People with good physical fitness in their 30s and 50s have more elastic arteries later in life. This is shown in a new study from Karolinska Institutet, published in the journal Scientific Reports. The association remains regardless of cholesterol levels and other risk factors.
Cardiovascular disease is the leading cause of death worldwide. One early sign of increased risk is stiffening of the arteries, which can contribute to heart attack and stroke. In the present study, researchers investigated whether physical fitness earlier in life can predict how elastic the blood vessels are in older age.
The study is based on data from the Swedish longitudinal study SPAF‑1958, led by Maria Westerståhl, senior lecturer at the Department of Laboratory Medicine, where 425 individuals were followed across adulthood. Participants were examined at ages 34, 52, and 63. The researchers assessed fitness using a cycle ergometer test, analysed blood samples to study lipids, and measured arterial stiffness at age 63 using a non-invasive method.
Fitness more important than blood lipids
The results show that individuals with higher fitness at ages 34 and 52 had more elastic arteries at age 63. The association remained even after accounting for factors such as blood pressure, body weight, smoking, and cholesterol levels. However, neither cholesterol nor more advanced measures of so-called “good” HDL cholesterol could predict arterial stiffness.
“Our findings show that good physical fitness early in life is linked to vascular health later in life, independently of traditional risk factors,” says Andrea Tryfonos, postdoctoral researcherat the Department of Laboratory Medicine, Karolinska Institutet.
According to the researchers, the results suggest that regular physical activity may have long-term effects on cardiovascular health that are not captured by blood lipids and other common risk markers alone.
“This highlights the importance of maintaining good fitness from early adulthood to reduce the risk of cardiovascular disease,” says Andrea Tryfonos.
Next step
The researchers are now planning a follow-up of the participants at age 68 to investigate how changes in fitness over time affect vascular health later in life.
The study was conducted in collaboration with the division of clinical physiology and the division of clinical chemistry at the department of laboratory medicine, as well as Karolinska University Hospital in Huddinge. Information on funding and potential conflicts of interest is not available in the provided material.
By Maria Fernanda Ziegler | Agência FAPESP – A study conducted on an animal model by researchers at the Federal University of São Paulo (UNIFESP) in Brazil demonstrated that swimming is more effective than running in promoting healthy heart growth and improving the strength with which the heart muscle (myocardium) contracts.
“Swimming and running are two excellent ways to improve cardiorespiratory health and protect the heart muscle, but we wanted to know if one could be even more beneficial than the other. We found that, although both increase respiratory capacity, swimming goes a step further by combining functional and molecular adaptations that make the heart stronger and more efficient,” says Andrey Jorge Serra, a professor at UNIFESP and coordinator of the study supported by FAPESP.
The study, published in the journal Scientific Reports, demonstrates that swimming promotes greater modulation of microRNAs that control various heart adaptations, such as cardiac cell growth, the formation of new blood vessels (angiogenesis), protection against cell death, and the regulation of contractility and responses to oxidative stress, compared to running training.
MicroRNAs are molecules that regulate the expression of messenger RNAs, which are responsible for protein synthesis.
“Although several studies had already examined the expression of microRNAs regulated by aerobic training in general, little was known about expression patterns when swimming and running were compared in the same experimental setting. Therefore, this study reveals that there’s a distinction in cardiovascular effects between these two modalities,” says Serra.
In the study, the mice underwent an eight-week training protocol consisting of daily 60-minute sessions five days a week. The rats were divided into three groups: one that did not train, one that only ran, and one that only swam. Since running and swimming are very different forms of exercise, the comparison between the training regimens was not based on the speed the animals reached but rather on the relative intensity of the effort, as measured by maximum oxygen consumption (VO₂ max) – an indicator that assesses the body’s ability to capture, transport, and utilize oxygen during physical activity.
According to the results, running and swimming improved physical fitness similarly: between the first and last training sessions, VO₂ max increased by more than 5%. However, only swimming promoted significant structural changes in the heart, such as increases in cardiac and left ventricular mass. Running did not show relevant differences compared to the sedentary animals.
