Certain conditions can impact how much exercise you need to ease depression, study finds

Updated: 6:17 PM EDT Jul 10, 2023

As little as 20 minutes of moderate activity a day for five days a week can significantly lower the risk of depressive symptoms for people over 50 who have conditions often linked to depression, such as diabetes, heart disease and chronic pain, a new study found.Video above: Cardio linked to reduced risk in men developing some cancersPeople with diabetes have twice the risk for depression, according to Diabetes UK, and a 2017 study found heart disease patients are twice as likely to die if they develop depression after their diagnosis. Up to 85% of people with chronic pain experience severe depression, according to a different 2017 study.People without chronic disease in the study, however, needed to do moderate to vigorous exercise two hours a day to see improvement in depressive symptoms, according to lead study author Eamon Laird, a researcher at the Physical Activity for Health Research Centre at the University of Limerick in Ireland.Moderate physical activity is typically defined as an activity that “takes your breath” so that it is hard to speak while doing it. Examples include brisk walking, bicycling, dancing, playing tennis, or running up and down stairs. If the exercise level is increased to vigorous — such as jogging or running, during which breathing is fast and the heart rate rises — the time spent exercising can be reduced, according to the U.S. Centers for Disease Control and Prevention.“What is unique (about this study) that it is the first and largest investigation of a longitudinal cohort — with and without chronic disease — to try and work out what was the lowest minimal dose to observe a difference in depression,” Laird said.“We do not advocate for reduced activity levels in any population, but these findings suggest that even doses lower than recommended may well protect mental health over time in older adults,” he added. “These doses may be more achievable as many older adults may find it difficult to undertake physical activity for a large number of reasons.”A 10-year studyThe study, published Monday in the journal JAMA Network Open, followed more than 4,000 Irish adults with an average age of 61 for 10 years. The participants, who were part of the Irish Longitudinal Study on Ageing, were evaluated every two years. They were asked about their physical activity and exercise levels and given tests to determine the number of depressive symptoms they displayed — if the symptoms were excessive, they were classified as having major depression.“Examples of symptoms from the questionnaire included: I had trouble keeping my mind on what I was doing; My sleep was restless; I felt I could not shake off the blues even with the help from my family and friends; etc,” Laird said in an email.People who had suffered a major depressive episode during the past 12 months were also put into the major depression group. An episode is defined as a period of two weeks or longer in which the person experienced fatigue, feelings of sadness and hopelessness, a loss of interest in activities or sleeping problems, weight gain or loss, or thoughts of suicide.The study found that the more time people spent exercising, the better. People who moderately exercised for 20 minutes a day, five days a week, had a 16% lower rate of depressive symptoms and a 43% lower risk of major depression compared with those who did not exercise, the study said.Those who exercised two hours a day benefitted the most, with a 23% reduction in depressive symptoms and a 49% lower risk of major depression, according to the study.“The higher the physical activity dose, the greater the mental health benefits for depression,” Larid said.Unfortunately, the overall rate of depression for the entire group rose over the 10 years, from an average of 8% to 12%, while antidepressant use increased from about 6% to 10%. However, rates of exercise also declined by about 10% for the group over the study’s duration.Not a surpriseThe study’s findings were not surprising, Larid said, noting extensive past research that shows a strong link between exercise and reducing depression. A systematic review and meta-analysis published in 2022 found brisk walking for just 2.5 hours a week cut depressive symptoms by 25%. The same study also found that doing half that amount lowered the risk of depression by 18%.Another large review published in February found that getting physical is 1.5 times more effective at reducing stress, anxiety and mild-to-moderate symptoms of depression than antidepressant medications or cognitive behavior therapy, which is considered a gold standard treatment.Exercise does more for a person’s health than just ease depression. It keeps the body in tip-top shape, allowing it to function efficiently and do a better job at warding off diseases of all kinds.“Physical activity is just absolutely magnificent,” Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, Colorado, told CNN in a prior interview.“If you blend that with eating a more plant-based diet, de-stressing, sleeping enough and connecting with others — that’s your magic recipe,” he added. “It’s the fountain of youth, if you will.”

If you’ve suspected you gain more benefits from your workouts depending on the time of day you complete them, your hunch might be right.

