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There is a growing interest in empirically testing the maxim that a healthy body leads to a healthy mind. Several recent statistical reviews have found that both acute and chronic physical activity have positive mental health benefits. Reduced anxiety, depression, and perceived stress, as well as increases in self-confidence, positive affect, self-esteem, and cognitive function, are among the mental health benefits. On a broader scale, there is evidence that physical activity can improve quality of life (QOL). This is especially significant in the context of the United States, which is an aging society.

Life expectancy for both men and women has increased significantly over the last century as a result of advances in modern medicine and increased participation in preventive health behaviors (e.g., not smoking and eating a healthy diet). Many would argue, however, that living longer does not necessarily imply living a higher-quality life. Furthermore, the chronic disease conditions that frequently accompany old age can impair QOL by jeopardizing physical, emotional, and psychological well-being.

This article discusses briefly how QOL is defined and measured, provide an overview of the relationship between QOL and physical activity, and then the possible mechanisms by which physical activity may influence QOL.

Defining Quality of Life

For many years, QOL was measured using morbidity (disease) and mortality (death) indices. However, it is critical to recognize that QOL is a subjective construct, and assessments of this construct must be based on the individual’s perceptions rather than physiological indices such as disease state or physical function. As a result, global measures of QOL that include both overall satisfaction with one’s life and satisfaction with more specific aspects of one’s life, such as physical and mental health, are more appropriate.

Many researchers regard QOL as a multidimensional construct in which dimensions such as physical, psychological, social, and spiritual well-being reside. These dimensions, particularly physical and mental health status, are frequently categorized as health related quality of life (HRQL), and they are given significant weight in the biomedical literature. HRQL is considered by some scientists to be a subset of overall quality of life. As an example, consider a hierarchical, multidimensional ordering in which specific components fall under various areas of function and well-being, which contribute to overall quality of life.

Physical Activity’s Influence

A substantial body of research suggests that physical activity is linked to higher levels of HRQL and QOL. In general, HRQL constructs such as reductions in depressive symptoms or disability status, as well as improvements in physical and mental health status, have a stronger positive relationship with physical activity than global QOL measures such as overall life satisfaction. This could be because HRQL constructs are more proximal to physical activity behaviors, and thus more likely to be influenced by them, than a construct as distal as overall life satisfaction.

To determine whether physical activity actually improves quality of life, evidence from intervention studies in which physical activity behavior is changed or manipulated must be examined. A recent meta-analysis of such studies found that people in physical activity intervention groups experienced significant increases in well-being (regardless of how it was measured) when compared to people in control groups, whose well-being did not change. Intervention studies, like cross-sectional studies, had the greatest impact on HRQL outcomes.

HOW MUCH IS NEEDED?

Knowing that physical activity can improve QOL outcomes begs the question, “How much physical activity is required to improve QOL?” This is known as a dose response issue, and it is currently unknown whether there is a minimum amount of physical activity that results in improved QOL.

The Centers for Disease Control and Prevention recently reported findings from a large population study that suggested meeting public health recommendations for physical activity (i.e., being physically active for at least 30 minutes on 5 or more days of the week) resulted in being significantly less likely to report 14 or more unhealthy days in the previous 30 days than not meeting public health recommendations.

Potential Mechanisms

As previously stated, the effects of physical activity on HRQL constructs tend to be stronger than the effects on global QOL. This suggests that a simple direct relationship between physical activity and overall QOL may be overly simplistic in characterizing the relationship. Physical activity is a complex behavior that influences a number of physical, social, and psychological factors, which in turn influence overall life satisfaction. These intermediate factors are crucial because they are more easily modifiable than overall QOL. In other words, changes in intermediate variables can cause changes in overall QOL. So, which of the underlying mechanisms is likely to be the most important?

SELF CONFIDENCE

Several researchers have attempted to answer this question by demonstrating that other variables may be linked to overall QOL. According to one model, physical activity has a direct impact on self efficacy, or confidence in one’s ability to be active on a regular basis. Those with higher self efficacy reported better physical and mental health, and health status was positively related to life satisfaction. This model is consistent with other research that has shown that physical activity is associated with positive mental health, and positive mental health is associated with life satisfaction. Other models have identified physical self-esteem and positive affect (emotion) as potential mediators of the effects of physical activity on QOL.

COGNITION

There is also mounting evidence that physical activity and fitness have a positive impact on cognitive function. Physical, cognitive, and psychosocial function become increasingly important as people age because they play an increasing role in living independently, which can be a significant contributor to life satisfaction. Age is typically accompanied by declines in cognitive processing, particularly in executive tasks such as planning, scheduling, and working memory, and researchers have shown that improvements in fitness may actually mitigate such declines.

PHYSICAL FUNCTION

Physical activity has been shown to improve physical function by improving cardiovascular fitness, muscular strength and endurance, and flexibility—all of which are important in performing basic daily functions like walking, lifting, carrying, and so on.

Conclusion

It is clear that QOL has become an increasingly important presence in American society, and this is likely to continue as the demographic landscape changes. QOL is a critical component of living a meaningful and fulfilling life. Physical activity interventions have consistently been shown to have a positive impact on more proximal QOL outcomes such as self-efficacy, positive affect, and physical and mental health status. Thus, maintaining a physically active lifestyle, while providing positive physical health benefits, holds great promise for increasing both the quality and quantity of our lives.

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