Exercise and Mental Health

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Suicide is a complex and devastating public health issue that affects millions of people worldwide. Despite advances in mental health treatment and suicide prevention efforts, rates of suicide continue to rise, particularly among vulnerable populations such as those with mental or physical illness. Previous research demonstrated that teens with high sedentary behavior had twice the risk of a suicide attempt vs those with low daily sedentary time. There is growing interest in interventions that may reduce the risk of suicide, including promoting physical activity.

Exercise has been shown to have numerous physical and mental health benefits. But can exercise also help prevent suicidal behaviors? In this systematic review and meta-analysis, researchers explore the potential protective effect of exercise against suicidal ideation, suicide attempts, and death by suicide in people with mental or physical illness. By examining the existing evidence on this topic, we hope to shed light on a promising new avenue for suicide prevention efforts.

The key findings of this systematic review and meta-analysis were that exercise may have a significant protective effect against suicidal behaviors in people with mental or physical illness. The study found that even though people who exercised had thoughts about suicide just as often, the likelihood of acting on those thoughts by attempting to end one’s life was 77% lower among people in exercise interventions compared to control groups. Death by suicide was 36% less likely among exercisers, but this difference did not achieve statistical significance. The randomized controlled trials included in this study were selected through a comprehensive search of multiple databases and were analyzed using established methods for meta-analyses. However, there was a high risk of bias in many studies. Depression was the most common condition in these studies, but people with menopause, breast cancer, sickle cell, and Huntington’s were included in one study each.

Although further research is needed to better understand the mechanisms underlying this effect, and to identify optimal exercise interventions for different populations, these findings suggest that exercise reduces the chance that a person suffering with depression or a medical illness will act on suicidal thoughts. Possible mechanisms include exercise providing relief from distress, improving depression, generating optimism or facilitating social connectedness.

Promoting regular physical activity appears to have important potential as a suicide prevention strategy that could serve us well in an age of growing mental health and suicide crises.

If you are interested in learning more about the connection between lifestyle medicine and mental health, check out a previous post on how physical activity may affect symptoms of depression, anxiety, and psychological distress. Other lifestyle behaviors, such as diet and sleep, may also impact mental health, and this is outlined in detail here.

By: Helena Zhang & Douglas Noordsy, MD

Sources:

  1. The effect of exercise on suicidal behaviors: A systematic review and meta-analysis of randomized controlled trials
A Metareview of Lifestyle Psychiatry

A Metareview of Lifestyle Psychiatry

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Recent research has elucidated the role of these lifestyle factors – diet, sleep, and exercise, on our minds. Upon finding a link between various mental disorders to these factors, Firth et al., conducted a review and analysis of the top-tier evidence to examine how physical activity, sleep, dietary patterns and tobacco smoking can impact the development and treatment of a variety of different mental disorders.

Broadly, they found evidence that physical activity is helpful for both the prevention and treatment of a variety of mental health disorders and is one of the most extensively researched “lifestyle factors”. They also found that tobacco smoking was a significant risk factor that contributed to people developing mental illness. Poor sleep was also a modifiable risk factor in both the development and worsening of mental health disorders and symptoms, and in the research, a complex two-way relationship between sleep and mental health symptoms is highlighted. More evidence is needed to establish the role of dietary patterns in mental health.

With these findings, the researchers have made recommendations for the integration and delivery of lifestyle interventions in healthcare settings at a broad scale to help people improve their mental health. A few important steps to optimizing mental health and cognitive performance include taking adequate time for exercise, creating an environment conducive to quality sleep, not smoking tobacco, and fueling your mind and body with healthy, whole foods. 

By: Douglas Noordsy, MD and Vanika Chawla, MD

 

Journal References:

  1. Reference: Firth J, Solmi M, Wootton RE, et al. A meta-review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders. World Psychiatry. 2020;19(3):360-380. doi:10.1002/wps.20773
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Lifestyle May Be More Important Than Age in Determining Risk of Cognitive Decline

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A great part of who were are is composed of the memories we have. With a growing interest in preventing the loss of memories, researchers have turned to preventative approaches – to address the lack of disease-modifying treatment for dementia. 

A recent study found that lifestyle may be more important than age in determining the risk of dementia and cognitive health. The study included data from over 22,000 participants between the ages of 18 – 89  and found that, for all ages, lifestyle is a more important risk factor for cognitive decline than age. The risk factors that were examined range from early-life factors to late-life factors. They include low education, traumatic brain injury, hypertension, smoking, diabetes, and depression. 