In the past, studies have found that the time of day you work out can play a role in anything from weight loss to how productive you are afterward. And now, according to new research, whether you work out in the morning or at night can influence mood, physical performance, and cardiometabolic health—and these pay-offs can vary depending on your gender. (Please note that the researchers only included cisgender individuals in this study.)

Researchers studied 56 highly active men and women, ages 25 to 55, for 12 weeks to help identify the most effective and feasible time of day to exercise. During this period, participants practiced the PRISE nutrition and training program designed by Paul J Arciero, Ph.D., lead researcher, and director of the human nutrition, metabolism and performance laboratory at Skidmore College, along with his colleagues.

The PRISE program requires participants to exercise four days a week, focusing on a different training modality each day, including resistance training, interval sprints, stretching or endurance training. The program also requires following a strict diet.

All participants practiced each workout for an hour or less, except for the endurance-focused workouts, which participants were allowed to practice for an hour or more. All groups completed the same type of exercise on the same day, under the direction of certified fitness professionals. On interval sprint days and endurance days, participants practiced a sport of their choice like going on an elliptical, riding a stationary bike, rollerblading or cycling outdoors.

Participants designated to the morning group worked out between the hours of 6:30 a.m. and 8:30 a.m. and those in the evening group exercised between 6 p.m. and 8 p.m.

Though nutrition wasn’t the main focal point of this study, says Arciero, participants did follow a strict diet. Men and women in all groups met with a registered dietitian and were given a 12-week meal plan to follow.

On resistance training days, participants in all groups ate a small snack one hour before training. On stretching, endurance, and interval days, morning participants arrived fasted, but hydrated, and evening participants were also hydrated and fasted for four hours.

Morning participants were instructed to eat breakfast after workout sessions and subsequent meals in four-hour increments. Evening participants were instructed to eat four meals a day in four-hour increments, with the last meal eaten within an hour of completing exercise. On rest days, all participants were instructed to eat breakfast within an hour of waking and following meals within those four-hour intervals. They consumed the last meal two hours before bed.

In the beginning, Arciero says, many of the participants who were active for more than four days a week were reluctant to cut back on their workouts. But that all changed once they started noticing improvements in their performance.

"They were realizing that the bottom line is all about the quality of the exercise experience, as opposed to the quantity," he said.

The program was inspired by the exercise recommendations of the American College of Sports Medicine, he says, but it was designed so that people can maintain a healthy active lifestyle that works around their work and family schedules.

In the end, for women, morning exercise reduced total body and abdominal fat, decreased blood pressure, and improved lower-body muscle power, while evening exercise enhanced mood, as well as improved upper-body strength, power and endurance.

“The likely reasons why women lose total-body and belly fat with morning exercise is because the body is in a more favorable hormonal state (lower insulin levels) which favors burning body fat as an energy source,” Aciero says.

Whereas evening exercise is associated with building muscular strength and power because the body is in a favorable hormonal and metabolic state, he says, which contributes to improving overall mood because it acts as a “de-stressor” at the end of the day for both women and men.

Men who worked out in both groups had improvements in mood and physical performance and decreased both total and abdominal body fat. But for those in the evening group, exercise had greater improvements in lowering systolic blood pressure, decreasing fatigue and stimulating fat oxidation when compared to the morning group.

The body and heart are better prepared for the exercise later in the day than in the early morning due to certain metabolic factors in men, says Aciero. This is the reason evening exercise helps with enhancing heart health and lowering blood pressure.

The bottom line: If you’re trying to achieve a specific goal like increasing upper body strength or decreasing blood pressure, then it’s worth considering the time of day you exercise. That’s because your body may react differently to an early morning ride or strength session versus a twilight workout. But what’s even more important to experience the effects of exercise: simply moving more, no matter what time of day that happens.

New research hints that even a simple exercise routine just might help older Americans with mild memory problems.

Doctors have long advised physical activity to help keep a healthy brain fit. But the government-funded study marks the longest test of whether exercise makes any difference once memory starts to slide — research performed amid a pandemic that added isolation to the list of risks to participants' brain health.

Researchers recruited about 300 sedentary older adults with hard-to-spot memory changes called mild cognitive impairment or MCI -- a condition that’s sometimes, but not always, a precursor to Alzheimer’s. Half were assigned aerobic exercises and the rest stretching-and-balance moves that only modestly raised their heart rate.

