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      Physical activity, exercise, and mental disorders: it is time to move on

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          Abstract

          Introduction

          Physical activity, conceptualized as any bodily movement that results in energy expenditure, and its structured form, exercise, play an important role in public health, preventing and treating a wide range of physical conditions, including metabolic and cardiovascular diseases and obesity.

          Objective

          This article aims to provide a brief overview and summary of the evidence on: 1) the preventive effects of physical activity on a wide range of mental disorders; 2) the role of physical activity in promoting the physical health of people with mental disorders; 3) the role of exercise as a strategy to manage mental health symptoms in a range of mental disorders; and 4) the challenges and barriers faced when implementing exercise in clinical practice.

          Methods

          This was a narrative review.

          Results

          Compelling evidence has demonstrated that physical activity and exercise can also prevent common mental disorders, such as depression and anxiety disorders, and have multiple beneficial effects on the physical and mental health of people with a wide range of mental disorders. This body of evidence has been incorporated in national and international guidelines over the last decades, which have recommended the inclusion of physical activity and exercise as therapeutic approaches for mental disorders, mainly for depression and schizophrenia. Nonetheless, implementation into clinical practice has been slow, probably due to barriers associated both with patients and mental health professionals.

          Conclusion

          Increases in physical activity levels in populations are likely to reduce the mental health burden. Exercise interventions should be incorporated to the routine care of people with mental disorders due its multiple benefits on physical and mental health outcomes. A multidisciplinary approach is needed to overcome patients barriers and enhance adherence and benefits.

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          Most cited references88

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          Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy.

          Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases such as coronary heart disease, type 2 diabetes, and breast and colon cancers, and shortens life expectancy. Because much of the world's population is inactive, this link presents a major public health issue. We aimed to quantify the eff ect of physical inactivity on these major non-communicable diseases by estimating how much disease could be averted if inactive people were to become active and to estimate gain in life expectancy at the population level. For our analysis of burden of disease, we calculated population attributable fractions (PAFs) associated with physical inactivity using conservative assumptions for each of the major non-communicable diseases, by country, to estimate how much disease could be averted if physical inactivity were eliminated. We used life-table analysis to estimate gains in life expectancy of the population. Worldwide, we estimate that physical inactivity causes 6% (ranging from 3·2% in southeast Asia to 7·8% in the eastern Mediterranean region) of the burden of disease from coronary heart disease, 7% (3·9-9·6) of type 2 diabetes, 10% (5·6-14·1) of breast cancer, and 10% (5·7-13·8) of colon cancer. Inactivity causes 9% (range 5·1-12·5) of premature mortality, or more than 5·3 million of the 57 million deaths that occurred worldwide in 2008. If inactivity were not eliminated, but decreased instead by 10% or 25%, more than 533 000 and more than 1·3 million deaths, respectively, could be averted every year. We estimated that elimination of physical inactivity would increase the life expectancy of the world's population by 0·68 (range 0·41-0·95) years. Physical inactivity has a major health eff ect worldwide. Decrease in or removal of this unhealthy behaviour could improve health substantially. None.
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            Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.

            "Physical activity," "exercise," and "physical fitness" are terms that describe different concepts. However, they are often confused with one another, and the terms are sometimes used interchangeably. This paper proposes definitions to distinguish them. Physical activity is defined as any bodily movement produced by skeletal muscles that results in energy expenditure. The energy expenditure can be measured in kilocalories. Physical activity in daily life can be categorized into occupational, sports, conditioning, household, or other activities. Exercise is a subset of physical activity that is planned, structured, and repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness. Physical fitness is a set of attributes that are either health- or skill-related. The degree to which people have these attributes can be measured with specific tests. These definitions are offered as an interpretational framework for comparing studies that relate physical activity, exercise, and physical fitness to health.
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              Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases.

              This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis); metabolic diseases (obesity, hyperlipidemia, metabolic syndrome, polycystic ovarian syndrome, type 2 diabetes, type 1 diabetes); cardiovascular diseases (hypertension, coronary heart disease, heart failure, cerebral apoplexy, and claudication intermittent); pulmonary diseases (chronic obstructive pulmonary disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise.
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                Author and article information

                Journal
                Trends Psychiatry Psychother
                Trends Psychiatry Psychother
                trends
                Trends in Psychiatry and Psychotherapy
                Associação de Psiquiatria do Rio Grande do Sul
                2237-6089
                2238-0019
                22 October 2021
                Jul-Sep 2021
                : 43
                : 3
                : 177-184
                Affiliations
                [1 ] orgdiv1Departamento de Métodos e Técnicas Desportivas orgnameUniversidade Federal de Santa Maria Santa Maria RS Brazil originalDepartamento de Métodos e Técnicas Desportivas, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
                [2 ] orgdiv1Department of Rehabilitation Sciences orgnameKatholieke Universiteit Leuven Leuven Belgium originalDepartment of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
                Author notes
                Correspondence: Felipe Barreto Schuch Universidade Federal de Santa Maria (UFSM) Av. Roraima, 1000, Prédio 51 (CEFD), sala 1025 97105-900 - Santa Maria, RS - Brazil Tel.: +555532207788 E-mail: felipe.schuch@ 123456ufsm.br

                Disclosure

                No conflicts of interest declared concerning the publication of this article.

                Author information
                https://orcid.org/0000-0002-5190-4515
                Article
                2237-6089-2021-0237
                10.47626/2237-6089-2021-0237
                8638711
                33890431
                87d67efa-d2ac-4ce0-ae96-5c212d77bf49

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 February 2021
                : 13 April 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 76, Pages: 8
                Funding
                Funded by: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
                Award ID: 001
                Categories
                Review Article

                exercise,physical activity,mental disorders,physical health,mental health

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