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The Role of Diet and Exercise in Improving Mental Health

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It’s no secret that mental health has found itself at the forefront of public consciousness since the start of the COVID-19 pandemic. Long lockdowns, social isolation, loss of jobs and fear of the future have contributed to a sharp increase in the number of adults and children dealing with anxiety and depression-related disorders. In this article, Laura DeFina, MD, President and Chief Executive Officer of The Cooper Institute, along with Steve Farrell, PhD, Senior Investigator for the Research Division of The Cooper Institute, will discuss recent research findings regarding the impact of diet and exercise on mental health disorders.

Mental health statistics in the United States
Extensive research has been conducted on mental health and the effects it can have on daily life. According to the National Institute of Mental Health, approximately 1 in 5 American adults live with a mental illness and have symptoms ranging from mild to severe. Mental illnesses in the United States affect:

  • 20% of adults (26% females and 16% males)
  • In 2019, 13.6% of U.S. children between the ages of 5-17 had received mental health treatment in the past 12 months

Not only can mental health issues impact overall quality of life and day-to-day functions, they have also been linked to life-threatening heart disease. Although heart disease and mental health disorders can occur independently of one another, they sometimes occur simultaneously. “Lifestyle strategies such as consuming a healthy diet and increasing physical activity may help improve not only mental health but heart health as well,” says Dr. DeFina.

Consuming a healthy diet
A heart-healthy, anti-inflammatory diet has been shown to be associated with improved mental health as well as improved physical function. For example, a Mediterranean-style diet typically emphasizes high consumption of fruits, vegetables, legumes, nuts, fish, olive oil and whole grains as well as a low intake of saturated fat. “The anti-inflammatory effects of this dietary approach as well as its beneficial effects on the microbiome (gut health) are thought to be among the mechanisms by which physical and mental health benefits are gained,” says Dr. Farrell.

One recent study evaluated a Mediterranean dietary pattern (MDP) and the relation to clinical depression. Individuals in the study did not have a history of depression at baseline. After a dietary assessment and follow-up period of 20 years, it was concluded that higher adherence to a Mediterranean-style diet was associated with a significantly lower risk of depression later in life.

Another important component of a healthy diet is the consumption of adequate amounts of omega-3s, which are found in fatty fish as well as fish-oil supplements. “Many individuals are aware that non-fried, fatty fish is beneficial to heart health, but fewer individuals are aware of the mental health benefit,” says Dr. Farrell. Mental health disorders such as depression and anxiety are partially related to poor communication between various regions of the brain, as well as high levels of inflammation within the brain. Communication within the brain is mediated by neurotransmitters such as serotonin. Increased levels of omega-3s in the brain enhances communication among the different regions of the brain and decreases inflammation as well, which in turn leads to improved mental health.

A summary of 26 different studies showed that when individuals diagnosed with depression consumed approximately one gram of omega-3 fatty acid supplements daily, their depressive symptoms improved significantly. As indicated above, this improvement was thought to be due to decreased inflammation and improved communication between different regions in the brain. Numerous studies of the Mediterranean-style diet and omega-3s have shown that practicing healthy dietary patterns lower the risk and symptoms of depression.

Improving mental health through exercise
“Along with a healthy diet, obtaining adequate amounts of physical activity is also strongly related to improved mental health,” says Dr. DeFina. The 2018 Physical Activity Guidelines for Americans recommend at least 150 minutes of moderate-intensity aerobic activity along with two days of strength training per week. One of the many benefits of aerobic activity is the improvement of cardiorespiratory fitness—the body’s ability to utilize oxygen—as well as an improved mental state. Regular physical activity is also associated with lower levels of inflammation.

Research at The Cooper Institute has been conducted on the relationship between fitness, depression and heart health. A study of approximately 18,000 men and women with no history of depression was conducted over the span of 20 years. At baseline, individuals completed a Cooper Clinic preventive physical exam, which included a maximal treadmill exercise test to assess fitness. During two decades of follow-up, those who were deemed highly fit at the baseline exam were 16% less likely to develop depression compared to those with a low level of fitness. Additionally, among those who did develop depression, individuals who were highly fit at baseline were 56% less likely to die from cardiovascular disease during the follow-up when compared to those who were low fit at baseline.

Since cognitive health is also an important aspect of mental health, The Cooper Institute has examined the relationship between fitness, cognitive function, and dementia. Approximately 5,000 older individuals were given a treadmill exercise test to measure fitness, as well as the Montreal Cognitive Assessment (MoCA) to evaluate cognitive function. The results showed those with the highest level of fitness were 42% less likely to suffer from cognitive dysfunction when compared to those with the lowest level of fitness. Similarly, in a 2013 study of healthy, middle-aged adults, individuals in the highest category of fitness were 36% less likely to be diagnosed with all-cause dementia in later life when compared to those in the lowest category of fitness.

Clearly, mental health disorders are highly prevalent in the United States. “It is indisputable that consuming a healthy diet and obtaining adequate amounts of physical activity are associated with improved mental health,” says Dr. DeFina. If you have concerns that you are experiencing symptoms of depression, anxiety or other mental health disorders, talk with your primary-care physician. Practicing a healthy lifestyle by exercising regularly and consuming a heart-healthy diet not only help your physical health, but your mental health as well.

Learn more about The Cooper Institute’s current and ongoing research by visiting cooperinstitute.org/research.