Confidence and Well-beingin Motion

What research tells us we can achieve Nanette Mutrie

Professor of Exercise and Sport PsychologyUniversity of Strathclyde

Presentation PlanWhat the research tell us

Confidence and well being through physical activity– Not a new idea– By promoting physical health– By promoting good mental health – By preventing poor mental health– By providing a therapeutic role– By fostering communities

Getting ourselves and the nation more physically active

Not a new idea…..

Physical activity relates all kinds of movement – everyday activities and sport

Some historic connections

Mens sana in corpore sano William James (1899) ‘our

muscular vigor will…always be needed to furnish the background of sanity,and cheerfulness to life, to give moral elasticity to our dispositions, to round off the wiry edge of our fretfulness, and make us good-humoured

But…muscular vigour has been engineered out of our lives…

By promoting good physical health

Scottish Strategy 2003 ‘let’s make Scotland more active’– Advocates at least 30 minutes of accumulated moderate intensity

activity [such as walking] on at least 5 days a week for health CMO report 2004 ‘at least 5 a week’

– Strong evidence for preventative effect for: Cardiovascular disease Type 2 diabetes Osteoporosis Colon cancer

– Moderate evidence for Obesity overall cancer and breast cancer

Social psychology

Food production

Food consumption

Physiology

Physical activity environment

Individual physical activity

Individual psychology

By promoting good mental health

The feel good effect– People report that being active makes them feel good– Large scale surveys and experimental studies show that

activity is positively linked to psychological well being Being fit and physically active reduces stress reactivity Self esteem is higher among active children than non

active children Sleep quality is better in active versus inactive adults Cognitive function improves for older adults who begin to

exercise Exercise is now recognised as a possible treatment of

depression

See Foresight report on mental capital and wellbeing

http://www.foresight.gov.uk/ See Centre for Confidence and Wellbeing ‘Turbulent

Times’ presentation by Nic Marks http://www.centreforconfidence.co.uk/ 5 ways to take to promote well-being

– Connect- to people family friends– Be physically active– Take notice- be curious– Keep learning- clearly you are doing this!– Give- do something nice for someone

By preventing poor mental health

Fox, K., & Mutrie, N. (in press). Physical activity and the prevention of mental illness, dysfunction and cognitive deterioration. In G. O'Donovan (Ed.), BASES' Guidelines on Physical Activity in the Prevention of Chronic Disease.: Human Kinetics.

Prospective population level studiesrelating to depression

• Eleven studies found with 2 time points in which physical activity and clinically defined depression were measured on the same cohort

• Eight of these studies show a protective effect for activity on the onset of depression

• Relative risk (not given in all studies) of inactivity for depression ranged from 1.6 – 2.

• Most confounding variables accounted for.

1965 activity level and 1974 depression (reporting 5 or more symptoms from 18 symptom list)

Camacho et al (1991) American J Epidemiology, 134, 220-231

0.91

1.11.21.31.41.51.61.71.81.9

low activity moderateactivity

high activity

odd

s ra

tio men

w omen

Activity level calculated from frequency intensity reports of leisure activities producing a 14 point scale that predicted mortality and morbidity for this sample. Low = 0-4 points; moderate =5-8; high = 9-14.

Prospective population studies relating to cognitive decline

• 17 cohort studies showed a reduced risk of either cognitive impairment, dementia or Alzheimer’s or some combination with higher levels of physical activity

• Reduced risk is in the region of 30-40% (more in some cases).

• Similar effects for men and women

By providing a therapeutic role in certain medical conditions

Physical activity has been shown to improve quality of life and medical outcomes for those coping with – Type ii diabetes [Kirk et al., 2004, ]– Phase iv Cardiac Rehab [ Hughes et al., 2004]– Pregnancy [Rankin, 2002]– Alcohol abuse [Donaghy & Mutrie, 1999]– Breast cancer [Mutrie et al., 2007]

Effect estimates (Exercise – Control) with 95% confidence intervals and p-values for outcome variables at the 6 month assessment, expressed in units of

one standard deviation (SD) of the outcome distributions, based on mixed effects models adjusting for baseline values, study site, therapy at baseline and

age.

PANAS- positive affect

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45

50

Baseline 12 weeks 6 months post

ExerciseUsual care

The participants talked about confidence

“..it is so worthwhile…not just because of the exercise benefits but because it helps us get our confidence back and get out of the ‘patient’ mind-set.” [participant after completing 12 weeks]

What are the potential mechanisms of these positive effects?

Psychological processes– Being in control– Self- determination– Doing something positive for oneself – Empowerment– Distraction

Neurochemical processes– Endorphins– Serotonin– Adrenaline

Somatopsychic processes – Synergy – all of these possible mechanisms occur at the same time linking

body and mind!

By fostering active communities

There is potential [but not yet a lot of evidence, Coalter, 2001] for physical activity to:– Reduce social exclusion– Reduce crime– Build a sense of community– Improve social interaction

Getting ourselves and the nation more physically active What can we do?

The majority of the Scottish population do not achieve the minimum recommended amounts of physical activity

Do some more walking every day

Find activities that are fun to do

“One of my greatest achievements was completing the Walk Leader training last year” John, Walkaboutabit, Islay

“Its not only the physical health reasons that make walking so good for everyone but also the benefits to your inner self by sharing our beautiful countryside with other like-minded people” Danny, Renfrewshire walks, Renfrewshire

“Walking keeps you young and allows you to do other things. It’s pure, dead, brilliant” Chris, Next Steps, Blairgowrie

Paths to Health train walk leaders

Percentage of commuters using the stairs[Blamey, A., Mutrie, N., Aitchison, T. (1995) British

Medical Journal, 311, 289-290.]

0

5

10

15

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percentage

Baseline Poster up 12 weeks afterposter down

menwomen

Conclusions

Confidence and well being can be achieved through physical activity by improving

– Physical and mental health– Preventing poor health– Enhancing recovery– Fostering communities

You can start by – increasing the amount of walking

you do – finding some fun in your activity

sessions!