Another key component: Participants in both groups were showered with attention by trainers who worked with them at YMCAs around the country -- and when COVID-19 shut down gyms, helped them keep moving at home via video calls.

After a year, cognitive testing showed overall neither group had worsened, said lead researcher Laura Baker, a neuroscientist at Wake Forest School of Medicine. Nor did brain scans show the shrinkage that accompanies worsening memory problems, she said.

By comparison, similar MCI patients in another long-term study of brain health -- but without exercise -- experienced significant cognitive decline over a year.

Those early findings are surprising, and the National Institute on Aging cautioned that tracking non-exercisers in the same study would have offered better proof.

But the results suggest “this is doable for everybody” -- not just seniors healthy enough to work up a hard sweat, said Baker, who presented the data Tuesday at the Alzheimer's Association International Conference. ”Exercise needs to be part of the prevention strategies" for at-risk seniors.

Previous research has found regular physical activity of any sort may reduce damaging inflammation and increase blood flow to the brain, said Alzheimer’s Association chief scientific officer Maria Carrillo.

But the new study is especially intriguing because the pandemic hit halfway through, leaving already vulnerable seniors socially isolated -- something long known to increase people’s risk of memory problems, Carrillo said.

It’s a frustrating time for dementia research. Doctors are hesitant to prescribe a high-priced new drug called Aduhelm that was supposed to be the first to slow the progression of Alzheimer’s -- but it’s not yet clear if it really helps patients. Researchers last month reported another drug that works similarly -- by targeting amyloid plaques that are an Alzheimer’s hallmark -- failed in a key study.

While amyloid clearly plays a role, it's important that drugmakers increasingly are targeting many other factors that can lead to dementia, Carrillo said, because effective treatment or prevention likely will require a combination of customized strategies.

One example of a new approach: Sometimes in dementia, the brain has trouble processing blood sugar and fats for the energy it needs, John Didsbury of T3D Therapeutics told the Alzheimer's meeting. His company is testing a pill that aims to rev up that metabolism, with results expected next year.

Meanwhile, there’s growing urgency to settle whether steps people could take today -- like exercise -- might offer at least some protection.

How much and what kind of exercise? In Baker’s study, seniors were supposed to get moving for 30 to 45 minutes four times a week, whether it was on a vigorous turn on the treadmill or the stretching exercises. That’s a big ask of anyone who’s sedentary, but Baker said MCI’s effects on the brain make it even harder for people to plan and stick with the new activity.

Hence the social stimulation — which she credited with each participant completing over 100 hours of exercise. Baker suspects that sheer volume might explain why even the simple stretching added up to an apparent benefit. Participants were supposed to exercise without formal support for an additional six months, data Baker hasn't yet analyzed.

“We wouldn’t have done the exercise on our own,” said retired agriculture researcher Doug Maxwell of Verona, Wisconsin, who joined the study with his wife.

The duo, both 81, were both assigned to the stretching classes. They felt so good afterward that when the study ended, they bought electric bikes in hopes of even more activity -- efforts Maxwell acknowledged are hard to keep up.

Next up: Baker is leading an even larger study of older adults to see if adding exercise to other can’t-hurt steps such as a heart-healthy diet, brain games and social stimulation together may reduce the risk of dementia.

The Centers for Disease Control and Prevention released new data on Friday indicating that most U.S. adults are not meeting physical activity guidelines set out by the CDC.

The CDC advises adults to get at least 150 minutes of moderate – or 75 minutes of vigorous – physical activity a week in addition to two days of strength training. But the data show most adults aren’t getting enough of either.

The data indicate people in rural areas are more likely not to meet the guidelines. Just 16.1% of adults in rural America meet both guidelines for physical activity and muscle building. That is compared to 27.8% for people living in large metro areas.

In large and fringe metro areas, about half of all adults meet the CDC’s standard for 150 minutes of physical activity a week. In rural areas, that number declines to 38.2%.

According to Dr. Daniel Sullivan, director of the National Consultation Service with the Cleveland Clinic, the benefits of exercise are immense. Physical activity reduces the risk of many diseases. He also notes that those who exercise encounter less depression.

“This was interesting information for people who are public health advocates to improve health,” Sullivan said. “If they are looking at a rural area of their state and are involved in health care planning, this information could help them try to put resources in place in rural areas to make it more likely that they would consider getting more frequent physical activity.”

