved mood.
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Affiliation(s)
- Brendon H Roxburgh
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; School of Physical Education, Sport and Exercise Sciences, Dunedin, University of Otago, New Zealand.
| | - James D Cotter
- School of Physical Education, Sport and Exercise Sciences, Dunedin, University of Otago, New Zealand
| | - Holly A Campbell
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Ulla Reymann
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Luke C Wilson
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - David Gwynne-Jones
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Department of Orthopaedic Surgery, Southern District Health Board, Dunedin, New Zealand
| | - Andre M van Rij
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Kate N Thomas
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Shuval K, Leonard D, DeFina LF, Barlow CE, Drope J, Amir O, Gneezy A, Tzafrir S, Chartier KG, Qadan M. Cardiorespiratory Fitness and Depression Symptoms among Adults During the COVID-19 Pandemic: Cooper Center Longitudinal Study. Prev Med Rep 2022; 30:102065. [PMCID: PMC9677558 DOI: 10.1016/j.pmedr.2022.102065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/31/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022] Open
Abstract
This study examined the relation between cardiorespiratory fitness (fitness) and depression symptoms prior to and during COVID-19 among adults seeking preventive medical care. Participants consisted of 967 patients attending the Cooper Clinic (Dallas, TX) pre-pandemic (March 2018-December 2019) and during the pandemic (March-December 2020). The outcome, depression symptoms, was based on the Center for Epidemiological Studies-Depression (CES-D). Maximal metabolic equivalents task (MET) levels for fitness were determined from the final treadmill speed and grade. Multiple linear regression models were computed by sex. Analysis revealed that mean fitness decreased from 11.4 METs (SD=2.1) prior to the pandemic to 10.9 METs (SD=2.3) during the pandemic (p-value<0.001). The mean CES-D score increased from 2.8 (SD= 3.1) before to pandemic to 3.1 (SD=3.2) during the pandemic (p-value=0.003). Results from multiple linear regression indicate that increased fitness was associated with a statistically significant decrease in depression scores in men (-0.17 per MET; 95%CI -0.33, -0.02) but not women. This modest decrease may have been tempered by high fitness levels and low depression scores at baseline in this well-educated sample.
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Affiliation(s)
- Kerem Shuval
- The Cooper Institute, Dallas, Texas 75230, USA,School of Business Administration, University of Haifa, Haifa 3498838, Israel,School of Public Health, University of Haifa, Haifa 3498838, Israel,Corresponding author
| | | | | | | | - Jeffrey Drope
- Health Policy & Administration, School of Public Health, University of Illinois at Chicago, Illinois, USA
| | - On Amir
- Rady School of Management, University of California San Diego, CA, USA
| | - Ayelet Gneezy
- Rady School of Management, University of California San Diego, CA, USA
| | - Shay Tzafrir
- School of Business Administration, University of Haifa, Haifa 3498838, Israel
| | - Karen G. Chartier
- School of Social Work and Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Mahmoud Qadan
- School of Business Administration, University of Haifa, Haifa 3498838, Israel
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Factors Predicting Training Delays and Attrition of Recruits during Basic Military Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127271. [PMID: 35742522 PMCID: PMC9223722 DOI: 10.3390/ijerph19127271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 01/22/2023]
Abstract
Ensuring a balance between training demands and recovery during basic military training (BMT) is necessary for avoiding maladaptive training responses (e.g., illness or injury). These can lead to delays in training completion and to training attrition. Previously identified predictors of injury and attrition during BMT include demographic and performance data, which are typically collected at a single time point. The aim of this study was to determine individual risk factors for injury and training delays from a suite of measures collected across BMT. A total of 46 male and female recruits undertaking the 12-week Australian Army BMT course consented to this study. Injury, illness, attrition, and demographic data were collected across BMT. Objective measures included salivary cortisol and testosterone, step counts, cardiorespiratory fitness, and muscular endurance. Perceptions of well-being, recovery, workload, fatigue, and sleep were assessed with questionnaires. Baseline and mean scores across BMT were evaluated as predictors of injury and attrition using generalized linear regressions, while repeated-measures ANOVA was used for the group comparisons. From the 46 recruits, 36 recruits completed BMT on time; 10 were delayed in completion or discharged. Multiple risk factors for injury during BMT included higher subjective ratings of training load, fatigue, and stress, lower sleep quality, and higher cortisol concentrations. Higher ratings of depression, anxiety, and stress, and more injuries were associated with a higher risk of delayed completion. Higher concentrations of testosterone and higher levels of fitness upon entry to BMT were associated with reduced risk of injury and delayed completion of BMT. Ongoing monitoring with a suite of easily administered measures may have utility in forewarning risk of training maladaptation in recruits and may complement strategies to address previously identified demographic and performance-based risk factors to mitigate injury, training delays, and attrition.
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7
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Lattari E, Pascouto AJC, Oliveira BRR, Silva LS, Oliveira AJ, Machado S, Neto GAM. Association between Estimated Cardiorespiratory Fitness and Depression among Middle-income Country Adults: Evidence from National Health Survey. Clin Pract Epidemiol Ment Health 2021; 17:198-204. [PMID: 35173788 PMCID: PMC8728566 DOI: 10.2174/1745017902117010198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/24/2021] [Accepted: 09/30/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study assessed the relationship between cardiorespiratory fitness (CRF) and depression in adults. METHODS A total of 52,611 individuals aged between 18-59 years old were evaluated for symptoms of depression and CRF. The presence of depressive symptoms was self-report through the Patient Health Questionnaire (PHQ-9), and the CRF was predicted from a non-exercise equation. The association between CRF and the presence of depression was determined by crude and multivariable-adjusted logistic regressions. RESULTS The associations were identified between symptoms of depression and CRF in both unadjusted and adjusted models. After adjusting for age categories, sex, body mass index categories, educational level, marital status, smoking, and alcohol use, the individuals with moderate CRF had 18% lower odds of depression (OR: 0.82, CI 95%: 0.71 - 0.95) compared to individuals with low CRF. CONCLUSION Depressive symptoms are inversely related to CRF levels in adults.
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Affiliation(s)
- Eduardo Lattari
- Salgado de Oliveira University, Postgraduate Program in Physical Activity Sciences (PGCAF), Niterói, RJ, Brazil
| | | | - Bruno Ribeiro Ramalho Oliveira
- Rural Federal University of Rio de Janeiro, Physical Activity, Health, and Performance Research Laboratory, Department of Physical; Education and Sports, Seropédica, Brazil
| | - Livia Soares Silva
- Salgado de Oliveira University, Postgraduate Program in Physical Activity Sciences (PGCAF), Niterói, RJ, Brazil
- Rural Federal University of Rio de Janeiro, Laboratory of Social Dimensions Applied to Physical Activity and Sport (LABSAFE), Department of Physical; Education and Sports, Seropédica, Brazil
| | - Aldair José Oliveira
- Salgado de Oliveira University, Postgraduate Program in Physical Activity Sciences (PGCAF), Niterói, RJ, Brazil
- Rural Federal University of Rio de Janeiro, Laboratory of Social Dimensions Applied to Physical Activity and Sport (LABSAFE), Department of Physical; Education and Sports, Seropédica, Brazil
| | - Sérgio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil
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Holmlund T, Blom V, Hemmingsson E, Ekblom B, Andersson G, Wallin P, Ekblom-Bak E. Change in cardiorespiratory fitness on self-rated health: prospective cohort study in 98 718 Swedish adults. Scand J Public Health 2021:14034948211047140. [PMID: 34664534 DOI: 10.1177/14034948211047140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aim: To study how change in cardiorespiratory fitness over time is associated with the development of poor self-rated health in healthy Swedish adults, and whether this association varies with sex, age, body mass index and cardiorespiratory fitness at baseline. A secondary aim was to study the influence of other predictors of self-rated health. Methods: A total of 98,718 participants (45% women, mean age 42.2 years) with two assessments from occupational health service screenings between 1988 and 2019 (mean duration 4.3 years), with good self-rated health at baseline were included. Cardiorespiratory fitness was assessed as estimated maximal oxygen consumption using submaximal cycle testing. Change in cardiorespiratory fitness was expressed as percentage annual change. Poor self-rated health at follow-up was defined as percieving self-rated health as 'poor' or 'very poor'. Results: A large decrease in cardiorespiratory fitness (⩾-3%) was associated with a 34% higher risk of poor self-rated health compared to maintainers (-1 to +1%) after multi-adjustment including change in body mass index, back/neck pain, stress, exercise habits and sleep quality or sleep problems. The associations for decreasers were stronger with longer follow-up time (>10 years). Preserving, or changing to, risk level for body mass index, back/neck pain, stress, exercise and sleep quality/problems were associated with a higher risk of poor self-rated health. Conclusions: Preserving or increasing cardiorespiratory fitness is associated with a lower risk of poor self-rated health, independently of change in other health-related variables, which may act as a protection against future poor self-rated health. This is of high clinical value, and strategies for maintaining or improving cardiorespiratory fitness have the potential to influence both disease and mortality.
