Cardiorespiratory Fitness May Help in Protecting Against Depression Among Middle School Adolescents

doi:10.1016/j.jadohealth.2015.03.016

Journal of Adolescent Health

Volume 57, Issue 1, July 2015, Pages 60-65

https://doi.org/10.1016/j.jadohealth.2015.03.016 Get rights and content

Abstract

Purpose

Cross-sectional studies demonstrate a robust association between depression, physical activity, and cardiorespiratory fitness in adolescents, but longitudinal evidence that can better parse the direction of these effects is scarce and conflicting, and no such studies in adolescents have considered the importance of fitness (as opposed to physical activity per se) for preventing depression. Therefore, the present study sought to determine if cardiorespiratory fitness in the first year of middle school (sixth grade) would protect against developing depression a year later (seventh grade), even after controlling for other risk factors (i.e., preexisting depression levels and weight status).

Methods

Participants (N = 437 with 54.9% female) were recruited from six different middle schools during their sixth-grade year and reassessed during the seventh grade. At each assessment, participants completed self-report measures of depression and fitness. Participants were also weighed and were asked to complete a shuttle-run at both points.

Results

A cross-lagged panel model indicated that cardiorespiratory fitness in the sixth grade was associated with significantly less depression by the seventh grade in girls, even after controlling for preexisting depression and weight. The effect was in the same direction for boys, but was nonsignificant. In both cases, effects were modest to small.

Conclusions

Cardiorespiratory fitness had a small, but significant protective effect against developing depression in middle school girls, and may have a similar but smaller effect in boys. Promotion of cardiorespiratory fitness can be an important strategy for preventing depression in middle school adolescents, but needs to be coupled with interventions that more directly address symptom treatment.

Section snippets

Participants and procedures

Participants were male (n = 197) and female (n = 240) middle school students assessed in the sixth and seventh grades; they were drawn from six middle schools from a metropolitan county in North Texas. Mean age in the sixth grade was 11.55 years (standard deviation = .59). Participants were mostly white (89.0%) or African-American (9.2%), with a significant portion also identifying as Hispanic (23.6%). Based on federal guidelines, almost one fourth (23.5%) of the students qualified for free or

Results

Mean and standard deviations for the observed depression, fitness, and BMI variables according to gender and grade are reported in Table 1. With respect to depression, the percentages of girls who had CES-DC scores consistent with possible depression (i.e., CES-DC > 14) were 28.3% in sixth grade and 28.5% in seventh grade; the percentages for boys were 22.3% and 18.8% for sixth and seventh grade, respectively. However, only 13.8% of the girls and 10.2% of the boys had elevated depression scores

Discussion

The present study assessed the extent to which CRF longitudinally protects against depression in male and female middle school students. To our knowledge, this is the first time any study has naturally assessed the long-term (i.e., 1 year) association of CRF (as opposed to physical activity per se) on depression in adolescents. Moreover, unlike previous studies of CRF/physical activity and depression, the present study first controlled for preexisting depression in attempt to determine the