The National Rural Mental Health Association notes that rates of depression in rural and urban areas are generally about the same, but suicide rates tend to be higher in rural areas. The group also notes that access to care is more challenging for those in rural areas.

Sullivan said that given rural areas generally have fewer health care options, a less physically active population in these areas only exacerbates disparities in health outcomes.

“People have to travel further. Access to care is a little more cumbersome,” he said. “So if people are in rural areas and perhaps not meeting exercise guidelines, their disease burden could be higher, but their access to matching those diseases by virtue of being in a rural area is more challenging. There is a double challenge here.”

While many people might think of needing equipment or a gym membership to exercise, Sullivan notes the public can meet physical activity guidelines simply by walking for 30 minutes a day five days a week.

“It doesn’t cost much,” he said. “It’s accessible to virtually everyone and if someone is in a rural area and feels like their resources are limited, perhaps identifying an opportunity in their community to bring people together in that rural area to find shared interests in exercise.”

National Wear Red Day falls on the first Friday in February and is an annual campaign meant to raise awareness about heart disease in women. 

The national campaign urges women to learn their risk for heart disease and to take steps to lower their risk. Although heart disease is said to be about 80% preventable, it causes one out of every three deaths in women each year.

You can help spread the word by dressing in red and also encouraging women to learn their risks. According to The American Heart Association, smoking, sedentary lifestyles, a family history of the illness, diabetes, stress, inflammatory diseases like rheumatoid arthritis and Crohn’s, along with complications during pregnancy and menopause can increase a woman’s chances of being diagnosed with heart disease.

Let’s go! It's #WearRedDay! So crank up the tunes, get on your feet and rock your red for women’s heart health. pic.twitter.com/ezzDSMb1OL

— GoRedforWomen (@GoRedForWomen) February 4, 2022

As the CDC notes, only around half of women recognize that heart disease is the number one killer for women. It is the leading cause of death in women in the United States, and killed 299, 578 women in 2017 alone, which equates to about 1 in every 5 female deaths the CDC said.

Talk to your doctor if you're experiencing symptoms the CDC says are associated with heart disease like angina, pain the the neck, jaw, or throat or pain in the upper abdomen or back.

For more information on National Wear Red Day visit www.goredforwomen.org

This story was originally published by Alex Livingston of Newsy.

