# Exercise as it relates to Disease/How vigorous-intensity exercise is associated with an increase in mental health
## What is the background of this research?

The background of the research was in stress experienced at university and how it related to stress related mental disorders along with how they can lead to many mental health problems such as depression, higher burnout rates, augmented sleep complaints, anxiety or even panic attacks. This study pointed out a recent systematic review of studies of depression prevalence at universities and showed that university students have a prevalence rate of poor mental health of 31% and more so showed there's was a 50% rate of student with mental health symptoms. The main focus of this study however was identifying if vigorous intensity physical activity lead to a noticeable decrease in stress symptoms, depression rates and better sleeping patterns. The study used the American Collage of Sports medicine vigorous exercise intensity recommendations which is equal to or greater than 3x20min of vigorous physical activity per week and compared it to students that didn't meet these recommendations and therefore only did moderate physical activity.

## Where is the research from?

This research was based out of the department of Sport, Exercise and Health within the University of Basel in Basel Switzerland. Along with the Psychiatric Hospital of the University of Basel, Centre for Affective, Stress and Sleep Disorders, also is Basel Switzerland

## What kind of research was this?

This article was a cross-sectional study design due to it not having a control group but rather comparing multiple population groups at specific times. Which in this study can be seen as comparing vigorous activity group to the moderate activity group within the three questioning periods.

## What did the research involve?

This study involves using a very small cohort of 42 university students with poor mental health, high stress levels and poor sleep. Then seeing if meeting the American College of Sports Medicine's vigorous-intensity exercise recommendation increased their overall mental health compared to people who may have had moderate activity or none. To track physical activity the participants were taught how to correctly use accelerometers then proceeded to wear them on their hips during the day to track activity. Stress was recorded via a simple self-perceived stress scale. Assessing the severity of depressive symptoms was done by the German version of the Beck Depression Scale. Sleep complaints were assessed via The Insomnia Severity Index and sleep pattern was assessed by the use of a portable sleep-EEG to give participants the ability to sleep at home in comfort. All of these measured are proven to be statistically reliable and were a good choice for the basis of this study.

## What were the basic results?

The study showed that participants above the ASCM's vigorous intensity guidelines slept better, had lowered stress levels, had fewer depressive symptoms with a lower self-perception of overall stress compared to those who did not meet the guidelines. It also shows that the participants that met the moderate physical activity guidelines also saw better mental health and stress levels just not to the same extent. However, this study only used a very small sample size of 42 and just let the participants go on their own daily life without a proper control group. This lead to only 19 participants representing the studies findings of meeting the vigorous activity guidelines and the other 23 meeting the moderate physical activity guideline (MPA). This small sample size showed that 10% reported mild or moderate depression symptoms. However, the study didn't contain an inactive or low activity group which may have shown a lot more important data when compared to the VPA or MPA group, this is turn may skew the results. A 2010 study looking at physical activity and mental health in student used three trial groups, them being highly active, medium level of activity and a low-none level of activity. This study showed a much greater gap when comparing low to high whereas this study just compared moderate to vigorous which shows a much smaller gap.

## What conclusions can we take from this research?

This research does certainly show that vigorous intensity exercise is better for mental health, stress levels and sleep compared to moderate level exercise. And more so demonstrates that intensity is the key not just to cardiovascular health but to mental health as well and that high-intensity exercise doesn't require a lot of time out of your week, something as simple as ACSM's recommended 3 x 20 minute vigorous intensity sessions a week is enough. However, the sample size was very small and although it did show improvements more study is needed with a larger cohort and an inactive group to provide comparison to. The inclusion of an inactive group in this study may make an extremely good case for the MPA group. Showing that vigorous intensity is better than moderate intensity but moderate may still show significant increases in mental health, stress and sleep when compared to an inactive/ low physical activity group of participants.

## Practical advice

All you need to meet the vigorous activity guidelines is as simple as three 20 minute sessions a week of high intensity exercise. This 60 minutes of exercise alone results in better cardiovascular health, better mental health, lower stress levels and better sleep. It's highly achievable and has many benefits even when done to the minimum level of 60 minutes a week.

## Further information/resources

* For information on the Australian Department of Health's physical activity guidelines visit: https://www1.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines#npa1864
* Multiple mental health helplines can be found on health directs website to help answer any mental health questions at: https://www.healthdirect.gov.au/mental-health-helplines
* A great multi-study analysis on how dosage of green exercise is also great at improving mental health can be found at: https://pubs.acs.org/doi/abs/10.1021/es903183r
* The Website verywellfit provides great explanations into what vigorous intensity exercise is, how it can be measured and some good examples of how you can do it yourself. This website can be found at: https://www.verywellfit.com/what-is-vigorous-intensity-exercise-3435408

### References

* 1 2 3 4 5 6 7 8 9 10 Gerber M, Brand S, Herrmann C, Colledge F, Holsboer-Trachsler E, Pühse U. Increased objectively assessed vigorous-intensity exercise is associated with reduced stress, increased mental health and good objective and subjective sleep in young adults. Physiology & behavior. 2014;135:17-24.
* ↑ Shankar NL, Park CL. Effects of stress on students' physical and mental health and academic success. International Journal of School & Educational Psychology. 2016;4(1):5-9.
* ↑ Ibrahim AK, Kelly SJ, Adams CE, Glazebrook C. A systematic review of studies of depression prevalence in university students. Journal of psychiatric research. 2013;47(3):391-400.
* 1 2 Haskell WL, Lee I-M, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation. 2007;116(9):1081.
* ↑ Beck AT, Ward C, Mendelson M, Mock J, Erbaugh J. Beck depression inventory (BDI). Arch Gen Psychiatry. 1961;4(6):561-71.
* ↑ Bastien CH, Vallières A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep medicine. 2001;2(4):297-307.
* ↑ Tyson P, Wilson K, Crone D, Brailsford R, Laws K. Physical activity and mental health in a student population. Journal of mental health. 2010;19(6):492-9.