“People’s choice of sport depends largely on personal preference, aptitude, and enjoyment. But our results show that swimming may have a special impact in situations involving myocardial recovery, cardiac rehabilitation, and above all, scientific research. This is also relevant because studies on aerobic exercise often use running and swimming interchangeably, and we now know that the effects aren’t the same,” Serra explains.
Before and after the training period, the researchers administered a series of tests to evaluate various aspects of cardiac health, including cardiorespiratory capacity, fitness, and the structure and function of the heart and myocardium.
The study also analyzed the gene expression and protein pathways involved in physiological cardiac hypertrophy and the mechanisms involved in identifying regulatory microRNAs.
“Although we don’t yet know why this change occurs at the molecular level, of the microRNA, we were able to delve deeply into and investigate the molecular pathways that control physiological hypertrophy,” the researcher adds.
The article “Swimming is superior to running in inducing physiological cardiac hypertrophy and enhancing myocardial performance” can be read at nature.com/articles/s41598-026-36818-2.
South Africa is facing an alarming increase in non-communicable diseases and related mortality. According to Statistics South Africa, deaths due to non-communicable diseases such as type 2 diabetes and hypertension increased by over 58% between 1997 and 2018.
The crisis of overweight and obesity in the country adds to the risk of these diseases. Nearly 40% of the adult population is overweight. Although physical activity can help prevent and manage many non-communicable diseases, 47% of adults do not engage in any physical activity. Most people struggle to meet the World Health Organization’s recommended 150-300 minutes of moderate-intensity aerobic physical activity per week.
A significant part of the challenge is that people have adopted an “all or nothing” approach to physical activity. The perception is that one has to participate in structured workouts, such as gym sessions, running, or cycling.
Instead, research has shown that even brief, low-intensity movements can yield measurable physical and mental health benefits. Even everyday tasks count. New evidence shows that short movement bouts of less than five minutes can have positive health implications.
As researchers in exercise science and sports medicine we have observed that physical activity is particularly low in South Africa. Only 19.8% of adults meet the WHO’s guideline, against the global average of 73%.
Our study of 62 office-based workers at the University of the Witwatersrand also showed the short-term health impact of height-adjustable, sit-to-stand desks. Our intervention reduced prolonged sitting and slightly improved indicators such as body mass index and blood pressure. Given South Africa’s high burden of obesity and sedentary lifestyles among office workers, these improvements are encouraging and support global health messaging that even modest increases in daily movement can positively influence health.
These findings were the springboard for the “Mzansi, what’s your move?” campaign at the university. We want to encourage staff and students to move more by showing how simple actions add up to physical activity. The campaign is supported by a series of comics and murals on campuses.
Here, we highlight some of the actions that we used in our campaign to encourage everyone to get moving. These are daily tasks that may seem mundane but count as physical activity, while reflecting people’s realities.
Housework
Many people do not consider housework a form of physical activity. But tasks like sweeping, mopping or vacuuming require sustained movement and engage multiple muscle groups.
Scrubbing floors, washing windows and cleaning bathrooms involve movements such as squatting and stretching. Working in the garden can strengthen muscles too.
As part of our campaign, we’ve developed comic strips that highlight movements that can be done at home and in the community. We emphasise how all family members can move in ways that fit their lifestyles and physical abilities.
Active commuting
Walking or cycling to work or school contribute significantly to daily physical activity. Studies have shown that active commuting is associated with lower body fat, reduced blood pressure, and improved mental well-being.
Including movement into daily travel routines is a practical way to accumulate physical activity without setting time aside. Walking briskly to a train station, cycling a few kilometres to work, or taking a longer walking route to drop off children at school accumulates over time. Even seemingly small changes, such as getting off the bus one stop early or taking the stairs instead of the elevator, produce measurable health benefits over weeks and months.
However, achieving the full benefits of active commuting is complex and it relies on cities building and maintaining road infrastructure. In South Africa, safety is a legitimate concern for all road users. A 2024 Statistics South Africa report shows that more pedestrians than car occupants died in road crashes in 2007, 2013, and 2019. Another safety concern relates to the country’s high crime rates. People may be reluctant to walk, even in their own neighbourhoods.
These challenges are not insurmountable. For starters, people should consider people moving in groups, joining walking and running clubs.