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Affiliation(s)
- Tobias Holmlund
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Sweden
| | - Victoria Blom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Sweden
| | - Erik Hemmingsson
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Sweden
| | - Björn Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Sweden
| | | | - Peter Wallin
- Research Department, HPI Health Profile Institute, Sweden
| | - Elin Ekblom-Bak
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Sweden
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Hartmann TE, Robertson CV, Miller TD, Hunter JR, Skein M. Associations between exercise, inflammation and symptom severity in those with mental health disorders. Cytokine 2021; 146:155648. [PMID: 34320459 DOI: 10.1016/j.cyto.2021.155648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/21/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
AIM This study aimed to investigate the effects of 6-weeks of moderate intensity aerobic exercise on markers of inflammation and symptom severity in those undergoing management of a mental health disorder. METHOD Twenty six participants were allocated into two groups, those reporting as apparently healthy (AH, n = 13) or those undergoing the management of a mental health disorder (MI, n = 13). Following a baseline testing and familiarization session, participants commenced the 6-week aerobic training intervention, involving stationary cycling at 65% heart rate reserve for 35 min progressing to 70% for 40 min. Measures of aerobic fitness (VO2peak), anthropometric variables, symptom questionnaires and venous blood were collect pre- and post-intervention. Venous blood was assessed for nod-like receptor pyrin containing-3, interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), IL-1β, C-reactive protein (CRP) and brain-derived neurotropic factor (BDNF). RESULTS There were no baseline differences between groups, however following the intervention the AH demonstrated lower TNF-α (p = 0.049) than the MI group. Within change was observed for the MI group with an increase in VO2peak (p = 0.049) and declines in symptom severity (p = 0.00-0.005). Significant correlations between variables indicated a positive association between body fat, body fat percentage, CRP and symptom severity (p = 0.01-0.04). Conversely, symptom severity and CRP were inversely associated with VO2peak values (p = 0.02-0.04). CONCLUSION Six-weeks of moderate intensity aerobic exercise increases VO2peak and reduces symptom severity in those currently undergoing management of a mental health disorder. Further, there may be a physiological link between aerobic capacity, symptom severity, inflammation and adiposity, however greater exploration is required.
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Affiliation(s)
- Tegan E Hartmann
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW, Australia.
| | - Caroline V Robertson
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW, Australia
| | - Timothy D Miller
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW, Australia
| | - Jayden R Hunter
- Holsworth Research Initiative, La Trobe University, Bendigo, VIC, Australia
| | - Melissa Skein
- School of Exercise Science, Sport and Health, Charles Sturt University, Bathurst, NSW, Australia
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Dishman RK, McDowell CP, Herring MP. Customary physical activity and odds of depression: a systematic review and meta-analysis of 111 prospective cohort studies. Br J Sports Med 2021; 55:926-934. [DOI: 10.1136/bjsports-2020-103140] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 12/21/2022]
Abstract
ObjectiveTo explore whether physical activity is inversely associated with the onset of depression, we quantified the cumulative association of customary physical activity with incident depression and with an increase in subclinical depressive symptoms over time as reported from prospective observational studies.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, PsycINFO, PsycARTICLES and CINAHL Complete databases, supplemented by Google Scholar.Eligibility criteriaProspective cohort studies in adults, published prior to January 2020, reporting associations between physical activity and depression.Study appraisal and synthesisMultilevel random-effects meta-analysis was performed adjusting for study and cohort or region. Mixed-model meta-regression of putative modifiers.ResultsSearches yielded 111 reports including over 3 million adults sampled from 11 nations in five continents. Odds of incident cases of depression or an increase in subclinical depressive symptoms were reduced after exposure to physical activity (OR, 95% CI) in crude (0.69, 0.63 to 0.75; I2=93.7) and adjusted (0.79, 0.75 to 0.82; I2=87.6) analyses. Results were materially the same for incident depression and subclinical symptoms. Odds were lower after moderate or vigorous physical activity that met public health guidelines than after light physical activity. These odds were also lower when exposure to physical activity increased over time during a study period compared with the odds when physical activity was captured as a single baseline measure of exposure.ConclusionCustomary and increasing levels of moderate-to-vigorous physical activity in observational studies are inversely associated with incident depression and the onset of subclinical depressive symptoms among adults regardless of global region, gender, age or follow-up period.
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Tait JL, Bulmer S, Drain JR, Main LC. Associations between inflammatory markers and well-being during 12 weeks of basic military training. Eur J Appl Physiol 2021; 121:849-860. [PMID: 33389139 DOI: 10.1007/s00421-020-04554-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/07/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE Stress, anxiety and physical exertion are all closely linked to well-being, and each can alter immune function. Diminished well-being has been observed during military training, however there is mixed evidence regarding whether concomitant changes in inflammatory markers occur, with these phenomena indicating potential maladaptive responses to imposed training loads. The aims of this project were (1) assess changes in inflammation and subjective well-being across a 12-week basic military training (BMT) program, and (2) evaluate relationships between circulating inflammatory markers and well-being. METHODS A total of 37 men and women undergoing 12 weeks of BMT in Australia were recruited. Well-being was assessed via questionnaire (DASS-21), and plasma samples were collected for the analysis of inflammatory cytokines [interleukin (IL)-4, IL-6, IL-1β, IL-8, IL-10, and tumor necrosis factor (TNF)-α] at weeks 1, 4, 8 and 12. Data were analysed using general linear mixed models. RESULTS Depression, anxiety and stress subscale scores all significantly improved (all P ≤ 0.001), and TNF-α decreased (P = 0.031) across time. Compared to baseline (week 1), significant decreases in associations between depression and IL-10, anxiety and IL-10, and stress and IL-10, IL-4 IL-6 and TNF-α (all P < 0.05), were detected across BMT. CONCLUSION The BMT program appears to support improved well-being over the 12 weeks, with minimal perturbation to inflammatory markers. Biomarkers and well-being displayed consistent associations and may have utility as psychophysiological indicators of health status in military research, however for now, subjective measures may represent more cost-effective proxies for ongoing monitoring of military personnel.
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Affiliation(s)
- Jamie L Tait
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Sean Bulmer
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Jace R Drain
- Defence Science and Technology Group, Fishermans Bend, Australia
| | - Luana C Main
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
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Hayek S, Brinkman TM, Plana JC, Joshi VM, Leupker RV, Durand JB, Green DM, Partin RE, Santucci AK, Howell RM, Srivastava DK, Hudson MM, Robison LL, Armstrong GT, Ness KK. Association of Exercise Intolerance With Emotional Distress, Attainment of Social Roles, and Health-Related Quality of Life Among Adult Survivors of Childhood Cancer. JAMA Oncol 2020; 6:1194-1202. [PMID: 32584369 PMCID: PMC7317652 DOI: 10.1001/jamaoncol.2020.2054] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 04/17/2020] [Indexed: 12/19/2022]
Abstract
Importance Exercise intolerance is associated with increased risk for morbidity and mortality in childhood cancer survivors. However, an association between exercise intolerance and psychosocial outcomes has not been fully explored. Objective To examine the associations between exercise intolerance and emotional distress, attainment of social roles, and health-related quality of life in childhood cancer survivors. Design, Setting, and Participants A cross-sectional study including 1041 adult survivors of childhood cancer and 286 community controls in the St Jude Lifetime Cohort was conducted at St Jude Children's Research Hospital. The study was performed from April 1, 2012, to March 15, 2020. Exposures Exercise intolerance was defined as relative peak oxygen uptake less than 85% of age- and sex-estimated levels from maximal cardiopulmonary exercise testing. Main Outcomes and Measures Emotional distress was measured with the 18-item Brief Symptom Inventory-18, which includes overall Global Severity Index and depression, anxiety, and somatization subscales. Participants with T scores greater than or equal to 63 were classified as having elevated levels of distress. Social attainment was evaluated using patient-reported educational, employment, and marital status. Health-related quality of life was examined with the Medical Outcomes Survey Short Form-36. Participants with T scores less than or equal to 40 were classified as reporting poor health-related quality of life. Results Of the 1041 participants, 528 were women (50.7%). The prevalence of exercise intolerance among survivors (mean [SD] age, 35.5 [9.2] years) was higher than that among controls (age, 34.5 [10.0] years) (survivors: 634 [60.9%] vs controls: 75 [26.2%], P < .001). After adjusting for age at diagnosis and cardiopulmonary exercise testing, sex, race/ethnicity, smoking, physical activity, and exercise intolerance were associated with an increased risk for anxiety (prevalence rate ratio [PRR], 1.95; 95% CI, 1.20-3.16), somatization (PRR, 1.86; 95% CI, 1.23-2.80), and unemployment (PRR, 1.76; 95% CI, 1.23-2.52); an inverse association was noted with having a college degree (PRR, 0.67; 95% CI, 0.50-0.88). Exercise intolerance was associated with an increased the risk for scoring less than or equal to 40 on the physical component summary of the Medical Outcomes Survey Short Form-36 (PRR, 3.69; 95% CI, 2.34-5.84). These associations persisted when either cancer treatment exposures or chronic health conditions were added to the model. Conclusions and Relevance The findings of this study suggest that exercise intolerance is independently associated with emotional distress, attainment of social roles, and health-related quality of life of long-term survivors of childhood cancer. The results also suggest that improving physiologic capacity may benefit general health and wellness, as well as emotional health, ability to participate in social roles, and health-related quality of life.
