December 6 — 7, 2007 Advisory Committee Meeting Minutes

Mental Health Subcommittee Report

Rod Dishman, Ph.D., led discussion on the Mental Health Subcommittee report. Dr. Dishman acknowledged his subcommittee members, Antronette Yancey, M.D., and their consultants, Pat O'Connor, Anita Stewart and Philip Tomporowski with CDC liaisons Jesus Suarez and David Brown. Based on the IOM's report, which outlined sufficient evidence for the Physical Activity Guidelines process to proceed, it was concluded there was sufficient evidence for the group to include depression, anxiety, sleep disorders, cognitive function, smoking cessation, chronic pain, Alzheimer's and Parkinson's in their work.

Through the CDC database about 300 studies were available and relevant to the topic. The evidence from prospective observational studies and the randomized controlled trials indicates that moderate to vigorous physical activity is associated with fewer symptoms and incident cases of major depression, fewer symptoms of anxiety, although less strong, enhanced cognitive function and reduced odds of dementia. While the literature is small there are encouraging trends that lead towards an enhanced quality of life, including feelings of well-being, energy, self-esteem and sleep quality.

These outcomes seem to be generally positive for both men and women, different age groups, nationalities, and health status, although there are very few comparison studies based on race and there are very few observational studies and controlled trials with youth. However, the clearest effects in youth are for self-esteem and depression. The evidence is suggestive of a dose-response gradient for depression symptoms. There is insufficient evidence to determine whether an increase in fitness is necessary for mental health benefits. The positive relations seen for depression and self-esteem in fitness studies may just be a surrogate index of adherence to the intervention.