Beyond what individuals can do, municipalities can do something about green spaces. This includes ensuring that parks are safe to walk in and are clean. Broken pavements and bicycle lanes need to be maintained in all neighbourhoods.
Incidental movements
Incidental movements refer to small bouts of activity that occur throughout the day. Integrating these movements into everyday life can yield significant health benefits, especially in office contexts, where many people sit for extended periods. Employers can try nudging staff, for example to use the stairs instead of elevators, with simple posters or painted footprints. Another way to encourage physical activity is to centralise shared equipment (printers, bins, water stations) so that staff walk short distances.
Micro-breaks also provide opportunities for informal movements. Stretching during meetings or after long sitting periods, standing discussions instead of seated ones, and walking meetings for small groups all contribute to the physical activity of employees.
In 2024, we investigated the short-term impact of physical activity interventions such as high-intensity interval training and moderate-intensity continuous training on 43 labourers at the University of the Witwatersrand. The number of participants in this study was small, but the findings show that our intervention reduced indicators such as waist circumference, body mass index, blood glucose and blood pressure, and improved physical fitness.
Way forward
People don’t need a gym membership or a strict workout schedule to get moving. Simple, everyday activities all add up to meaningful physical activity. Small movements help to reduce the risks of chronic diseases, strengthen muscles, boost mental wellbeing, and counteract the harmful effects of prolonged sitting.
These “movement snacks” make exercise accessible, manageable and sustainable, particularly for people who find structured workouts intimidating or time-consuming.
A new study has found that metformin may mimic one of exercise’s core biological effects in men with prostate cancer, raising levels of a molecule tied to energy balance and weight control even when patients are inactive. The findings suggest that metformin could help counter the metabolic strain of hormone therapy, when fatigue and other side effects often limit physical activity.
Led by physician-scientists at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, the study appears in the journal EMBO Molecular Medicine.
Exercise is one of the most reliable ways to support health during cancer treatment. It helps regulate weight, blood sugar, and cardiovascular health – factors that shape how patients feel during therapy and how well they recover afterward.
For many people with cancer, however, regular exercise isn’t always feasible. Fatigue, hormone therapy, pain, or advanced disease can limit physical activity precisely when metabolic health becomes most important.
That reality has led researchers to ask a practical question: If exercise confers its benefits through specific biological signals, could some of those signals be activated in other ways?
According to the research, the answer may be yes. Sylvester investigators report that metformin raises levels of a naturally occurring molecule involved in how the body manages energy and weight in prostate cancer patients.
The finding does not suggest that a pill can replace physical activity. Instead, it offers insight into the internal pathways that underlie exercise’s metabolic benefits – and how those pathways might still be engaged when movement is limited.
“This study reflects what’s possible when laboratory science, metabolic biology, and clinical investigation are intentionally brought together for transdisciplinary studies,” said Sylvester researcher and first author, Marijo Bilusic, MD, PhD, genitourinary medical oncologist and professor of medicine and medical oncology at the Miller School. “The result isn’t a new cancer biomarker, but a clearer understanding of how a widely used drug may support metabolic health during prostate cancer treatment – an outcome that matters to patients and clinicians alike.”
The molecule at the heart of the study
At the center of the collaborative, team-science study is a molecule called N-lactoyl-phenylalanine (Lac-Phe). While its name is technical, its role is relatively simple.
Lac‑Phe is produced when the body is under metabolic demand. It forms when lactate, which accumulates during exertion, combines with phenylalanine, a basic building block of protein. Scientists first took notice of Lac‑Phe because its levels spike after intense exercise, coinciding with shifts in energy use and appetite regulation.
In preclinical and early human studies, higher Lac‑Phe levels have been associated with reduced appetite and improved weight control – two effects commonly linked to regular physical activity.
Lac-Phe does not rise only with exercise. Scientists observed elevated Lac-Phe levels in people taking metformin, even in the absence of physical activity. That overlap raised an important question for cancer care: Could a pathway typically associated with exercise be activated pharmacologically in patients whose treatments limit movement?
Why prostate cancer patients are a focus
To explore that question, the Sylvester team focused on prostate cancer, where hormone-based therapies are known to disrupt metabolism, contributing to weight gain, insulin resistance, and cardiovascular risk.
