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Healthier Minds in Fitter Bodies: A Systematic Review and Meta-Analysis of the Association between Physical Fitness and Mental Health in Youth

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Abstract

Background

Physical fitness is an important marker of current and future health status, yet the association between physical fitness and indicators of mental health in youth has not been systematically reviewed and meta-analyzed.

Objective

The aim of this work was to systematically review and meta-analyze the association between physical fitness components (i.e. cardiorespiratory fitness, muscular fitness, speed-agility, flexibility and fitness composite) and mental health indicators (i.e. psychological well-being and psychological ill-being) in preschoolers, children and adolescents.

Design

Systematic review and meta-analysis.

Data Sources

Systematic searches were conducted in PubMed, Web of Science and Scopus from database inception to May 2020.

Eligibility Criteria

Studies (cross-sectional, longitudinal and intervention designs) were included if they measured at least one physical fitness component and one mental health indicator in healthy youth (2–18 years).

Results

A total of 58 unique studies (52 cross-sectional, 4 longitudinal and 4 intervention studies) met all eligibility criteria and were included. There was a significant positive overall association between physical fitness and mental health in children and adolescents (pooled r = 0.206, p < 0.001). We found suggestive evidence of moderation by age group, fitness components and socioeconomic status (all p < 0.08). No relevant studies focusing on preschoolers were identified. Evidence based on longitudinal and intervention studies was limited.

Conclusion

We observed a small to medium sized positive association between physical fitness and overall mental health in youth. However, as the majority of studies were cross-sectional, additional longitudinal and intervention studies are needed to provide evidence of causation.

Trial Registration

PROSPERO registration number CRD42017080005.

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Acknowledgements

María Rodriguez-Ayllon is no longer at the University of Granada. Her current affiliation is with the Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands. Jairo H. Migueles is also now affiliated with the Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.

Author information

Authors and Affiliations

  1. Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Department of Health Sciences, Public University of Navarre, Pamplona, Spain

    Cristina Cadenas-Sanchez

  2. PROFITH ‘PROmoting FITness and Health Through Physical Activity’ Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain

    Cristina Cadenas-Sanchez, Alejandra Mena-Molina, Lucia V. Torres-Lopez, Jairo H. Migueles, María Rodriguez-Ayllon & Francisco B. Ortega

  3. Priority Research Centre for Physical Activity and Nutrition, College of Human and Social Futures, University of Newcastle, Callaghan Campus, Newcastle, Australia

    David R. Lubans

  4. Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden

    Francisco B. Ortega

Authors
  1. Cristina Cadenas-Sanchez
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  2. Alejandra Mena-Molina
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  3. Lucia V. Torres-Lopez
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  4. Jairo H. Migueles
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  5. María Rodriguez-Ayllon
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  6. David R. Lubans
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  7. Francisco B. Ortega
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Corresponding author

Correspondence to Cristina Cadenas-Sanchez.

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Funding

The ActiveBrains project was funded by the Spanish Ministry of Economy and Competitiveness and the ‘Fondo Europeo de Desarrollo Regional (FEDER)’ (DEP2013-47540, DEP2016-79512-R, DEP2017‐91544‐EXP and RYC-2011-09011). CCS is supported by a grant from the Spanish Ministry of Science and Innovation (FJC2018-037925-I). JHM and LVTL are supported by the Spanish Ministry of Education, Culture and Sport (FPU15/02645 and FPU17/04802, respectively). DRL is funded by a National Health and Medical Research Council Senior Research Fellowship (APP1154507). Additional funding was obtained from the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Scientific Excellence Unit on Exercise and Health (UCEES). Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades and European Regional Development Funds (ref. SOMM17/6107/UGR). In addition, funding was provided by the SAMID III network, RETICS, funded by the PN I + D + I 2017–2021 (Spain), ISCIII Sub‐Directorate General for Research Assessment and Promotion, the European Regional Development Fund (ERDF) [Ref. RD16/0022], the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005‐00046/ACTI), the European Union’s 2020 research and innovation program under grant agreement no. 667302, the Andalusian Operational Programme supported by European Regional Development Funds (ERDF in English, FEDER in Spanish; project ref: B-CTS-355-UGR18), and the HL-PIVOT network – Healthy Living for Pandemic Event Protection.

Conflict of interest

Cristina Cadenas-Sanchez, Alejandra Mena-Molina, Lucia V. Torres-Lopez, Jairo H. Migueles, María Rodriguez-Ayllon, David R. Lubans, and Francisco B. Ortega declare they have no conflicts of interest relevant to the content of this review.

Author contributions

CCS: literature search, figures, study design, data analysis, data interpretation, and writing. AMM: literature search, data interpretation, and writing—review or editing of the manuscript. LVTL: data interpretation and writing—review or editing of the manuscript. JHM: figures, data analysis, data interpretation, and writing—review or editing of the manuscript. MRA: data interpretation and writing—review or editing of the manuscript. DRL: study design, data analysis, data interpretation, and writing—review or editing of the manuscript. FBO: study design, data analysis, data interpretation, and writing—review or editing of the manuscript. CCS, AMM, LVTL, and JHM have verified the underlying data, and all authors read and approved the final version of the manuscript.

Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Cadenas-Sanchez, C., Mena-Molina, A., Torres-Lopez, L.V. et al. Healthier Minds in Fitter Bodies: A Systematic Review and Meta-Analysis of the Association between Physical Fitness and Mental Health in Youth. Sports Med 51, 2571–2605 (2021). https://doi.org/10.1007/s40279-021-01520-y

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  • DOI: https://doi.org/10.1007/s40279-021-01520-y

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