Why exercise is best medicine
A new study involving more than 17,000 participants found that those with high fitness in middle age were significantly less likely to die from heart disease in later life – even if they were diagnosed with depression.
The research highlights several ways in which depression may ultimately impact health and mortality.
Heart health and depression often go hand-in-hand and depression has been linked to higher probabilities that someone will develop heart disease and chest pain.
The University of Texas scientists suggest that starting to exercise early in life and continuing to do it often could protect both the mental and physical health of patients battling depression and facing heart disease risks.
It also highlights the importance of overcoming a common dilemma among patients: how to cope with hopelessness and still find motivation to exercise.
Study co-author Dr. Madhukar Trivedi, of the University of Texas, Southwestern, United States (U.S.), said: “Maintaining a healthy dose of exercise is difficult, but it can be done.
“It just requires more effort and addressing unique barriers to regular exercise.”
He said previous research shows that depressed patients can often perform about three-quarters of the exercise they’re asked to do.
He recommends patients take several steps to boost their chances of success, including setting aside a consistent time to exercise every day, but do not get discouraged by stretches of inactivity.
Trivedi said keep a log to track progress, varying exercises to avoid monotony, and exercising with a friend also help.
The study, published in the Journal of the American Medical Association Psychiatry, used a database of participants who had their cardio-respiratory fitness measured at an average age of 50.
Researchers used Medicare administrative data to establish correlations between the participants’ fitness at midlife to rates of depression and heart disease in older age.
Participants with high fitness levels were 56 percent less likely to eventually die from heart disease following a depression diagnosis.
Trivedi says the findings are just as relevant to younger age groups, in particular university-age young adults who are just entering the workforce.
He said: “This is the age where we typically see physical activity drop off because they’re not involved in school activities and sports.
“The earlier you maintain fitness, the better chance of preventing depression, which in the long run will help lower the risk of heart disease.”
Depression has been linked to several other chronic medical conditions including diabetes, obesity, and chronic kidney disease, which studies show can affect whether antidepressants are likely to help.
For patients with these conditions, Trivedi said the more appropriate treatment may be exercise.
He says the reasons behind this may partly be connected to the general health effects of physical activity, including the fact that exercise decreases inflammation that may cause depression.
By reducing inflammation, he said the risk for depression and heart disease are lowered.
Trivedi said: “There is value to not starting a medication if it’s not needed. Being active and getting psychotherapy are sometimes the best prescription, especially in younger patients who don’t have severe depression.”
He has organized large studies to further solidify the cause and effect relationships among fitness, depression, and heart disease.
One example is RAD, Resilience in Adolescent Development, a 10-year study that will enroll 1,500 participants who are at risk to develop depression but have not done so.
The study’s primary aim is to examine whether personal factors such as lifestyle and biology influence a teenager’s ability to resist mood disorders.