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Please cite this article in press as: Asztalos M, et al. Specific associations between types of physical activity and components of mental
health. J Sci Med Sport (2008), doi:10.1016/j.jsams.2008.06.009
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A
vailable online at www.sciencedirect.com
Journal of Science and Medicine in Sport xxx (2008) xxx–xxx
Specific associations between types of physical
activity and components of mental health
Melinda Asztalos a, Katrien Wijndaelea, Ilse De Bourdeaudhuij a, Renaat Philippaerts a,
Lynn Matton b, Nathalie Duvigneaud c, Martine Thomisb, William Duquetc,
Johan Lefevre b, Greet Cardona,∗
aDepartment of Movement and Sports Sciences, Ghent University, Belgium
bDepartment of Biomedical Kinesiology, Belgium
cFaculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Belgium
Received 31 October 2007; received in revised form 25 June 2008; accepted 30 June 2008
Abstract
Findings of previous studies suggest that the relationship between physical activity and mental health may change across different domains
of physical activity, different dimensions of mental health, and different population subgroups. The present study examined associations
between five types of physical activity with different contents: housework, leisure active transportation, biking to/from work, walking to/from
work, and sports participation, and two dimensions of mental health: perceived stress and psychological distress, in 1919 participants aged
20–65 years, using the data from the Flemish Policy Research Centre Sport, Physical Activity and Health. Multiple logistic regression analyses
were performed with the total sample, and with the sample stratified by gender, age, and occupational category. Further, separate models were
used in the gender and age subgroups of each occupational category. Sports participation was the only type of physical activity inversely
associated with both stress (OR = 0.375; CI: 0.200–0.704) and distress (OR = 0.480; CI: 0.253–0.910). Sports participation related to less
distress in unemployed mid-aged adults, and to less stress in unemployed women, unemployed young adults, and young adults with blue-
collar jobs. Housework was associated with more stress and more distress in women with blue-collar jobs. In young adults with white-collar
jobs, however, an inverse association between housework and distress was found. Biking to and from work was associated with more stress
in men with blue-collar jobs. Results invite consideration for the utility, and perhaps the necessity, of differentiated health recommendations
for physical health and for mental health in different population subgroups.
© 2008 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Keywords: Motor activity (MeSH entry term: physical activity); Sports; Leisure activities; Mental health; Stress (psychological); Types of physical activity;
Psychological distress
1. Introduction
Little research has examined the relative importance of dif-
ferent domains of physical activity (PA) (e.g., content/type,
frequency, duration, intensity) in achieving specific health
outcomes1(e.g., mental health (MH) benefits). Research has
found that more PA, and more intense PA, could result in
physical health benefits,19 however, a too strenuous PA regi-
men might lead to deleterious effects on MH.2–4
∗Corresponding author.
E-mail address: Greet.Cardon@UGent.be (G. Cardon).
The relationship between PA and MH appears to be much
more complex in terms of the domains of PA and possi-
ble responses than the relationship between PA and physical
health.17 Scarce research examined whether different PAs
have different relationships with MH. Intervention studies
evaluated primarily the effects of aerobic PA on MH.5Some
found these most viable for psychological benefits.6Oth-
ers showed that aerobic and anaerobic activities influence
MH similarly.7Most of the important findings associated
PA with: relief in symptoms of depression and anxiety,
elevated mood, improved self-esteem,6enhanced physical
self-perception, self-efficacy, cognitive functioning,8greater
1440-2440/$ – see front matter © 2008 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.jsams.2008.06.009
Please cite this article in press as: Asztalos M, et al. Specific associations between types of physical activity and components of mental
health. J Sci Med Sport (2008), doi:10.1016/j.jsams.2008.06.009
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2M. Asztalos et al. / Journal of Science and Medicine in Sport xxx (2008) xxx–xxx
health-related quality of life,9and efficient stress prevention
and reduction.10
The Surgeon General (1999) encouraged research exam-
ining the relationship between different forms of PA and
MH, as psychological outcomes may depend on the type of
PA being performed.5Nevertheless, studies seldom analysed
activities with different contents. In one study, women man-
ifested higher positive affect when their energy expenditure
came from recreational activities only, than from recreational
and household activities combined.11 Another study found
that although all types of PA including housework, garden-
ing, walking, and sports participation, associated with lower
odds of psychological distress, the strongest effects were for
sports participation.15
Research also suggested that the relationship between
PA and MH might change among population subgroups.