Notably, Lac-Phe levels in patients treated with metformin approximated those previously reported after strenuous exercise. This occurred even though patients were not exercising at the time of blood collection, and the effect persisted after hormone therapy began.
“From a clinical standpoint, seeing a metabolic signal that mirrors what we associate with intense exercise was striking,” said Bilusic. “For patients whose treatments or symptoms limit physical activity, that kind of effect could be especially meaningful.”
Higher Lac-Phe levels were not associated with anti-tumour response to metformin. The metabolite did not correlate with changes in prostate-specific antigen (PSA), a standard marker used to monitor prostate cancer.
What Lac-Phe might mean for patients
That distinction is central to the study’s interpretation. While more expanded studies are needed to determine the utility of Lac-Phe as a marker of anticancer efficacy, it appears to reflect how the body manages energy, weight and metabolic strain during treatment. These results were confirmed to ensure the findings were not limited to one clinical setting. In fact, increases were also observed in patients receiving other metabolic therapies, suggesting Lac-Phe may reflect a broader metabolic response rather than a drug‑specific effect.
“Cancer therapy often affects the body in ways that go beyond the tumour,” said Sylvester researcher Priyamvada Rai, PhD, co-leader, Tumor Biology Program and professor of radiation oncology at the Miller School. “Supporting metabolic health can influence how patients tolerate treatment and how they feel over time, even if it doesn’t directly change tumour growth. This study was an opportunity to investigate molecular pathways that can be therapeutically activated for better outcomes to treatments that induce metabolic stress.”
Metformin raises a stress hormone called GDF‑15, but this study found that Lac‑Phe was more closely tied to weight changes. Because the two didn’t rise together, metformin likely affects weight through multiple pathways, with Lac‑Phe playing a bigger role.
Taken together, the findings offer a clearer picture of how a widely used diabetes medication may influence metabolic health during prostate cancer care.
“What’s encouraging about this work is that it reminds us cancer care isn’t only about targeting tumours – it’s also about supporting the whole patient,” said Rai. “By better understanding how treatments affect metabolism, we can begin to identify ways to help patients maintain strength, resilience, and quality of life throughout their care.”
In a study of US adults, walking was, by far, the most popular leisure-time physical activity, while rural residents also enjoyed gardening, hunting and fishing, and urban residents more commonly reported running, weightlifting and dance. Urban residents were more likely than rural residents to meet physical activity guidelines. Christiaan Abildso of West Virginia University, US, and colleagues present these findings in the open-access journal PLOS One on April 1, 2026.
The US Department of Health and Human Services publishes guidelines on recommended amounts of aerobic and muscle-strengthening physical activity for adults. While the overall proportion of U.S. adults meeting these guidelines has increased in recent decades, certain populations are less likely to meet them, including adults living in rural areas. Understanding differences in preferred recreational physical activities could help inform efforts to reduce such disparities.
However, few studies have examined urban versus rural preferences for leisure-time physical activities, and how they relate to meeting guidelines. To address that gap, Abildso and colleagues analysed telephone survey data collected from a national sample of 396 261 U.S. adults in 2019.
Out of 75 survey options for leisure-time physical activities, walking was the most popular among both urban and rural adults, with 44.1% reporting walking as the activity they spent the most time doing. This finding echoes a similar study of U.S. data collected in 2011, which also found walking to be the top activity. However, further analysis of the 2019 data showed that even among walkers, only 25% met combined guidelines for aerobic and muscle-strengthening physical activity, and about 22% did not meet either guideline.
The popularity of other activities varied. For instance, rural residents reported higher rates of gardening, hunting, fishing, and farm work, while urban residents had higher participation in running, weightlifting, bicycling, and dance. However, in general, rural adults were more likely to be inactive and less likely to meet guidelines for aerobic or muscle-strengthening physical activity.
These findings could help inform efforts to boost physical activity by tailoring solutions to be more culturally and demographically appropriate. The researchers also call for a similar analysis of more recently collected data, as habits may have shifted during the COVID-19 pandemic.
