Sammi R Chekroud1, Ralitza Gueorguieva2, Amanda B Zheutlin3, Martin Paulus4, Harlan M Krumholz5, John H Krystal6, Adam M Chekroud7. 1. Oxford Centre for Human Brain Activity, Wellcome Centre for Integrative Neuroimaging, Department of Psychiatry, University of Oxford, Oxford, UK. 2. Department of Biostatistics, Yale University, New Haven, CT, USA; School of Medicine, Yale University, New Haven, CT, USA. 3. Massachusetts General Hospital, Boston, MA, USA. 4. Laureate Institute for Brain Research, Tulsa, OK, USA. 5. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University, New Haven, CT, USA; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA. 6. Department of Psychiatry, Yale University, New Haven, CT, USA; Psychiatry and Behavioral Health Services, Yale-New Haven Hospital, New Haven, CT, USA; Clinical Neuroscience Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA. 7. School of Medicine, Yale University, New Haven, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA; Spring Health, New York City, NY, USA. Electronic address: adam.chekroud@yale.edu.
Abstract
BACKGROUND: Exercise is known to be associated with reduced risk of all-cause mortality, cardiovascular disease, stroke, and diabetes, but its association with mental health remains unclear. We aimed to examine the association between exercise and mental health burden in a large sample, and to better understand the influence of exercise type, frequency, duration, and intensity. METHODS: In this cross-sectional study, we analysed data from 1 237 194 people aged 18 years or older in the USA from the 2011, 2013, and 2015 Centers for Disease Control and Prevention Behavioral Risk Factors Surveillance System survey. We compared the number of days of bad self-reported mental health between individuals who exercised and those who did not, using an exact non-parametric matching procedure to balance the two groups in terms of age, race, gender, marital status, income, education level, body-mass index category, self-reported physical health, and previous diagnosis of depression. We examined the effects of exercise type, duration, frequency, and intensity using regression methods adjusted for potential confounders, and did multiple sensitivity analyses. FINDINGS: Individuals who exercised had 1·49 (43·2%) fewer days of poor mental health in the past month than individuals who did not exercise but were otherwise matched for several physical and sociodemographic characteristics (W=7·42 × 1010, p<2·2 × 10-16). All exercise types were associated with a lower mental health burden (minimum reduction of 11·8% and maximum reduction of 22·3%) than not exercising (p<2·2 × 10-16 for all exercise types). The largest associations were seen for popular team sports (22·3% lower), cycling (21·6% lower), and aerobic and gym activities (20·1% lower), as well as durations of 45 min and frequencies of three to five times per week. INTERPRETATION: In a large US sample, physical exercise was significantly and meaningfully associated with self-reported mental health burden in the past month. More exercise was not always better. Differences as a function of exercise were large relative to other demographic variables such as education and income. Specific types, durations, and frequencies of exercise might be more effective clinical targets than others for reducing mental health burden, and merit interventional study. FUNDING: Cloud computing resources were provided by Microsoft.
BACKGROUND: Exercise is known to be associated with reduced risk of all-cause mortality, cardiovascular disease, stroke, and diabetes, but its association with mental health remains unclear. We aimed to examine the association between exercise and mental health burden in a large sample, and to better understand the influence of exercise type, frequency, duration, and intensity. METHODS: In this cross-sectional study, we analysed data from 1 237 194 people aged 18 years or older in the USA from the 2011, 2013, and 2015 Centers for Disease Control and Prevention Behavioral Risk Factors Surveillance System survey. We compared the number of days of bad self-reported mental health between individuals who exercised and those who did not, using an exact non-parametric matching procedure to balance the two groups in terms of age, race, gender, marital status, income, education level, body-mass index category, self-reported physical health, and previous diagnosis of depression. We examined the effects of exercise type, duration, frequency, and intensity using regression methods adjusted for potential confounders, and did multiple sensitivity analyses. FINDINGS: Individuals who exercised had 1·49 (43·2%) fewer days of poor mental health in the past month than individuals who did not exercise but were otherwise matched for several physical and sociodemographic characteristics (W=7·42 × 1010, p<2·2 × 10-16). All exercise types were associated with a lower mental health burden (minimum reduction of 11·8% and maximum reduction of 22·3%) than not exercising (p<2·2 × 10-16 for all exercise types). The largest associations were seen for popular team sports (22·3% lower), cycling (21·6% lower), and aerobic and gym activities (20·1% lower), as well as durations of 45 min and frequencies of three to five times per week. INTERPRETATION: In a large US sample, physical exercise was significantly and meaningfully associated with self-reported mental health burden in the past month. More exercise was not always better. Differences as a function of exercise were large relative to other demographic variables such as education and income. Specific types, durations, and frequencies of exercise might be more effective clinical targets than others for reducing mental health burden, and merit interventional study. FUNDING: Cloud computing resources were provided by Microsoft.
Authors: Natalia Z Bielczyk; Ayaka Ando; AmanPreet Badhwar; Chiara Caldinelli; Mengxia Gao; Amelie Haugg; Leanna M Hernandez; Kaori L Ito; Dan Kessler; Dan Lurie; Meena M Makary; Aki Nikolaidis; Michele Veldsman; Christopher Allen; Adriana Bankston; Katherine L Bottenhorn; Ricarda Braukmann; Vince Calhoun; Veronika Cheplygina; Catarina Costa Boffino; Ece Ercan; Karolina Finc; Heidi Foo; Ali Khatibi; Christian La; David M A Mehler; Sridar Narayanan; Russell A Poldrack; Pradeep Reddy Raamana; Taylor Salo; Claire Godard-Sebillotte; Lucina Q Uddin; Davide Valeriani; Sofie L Valk; Courtney C Walton; Phillip G D Ward; Julio A Yanes; Xinqi Zhou Journal: Neuron Date: 2020-04-22 Impact factor: 17.173
Authors: Kathryn E Smith; Alissa Haedt-Matt; Tyler B Mason; Shirlene Wang; Chih-Hsiang Yang; Jessica L Unick; Dale Bond; Andrea B Goldschmidt Journal: J Behav Med Date: 2020-04-17
Authors: Kathleen M McIntyre; Eli Puterman; Jennifer M Scodes; Tse-Hwei Choo; C Jean Choi; Martina Pavlicova; Richard P Sloan Journal: Health Psychol Date: 2020-01-09 Impact factor: 4.267
Authors: Kathryn E Smith; Tyler B Mason; Adrienne Juarascio; Lauren M Schaefer; Ross D Crosby; Scott G Engel; Stephen A Wonderlich Journal: Int J Eat Disord Date: 2019-07-16 Impact factor: 4.861
Authors: Jean Michel Rocha Sampaio Leite; Júlia Maria Pavan Soler; Andréa Roseli Vançan Russo Horimoto; Rafael O Alvim; Alexandre C Pereira Journal: Hum Hered Date: 2020-02-21 Impact factor: 0.444
Authors: Karmel W Choi; Chia-Yen Chen; Murray B Stein; Yann C Klimentidis; Min-Jung Wang; Karestan C Koenen; Jordan W Smoller Journal: JAMA Psychiatry Date: 2019-04-01 Impact factor: 21.596