Even if you aren't gifted athletically or you hate all things involving exercise, reams of research shows physical activity is critical to good health. "Exercise is key, because your life depends on it," said Howard Rankin, a behavior change researcher and director of science at Intuality, Inc.That's no exaggeration. Establishing a regular workout regimen slashes your risk of heart disease and stroke, Type 2 diabetes, and certain forms of cancer, such as breast, colon and lung, according to the U.S. Centers for Disease Control and Prevention. Exercising also strengthens your bones and muscles, improves sleep, and lessens the pain from arthritis and other joint conditions. And there's more.Regular physical activity is great at combating anxiety and depression, Rankin said, and it's critical for the development of new brain cells. Movement also helps balance brain chemicals like endorphins and dopamine, which are responsible for motivation and feeling energetic, and it's a great stress buster. Consistent exercise even improves your sex life, according to experts at Mayo Clinic.Conversely, ignore exercise and your risk of death soars 20% to 30% compared to those who are active, according to the World Health Organization. Luckily, all you need to do is about 150 minutes of moderate-intensity physical activity — just 21 minutes a day — to enjoy the benefits.Ready to create a workout routine you can stick with and enjoy? Here are four tips you may find beneficial.Important note: Before beginning any new exercise program, consult your doctor. Stop immediately if you experience pain.1. Make exercising a regular part of your dayDecide exercise has to be a regular part of your day, like eating or sleeping — because it's equally important. Once your mindset shifts, your excuses may disappear.You can also schedule your workouts ahead of time if you can't always exercise at the same time every day. Setting a specific time for working out can help you keep on task. If you can't find one big block of time, break up your workout into several shorter segments to complete throughout the day. Experts say this is fine, as you'll reap the same benefits.2. Start slowly, and give your new routine timeDon't do too much, too soon. If you want to try running, don't go out and run 3 miles as fast as you can. Alternate running a block or a minute with walking a block or a minute for just 1 mile and build from there. This same principle applies to any new activity you select.And give your new activity time, as it takes a while for a new behavior to become a habit."I can't tell you how many people give up after a week or two because it feels hard or they aren't seeing results," said Tami Smith, a certified personal trainer and CEO of Fit Healthy Momma. "Give yourself a chance to begin to see and feel the benefits. Commit to at least 30 days of consistency and then evaluate how you're feeling about it."3. Find a form of exercise you like doingNot everyone will get into running. Try a variety of exercises and see what suits you. It might be running, swimming, biking, using an elliptical machine, or a taking a kickboxing class. Or you might prefer working out to a video or dancing in your living room. It's all movement, and that's all good.Remember, too, that many simple activities like walking promote physical fitness. "The term 'exercise' can imply rigorous workouts, but movement doesn't have to be rigorous to be beneficial," Rankin said. "Any movement is better than no movement."The more you enjoy exercising, the more confidence you'll have that you can overcome any barriers to exercise, which means you'll be more likely to stick with your regime, according to a 2015 study by Beth Lewis, director of the University of Minnesota's School of Kinesiology. "The key to maintaining exercise is to find an exercise routine that you enjoy, whether it is alone or with people; outside, at home or at a gym."4. Ramp up the fun factorEven if you find an exercise you enjoy, not every workout will be fun. Sometimes you'll be tired or cranky or just not in the mood to work out. You can also get in a rut, where you don't necessarily dislike your workout, but it doesn't excite you, either. This is when it's time to get creative.Instead of working out at the gym, drive to your favorite park for an al fresco exercise session. Join a friend in their favorite activity. Sign up for a class that's piqued your interest, like aqua yoga or Pilates. Treat yourself to some new workout clothes. Do whatever it takes to stay in motion. Because not only is movement good for us, it's what our bodies are designed to do."We are built to move," said Brett Durney, cofounder of London's Fitness Lab, a private personal training studio. "Those of us who are blessed enough to be able to move freely should reap the benefits daily."

The stress of the COVID-19 pandemic has led to weight gain for many Americans.

“During the beginning, I had to start working out outside because the gyms and things like that were closed. So, I made do with what I could,” said Marcus Rogers, a YMCA member.

Each time a weight clanks or someone breathes deep, it’s the sound of someone like Rogers releasing a little bit of stress.

But many of us haven’t been able to release that stress during the pandemic, and that may have caused us to be a little heavier when we step on the scale.

“The more stress people that people were experiencing, the more weight they were gaining,” said Dr. Arthur Evans, the CEO of the American Psychological Association (APA).

The APA has been looking at the impacts of stress and weight gain during the pandemic.

“Americans are gaining weight at a pretty significant level about, about 15 pounds,” said Evans.

About 42% of people surveyed by the APA gained more weight than they intended. In that group, people gained 29 pounds on average.

Fifteen to 30 pounds is no small matter. We asked Cami Woomer, a nutritionist with the YMCA Metro Denver about the relationship between stress and weight gain.

“Stress can be an indicator of weight gain itself. So when people are feeling stressed out, sometimes we go to food, sometimes that means we’re eating more in portions, or we’re eating more throughout the day. Also, stress levels impact our ability to lose weight as well,” said Woomer.

Cortisol is the bodies main stress hormone and several scientific studies have linked cortisol levels to changes in weight. Higher levels of cortisol are also linked to people being less likely to control how much and what they eat.

But not everyone’s stress has risen the same over the course of the last year.

“People who are essential workers had more stress than other people. Parents whose children were doing remote learning were also experiencing more stress. We also found people of color were experiencing more stress and younger people were experiencing more stress,” said Evans.

While that extra stress can lead to weight gain, a healthier lifestyle can help reduce your stress levels.

“Exercise is releasing those endorphins, you’re feeling a little bit better,” said Woomer.

Exercise can also release muscle tension and help regulate cortisol levels.

Certain foods can also have an effect on you.

“Things like caffeine, things that are high in carbohydrates, high in fat, high sodium things can kind of aggravate the stress levels in our body a little bit. And things like whole foods, like whole grains, fruits and vegetables, lean proteins and healthy fats can help reduce inflammation and stress in our body,” said Woomer.

Stress can be the source of some of your weight gain, but losing a little bit and eating a little better could be your road map pushing out some of the stress in your life.