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Affiliation(s)
| | - Tara M. Brinkman
- Department of Epidemiology and Cancer Control, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Juan C. Plana
- Section of Cardiology, Baylor College of Medicine, Houston, Texas
| | - Vijaya M. Joshi
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis
| | - Russell V. Leupker
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis
| | - Jean B. Durand
- Division of Cardiology, The University of Texas, MD Anderson Cancer Center, Houston
| | - Daniel M. Green
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Robyn E. Partin
- Department of Epidemiology and Cancer Control, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Aimee K. Santucci
- Department of Epidemiology and Cancer Control, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Rebecca M. Howell
- Division of Radiology Oncology, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston
| | - Deo Kumar Srivastava
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Melissa M. Hudson
- Department of Oncology, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Leslie L. Robison
- Department of Epidemiology and Cancer Control, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Gregory T. Armstrong
- Department of Epidemiology and Cancer Control, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Kirsten K. Ness
- Department of Epidemiology and Cancer Control, St Jude Children’s Research Hospital, Memphis, Tennessee
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Association between muscle strength and depressive symptoms among Chinese female college freshmen: a cross-sectional study. BMC Musculoskelet Disord 2020; 21:510. [PMID: 32736621 PMCID: PMC7395416 DOI: 10.1186/s12891-020-03478-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 07/05/2020] [Indexed: 12/23/2022] Open
Abstract
Background Increased physical activity level is related to lower risk of depressive symptoms, and there is an inverse association between muscle strength and risk of depressive symptoms among the elderly. Although there is evidence of an inverse association between muscle strength and depressive symptoms, the relationship between these variables in a younger population is still unknown. This study aimed to examine the association between handgrip strength, a representative indicator of skeletal muscle strength, and the risk of depressive symptoms among Chinese female college freshmen. Methods A cross-sectional study was conducted among 867 participants aged between 16 and 23 years. Handgrip strength was measured with a handheld digital Smedley dynamometer, and handgrip strength relative to body weight (kg/kg) was calculated and was classified into tertiles as follows: low (0.32–0.50), medium (0.51–0.58), and high (0.59–0.94). Depressive symptoms were evaluated using the 20-item Zung self-rating depression scale (SDS), and three cutoff points were used to indicate different depression levels. Results We found that 10.7% of participants were classified as having severe depressive symptoms using an SDS score of 50 as the cutoff point. After adjusting for potential confounders, the adjusted odds ratios and 95% confidence intervals (CIs) for moderate-to-severe depressive symptoms across tertiles of the relative handgrip strength were 1.00 (reference) for tertile 1, 0.614 (0.353, 1.069) for tertile 2, and 0.537 (0.292, 0.988) for tertile 3 (P for trend = 0.041). The significant associations remained when other cutoff points (SDS scores: 48 or 45) were used. Interactions between handgrip strength and potential confounders for depressive symptoms in the final models were not significant. Conclusions Our findings indicate that handgrip strength is inversely and independently related to the risk of depressive symptoms among Chinese female college freshmen. The present findings can help develop an effective intervention strategy against depression. Further intervention studies are needed to explore the mechanisms underlying the effects of handgrip strength on depressive symptoms.
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Doctor, ask your perimenopausal patient about her physical fitness; association of self-reported physical fitness with cardiometabolic and mental health in perimenopausal women: the FLAMENCO project. Menopause 2020; 26:1146-1153. [PMID: 31513090 DOI: 10.1097/gme.0000000000001384] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The aim of this study was to explore the association of self-reported physical fitness (PF) and its components with cardiometabolic and mental health in perimenopausal women. METHODS These cross-sectional analyses included 191 participants (53 ± 4 y old) from the FLAMENCO project. Self-reported PF was assessed with the International Fitness Scale (IFIS). Body mass index (BMI), fat mass (FM), waist circumference (WC), systolic and diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglycerides, C-reactive protein (CRP), and glucose were measured. The Beck's Depression Inventory, State-Trait Anxiety Inventory, Pittsburgh Sleep Quality Index, Life Orientation Test Revised, and Positive and Negative Affect Schedule were used to assess mental health. RESULTS After adjusting for potential confounders, greater overall PF was associated with lower BMI, FM, WC (P < 0.001), DBP and CRP, and higher HDL-C (P < 0.05). Cardiorespiratory fitness (CRF), speed-agility, and flexibility were associated with lower BMI, WC, and FM (P < 0.001), and muscle strength (MS) with lower WC and FM (P < 0.05). In addition, CRF, MS, and speed-agility were associated with lower CRP (P < 0.01), and flexibility with enhanced triglycerides and HDL-C (P < 0.05). Overall PF and all its components were associated with lower depression, anxiety, and negative affect (P≤0.01), and greater positive affect (P≤0.05). Overall PF and MS were associated with better sleep quality (P < 0.05), and CRF, MS, and speed-agility with greater optimism (P≤0.05). Finally, overall PF showed evidence of significant association with less pharmaceutical expenditure (B = -7.2, β=-0.145, P = 0.08). CONCLUSIONS Self-reported PF was associated with better cardiometabolic and mental health in perimenopausal women. The IFIS might be proposed as an inexpensive, quick, and easy tool in clinical settings.
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Appelqvist-Schmidlechner K, Vaara JP, Vasankari T, Häkkinen A, Mäntysaari M, Kyröläinen H. Muscular and cardiorespiratory fitness are associated with health-related quality of life among young adult men. BMC Public Health 2020; 20:842. [PMID: 32493259 PMCID: PMC7268218 DOI: 10.1186/s12889-020-08969-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 05/21/2020] [Indexed: 11/17/2022] Open
Abstract
Background Despite numerous studies providing evidence for positive effects of physical activity and physical fitness, evidence for association between physical fitness and health-related quality of life (HRQoL) in young adults is limited. The aim of the present cross-sectional study was to investigate the association of cardiorespiratory and muscular fitness with HRQoL from the perspective of its physical and mental components among young adult Finnish males. Methods The sample consisted of 754 men, with the mean age of 26 years (SD 6.7 years), who participated in the military refresher training. HRQoL was measured using the Finnish RAND 36-item health survey. Cardiorespiratory fitness was determined by a bicycle ergometer test, and muscular fitness by various tests measuring maximal strength and muscular endurance. Logistic regression modelling was used to compare low, moderate and high physical and mental component of HRQoL scores to the respective levels of muscular and cardiorespiratory fitness. Results The findings of the adjusted (age, educational level, marital status, employment status, smoking, use of alcohol and BMI) analysis showed that cardiorespiratory and muscular fitness are positively associated with both physical and mental components of HRQoL. In terms of the physical component of HRQoL, even a moderate fitness level was positively associated with better HRQoL. In terms of the mental component of HRQoL, the impact was seen only in the group with the highest fitness level. Conclusions The findings suggest a positive contribution of physical fitness to mental health and highlight the importance of both muscular and cardiorespiratory fitness in the promotion of HRQoL. Even lighter forms of physical activity that result in moderate physical fitness could contribute to the physical component of HRQoL. In terms of the mental component of HRQoL, higher levels of physical fitness may be needed to gain higher levels of HRQoL among young males.
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Affiliation(s)
| | - Jani P Vaara
- The Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland
| | | | - Arja Häkkinen
- Department of Physical Medicine and Rehabilitation, Health Sciences / Central Hospital of Central Finland, University of Jyväskylä, Jyväskylä, Finland
| | | | - Heikki Kyröläinen
- The Department of Leadership and Military Pedagogy, National Defence University, Helsinki, Finland.,Department of biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland
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Nikolakaros G, Vahlberg T, Sillanmäki L, Sourander A. Recurrent depression in childhood and adolescence and low childhood socioeconomic status predict low cardiorespiratory fitness in early adulthood. J Affect Disord 2020; 266:782-792. [PMID: 32217260 DOI: 10.1016/j.jad.2019.11.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 10/30/2019] [Accepted: 11/09/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) strongly influences health, but very little is known about the childhood determinants of adult CRF. Our longitudinal study investigated whether childhood psychopathology and socioeconomic status (SES) were related to adult CRF in 1647 Finnish male military conscripts. METHODS Childhood psychopathology was assessed at the age of eight using the Rutter and Children's Depression Inventory questionnaires. Parental education and family structure were used to assess childhood SES. In late adolescence, depressive symptoms were assessed with the Beck Depression Inventory and smoking with a questionnaire. CRF in early adulthood was examined with the Cooper's 12-minute run test. RESULTS General linear models showed that low parental education (p=0.001), depressive symptoms in childhood (p=0.035) and late adolescence, smoking, underweight, and overweight/obesity (all p<0.001) independently predicted lower CRF. The interaction between depressive symptoms in childhood and adolescence was significant (p=0.003). In adolescents with depressive symptoms, childhood depressive symptoms (p=0.001) and overweight/obesity (p<0.001) predicted lower CRF. In adolescents without depressive symptoms, conduct problems in childhood predicted lower CRF in the initial models, but the effect disappeared after taking into account smoking and body mass index. Mediational analysis confirmed these results. LIMITATIONS We lacked data on physical activity and only studied males at three time-points. CONCLUSIONS Recurrent depression in childhood and adolescence and low SES in childhood predict lower adult CRF. Conduct problems in childhood predict lower CRF, but the effect is mediated by overweight/obesity and smoking. Psychiatric treatment for children and adolescents should promote physical activity, particularly for children with low SES.