One cross-sectional study using four surveys with 55,979
participants,11 found that associations between PA and fewer
symptoms of anxiety and depression, and higher positive
mood and general well-being, were strongest among women
and 40+ years old. Another study16 found that women and
men attained psychological benefits most effectively through
different PAs. Women responded better to lighter PA includ-
ing cognitive strategy training programs (i.e., Tai Chi); while
men responded better to more intense PA lacking a struc-
tured cognitive component (i.e., 75% maximum heart rate
while brisk walking).
The literature suggests that it is necessary to produce a
more differentiated picture about the relationship between
PA and MH,12 as different types of PA might relate to dis-
tinct dimensions of MH,10 and the association between PA
and MH may change in different populations.13 Researchers
should clarify which types of PA enhance psychologi-
cal functioning,18 as this would facilitate the development
of guidelines on how PA could aid MH, and on which
forms of PA are likely to be most beneficial in different
circumstances.17
The present study analysed associations between five
types of PA: housework, leisure active transportation, biking
to/from work, and walking to/from work, and sports partic-
ipation, and two dimensions of MH: perceived stress and
psychological distress, stratified by gender, age and occupa-
tional category. We expected that different types of PA would
associate with less stress and/or less distress in different popu-
lation subgroups; and that the nature of the associations (e.g.,
inverse) would vary with individual characteristics.
2. Methods
Data for this study were collected by the Flemish Policy
Research Centre Sport, Physical Activity and Health (SPAH),
in 2002–2004, for a cross-sectional survey on the relation-
ship between sports participation, PA, physical fitness, and
several health parameters. The National Institute of Statistics
has randomly selected a sample of 18,464 adults, aged 18–75
years, from 46 randomly chosen Flemish municipalities, con-
tacted by letter and telephone, and invited to participate in
the study. Of them, 28% accepted the invitation: 5170 indi-
viduals; 2746 men; 2420 women. Main reasons for refusing
participation were: lack of time (25.9%), health problems
(23.2%), work obligations (14.6%), previous engagements
(14.1%), and other reasons (22.2%). The final sample was
compared to the total Flemish adult population, and found
sufficiently representative for geographic distribution, age,
gender and educational level.20 Details regarding the sam-
pling are given elsewhere.14
Data were collected by means of two self-report com-
puterised questionnaires, one on MH, another on PA and
demographics. Participants completed them in a municipal
centre in their neighborhood, in the presence of a scientific
staff member.
This study included participants with complete data for
the variables used in the analyses: 1919 working/unemployed
adults aged 20–65 years. Table 1 describes the sample. All
participants signed an informed consent statement before par-
ticipating in the study, which was approved by the Ghent
University Ethics Committee.
The Flemish Physical Activity Computerised Question-
naire (FPACQ) evaluated demographics and PA. The FPACQ
is a reliable and reasonably valid questionnaire for the assess-
ment of different dimensions of PA and sedentary behavior
in working/unemployed people.20 Based on the FPACQ, five
types of PA were computed: sports participation, housework,
leisure active transportation, biking to/from work, and walk-
ing to/from work. Sports participation was assessed by asking
participants to select their three most frequently practiced
sports out of a list of 196 different sports. Frequency from
once/year to more-times/day, and corresponding amounts of
time spent in sports, were also reported. The mean frequency
of sports participation was once/week in the sample, and the
average time spent in sports was 2.75 h/week. Thus, the vari-
able sports participation represented participation in any sport
on an average frequency of minimum once/week, for the aver-
age time of 2.75 h/week. Participants also reported amounts
of time spent in each of the following activities over a usual
week: housekeeping and gardening, active transportation in
leisure time (i.e., leisure walking/bicycling), biking to/from
work, and walking to/from work. Once computed, each of
these four PA indexes was divided in two categories based
on its mean value. We chose to do this because the data were
strongly right-skewed, and logistic transformation did not
help obtaining valid results with continuous variables. We
considered that the large sample size, the use of powerful
tests, and the advantage of efficient data interpretation com-
pensated for losing a little variability due to dichotomization.