Christiaan Abildso adds: “We expected to see that walking would continue to be the most common physical activity. However, it was surprising to see that nearly 1 in 4 adults who walk as their main activity did not meet either of the physical activity guidelines. That is, they reported less than the recommended 150 minutes per week of moderate-intensity aerobic activity and less than the recommended 2 days per week of muscle strengthening activity, such as yoga or exercises with resistance bands.”
“What we might be seeing in these rural-urban differences in preferences may just reflect what people have access to or what is culturally supported. In our work, we see a need to continue to support our partners in small towns and rural places by creating physical, social, and cultural conditions that support physical activity. This could mean creating a wide shoulder on a country road for running and cycling, helping a senior centre with their chair exercise programming, creating or improving park spaces, expanding the national network of rail-trails, renovating abandoned and dilapidated structures (Brownfields) into viable activity centres, keeping school facilities open to the public, and many other strategies. Everyone needs to ask, ‘how does what we’re doing affect physical activity,’ in order to help get people more active, more often, in more places.”
Australian study tracking more than 11 000 women found that meeting exercise guidelines during midlife had strong benefits for mortality
Photo by Teona Swift on Unsplash
Women who consistently met physical activity guidelines throughout middle age had half the risk of dying from any cause compared to women who remained inactive, according to a new paper publishing March 26th in the open-access journal PLOS Medicine by Binh Nguyen of the University of Sydney, Australia, and colleagues.
Physical activity is known to provide numerous health benefits and to reduce the risk of chronic diseases and premature mortality. However, most prior studies have measured physical activity at only a single point in time, which fails to capture how activity levels change over time.
In the new study, researchers used data from 11 169 women born between 1946 and 1951 who enrolled in the Australian Longitudinal Study on Women’s Health. Participants were surveyed nine times between 1996 and 2019, approximately every three years. Data was collected on how often the women met the World Health Organization’s recommendation of at least 150 minutes of moderate-to-vigorous physical activity (MVPA) per week.
The researchers found that consistently meeting MVPA recommendations throughout midlife was associated with a relative risk of all-cause mortality that was half that of those who consistently did not meet the recommendations (relative risk: 0.50). In absolute terms, the incidence of death was 5.3% among women who consistently met guidelines versus 10.4% among those who consistently did not. The magnitude of effect appeared similar or even stronger for cardiovascular disease and cancer mortality, though greater uncertainty in those estimates made the findings less conclusive, possibly because fewer deaths from those causes were observed. The evidence for benefits of starting to meet recommendations later in midlife – at age 55, 60, or 65 – rather than throughout all of midlife was also uncertain and inconclusive.
The study was limited by the fact that physical activity was self-reported and that the study sample may not be representative of all mid-aged Australian women.
“This study supports the growing evidence that maintaining an active lifestyle in midlife provides health benefits,” the authors say. “Women should be encouraged to meet physical activity recommendations throughout mid-age to derive these benefits.”
Nguyen adds, “Staying active throughout midlife can make a real difference for women’s long-term health. Our study shows that maintaining recommended levels of physical activity over multiple years helps protect against early death.”
The first major update to resistance-training guidelines in 17 years delivers one clear message: any amount of resistance training improves strength, muscle size, power and physical function.
The new recommendations, published by the American College of Sports Medicine (ACSM) as a Position Stand, are based on 137 systematic reviews involving more than 30 000 participants, making them the most comprehensive resistance-training guidelines to date.
“The best resistance training programme is the one you’ll actually stick with,” says Stuart Phillips, distinguished professor in the Department of Kinesiology and an author on the Position Stand. “Training all major muscle groups at least twice a week matters far more than chasing the idea of a ‘perfect’ or complex training plan. Whether it’s barbells, bands, or bodyweight, consistency and effort drive results.”
This update has been a long time coming. ACSM last published a Position Stand on resistance training for healthy adults in 2009, predating the explosion of research on muscle health, aging and the role of strength in long-term wellbeing.
“The new document reflects that surge in evidence and expands its recommendations to include more people and more types of training than ever before,” Phillips says.
A central theme of the new Position Stand is that the most meaningful gains come from a simple shift: moving from no resistance training to any form of it. While training variables such as load, volume, or frequency can be fine-tuned, the primary goal for most adults should be to build a consistent routine.