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Affiliation(s)
- Georgios Nikolakaros
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, Helsinki University and Helsinki University Hospital, Finland; Sleep Disorders Outpatient Clinic, Psychiatry, Helsinki University and Helsinki University Hospital, Finland.
| | - Tero Vahlberg
- Department of Clinical Medicine, Biostatistics, University of Turku, Finland
| | - Lauri Sillanmäki
- Research Center for Child Psychiatry, University of Turku, Finland
| | - Andre Sourander
- Research Center for Child Psychiatry, University of Turku, Finland; INVEST Research Flagship, University of Turku, Finland (Principal Investigator)
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Gür F, Can Gür G. Is Exercise a Useful Intervention in the Treatment of Alcohol Use Disorder? Systematic Review and Meta-Analysis. Am J Health Promot 2020; 34:520-537. [PMID: 32212949 DOI: 10.1177/0890117120913169] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis examined the effects of exercise on individuals with alcohol use disorders (AUDs) across multiple health outcomes. DATA SOURCES PubMed, Medline, Web of Science, Scopus, Academic Search complete, Sport Discuss, and ERIC databases. STUDY INCLUSION AND EXCLUSION CRITERIA Interventional studies published between 2000 and 2018 focused on evaluating the effectiveness of exercise interventions in adults with AUD. DATA EXTRACTION This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines. DATA SYNTHESIS Physical activity levels/fitness [VO2 max (Oxygen Uptake) and HRmax (Maximum Heart Rate)], levels of depression, anxiety, self-efficacy, quality of life, and alcohol consumption (number of standard drinks consumed per day and per week). RESULTS The findings indicated that exercise significantly improved physical fitness as assessed by VO2 max (standardized mean difference [SMD]: 0.487, P < .05) and HRmax (SMD: 0.717, P < .05). Similarly, exercise significantly improved mental health as assessed by quality of life (SMD: 0.425, P < .05), but levels of depression, anxiety, self-efficacy, and alcohol consumption did not change significantly. Aerobic exercise alleviated depression and anxiety symptoms more than that of yoga and mixed types. Duration of exercise also had a similar effect on anxiety and depression. CONCLUSIONS Exercise can be an effective and persistent adjunctive treatment for individuals with AUDs.
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Affiliation(s)
- Fatih Gür
- Faculty of Sport Science, University of Pamukkale, Pamukkale, Turkey
| | - Ganime Can Gür
- Faculty of Sport Science, University of Pamukkale, Pamukkale, Turkey
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18
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Active Commuting and Depression Symptoms in Adults: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031041. [PMID: 32041331 PMCID: PMC7037710 DOI: 10.3390/ijerph17031041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 12/13/2022]
Abstract
Physical activity (PA) is suggested to have a protective effect against depression. One way of engaging in PA is through active commuting. This review summarises the literature regarding the relationship between active commuting and depression among adults and older adults. A systematic review of studies published up to December 2019, performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, was conducted using three databases (PubMed, Scopus, and Web of Science). A total of seven articles were identified as relevant. The results from these studies were inconsistent. Only two presented a significant relationship between active commuting and depression symptoms. In those two studies, switching to more active modes of travel and walking long distances were negatively related to the likelihood of developing new depressive symptoms. In the other five studies, no significant association between active travel or active commuting and depression was found. The relationship between active commuting and depression symptoms in adults is not clear. More studies on this topic are necessary in order to understand if active commuting can be used as a public health strategy to tackle mental health issues such as depression.
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Abstract
Anxiety disorders are a group of highly prevalent mental health conditions that can have a debilitating impact on daily functioning and well-being. They can co-occur with other mental health disorders, such as depression. People with anxiety disorders are also at an elevated risk of cardiovascular disease and premature mortality. Physical activity appears to be protective against anxiety disorders in clinical and nonclinical populations. Exercise, a subset of physical activity, has been shown to significantly reduce the symptoms of anxiety. The mechanisms through which exercise produces these effects are likely to involve a combination of biological and psychological factors. Physical activity may also be useful in reducing the symptoms of comorbid mental health conditions and the risk of physical health complications over time. Promoting physical activity could be a method of preventing or treating anxiety disorders with a wide range of benefits. However, further research will be necessary to address important gaps in the literature before these approaches can be fully implemented in mental health services.
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Affiliation(s)
- Aaron Kandola
- Division of Psychiatry, University College London, London, UK.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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20
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Tacchi MJ, Heggelund J, Scott J. Predictive validity of objective measures of physical fitness for the new onset of mental disorders in adolescents and young adults. Early Interv Psychiatry 2019; 13:1310-1318. [PMID: 30666789 DOI: 10.1111/eip.12783] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/19/2018] [Accepted: 12/26/2018] [Indexed: 11/28/2022]
Abstract
AIM To systematically review evidence that objectively assessed level of physical fitness is associated with future risk of adverse mental health outcomes during the peak age range for onset of adult mental disorders. METHODS Searches of Electronic databases (EBSCOhost, SPORTDISCUS, EMBASE, MedLINE, Cochrane database, CINAHL, PsychInfo, and Dissertation Abstracts), supplemented by hand searches of journals, conference proceedings and citations. Random-effects meta-analysis models were used to pool the intervention effects. RESULTS Eight studies of adolescents and young adults were included in the qualitative review and six studies derived from four independent cohorts were included in the statistical analyses. Most publications reported on large samples (including >1 million), but male conscripts were over-represented in the study cohorts; quality of included studies was modest, and heterogeneity was significant. Meta-analytic estimates were conducted for different adverse mental health outcomes, but all showed an inverse association between fitness and incidence of mental disorders or suicidality. Overall, higher level of physical fitness was associated with lower rates of onset of mental health problems (odds ratio: 0.59; 95% confidence intervals: 0.54, 0.65). CONCLUSIONS All eligible studies were undertaken since 2010, suggesting this is an emerging but unfinished field of research. The study design and methodological limitations indicate that the reported results should be treated with caution. However, if the meta-analytic findings are reliably replicated for new cohorts of males and females, they have implications for research into the prevention of non-communicable diseases, as our review suggests that interventions should target physical and mental health in equal measure.
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Affiliation(s)
- Mary Jane Tacchi
- Crisis Resolution and Home-Based Treatment Service, NTW NHS Trust, Newcastle, UK
| | - Jorn Heggelund
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle, UK
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Walter FA, Gathright E, Redle JD, Gunstad J, Hughes JW. Depressive Symptoms are Associated with Heart Rate Variability Independently of Fitness: A Cross-Sectional Study of Patients with Heart Failure. Ann Behav Med 2019; 53:955-963. [PMID: 30958884 PMCID: PMC6779069 DOI: 10.1093/abm/kaz006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Depression is associated with reduced heart rate variability (HRV) in healthy and cardiac samples, which may be accounted for by physical fitness. In a small sample of cardiac patients, activity and fitness levels attenuated the relationship between HRV and depression. In the current study of heart failure (HF) patients, we hypothesized that depressive symptoms and HRV would be inversely related and physical fitness would attenuate this association. PURPOSE To determine if previous associations among depressive symptoms, physical fitness, and HRV would replicate in a sample of HF patients. METHODS The sample consisted of HF patients (N = 125) aged 68.55 ± 8.92 years, 68.8% male, and 83.2% Caucasian. The study was cross-sectional and a secondary analysis of a nonrandomized clinical trial (Trial Identifier: NCT00871897). Depressive symptoms were evaluated using the Beck Depression Inventory (BDI)-II, fitness with the 2 min step test (2MST), and HRV during a 10 min resting laboratory psychophysiology protocol. The dependent variable in hierarchical linear regressions was the root mean square of successive differences. RESULTS Controlling for sex, age, β-blocker use, hypertension, and diabetes, higher BDI-II scores significantly predicted lower HRV, β = -.29, t(92) = -2.79, p < .01. Adding 2MST did not attenuate the relationship in a follow-up regression. CONCLUSION Depressive symptoms were associated with lower HRV in HF patients, independent of physical fitness. Given the prevalence of depression and suppressed HRV common among HF patients, interventions addressing depressive symptoms and other predictors of poor outcomes may be warranted.