Furthermore, analyses on non-dichotomised data gave iden-
tical results. Sample-average times spent in each type of PA
(i.e. cut-points used for dichotomization) are listed in Table 1.
Two dimensions of MH were analysed in this study: per-
ceived stress and psychological distress.
Please cite this article in press as: Asztalos M, et al. Specific associations between types of physical activity and components of mental
health. J Sci Med Sport (2008), doi:10.1016/j.jsams.2008.06.009
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M. Asztalos et al. / Journal of Science and Medicine in Sport xxx (2008) xxx–xxx 3
The Perceived Stress Scale (PSS) was employed, as it is
a widely used psychological instrument for measuring the
degree to which situations in one’s life are appraised as
stressful.21 Items assess to what extent individuals see their
lives as unpredictable, uncontrollable and overloaded, refer-
ring to their feelings and thoughts in the last month. Answer
categories to the 10 items of the PSS are on a 5-point Likert
scale from ‘never’ = 0 to ‘very often’ =4. Total scores range
from 0 to 40, with higher sum-scores indicating higher levels
of perceived stress. Before summing all scores, scores on the
positive items were reversed.
Levels of psychological distress were measured by the
General Health Questionnaire (GHQ12) – a well-established
screening instrument designed to detect possible non-
psychotic psychiatric morbidity in community settings.22
Answers categories are on a four-point response scale (‘not
at all’, ‘same as usual’, ‘more than usual’, and ‘much more
than usual’). The bimodal GHQ-scoring method (0-0-1-1)
was applied.22 Total scores ranged from 0 to 12, with higher
scores indicating more psychological distress.
Computerised versions of both psychological instruments
were applied. Wijndaele et al.10 showed that the reliabil-
ity of these scales was acceptable to excellent (Cronbach’s
α= 0.79; ICC for test-retest reliability for GHQ12 = 0.76 and
for PSS = 0.87; equivalence = 0.75).23
Multiple logistic regression analyses were used to test
associations between five types of PA and perceived stress
and psychological distress respectively. Age 42 was used as
threshold for obtaining two fairly equal groups of young- and
mid-aged adults. Participants were grouped in three occupa-
tional categories based on their working status: unemployed,
blue, and white-collar job people. Separate models tested
associations in the total sample (controlling for gender, age,
and occupational category); in the sample stratified by gen-
der, age, and occupational category; and in the gender and
age subgroups of each occupational category. SPSS 12.0 was
used for all analyses.
3. Results
Table 2 presents the results of the analyses performed
in the total sample, and in the sample stratified by gender,
age, and occupational category. Housework was associ-
ated with more stress in the total sample (OR = 1.264; CI:
1.014–1.576); and inverse associations were found in the
unemployed between sports participation and both stress
(OR =0.375; CI: 0.200–0.704) and distress (OR =0.480; CI:
0.253–0.910).
More associations showed in the gender and age sub-
groups of each occupational category. As Table 3 presents,
sports participation was inversely associated with stress
in unemployed women (OR = 0.307; CI: 0.146–0.644),
unemployed young adults (OR = 0.178; CI: 0.055–0.578),
Table 1
Demographics and physical activity characteristics
Characteristics of the sample % N
Gender Women 46.95 901
Men 53.05 1018
Age Young adults 20–42 years 47.32 908
Mid-aged adults 42–65 years 52.68 1011
Occupational category Unemployed 11.00 211
Blue-collar jobs (workers, freelancers) 22.62 434
White-collar jobs (employees,
executives, teachers, professionals)
66.38 1274
Sports participation “Yes” (average frequency: minimum
once/week, average time spent in
sports: ∼2.75 h/week)
74.3 1427
“No” 25.6 492
Housework More than average of ∼3 h/week
(subgroup average: ∼6 h/week)
43.4 814
Less than average of ∼3 h/week 56.6 1063
Leisure active transportation More than average of ∼20 min/day
(subgroup average: ∼40 min/day)
38.9 747
Less than average of ∼20 min/day 61.1 1172
Biking to/from work More than average of 10 min/day
(subgroup average: 30 min/day)
17.6 318
Less than average of 10 min/day 82.4 1601
Walking to/from work More than average of 5 min/day
(subgroup average: 10 min/day)
25 479
Less than average of 5 min/day 75 1440
Total 100 1919
Please cite this article in press as: Asztalos M, et al. Specific associations between types of physical activity and components of mental
health. J Sci Med Sport (2008), doi:10.1016/j.jsams.2008.06.009
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Table 2
Associations between five types of physical activity and perceived stress and psychological distress in different populations
Significant odds ratios (OR) and 95% confidence intervals (95% CI) are highlighted.