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Impact of high-intensity interval training including Indigenous narratives on adolescents’ mental health: a cluster-randomised controlled trial
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We investigated the efficacy of teacher‐delivered high‐intensity interval training (HIIT) with Indigenous narrative options on the mental health of school students in low–mid socioeconomic areas, compared to standard curriculum physical education practice.
A cluster‐randomised controlled trial was conducted in eight schools (N=368, age range 11–13 years) over 16 weeks. The primary outcome was the Strengths and Difficulties Questionnaire (SDQ) score. Generalised linear mixed models, controlling for the SDQ at baseline were applied, expressed as β, 95% confidence intervals, standardised effect, and p‐value. Focus groups elicited experiences with participating in and delivering the intervention.
There were no clear effects for SDQ total score (β ‐0.15, CI ‐0.98 ‐ 0.67, SE 0.42, p=0.714). Teachers did not deliver the Indigenous narrative options consistently owing to the perceived preparation needed and lack of confidence.
HIIT delivered in this manner had no effect on self‐perceived psychological difficulty or mental wellbeing in a cohort of young adolescents.
Future research should continue to explore opportunities to improve mental wellbeing via physical activity, but HIIT should not be implemented as a universal intervention for mental health gains alone. Teachers need more support to utilise Indigenous narratives as part of HIIT delivery.
Associations between changes in physical fitness and psychological difficulties status among Norwegian adolescents
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Citation Excerpt :
The results are also supported by previous cross-sectional studies that only found CRF to be associated with a mental health outcome, while controlling for at least one other measure of physical fitness (Andersen et al., 2017; Rieck, Jackson, Martin, Petrie, & Greenleaf, 2013; Yeatts, Martin, & Petrie, 2017). To the best of our knowledge, only Ruggero et al. (2015) have previously investigated the prospective association between physical fitness and mental health outcomes in a similar adolescent population. However, the present results stand in contrast to the results by Ruggero et al. (2015), which showed that baseline CRF was inversely associated with follow-up depression levels among girls, not boys.
To investigate the associations for one-year changes in cardiorespiratory fitness, muscular strength and body mass index, with psychological difficulties status in adolescents.
Norwegian 14-15-year-olds (n = 925) participated in data collection at two time points separated by one year. Psychological difficulties were assessed via the Strengths and Difficulties questionnaire and data from follow-up serve as the dependent variable. Cardiorespiratory fitness (the Andersen-test), muscular strength (Eurofit) and body mass index were measured. Change scores were calculated from the physical fitness variables and serve as independent variables in linear mixed effects models.
There was no association between change in body mass index and psychological difficulties. Sex and socioeconomic status moderated the association between cardiorespiratory fitness and psychological difficulties. Immigrant status moderated the association between muscular strength and psychological difficulties. Subgroup results indicated inverse associations between change in cardiorespiratory fitness and psychological difficulties among boys (b = −0.009; 95% CI = −0.015 to −0.003; p = .006); change in muscular strength and psychological difficulties among immigrants (b = −1.97; 95% CI = −4.03 to 0.09; p = .061). Subgroup results also indicated an association between change in cardiorespiratory fitness and psychological difficulties among girls in the highest socioeconomic group (b = 0.014; 95% CI = 0.003 to 0.025; p = .014).
The associations for different fitness components were dependent on different moderators. Possibly, this indicates that associations in different subgroups are mediated by different mechanisms. Moderated associations should be addressed in future investigations.
Association between cardiorespiratory fitness and depressive symptoms in children and adolescents: A systematic review and meta-analysis
2021, Journal of Affective Disorders
Background Higher cardiorespiratory fitness (CRF) is associated with lower depressive symptoms in adults. However, no systematic review with meta-analysis assessed the cross-sectional associations between CRF and depressive symptoms in children and adolescents. Therefore, this meta-analysis assessed the relationship between CRF and depressive symptom in these populations. Methods Cross-sectional data evaluating the correlation between CRF and depression were searched, from database inception through 21/05/2020, on PubMed, PsycINFO, Web of Science, and SPORTDiscus. Age, sex, CRF and depression assessments, and correlations were extracted. A random-effects meta-analysis was conducted, and the potential sources of heterogeneity were also explored through meta-regression analysis. Results Across 14 effects of 11 unique studies, including a total of 7,095 participants (median age=12.49) with nearly equal sex distribution (median=53% females), it was found that higher CRF was associated with lower depressive symptoms in children and adolescents (r =-0.174, 95%CI -0.221 to -0.126, p<0.001, I²=75.09, Q value=52.19). No moderators were identified. Conclusion Available evidence supports the notion that higher CRF is inversely associated with depressive symptoms in children and adolescents. Physical activity and exercise interventions targeting improving CRF should be promoted for these populations. Further studies, including clinical populations, should be conducted to assess objective measures of aerobic fitness and body composition, while controlling for puberty status, to better characterize this association.
Recurrent depression in childhood and adolescence and low childhood socioeconomic status predict low cardiorespiratory fitness in early adulthood
2020, Journal of Affective Disorders
Citation Excerpt :
In children and adolescences, cross-sectional studies have suggested associations between childhood psychopathology and CRF (Esmaeilzadeh, 2015; LaVigne et al., 2016; Rieck et al., 2013; Shomaker et al., 2012; Yeatts et al., 2017). In a prospective study with a one-year follow-up, high CRF protected subjects from developing depression in middle school, particularly girls (Ruggero et al., 2015). Exercise interventions improved depressive symptoms in adolescents (Carter et al., 2016).
Cardiorespiratory fitness (CRF) strongly influences health, but very little is known about the childhood determinants of adult CRF. Our longitudinal study investigated whether childhood psychopathology and socioeconomic status (SES) were related to adult CRF in 1647 Finnish male military conscripts.
Childhood psychopathology was assessed at the age of eight using the Rutter and Children's Depression Inventory questionnaires. Parental education and family structure were used to assess childhood SES. In late adolescence, depressive symptoms were assessed with the Beck Depression Inventory and smoking with a questionnaire. CRF in early adulthood was examined with the Cooper's 12-minute run test.
General linear models showed that low parental education (p=0.001), depressive symptoms in childhood (p=0.035) and late adolescence, smoking, underweight, and overweight/obesity (all p<0.001) independently predicted lower CRF. The interaction between depressive symptoms in childhood and adolescence was significant (p=0.003). In adolescents with depressive symptoms, childhood depressive symptoms (p=0.001) and overweight/obesity (p<0.001) predicted lower CRF. In adolescents without depressive symptoms, conduct problems in childhood predicted lower CRF in the initial models, but the effect disappeared after taking into account smoking and body mass index. Mediational analysis confirmed these results.
We lacked data on physical activity and only studied males at three time-points.
Recurrent depression in childhood and adolescence and low SES in childhood predict lower adult CRF. Conduct problems in childhood predict lower CRF, but the effect is mediated by overweight/obesity and smoking. Psychiatric treatment for children and adolescents should promote physical activity, particularly for children with low SES.
Cardiorespiratory fitness, muscular fitness and mental health in older adolescents: A multi-level cross-sectional analysis
2020, Preventive Medicine
Physical activity interventions that promote cardiorespiratory (CRF) and muscular fitness (MF) may improve mental health in young adolescents. However, less is known about the links between fitness and mental health in older adolescents, as they are an understudied population. In addition, the association between MF and adolescents' mental health is less clear than it is for CRF. Our primary aim was to investigate whether MF is independently associated with mental health in a sample of older adolescents. Our secondary aim was to determine if the association between fitness and mental health was moderated by sex, socio-economic status (SES) or weight status. Participants were 670 students (16.0 [0.4] years, 44.6% female) from 20 secondary schools in New South Wales, Australia. Mental health (well-being and internalizing problems) was self-reported using the Short Warwick-Edinburgh Mental Wellbeing Scale and the Strengths and Difficulties Questionnaire. We assessed CRF using the Progressive Aerobic Cardiovascular Endurance Run and MF using the push-up and standing long jump tests. After controlling for CRF, MF was not associated with mental health. CRF was associated with well-being (β = 0.20, p < .001) and internalizing problems (β = −0.27, p < .001). The strength of association between CRF and mental health was stronger in girls, than boys. No interaction effects were observed for SES or weight status. Although cross-sectional, our findings provide further evidence of the potential benefits of CRF for adolescents' mental health (i.e., well-being and internalizing problems), particularly girls. However, MF may be less relevant for mental health among this population.
Physical fitness variables predictive of depressive symptomatology in university students in Cali, Colombia
2023, Psicogente