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Affiliation(s)
- Fawn A Walter
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Emily Gathright
- Department of Psychiatry and Human Behavior, The Miriam Hospital and Alpert School of Medicine at Brown University, Providence, RI, USA
| | - Joseph D Redle
- Summa Health Systems, Cardiovascular Institute, Akron City Hospital, Akron, OH, USA
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Joel W Hughes
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
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McDowell CP, Dishman RK, Gordon BR, Herring MP. Physical Activity and Anxiety: A Systematic Review and Meta-analysis of Prospective Cohort Studies. Am J Prev Med 2019; 57:545-556. [PMID: 31542132 DOI: 10.1016/j.amepre.2019.05.012] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 01/04/2023]
Abstract
CONTEXT Anxiety symptoms and disorders are highly prevalent and costly. Prospective studies suggest that physical activity may prevent anxiety development; however, this body of literature has not been reviewed comprehensively. EVIDENCE ACQUISITION Studies measuring physical activity at baseline and anxiety at a designated follow-up at least 1 year later were located using MEDLINE, PsycINFO, and CINAHL Complete through June 2018. EVIDENCE SYNTHESIS Data were analyzed July-December 2018. Study quality was assessed using Q-Coh. Among studies of adults, a random-effects meta-analysis was conducted for crude and the most fully adjusted models for three outcomes: self-reported anxiety symptoms, a diagnosis of any anxiety disorder, and a diagnosis of generalized anxiety disorder. As there were few studies with diverse samples and outcome measures, findings were elaborated with a critical narrative review of all studies. Twenty-four studies (median follow-up, 4.75 years) of >80,000 unique individuals were included in the systematic review; thirteen were included in the meta-analyses. Six studies were assessed as low quality, nine as acceptable, and nine as good. From adjusted models, odds of elevated anxiety symptoms (OR=0.8742, 95% CI=0.7731, 0.9886, n=9), any anxiety disorder (OR=0.6626, 95% CI=0.5337, 0.8227, n=3), and generalized anxiety disorder specifically (OR=0.5438, 95% CI=0.3231, 0.9153, n=3) were significantly lower after physical activity exposure. CONCLUSIONS Available evidence suggests that engaging in physical activity protects against anxiety symptoms and disorders. However, notable challenges in the current evidence base include issues regarding exposure and outcome measures, consistent adjustment for putative confounders, representativeness of samples, and attrition bias, which warrant further research.
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Affiliation(s)
- Cillian P McDowell
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Rodney K Dishman
- Department of Kinesiology, University of Georgia, Athens, Georgia
| | - Brett R Gordon
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Matthew P Herring
- Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland; Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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Kandola A, Ashdown-Franks G, Stubbs B, Osborn DPJ, Hayes JF. The association between cardiorespiratory fitness and the incidence of common mental health disorders: A systematic review and meta-analysis. J Affect Disord 2019; 257:748-757. [PMID: 31398589 PMCID: PMC6997883 DOI: 10.1016/j.jad.2019.07.088] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/26/2019] [Accepted: 07/29/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Physical activity is associated with a lower incidence of common mental health disorder, but less is known about the impact of cardiorespiratory fitness (CRF). METHODS In this review, we systematically evaluated the relationship between CRF and the incidence of common mental health disorders in prospective cohort studies. We systematically searched six major electronic databases from inception to 23rd of May 2019. We assessed study quality using the Newcastle-Ottawa scale. RESULTS We were able to pool the hazard ratios (HRs) and 95% confidence intervals (CIs) of four studies including at least 27,733,154 person-years of data. We found that low CRF (HR = 1.47, [95% CI 1.23 - 1.76] p < 0.001 I2 = 85.1) and medium CRF (HR = 1.23, [95% CI 1.09 - 1.38] p < 0.001 I2 = 87.20) CRF are associated with a 47% and 23% greater risk of a common mental health disorders respectively, compared with high CRF. We found evidence to suggest a dose-response relationship between CRF and the risk of common mental health disorders. LIMITATIONS We were only able to identify a small number of eligible studies from our search and heterogeneity was substantial in the subsequent meta-analysis. CONCLUSIONS Our findings indicate that there is a longitudinal association between CRF levels and the risk of a common mental health disorder. CRF levels could be useful for identifying and preventing common mental health disorders at a population-level.
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Affiliation(s)
- A Kandola
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7BN, UK.
| | - G Ashdown-Franks
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK; Department of Exercise Sciences, University of Toronto, 27 King's College Circle, Toronto, Ontario, ON M5S, Canada
| | - B Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AB, UK; Physiotherapy Department, South London and Maudsley National Health Services Foundation Trust, London, SE5 8AZ, UK
| | - D P J Osborn
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7BN, UK
| | - J F Hayes
- Division of Psychiatry, University College London, 149 Tottenham Court Road, London W1T 7BN, UK
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Shigdel R, Stubbs B, Sui X, Ernstsen L. Cross-sectional and longitudinal association of non-exercise estimated cardiorespiratory fitness with depression and anxiety in the general population: The HUNT study. J Affect Disord 2019; 252:122-129. [PMID: 30981055 DOI: 10.1016/j.jad.2019.04.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/19/2019] [Accepted: 04/06/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cardiorespiratory fitness may help to prevent depression and anxiety. A paucity of literature has considered the relationship between cardiorespiratory fitness (CRF) and the incidence of depression and anxiety. The objective of this study was to investigate cross-sectional and longitudinal associations of estimated cardiorespiratory fitness (CRF) with depression and anxiety. METHODS This study included middle-aged and older participants from the second (HUNT 2, 1995-1997) and third (HUNT3, 2006-2008) survery of the Nord-Trøndelag Health Study (HUNT). Baseline non-exercise estimated CRF (eCRF) was determined using standardized algorithms. Depression and anxiety were measured using the Hospital Anxiety and Depression Scale. Logistic regression models were used to evaluate the cross-sectional and longitudinal associations between eCRF and depression and anxiety. RESULTS In cross-sectional adjusted analysis including those who participated in HUNT2 (n = 26,615 mean age 55.7 years), those with medium and high level of eCRF had 21% (OR, 0.79; 95% CI, 0.71-0.89) and 26% (OR, 0.74; 95% CI, 0.66-0.83) lower odds of depression compared to those with low eCRF level, respectively. Longitudinal analysis including those who participated in both HUNT2 and HUNT3 (n = 14,020 mean age 52.2 years) found that medium and level of eCRF was associated with 22% (OR, 0.78; 95% CI, 0.64-0.96) and 19% (OR, 0.81; 95% CI, 0.66-0.99) lower odds of depression compared to those with low eCRF level, respectively. CRF was not associated with anxiety, either cross-sectionally or longitudinally. CONCLUSION Our data suggest that a medium and high level of eCRF during late middle age is cross-sectionally and prospectively associated with lower odds of depression. However, our data do not support that eCRF is associated with anxiety. Further studies are warranted to conclude a causal relationship between eCRF and depression.
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Affiliation(s)
- Rajesh Shigdel
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, King`s College London, De Crespigny Park, London, United Kingdom
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Linda Ernstsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Tonello L, Oliveira-Silva I, Medeiros AR, Donato ANA, Schuch FB, Donath L, Boullosa D. Prediction of Depression Scores From Aerobic Fitness, Body Fatness, Physical Activity, and Vagal Indices in Non-exercising, Female Workers. Front Psychiatry 2019; 10:192. [PMID: 31031652 PMCID: PMC6473624 DOI: 10.3389/fpsyt.2019.00192] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 03/15/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Depression is associated with a decreased cardiorespiratory fitness, and physical activity [PA] levels, higher rates of obesity, and dysfunction in autonomic control of heart rate [HR]. However, these parameters were mostly recorded with indirect methods. Thus, the aim of the current study was to investigate the relationships between depression scores and objective measures of body fatness, autonomic indices (i.e. HRV and HRR), cardiorespiratory fitness and PA levels; and subsequently to present the best predictive models of depression scores for this population, based on these variables. Methods: Thirty-five non-exercising women (26-43 years; maximal oxygen consumption [VO2max] ~ 17.4-38.3 mL/kg/min) volunteered for participation in this study. All participants responded to the Beck Depression Inventory [DBI] and were evaluated for body mass index [BMI], percentage of body fat, sum of skinfolds, and VO2max. Subsequently, over four consecutive days, an orthostatic test and a submaximal exercise on a cycle ergometer were performed to record HRV and HRR, respectively. In addition, incidental PA was recorded during 5 consecutive days using accelerometers. Results: depression scores were related to VO2max (r = -0.446, p = 0.007) and the sum of skinfolds (r = 0.434, p = 0.009). Several stepwise multiple linear regression models were performed and only VO2max was revealed as an independent predictor of the Beck scores (ß = -0.446, R 2 = 0.199, p = 0.007). Conclusion: The present study revealed that VO2max and the sum of skinfolds were moderately related to depression scores, while VO2max was the only independent predictor of depression scores in female workers.