One of the greatest changes is the recognition that meaningful results don’t require a gym. Elastic bands, bodyweight training and home-based routines offer clear and measurable improvements in strength, muscle size and functional performance.
Rigid rules and prescriptive ideal programs are no longer supported by evidence, explains Phillips. Instead, personal goals, enjoyment, and long-term adherence matter most, especially for adults looking to stay strong, healthy and functional as they age.
Athletes and highly trained individuals will still require more specialized, sport-specific programs, but for the average adult, the message is simple: find a resistance-training routine you enjoy and stick with it.
Ageing naturally weakens our muscles, but a new study published in the journal Gut have found a gut bacterium that may help turn the tide. The researchers Leiden University Medical Center and the Universities of Granada and Almería, found that Roseburia inulinivorans is linked to stronger muscles in both people and mice. The discovery hints at the potential for new probiotics to support muscle strength and healthy ageing.
While exercise and good nutrition remain important for maintaining muscle strength, scientists are now turning their attention to a lesser‑known player: the gut. “The bacteria living in our intestines help us process nutrients, regulate inflammation and manage energy,” Patrick Rensen, professor at the division of Endocrinology, notes. “All of these processes are essential for keeping our muscles healthy as we age.”
A gut bacterium linked to stronger muscles
In their new work, the researchers identified one particular gut bacterium, Roseburia inulinivorans, that appears to be linked to stronger muscles across the lifespan. “When we compared young adults aged 18 to 25 with older adults aged 65 and above, we noticed clear differences,” postdoc Borja Martínez-Téllez says. “Older adults who carried this bacterium had 29 percent stronger handgrip strength than those who didn’t.” In young adults, higher levels of Roseburia inulinivorans were associated with stronger muscles and better overall fitness. “It was remarkable to see the same pattern in both age groups,” Martínez-Téllez adds.
Testing the bacterium in mice
To find out whether this link was more than coincidence, the researchers carried out a series of experiments in mice. “We wanted to understand whether this bacterium actually causes improvements in muscle strength,” Rensen explains. After clearing the mice’s gut bacteria using antibiotics, they introduced human strains of Roseburia inulinivorans for eight weeks.
“The results were striking,” Rensen says. “The mice became 30 percent stronger, developed larger muscle fibres and produced more fast‑twitch fibres.”
The team also found that the bacterium changed how the muscles used certain building blocks and activated energy‑related pathways inside the muscle. “These metabolic changes may help explain why the muscles grew stronger,” according to Martínez-Téllez.
From discovery to potential probiotic treatment
Another key observation is that levels of Roseburia inulinivorans naturally decline with age. “This could partly explain why muscle strength drops as we get older,” Martínez-Téllez says. “If this bacterium supports muscle metabolism, then restoring it might one day help preserve muscle function later in life.”
Together, the findings suggest that Roseburia inulinivorans could become a future probiotic, developed into a safe, supplement‑like product aimed at preventing age‑related muscle‑wasting conditions. “A nutraceutical approach – using food‑based or naturally derived products – could offer a gentle and non‑invasive way to support healthy ageing,” Martínez-Téllez explains.
The researchers however caution that considerable work needs to be done before these findings can be turned into a treatment for humans.
Replacing time spent watching TV with other activities can help prevent depressive disorder in middle-aged adults, revealed a new study in European Psychiatry, published on behalf of the European Psychiatric Association by Cambridge University Press. The effects were less pronounced in older and younger adults.
Lead researcher Rosa Palazuelos-González, of the University of Groningen, said that this new study is unique for investigating how reallocating time from TV-watching to various physical activities and sleep affects the onset of depression. Most studies until now have focused on identifying correlations between sedentary lifestyles and incidences of depression, rather than tracking how replacement activities affect the condition.
“We found that reducing TV-watching time by 60 minutes and reallocating it to other activities decreased the likelihood of developing major depression by 11 percent,” said Palazuelos-González.
“For 90- and 120-minute reallocations, this decrease in likelihood goes up to 25.91 percent.”
Middle-aged people benefit more from watching less
The benefits for middle-aged people who replace TV-watching with other activities are especially pronounced. Among this demographic, reallocating 60 minutes daily from TV-watching to other activities decreased the probability of developing depression by 18.8%. Reallocating 90 minutes resulted in decreased likelihood of 29%, and 120 minutes led to a reduction of 43%.
