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Physical fitness and risk of mental disorders in children and adolescents

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Re: Physical fitness and risk of mental disorders in children and adolescents

#51

This seems like a very easy one to point out that they may be getting the cause and effect backward.

They've done the analysis: meta-analysis of random controlled trials , see https://www.bmj.com/content/384/bmj-2023-075847 "Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. Yoga and strength training were well tolerated compared with other treatments. Exercise appeared equally effective for people wi…

That’s a meta analysis (which is always a solid indicator of pseudoscience) of studies that are not really controlled because

A.) you have to actually do the exercise, which means the people who don’t may simply not do so because their mental illness is worse or at least different than the ones who do.

2. If you’ve ever read the attempts to quantify various mental illnesses, they’re extremely unscientific and borderline laughable if you’ve ever known a few people who suffer from them. What we call “depression” affects so many people in so many ways that in the future, it’s likely it will become a category of diseases with many different individual names. One of my exes medicated her depression by working, one by calling off work, for example. One would have (and did) do lots of exercise, one did not, and there’d be no way to quantify either on any simple scale.

3.) It’s obviously neither double nor single blind. You can’t not know if you’re exercising, and the researcher can likely tell which are which to a decent degree just by looking at them.

All a meta analysis of a bunch of non-controlled studies really tells you is the prevailing pre-sentiment among the researchers of a topic. Which, really, isn’t nothing (they’re more likely to guess correctly than a random person) but it’s far from an actual controlled study.

And I still stand by that there’s no way you could realistically say this study indicates causation with any certainty. Though that never stops people in the social sciences I guess.

Re: Physical fitness and risk of mental disorders in children and adolescents

#52
I am trying to learn how to interpret clinical study results. It seems that the confidence intervals and p-values suggest there is high degree of certainty in the results. Still, the odds ratio seems to have marginal improvements over the control, 4-8% depending on what was being measured. If I'm interpreting this study correctly, exercise has a marginal impact on adolescents mental health. I kind of hope I misread that study, and that exercise plays a larger role.

If I read a study that tells me I may see a 4% chance of improvement if I make significant changes to my lifestyle, the chances that I ignore that study are about 96%.

Guess, when viewed on aggregate a 4-8% improvement would be a valuable improvement.

Re: Physical fitness and risk of mental disorders in children and adolescents

#53
post #2

The role of brain health in mental illness is commonly discounted, but so consistently found in studies. I got roasted here for recommending psychiatrist Mary Edes' book on improving mental health with dietary changes, but the benefits of the approach are clear. https://www.npr.org/sections/health-shots/2024/01/27/1227062... I've resolved most of my diabetes type 2 with diet, and nobody should be surprised that this…

> I got roasted here for recommending psychiatrist Mary Edes' book on improving mental health with dietary changes,

This is because sadly diet, fitness and weight loss are some of the topics this otherwise very lucid website literally loses its mind over. Another is natality.

Re: Physical fitness and risk of mental disorders in children and adolescents

#54
post #2

The role of brain health in mental illness is commonly discounted, but so consistently found in studies. I got roasted here for recommending psychiatrist Mary Edes' book on improving mental health with dietary changes, but the benefits of the approach are clear. https://www.npr.org/sections/health-shots/2024/01/27/1227062... I've resolved most of my diabetes type 2 with diet, and nobody should be surprised that this…

Only want to chime in here for folks to not feel bad about also getting help beyond physical fitness and diet.

I've been a health junky my whole life, very in shape, and I eat well.

Of course that helps my mental health a lot.

However, I still get depressed. I suffer from chronic sleep apnea (it's related to my anatomy, so I can't exercise out of it, it's around 79 AHI). I take zoloft for anxiety and it has helped me to calm down and enjoy my life more.

And finally, I recently got diagnosed with ADHD. I'm fairly high functioning without meds, but with meds I can finally do all the things I've wanted to. My todo list, those things I used to forget or put off, I just do them now.

So yes, take care of yourself, but don't feel bad if it doesn't solve everything. Some of us need extra help, and it's nothing to be ashamed of. I understand you weren't shaming folks, but I really want to share this in case folks think they're broken for needing medication.

And sometimes you need the help from medication to kick-start being more healthy physically, don't be ashamed! We are all different.

Re: Physical fitness and risk of mental disorders in children and adolescents

#55
post #9

Not doubting the importance of physical activity, but poor mental health makes it significantly harder to maintain fitness as a child. Often, school sports have minimum GPA requirements. A poor home life increases chances of mental illness and decreases chances that someone will drive you to practice. Will you even maintain the team sport if your teammates never accept you, given whatever mental condition that gives…

> but I doubt they went through all the effort to have deep, revealing conversations about the home life or other nuanced cofounders of each participant. Why is it that nearly every paper linked on HN, someone is in the comments saying the research didn't go far enough? In this case without even reading the paper? Nothing in your critique is relevant to the fact that the authors found physical fitness and mental heal…

This is such a bad, overly-cynical take.

> Why is it that nearly every paper linked on HN, someone is in the comments saying the research didn't go far enough?

Because they usually don't.

And for those who are actually curious, look up "reproducibility crisis" and "publish or perish" to learn more about issues in academia, and ask ChatGPT about why systemic skepticism of scientific research is critical to the process of science.