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Affiliation(s)
- Laís Tonello
- Educação Física, Universidade de Gurupi, Gurupi, Brazil.,Escola de Saúde e Medicina, Universidade Católica de Brasília, Brasília, Brazil
| | | | | | | | - Felipe Barreto Schuch
- Mestrado em Saúde e Desenvolvimento Humano, Universidade La Salle Canoas, Canoas, Brazil
| | - Lars Donath
- Department of Intervention Research in Exercise Training, German Sport University, Cologne, Germany
| | - Daniel Boullosa
- Sport and Excercise Science, James Cook University, Townsville, QLD, Australia
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Willis BL, Leonard D, Barlow CE, Martin SB, DeFina LF, Trivedi MH. Association of Midlife Cardiorespiratory Fitness With Incident Depression and Cardiovascular Death After Depression in Later Life. JAMA Psychiatry 2018; 75:911-917. [PMID: 29955781 PMCID: PMC6142909 DOI: 10.1001/jamapsychiatry.2018.1467] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Cardiorespiratory fitness (hereinafter referred to as fitness) as estimated by exercise testing is a modifiable risk factor independently associated with chronic diseases, cardiovascular disease (CVD) events, and mortality, but the association of fitness at midlife with incidence of later-life depression and the risk of CVD mortality after a depression diagnosis is unknown. OBJECTIVE To determine whether fitness measured in midlife would be inversely associated with later-life CVD mortality with antecedent depression. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study at a single-center, community-based preventive medicine clinic was performed as part of the Cooper Center Longitudinal Study. Data were collected from January 13, 1971, through December 31, 2009, and analyzed from October 6, 2015, through August 14, 2017. Participants included generally healthy men and women who presented for preventive medicine examinations at midlife and who were eligible for Medicare from 1999 to 2010. Those with a self-reported history of depression, myocardial infarction, or stroke at examination were excluded. EXPOSURES Objective midlife fitness estimated from results of treadmill exercise testing. MAIN OUTCOMES AND MEASURES Depression diagnosis from Medicare claims files using established algorithms and CVD mortality from National Death Index records. RESULTS A total of 17 989 participants (80.2% men) with a mean (SD) age of 50.0 (8.7) years were included. After 117 218 person-years of Medicare follow-up, 2701 depression diagnoses, 610 deaths due to CVD without prior depression, and 231 deaths due to CVD after depression were observed. A high level of fitness in midlife was associated with a 16% lower risk of depression (hazard ratio [HR], 0.84; 95% CI, 0.74-0.95) compared with a low level of fitness. A high fitness level was also associated with a 61% lower risk of death due to CVD without depression (HR, 0.39; 95% CI, 0.31-0.48) compared with a low level of fitness. After a diagnosis of depression, a high fitness level was associated with a 56% lower risk of death due to CVD (HR, 0.44; 95% CI, 0.31-0.64) compared with a low fitness level. CONCLUSIONS AND RELEVANCE Midlife fitness is associated with a lower risk of later-life depression, CVD mortality, and CVD mortality after incident later-life depression. These findings suggest the importance of midlife fitness in primary prevention of depression and subsequent CVD mortality in older age and should encourage physicians to consider fitness and physical activity in promoting healthy aging.
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Affiliation(s)
| | | | | | - Scott B. Martin
- Department of Kinesiology, Recreation, and Health Promotion, University of North Texas, Denton
| | | | - Madhukar H. Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas
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Rahman MS, Helgadóttir B, Hallgren M, Forsell Y, Stubbs B, Vancampfort D, Ekblom Ö. Cardiorespiratory fitness and response to exercise treatment in depression. BJPsych Open 2018; 4:346-351. [PMID: 30140446 PMCID: PMC6094184 DOI: 10.1192/bjo.2018.45] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 06/09/2018] [Accepted: 07/02/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Exercise improves cardiorespiratory fitness (CRF) and reduces depressive symptoms in people with depression. It is unclear if changes in CRF are a predictor of the antidepressant effect of exercise in people with depression. AIMS To investigate whether an increase in CRF is a predictor of depression severity reduction after 12 weeks of exercise (trial registration: DRKS study ID, DRKS00008745). METHOD The present study includes participants who took part in vigorous (n = 33), moderate (n = 38) and light (n = 39) intensity exercise and had CRF information (as predicted maximal oxygen uptake, V̇O2max) collected before and after the intervention. Depression severity was measured with the Montgomery-Åsberg Depression Rating Scale (MADRS). V̇O2max (L/min) was assessed with the Åstrand-Rhyming submaximal cycle ergometry test. The main analysis was conducted pooling all exercise intensity groups together. RESULTS All exercise intensities improved V̇O2max in people with depression. Regardless of frequency and intensity of exercise, an increase in post-treatment V̇O2max was significantly associated with reduced depression severity at follow-up (B = -3.52, 95% CI -6.08 to -0.96); adjusting for intensity of exercise, age and body mass index made the association stronger (B = -3.89, 95% CI -6.53 to -1.26). Similarly, increased V̇O2max was associated with higher odds (odds ratio = 3.73, 95% CI 1.22-11.43) of exercise treatment response (≥50% reduction in MADRS score) at follow-up. CONCLUSIONS Our data suggest that improvements in V̇O2max predict a greater reduction in depression severity among individuals who were clinically depressed. This finding indicates that improvements in V̇O2max may be a marker for the underpinning biological pathways for the antidepressant effect of exercise. DECLARATION OF INTEREST None.
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Affiliation(s)
- Md Shafiqur Rahman
- Research Assistant, Department of Public Health Sciences, Karolinska Institutet, Sweden
| | - Björg Helgadóttir
- Post-Doctoral Researcher, Department of Public Health Sciences, Karolinska Institutet and Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Mats Hallgren
- Assistant Professor, Department of Public Health Sciences, Karolinska Institutet, Sweden
| | - Yvonne Forsell
- Professor, Department of Public Health Sciences, Karolinska Institutet and Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
| | - Brendon Stubbs
- Research Physiotherapist, Physiotherapy Department, South London and Maudsley NHS Foundation Trust and Health Service and Population Research Department, King's College London and Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Davy Vancampfort
- Post-Doctoral Research Fellow, Department of Rehabilitation Sciences and University Psychiatric Center, KU Leuven, Belgium
| | - Örjan Ekblom
- Associate Professor, Department of Sport and Health Sciences, Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Sweden
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Lavie CJ, Sui X, Milani RV. Emotional distress after myocardial infarction: Importance of cardiorespiratory fitness. Eur J Prev Cardiol 2018; 25:906-909. [DOI: 10.1177/2047487318770516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Affiliation(s)
- Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, USA
| | - Xuemei Sui
- Department of Exercise Science, University of South Carolina, USA
| | - Richard V Milani
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, USA
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Rahman MS, Forsell Y, Hallgren M, Galanti MR. Tobacco use does not influence the response to non-pharmacologic depression treatment: A secondary analysis of the Regassa randomized controlled trial. Psychiatry Res 2018; 261:442-448. [PMID: 29395870 DOI: 10.1016/j.psychres.2018.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 12/04/2017] [Accepted: 01/06/2018] [Indexed: 10/18/2022]
Abstract
Behavioural interventions show promising results among patients with mild- to moderate depression. However, whether tobacco use moderates the effects of these interventions is not known. In the present study, we examined whether patients suffering from mild-to-moderate depression differed in their response to prescribed physical exercise or internet-based cognitive behavioural therapy (ICBT) according to their current tobacco use. We conducted a secondary analysis of data from 740 participants in a multicentre randomised controlled trial comparing physical exercise, internet-based cognitive behavioural therapy and treatment as usual (Regassa study). Information on current daily tobacco use was self-reported at baseline. Linear and logistic regression were used to examine the treatments' effect (reduction in depression score) in the subgroups of tobacco users (n=154) and non-users (n=586). We found that baseline tobacco use did not significantly moderate the association between treatment type and post-treatment depression severity. Both interventions (exercise and ICBT) resulted in a reduction of depression scores that was similar among non-users and users of tobacco, albeit formally statistically significant only among non-users. Physical exercise on prescription and ICBT can be used in the clinical management of depressed patients, with similar prognostic advantage among tobacco users and non-users.