In the study, participants with no risk factors for dementia had similar brain health to people 10-20 years younger than them! Additionally, the study found that each risk factor for dementia reduced cognitive abilities by the equivalent of 3 years of aging, and each additional risk factor added to this decline. 

For the risk factors that are modifiable with nutrition, exercise, and stress management, this study suggests it is never too early to start caring for your brain health. Maintaining healthy lifestyle habits can prevent the loss of memory and shape the life you live.

By: Helena Zhang, BS & Maya Shetty, BS

Journal Reference:

  1. LaPlume AA, McKetton L, Levine B, Troyer AK, Anderson ND. The adverse effect of modifiable dementia risk factors on cognition amplifies across the adult lifespan. Alzheimers Dement (Amst). 2022 Jul 13;14(1):e12337. doi: 10.1002/dad2.12337. PMID: 35845262; PMCID: PMC9277708.
Research Suggets Whole Food Diets Improve Mood and Quality of Life

Research Suggets Whole Food Diets Improve Mood and Quality of Life

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When the substance of food culture is composed of highly processed goods and advertisements of snacks, alcohol and soda as avenues of happiness, the poor food choices that arise are unsurprising. However, sugar-laden and high-fat consumption are associated with rising mortality rates, increased prevalence of chronic diseases, and soaring rates of addiction and mental health crises.  

In a first of its kind study, Francis et al randomly assigned 76 young adults to either eat a healthy Mediterranean diet, that is rich in fruit, vegetables, fish, and lean meat, or to continue eating a diet high in processed foods, saturated fats, and refined sugars. After a brief educational video and a $60 incentive to purchase Mediterranean foods, the Med diet group reported decreasing their intake of refined sugar and saturated fat. After only three weeks, the Med diet group showed significantly lower levels of depressive symptoms. On the other hand, young adults in the control group, who consumed a diet high in processed foods, saturated fats, and refined sugars, experienced no change in depression symptoms. 

With diet as a modifiable risk factor for depression, education on healthy eating habits, diet changes, and interventions are more important than ever as we face a world of increased stress and anxiety from the pandemic and saturation with social media and virtual technology. In the study, the diet intervention consisted of vegetables, omega-3 fatty acids, wholegrain cereals, protein from poultry to eggs and legumes, nuts and seeds, olive oil, and spices such as turmeric and cinnamon. In addition to following a Mediterranean style diet, the recommendations provided in this study included avoiding foods that come in a package with multiple ingredients, foods with more than 10g sugar per 100g, soft drinks, chocolates, sweets, and fried take away foods.  

 There is no doubt that what we eat affects us from our head to toe. Therefore, eating healthy, whole foods, is a promising way to improve our mood and the quality of our life.  

By: Helena Zhang, BS and Marily Oppezzo, PhD, MS

Journal Reference:

  1. Francis HM, Stevenson RJ, Chambers JR, Gupta D, Newey B, Lim CK. A brief diet intervention can reduce symptoms of depression in young adults – A randomised controlled trial. PLoS One. 2019 Oct 9;14(10):e0222768. doi: 10.1371/journal.pone.0222768. PMID: 31596866; PMCID: PMC6784975.
A One-Hour Walk in Nature Decreases Activity in the Stress-Related Regions of the Brain

A One-Hour Walk in Nature Decreases Activity in the Stress-Related Regions of the Brain

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A recently published study compared the effects walking in different environments has on the brain. Study participants were randomly assigned to go on a 60-minute walk in a natural or urban environment, and questionnaires and fMRI scans were administered before and after the walk. fMRI scans were used to measure the activation of different brain regions, while questionnaires were used to gauge participant’s perceived mood and stress levels. The study found that a one-hour walk in nature decreased activity in the amygdala, while no change was seen after a one-hour walk in an urban-environment. The amygdala is the part of our brain primarily associated with regulating emotions and processing stressful events. An overactive amygdala is associated with anxiety, while, decreased activity has an anxiolytic effect. Therefore, the findings of thisstudy suggest a walk in nature may be more beneficial for managing stress than a walk in the city. Additionally, our environment plays an important role in the cognitive benefits of walking. This study is a great example of how multiple components of lifestyle medicine can come together. Exercise and being in nature are both powerful tools for managing stress and improving mental health; however, their effect is even more potent when combined.

By: Maya Shetty, BS, Lifestyle Medicine Fellow

 

Journal Reference:

  1. Sudimac S, Sale V, Kühn S. How nature nurtures: Amygdala activity decreases as the result of a one-hour walk in nature. Mol Psychiatry. 2022 Sep 5. doi: 10.1038/s41380-022-01720-6. Epub ahead of print. PMID: 36059042.