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.
This cross-sectional study
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.
The researchers 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. They 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 × 10
10, p<2 10="" sup="">−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 10="" sup="">−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.
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