Adam Chekroud, PhD, on Exercising Your Way to Optimal Mental Health
Regular exercise is known to provide a wealth of physical benefits, and information about its effects on mental health continues to grow.
The frequency, duration, and types of exercise for ideal physical health are well-documented in current literature. However, these same aspects of exercise for optimal mental health are not as well-characterized, said Adam Chekroud, PhD, co-founder and chief scientist at Spring Health, which originated from the Department of Psychiatry at Yale School of Medicine in New Haven, Connecticut.
In hopes of exploring these factors further at a large scale, Dr Chekroud and colleagues conducted a cross-sectional study of more than 1.2 million American adults.1
Published recently in The Lancet Psychiatry, the study incorporated data from the Centers for Disease Control and Prevention regarding the mental health effects of various physical activities at different durations and frequencies compared with no exercise at all.
Consultant360 spoke with Dr Chekroud about the findings from his study, their clinical impact, and their implications for future research initiatives.
Consultant360: Many studies in the past have reported the beneficial effects of exercise on mental health. What was the inspiration for your study in particular, and what new information did you aim to add to the growing body of knowledge on this topic?
Adam Chekroud: Just as an anecdote- I like to cycle a lot. I find that when I cycle on the weekends, my mental health is definitely better. That was something that initially inspired my colleagues and me to look at the literature on the relationship between mental health and exercise.
As you mentioned, many randomized controlled trials and cohort studies have shown that exercise has an effect on mental health, but we aimed to determine 2 takeaways in particular.
First, we wanted to know what kind of exercise and how much exercise we should be doing. We have definitely seen studies on the effects of high-intensity or low-intensity exercise, but we wanted to know more about some specifics around exercise regimes that had not really been addressed in the literature. We didn’t see any specific recommendations in the literature in terms of the ideal types or duration of exercise for mental health.
Second, the relationship between exercise and mental health is a big public health issue. For big public health issues, we usually see studies that are quite large. There have been a lot of large studies with well over 1 million subjects for physical issues concerning body mass index, cardiovascular disease, the effectiveness of statins, and the like. However, we were surprised to find that the largest study that had ever been done on exercise and mental health was actually a meta-analysis and included only around 90,000 subjects.
It was surprising to us that such a big topic had never really been addressed at scale and also had not really been addressed in the kind of detail that we were curious about.
C360: What would you say was the most exciting or surprising finding from your study?
AC: I think there are a lot of important take-homes from this study. It continues to reiterate points made in the literature that exercise seems to have a strong relationship with mental health, and that people who exercise seem to have much better mental health than people who do not.
We were particularly excited by the fact that, in our study, even activities like walking and housework were associated with better mental health compared with no exercise at all.
If these effects do hold up, then it appears that we do not have to always do activities like resistance exercise training or power lifting to achieve the mental health benefits of physical activity. It seems like the effects might be quite accessible and scalable.
C360: You and your co-authors noted in the study that more exercise is “not always better” for mental health. Could you clarify what you meant by this?
AC: To clarify, I think that our study did not necessarily suggest that more exercise is not always better, but that it conferred no additional benefit. It seemed that people who exercised between 30 and 60 minutes may have had better mental health, but going beyond 90 minutes did not seem to increase that benefit.
Similarly, when we looked at the relationship between exercise frequency and mental health, people who were exercising between 3 and 5 times per week seemed to experience better mental health outcomes compared with people who were doing fewer sessions per week and people who were doing more than 5 sessions per week.
I am not sure whether this finding has been somewhat misconceptualized as ‘more exercise is worse,’ but that was not necessarily an argument that we were making. It certainly seems that a fairly moderate regime may be the sweet spot.
C360: In your study, the strongest associations between exercise and improved mental health were observed for popular team sports, cycling, and aerobic and gym activities. Were you able to identify any reason for this?
AC: This is definitely an area for further research. We can certainly speculate, and I think a lot of people have speculated in the same way: when you think about popular team sports, these group exercises have 2 aspects. First, group activities like a soccer match or cycling with a team have the physical exertion component, which is common across many exercises. But then, there is also a social element.
So, sports with an additional social element may have 2 separate influences. There is the influence of the neurobiological effects that come from physical exertion, but then there are also the additional benefits of interacting with people, being part of a group, and the motivational aspects that come with that.
Moving forward, I would love for researchers to use the findings from our study as a platform to design more experimental studies or even clinical trials to explore this further.
C360: What would you say are the clinical takeaways from this study?
AC: We showed in a very large representative sample that there is a clear association between mental health and exercise, and that people who exercise have better mental health. For clinicians, I think this study adds more evidence to a large body of literature suggesting these benefits are not only physical, but there may also be mental health benefits for exercise that warrant our attention.
For our coverage of Dr Chekroud’s study, click here.
1. Chekroud SR, Gueorguieva R, Zheutlin AB, et al. Association between physical exercise and mental health in 1.2 million individuals in the USA between 2011 and 2015: a cross-sectional study [published online August 8, 2018]. Lancet Psychiatry. https://doi.org/10.1016/S2215-0366(18)30227-X.