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Original articleCardiorespiratory Fitness May Help in Protecting Against Depression Among Middle School Adolescents

Abstract

Purpose

Methods

Results

Conclusions

Section snippets

Participants and procedures

Results

Discussion

Lancet

Lancet

J Am Acad Child Adolesc Psychiatry

Psychiatry Res

Ment Health Phys Act

J Adolesc Health

Psychol Sport Exerc

J Adolesc Health

Depression in children and adolescents, NO. 00–4744

Population-based study of first onset and chronicity in major depressive disorder

Arch Gen Psychiatry

Effect of age at onset on the course of major depressive disorder

Am J Psychiatry

Preventing the onset of depressive disorders: A meta-analytic review of psychological interventions

Am J Psychiatry

Distribution of health-related physical fitness in Texas youth: A demographic and geographic analysis

Res Q Exerc Sport

Maximal oxygen intake as an objective measure of cardio-respiratory performance

J Appl Physiol

Associations of cardiorespiratory fitness in children and adolescents with physical activity, active commuting to school, and screen time

J Phys Act Health

Associations between sports participation, levels of moderate to vigorous physical activity and cardiorespiratory fitness in children and adolescents

J Sports Sci

Daily physical activity and its relation to aerobic fitness in children aged 8-11 years

Eur J Appl Physiol

Physical activity and mental health in children and adolescents: A review of reviews

J Sports Med

Effects of physical activity on psychological variables in adolescents

Pediatr Exerc Sci

Original article
Cardiorespiratory Fitness May Help in Protecting Against Depression Among Middle School Adolescents