February 28 — 29, 2008 Advisory Committee Meeting Minutes

Subcommittee Report: Mental Health

Rod Dishman, Ph.D., led discussion on the subcommittee report on mental health. The methodology the subcommittee utilized included meta-analytic or otherwise systematic reviews of studies of mental health published since 1995. The questions researched included:

1. Does physical activity protect against the onset of disorders or symptoms?

2. Does physical activity reduce symptoms?

3. Do the effects of physical activity on symptoms differ according to age, gender, race/ethnicity or medical condition?

4. Do the effects of physical activity vary according to features of physical activity including type, intensity, or timing?

The topics the group reviewed included depression, anxiety, distress/wellbeing, cognitive function and dementia, sleep, self-esteem, chronic fatigue.

Overall the scientific evidence from prospective cohort studies and randomized controlled trials supports the overall conclusion that regular participation in moderate-to-vigorous physical activity is associated with fewer symptoms and incident cases of major depression, fewer symptoms of anxiety and distress, reduced onset of cognitive decline and onset of dementia and enhanced feelings of well-being, cognitive function, sleep quality, feelings of energy and self-esteem. The outcomes are generally positive for men and women of differing ages, nationalities and health status; however, there are few direct comparisons according to ethnic groups. The evidence from both observational and randomized controlled studies suggests a dose-gradient for depression symptoms that occurs within current public health recommendations for moderate-to-vigorous physical activity. There is insufficient evidence to determine whether an increase in fitness is necessary for mental health benefits. Positive relations seen for depression and self-esteem may be a surrogate index of intervention adherence.

Future research needs include more prospective cohort studies and tightly controlled RCTs, especially for anxiety and sleep disorders. Also, more studies that manipulate standardized features of physical activity and its setting are needed. Accelerated synergy between human brain imaging studies and neuroscience studies using animal models of human disease to elucidate biological mechanism and more modeling of social-cognitive mediators of mental health outcomes and studies of gene-environment interaction are needed.

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