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Affiliation(s)
- Md Shafiqur Rahman
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Maria Rosaria Galanti
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
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Fritz K, O’Connor PJ. Cardiorespiratory Fitness and Leisure Time Physical Activity are Low in Young Men with Elevated Symptoms of Attention Deficit Hyperactivity Disorder. EXERCISE MEDICINE 2018. [DOI: 10.26644/em.2018.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Stoutenberg M, Rethorst CD, Vidot DC, Greer TL, Trivedi MH. Cardiorespiratory fitness and body composition of stimulant users: A baseline analysis of the STRIDE cohort. J Subst Abuse Treat 2017; 78:74-79. [PMID: 28554607 DOI: 10.1016/j.jsat.2017.05.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/05/2017] [Accepted: 05/09/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Relatively little has been reported about the physical characteristics, such as cardiorespiratory fitness (CRF) and body composition, of stimulant users. Identifying risk factors associated with the physical health of stimulant users is an important public health issue as new treatments should better address the entire range of health concerns experienced by this population. METHODS We examined cross-sectional data gathered at baseline from the STimulant Reduction Intervention using Dosed Exercise (STRIDE) study, a multisite randomized clinical trial that examined exercise as an adjunct to treatment as usual for individuals in residential treatment programs (RTPs). Clients were approached after intake to the RTP. Prior to randomization, eligible individuals underwent a comprehensive screening process that included medical screening, where CRF was assessed through a maximal exercise test (time on treadmill), and a series of baseline examinations assessing domains of substance use and mental health. RESULTS Data from 295 individuals with recent stimulant use disorders were analyzed. The mean body mass index (BMI) and waist circumference (WC) and for all participants was 27.8±5.7kg/m2 and 93.5±14.2cm, respectively, while the mean time on treadmill was 13.7±2.9min. Few significant associations were observed between CRF, BMI, or WC and substance use and mental health measures. CONCLUSIONS Stimulant users in this study presented with low CRF levels and would be considered overweight based on their BMI. These individuals would likely benefit from interventions that address both their stimulant use, as well as their physical health.
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Affiliation(s)
- Mark Stoutenberg
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States.
| | - Chad D Rethorst
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Denise C Vidot
- School of Nursing & Health Studies, University of Miami, Coral Gables, FL, United States
| | - Tracy L Greer
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, United States
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Ross R, Blair SN, Arena R, Church TS, Després JP, Franklin BA, Haskell WL, Kaminsky LA, Levine BD, Lavie CJ, Myers J, Niebauer J, Sallis R, Sawada SS, Sui X, Wisløff U. Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association. Circulation 2016; 134:e653-e699. [PMID: 27881567 DOI: 10.1161/cir.0000000000000461] [Citation(s) in RCA: 1328] [Impact Index Per Article: 166.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes. The purpose of this statement is to review current knowledge related to the association between CRF and health outcomes, increase awareness of the added value of CRF to improve risk prediction, and suggest future directions in research. Although the statement is not intended to be a comprehensive review, critical references that address important advances in the field are highlighted. The underlying premise of this statement is that the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk. These opportunities must be realized to optimize the prevention and treatment of cardiovascular disease and hence meet the American Heart Association's 2020 goals.
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Stoutenberg M, Rethorst CD, Lawson O, Read JP. Exercise training - A beneficial intervention in the treatment of alcohol use disorders? Drug Alcohol Depend 2016; 160:2-11. [PMID: 26652900 PMCID: PMC6083864 DOI: 10.1016/j.drugalcdep.2015.11.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/13/2015] [Accepted: 11/17/2015] [Indexed: 02/08/2023]
Abstract
BACKGROUND A growing body of evidence suggests that exercise training may have multiple beneficial effects in individuals with mental health or substance use disorders. Yet, relatively little knowledge exists regarding the benefits of exercise training to augment treatment for alcohol use disorders (AUDs). PURPOSE The purpose of this narrative review is to present a summary of the growing body of published literature supporting exercise training as a treatment strategy for individuals with AUDs. We will provide evidence on the myriad of ways in which exercise may exert a positive effect on AUD outcomes including stress, anxiety, impulsivity, and depression. Further, we will explore how these mechanisms share common neurobiological pathways. The role of exercise in enhancing the social environment and increasing individual self-efficacy to reduce excess and/or inappropriate alcohol consumption will also be discussed. DISCUSSION We will conclude with a description of completed investigations involving exercise training and provide suggestions for next steps in this innovative field of study.
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Affiliation(s)
- Mark Stoutenberg
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Clinical Research Building, Suite 1008, Miami, FL 33136, USA.
| | - Chad D. Rethorst
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
| | - Olivia Lawson
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Clinical Research Building, Suite 1008, Miami, FL 33136, USA
| | - Jennifer P. Read
- Department of Psychology, The State University of New York at Buffalo, 213 Park Hall, Buffalo, NY 14260, USA
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Stubbs B, Rosenbaum S, Vancampfort D, Ward PB, Schuch FB. Exercise improves cardiorespiratory fitness in people with depression: A meta-analysis of randomized control trials. J Affect Disord 2016; 190:249-253. [PMID: 26523669 DOI: 10.1016/j.jad.2015.10.010] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 09/28/2015] [Accepted: 10/10/2015] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Cardiorespiratory fitness (CRF) is an independent predictor of cardiovascular disease and all-cause mortality. CRF improves in response to exercise interventions, yet the effectiveness of such interventions to improve CRF among people with depression is unclear. We conducted a systematic review and meta-analysis to evaluate whether CRF improves in people with depression in exercise randomized control trials (RCTs). METHOD Three authors identified RCTs from a recent Cochrane review and conducted updated searches of major electronic databases. We included RCTs of exercise interventions in people with depression (including major depressive disorder (MDD) and above-threshold depressive symptoms) that reported CRF (defined as predicted maximal oxygen uptake (VO2max predicted) or peak oxygen uptake (VO2peak)) versus a control condition. A random effects meta-analysis was conducted. RESULTS Seven unique RCTs including 8 aerobic exercise interventions for depression were eligible, including 293 people allocated to exercise (mean age=40.3 years, range=27.2-64.7 years and 35-100% female) and 205 allocated to control conditions. Across all studies exercise results in a significant increase in CRF (g=0.64, 95%CI=0.32-0.96, p<0.001) equating to a mean increase of 3.05 ml/kg/min. Results remained significant when restricted to MDD only (N=5, g=0.41, 95%CI=0.18-0.64, p<0.001) and in high quality studies (N=5, g=0.60, 95%CI=0.19-1.00, p=0.004). CONCLUSIONS People with depression can achieve clinically relevant improvements in CRF in response to exercise interventions. Targeting 'fitness' rather than 'fatness' may be another feasible intervention strategy in this population.
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Affiliation(s)
- Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London Box SE5 8 AF, United Kingdom.
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Davy Vancampfort
- KU Leuven University of Leuven Department of Rehabilitation Sciences, Leuven, Belgium; KU Leuven-University of Leuven, Z.org Leuven, Campus Kortenberg, Kortenberg, Belgium
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Felipe B Schuch
- Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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35
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Freudenberger P, Petrovic K, Sen A, Töglhofer AM, Fixa A, Hofer E, Perl S, Zweiker R, Seshadri S, Schmidt R, Schmidt H. Fitness and cognition in the elderly: The Austrian Stroke Prevention Study. Neurology 2016; 86:418-24. [PMID: 26740674 DOI: 10.1212/wnl.0000000000002329] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 08/10/2015] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To investigate whether greater cardiorespiratory fitness is associated with better global and domain-specific cognitive function. METHODS We investigated 877 participants (aged 65 ± 7 years, 55% women) of the Austrian Stroke Prevention Study. For cardiorespiratory fitness, the maximum oxygen consumption (V̇o2max) was calculated based on weight and maximum and resting heart rate on a treadmill test (mL·kg(-1)·min(-1)). A test battery assessing memory (Bäumler's Lern-und Gedächtnistest), executive function (Wisconsin Card Sorting Test, Trail Making Test-Part B, Digit Span Backward, Alters Konzentrationstest, a computerized complex reaction time task) and motor skills (Purdue Pegboard Test) was administered. Summary measures for cognitive domains and for global cognition were calculated. White matter lesions, lacunes, and brain atrophy were assessed using MRI. RESULTS Higher V̇o2max was associated with better global (B = 0.024; p = 0.000) and domain-specific cognitive function (memory B = 0.026, p = 0.000; executive function B = 0.009, p = 0.003; motor skills B = 0.012, p = 0.018) after adjustment for age, sex, education years, and Ca(2+) channel antagonists or β-blockers. White matter lesions, lacunes, or brain atrophy did not mediate the effect (p > 0.05 for all mediators). The interactions of V̇o2max with age, overweight, and APOE ε4 on cognition were not statistically significant (p > 0.05 for all interaction terms) with the exception of a modulating effect of body mass index on V̇o2max in the memory domain. CONCLUSIONS Higher V̇o2max is associated with better global cognitive function and with better performance in the cognitive domains of memory, executive function, and motor skills in the middle-aged and elderly. The association is not mediated by the presence of white matter lesions, lacunes, and brain atrophy.