> In this case without even reading the paper? Nothing in your critique is relevant to the fact that the authors found physical fitness and mental health linked. Nothing in your critique is relevant to the fact that the authors found physical fitness and mental health linked.

Such irony, that you didn't read any part of the preview yourself. If you did, you'd see:

"This study highlights the potential protective role of cardiorespiratory fitness, muscular endurance, and muscular power in preventing the onset of mental disorders. It warrants further investigation of the effectiveness of physical fitness programs as a preventive measure for mental disorders among children and adolescents."

The viability of this correlation, given controls for confounders, changes the significance of the results dramatically. Perhaps you think the point of research is to publish pointless correlations and suggest wild ideas for journalists to turn into clickbait?

For those actually curious: the authors are proposing a causation, and given the absence of any counter, it's a biased conclusion that attempts to increase the significance of the findings for the sake of publishing, at the cost of coming uncomfortably close to declaring a causal relationship. Not a criticism of the authors necessarily, but of the poor incentives plaguing academia. For studies like this to be of higher quality, they become very expensive, so given the lack of discussion regarding confounders in the preview, one should have strong skepticism regarding the actual practical significance of the strength of the causal relationship. Though if the research is of low quality, then it really all was pointless and probably only serves to keep the authors employed. At that point, the paper is only an unsubstantiated suggestion to study something else, so why even bother with the rest of the paper. That being said, having been an athlete for most of my life, I'm a huge proponent of children being given access to sports.

> No, not everyone has equal access to sports. Yes mental health is complicated.

Do you talk to people in real life like this? That's quite upsetting.

Re: Physical fitness and risk of mental disorders in children and adolescents

#56
post #9

Not doubting the importance of physical activity, but poor mental health makes it significantly harder to maintain fitness as a child. Often, school sports have minimum GPA requirements. A poor home life increases chances of mental illness and decreases chances that someone will drive you to practice. Will you even maintain the team sport if your teammates never accept you, given whatever mental condition that gives…

> A poor home life increases chances of mental illness and decreases chances that someone will drive you to practice. That you need to be driven at all to exercise is a huge part of the reason why exercise and fitness rates are so low in our youth. Our grandparents and great grandparents walked miles to go to school five days a week, and we've built our cities such that this is impossible or dangerous. We now live in…

> The study was conducted in Taiwan which does not suffer from US-style car extremism

This is true and a fair criticism of driving specifically. I noticed the location and do agree the 'driving' remark isn't as applicable to this specific study, but I still put forward the general sentiment regarding both a family's overall ability to support, where needed, and a childs ability to travel to travel if needed. Some kids won't need it, but in the cases where it is needed & they don't have it, it would lower the chances of keeping up with sports. Just one of many possible pathways that would make athletics hard to maintain.

But more generally to your point, while some sports won't require extra effort, it really does depend on the situation, which is why a study like this is so hard to carry out well. In my youth, it would have been more convenient to do lacrosse or soccer on-site, but those didn't work for with me so I picked different sports that had more of a demand for travel.

Re: Physical fitness and risk of mental disorders in children and adolescents

#57
post #9

Not doubting the importance of physical activity, but poor mental health makes it significantly harder to maintain fitness as a child. Often, school sports have minimum GPA requirements. A poor home life increases chances of mental illness and decreases chances that someone will drive you to practice. Will you even maintain the team sport if your teammates never accept you, given whatever mental condition that gives…

Obesity is an epidemic, broken or abusive households are not. It doesn't make sense to be skeptical of fitness on the conceit that it might not handle issues in the margins (except, they do -- sports can improve self-esteem in kids who otherwise struggle). > Will you even maintain the team sport if your teammates never accept you Kids are generally pretty accepting, and in a sports setting they spend nearly all of th…

This is so completely not true -- but if you're on the right side of ordinary, you do have the privilege of believing it.

Re: Physical fitness and risk of mental disorders in children and adolescents

#58
post #38

Earlier quoted context omitted.

Doesn't 'home life' depend on the parent's emphasis on physical activity, sports, or general fitness? I.e. if the parents put a higher value on other things, it seems likely that the children will follow their lead.

A poor home life in any sense of the term should not matter unless it means the parents are outright abusive. I did not play outside as a kid because my parents emphasized it. I did it because there were kids right outside and playing with them was more fun than anything I could do inside. If one of my parents had to drive me anywhere for me to be physically active, I would very rarely have gone anywhere or done anyt…

> A poor home life in any sense of the term should not matter unless it means the parents are outright abusive

I disagree. Stress from a dysfunctional family or timing demands from being required to act as a caretaker, among other things, will decrease the time and energy required to pursue physical activity.

And physical fitness, high enough to stimulate the indicators they measured, involves more than just causally playing outside - though my interpretation of that sets quite a low bar for the physical exertion involved.

Re: Physical fitness and risk of mental disorders in children and adolescents

#60
post #9

Not doubting the importance of physical activity, but poor mental health makes it significantly harder to maintain fitness as a child. Often, school sports have minimum GPA requirements. A poor home life increases chances of mental illness and decreases chances that someone will drive you to practice. Will you even maintain the team sport if your teammates never accept you, given whatever mental condition that gives…

Instead of looking for excuses, find a way. You don't have to play tennis, climbing a tree will do.

> Instead of looking for excuses, find a way. You don't have to play tennis, climbing a tree will do.

Please tell me this is a shitpost?

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