All reallocations of TV-watching time to specific activities were associated with reduced depression risk, except for reallocating only 30 minutes to household activities, which did not yield a significant effect. When reallocating 30 minutes specifically to sports, the reduction was 18%; to work/school physical activities, 10.2%; to leisure/commute activities, 8%; and to sleep, 9%. Time reallocations to sports, at any given duration, resulted in the largest reductions in the probability of major depression onset compared to all other activities.
Fewer comparable benefits for older adults and young adults
In older adults, reallocating TV-watching time proportionally to other activities did not lead to statistically significant reductions in onset of depression. Only substituting TV-watching time with sports reduced the probability of becoming depressed, from 1.01 to 0.71% with 30 minutes, 0.63% with 60 minutes, and 0.56% with 90 minutes.
In young adults, reallocating TV-watching time to one or multiple movement activities did not significantly change the likelihood of them developing depression. However, this group is also more physically active than older age groups – the researchers suggest that they may have already surpassed the physical activity threshold that is protective against depression.
This research was developed using a population-based cohort study (a Dutch initiative named ‘Lifelines’) with a four-year follow-up, which included 65 454 non-depressed adults. Patterns across age groups were examined carefully. Participants self-reported time spent in active commuting, leisure, sports, household, physical-related activities at work or school, TV-watching, and sleep. Major depressive disorder was assessed using the Mini International Neuropsychiatric Interview.
Researchers found that exercise can have a moderate benefit in reducing depressive symptoms, comparable to therapy and antidepressants
Photo by Ketut Subiyanto on Pexels
Exercise may reduce symptoms of depression to a similar extent as psychological therapy, according to an updated Cochrane review. When compared with antidepressant medication, exercise also showed a similar effect, but the evidence was of low certainty.
Depression is a leading cause of ill health and disability, affecting over 280 million people worldwide. Exercise is low-cost, widely available, and comes with additional health benefits, making it an attractive option for patients and healthcare providers.
The review, conducted by researchers from the University of Lancashire, and supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration North-West Coast (ARC NWC), examined 73 randomised controlled trials including nearly 5000 adults with depression. The studies compared exercise with no treatment or control interventions, as well as with psychological therapies and antidepressant medications.
The results show that exercising can have a moderate benefit on reducing depressive symptoms, compared with no treatment or a control intervention. When compared with psychological therapy, exercise had a similar effect on depressive symptoms, based on moderate-certainty evidence from ten trials. Comparisons with antidepressant medication also suggested a similar effect, but the evidence is limited and of low certainty. Long-term effects are unclear as few studies followed participants after treatment.
Side effects were rare, including occasional musculoskeletal injuries for those exercising and typical medication-related effects for those taking antidepressants, such as fatigue and gastrointestinal problems.
“Our findings suggest that exercise appears to be a safe and accessible option for helping to manage symptoms of depression,” said Professor Andrew Clegg, lead author of the review. “This suggests that exercise works well for some people, but not for everyone, and finding approaches that individuals are willing and able to maintain is important.”
The review found that light to moderate intensity exercise may be more beneficial than vigorous exercise, and that completing between 13 and 36 exercise sessions of light to moderate intensity exercise was associated with greater improvements in depressive symptoms.
No single type of exercise was clearly superior, although mixed exercise programmes and resistance training appeared more effective than aerobic exercise alone. Some forms of exercise, such as yoga, qigong and stretching, were not included in the analysis and represent areas for future research. Long-term effects are unclear as few studies followed participants after treatment.
This update adds 35 new trials to previous versions of this Cochrane review published in 2008 and 2013, which were supported by the NIHR. Despite the additional evidence, the overall conclusions remain largely unchanged. This is because the majority of trials were small, with fewer than 100 participants, making it difficult to draw firm conclusions.
“Although we’ve added more trials in this update, the findings are similar,” said Professor Clegg. “Exercise can help people with depression, but if we want to find which types work best, for who and whether the benefits last over time, we still need larger, high-quality studies. One large, well-conducted trial is much better than numerous poor quality small trials with limited numbers of participants in each.”