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Affiliation(s)
- Paul Freudenberger
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA
| | - Katja Petrovic
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA
| | - Abhijit Sen
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA
| | - Anna Maria Töglhofer
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA
| | - André Fixa
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA
| | - Edith Hofer
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA
| | - Sabine Perl
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA
| | - Robert Zweiker
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA
| | - Sudha Seshadri
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA
| | - Reinhold Schmidt
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA
| | - Helena Schmidt
- From the Institute of Molecular Biology and Biochemistry, Center for Molecular Medicine (P.F., A.M.T., A.F., H.S.), Department of Neurology (K.P., E.H., R.S., H.S.), Institute for Medical Informatics, Statistics and Documentation (E.H.), and Department of Cardiology (S.P., R.Z.), Medical University of Graz, Austria; Department of Public Health and General Practice (A.S.), Faculty of Medicine, Norwegian University of Science and Technology, Norway; and Department of Neurology (S.S.), Boston University School of Medicine, MA.
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Hallgren M, Vancampfort D, Stubbs B. Exercise is medicine for depression: even when the "pill" is small. Neuropsychiatr Dis Treat 2016; 12:2715-2721. [PMID: 27822043 PMCID: PMC5087774 DOI: 10.2147/ndt.s121782] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Davy Vancampfort
- Department of Rehabilitation Sciences; University Psychiatric Centre - KU Leuven, KU Leuven - University of Leuven, Leuven, Belgium
| | - Brendon Stubbs
- Department of Physiotherapy, South London and Maudsley NHS Foundation Trust; Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Becofsky K, Baruth M, Wilcox S. Physical activity mediates the relationship between program participation and improved mental health in older adults. Public Health 2015; 132:64-71. [PMID: 26318601 DOI: 10.1016/j.puhe.2015.07.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 06/12/2015] [Accepted: 07/16/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES There is an implicit assumption that increased physical activity (PA) levels are responsible for the mental health benefits resulting from participation in PA programs. Other factors associated with participation may in fact be responsible. The purpose of this study was to examine whether changes in PA mediated the effects of two PA programs (Active Choices [AC] and Active Living Every Day [ALED]) on mental health outcomes. STUDY DESIGN Secondary data analyses of quasi-experimental study. METHODS A sub-sample of older adults who participated in AC (n = 744) and ALED (n = 853) were included in the current analyses. MacKinnon's product of coefficients was used to test change in PA as a mediator of the relationship between program dose and change in mental health outcomes (depressive symptoms, stress, and number of days with poor mental health). RESULTS Change in PA explained 19% (AC) and 13% (ALED) of the absolute effects of program dose on depressive symptoms, 18% (AC) and 14% (ALED) of the effects on stress, and 37% (ALED) of the effects on days with poor mental health. CONCLUSIONS Mounting evidence from both epidemiological studies and controlled trials suggests that PA can improve mental health. This study adds that increasing PA levels may improve mental health in older adults in 'real-world' settings.
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Affiliation(s)
- K Becofsky
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA.
| | - M Baruth
- Department of Health Sciences, Saginaw Valley State University, 7400 Bay Road, University Center, MI 48710, USA
| | - S Wilcox
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA; Prevention Research Center, University of South Carolina, 921 Assembly Street, Columbia, SC 29208, USA
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Becofsky KM, Sui X, Lee DC, Wilcox S, Zhang J, Blair SN. A prospective study of fitness, fatness, and depressive symptoms. Am J Epidemiol 2015; 181:311-20. [PMID: 25693775 DOI: 10.1093/aje/kwu330] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Being overweight or obese might be a risk factor for developing depression. It is also possible that low cardiorespiratory fitness, rather than overweight or obesity, is the better predictor of depressive symptom onset. Adults in the Aerobics Center Longitudinal Study (Dallas, Texas) underwent fitness and fatness assessments between 1979 and 1998 and later completed a questionnaire about depressive symptoms in 1990, 1995, or 1999. Separate logistic regression models were used to test the associations between 3 fatness measures (body mass index, waist circumference, and percentage of body fat) and the onset of depressive symptoms. Analyses were repeated using fitness as the predictor variable. Additional analyses were performed to study the joint association of fatness and fitness with the onset of depressive symptoms. After controlling for fitness, no measure of fatness was associated with the onset of depressive symptoms. In joint analyses, low fitness was more strongly associated with the onset of elevated depressive symptoms than was fatness, regardless of the measure of fatness used. Overall, results from the present study suggest that low fitness is more strongly associated with the onset of elevated depressive symptoms than is fatness. To reduce the risk of developing depression, individuals should be encouraged to improve their fitness regardless of body fatness.
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Crowley SK, Wilkinson LL, Wigfall LT, Reynolds AM, Muraca ST, Glover SH, Wooten NR, Sui X, Beets MW, Durstine JL, Newman-Norlund RD, Youngstedt SD. Physical fitness and depressive symptoms during army basic combat training. Med Sci Sports Exerc 2015; 47:151-8. [PMID: 24870581 PMCID: PMC4246049 DOI: 10.1249/mss.0000000000000396] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Mental health-related problems are a significant cause of attrition during basic combat training (BCT). Evidence in civilian populations suggests that physical fitness is associated with psychological benefits in civilians, but little is known about the association between physical fitness and psychological adjustment during BCT. METHODS This study prospectively examined the association between physical fitness and depressive symptoms in 300 BCT soldiers from May to July 2012 at Fort Jackson, Columbia, SC. Soldiers completed a baseline Army Physical Fitness Test (APFT) and survey within 1 wk of arriving at BCT and an end-of-cycle survey after 8 wk of BCT. Soldiers were assigned to the "high" fitness category if they had a passing score on the standard APFT of greater than or equal to 180 out of 300 points. Soldiers scoring less than 180 points on the APFT were assigned to the "low" fitness category. Depressive symptoms were measured using the 20-item Center for Epidemiologic Studies Depression scale. RESULTS In multivariate analyses, adjusting for baseline demographics, self-reported sleep before BCT, BCT confidence, Army identification, and depressive symptoms, the odds of reporting depressive symptoms were 60% lower for soldiers in the high fitness category (odds ratio, 0.40; 95% confidence interval, 0.19-0.84) compared with soldiers in the low fitness category. CONCLUSIONS Analogous to other positive outcomes of soldier fitness, improvement of soldier physical fitness before BCT might improve soldiers' psychological health outcomes.
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Affiliation(s)
- Shannon K. Crowley
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Larrell L. Wilkinson
- Department of Human Studies, School of Education, University of Alabama at Birmingham, Birmingham, AL
| | - Lisa T. Wigfall
- Department of Health Services Policy and Management, and Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Alexandria M. Reynolds
- Department of Psychology, University of South Carolina, Columbia, SC
- WJB Dorn VA Medical Center, Columbia, SC
| | | | - Saundra H. Glover
- Department of Health Services Policy and Management, and Institute for Partnerships to Eliminate Health Disparities, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Nikki R. Wooten
- College of Social Work, University of South Carolina, Columbia, SC
- District of Columbia Army National Guard, Washington, DC
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Michael W. Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - J. Larry Durstine
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Roger D. Newman-Norlund
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Shawn D. Youngstedt
- Department of Psychology, University of South Carolina, Columbia, SC
- WJB Dorn VA Medical Center, Columbia, SC
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC
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40
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Torres ER, Sampselle CM, Neighbors HW, Ronis DL, Gretebeck KA. Depressive Symptoms and Walking in African-Americans. Public Health Nurs 2014; 32:381-7. [PMID: 25475884 DOI: 10.1111/phn.12171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Although increased frequency of physical activity is associated with fewer depressive symptoms in African-Americans, most studies do not focus on a specific type of activity. Identifying the activity can provide helpful information for designing interventions that focus on depressive symptoms. The objective of this study was to examine the odds of depressive symptoms in relation to walking in African-Americans. DESIGN AND SAMPLE A secondary analysis was performed on the National Survey of American Life. The sample was made up of community-dwelling African-American women (n = 1,903) and men (n = 1,075) who did not meet the DSM-IV-TR criteria for depression. MEASURES Walking was measured by self-reported frequency (i.e., never, rarely, sometimes, often). Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale. Logistic regression for complex samples was used to examine the odds of depressive symptoms in relation to walking. RESULTS Women who reported often walking had lower odds for depressive symptoms than women who reported never walking (OR = 0.56, 95% CI = 0.38-0.82). Walking frequency was not related to depressive symptoms in men. CONCLUSIONS Walking frequency is a modifiable risk factor for elevated depressive symptoms in African-American women.
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Affiliation(s)
- Elisa R Torres
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin
| | | | | | - David L Ronis
- School of Nursing, University of Michigan, Ann Arbor, Michigan
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Park M. Evidence-based stress management: focusing on nonpharmacological procedure which reduce stress and promote health. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2013. [DOI: 10.5124/jkma.2013.56.6.478] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Minseon Park
- Department of Family Medicien, Seoul National University Hospital, Seoul, Korea
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