and young adults with blue-collar jobs (OR = 0.402; CI:
0.197–0.819); and with distress in unemployed mid-aged
adults (OR = 0.405; CI: 0.178–0.920). Biking to/from work
was associated with more stress in men with blue-collar jobs
(OR = 1.953; CI: 1.012–3.766). Housework was associated
with more of both stress (OR = 2.661; CI: 1.098–6.447) and
distress (OR = 2.911; CI: 1.055–8.031) in women with blue-
collar jobs. In contrast, an inverse association was found
between housework and distress in young adults with white-
collar jobs (OR = 0.667; CI: 0.460–0.969).
4. Discussion
This study explored associations between five types of
PA: housework, leisure active transportation, biking to/from
work, walking to/from work, sports participation, and two
dimensions of MH: perceived stress and psychological dis-
tress, in a population-based sample of 1919 adults aged 20–65
years. Multiple logistic regression was performed with the
sample stratified by gender, age, and occupational category.
We expected different types of PA to associate with less stress
and/or less distress in different populations; and the nature of
the associations to vary with individual characteristics. Our
results mostly supported our hypotheses.
The central finding of the study is that sports participation
and no other type of PA was consistently associated with sig-
nificantly less stress and less distress. Similarly, Wijndaele
et al.10 found that sports participation and no other type of
PA could discriminate between three meaningful clusters of
perceived stress, social support and coping behavior. It is
therefore arguable that sports participation and not other types
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health. J Sci Med Sport (2008), doi:10.1016/j.jsams.2008.06.009
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Table 3
Associations between five types of physical activity and stress/ distress in the gender and age subgroups of three occupational categories
Significant odds ratios (bolded, flushed left) and 95% confidence intervals (italicized, flushed right) are highlighted.
of PA may represent effective preventive and intervention
strategies against stress and distress, particularly in specific
populations (e.g. the unemployed). The main reason why
sports participation was the only type of PA associating with
less stress/distress might be that sports participation usually
represents a chosen leisure-time activity that aims for recre-
ation, enjoyment and social interaction. These attributes are
associated with enhanced psychological well-being,8but they
rarely can be attributed to types of PA that imply compulsion
to a certain extent, such as housework or active transporta-
tion.
One type of PA behaved in the same way in its relation-
ship with both stress and distress in one specific population:
housework was associated with more of both stress and dis-
tress in women with blue-collar jobs. In line with Stephens,11
this suggests that housework may not be a PA that aids MH,
especially in women with blue-collar jobs. Housework is sel-
dom an activity chosen by the individual for enjoyment or
recreation; instead, it is an activity that “must be done”. It is
possible that women with blue-collar jobs simply must add
housework to their daily routine (because hiring help is not
an option), hence, these women might feel overwhelmed by
duties. This could account for their higher levels of stress and
distress.
Nonetheless, housework was inversely associated with
distress in young adults with white-collar jobs. This was the
only significant association found in people with white-collar
jobs, and it supports our hypothesis that the nature of the rela-
tionships between different types of PA and stress/distress
might change with individual characteristics. It is likely
that young adults with white-collar jobs can choose to do
housework, but they must not do it (because e.g. they can
afford help, young couples in this occupational category
share duties), therefore, their levels of distress are signifi-
cantly lower in relation with housework. Further research is
needed to understand under which conditions housework may
be beneficial or detrimental to MH.
A similar issue arises from the association between biking
to/from work and more stress, found in men with blue-collar
jobs. Although choosing the bicycle as transportation can
make this type of PA a chosen activity, the purpose of the
activity may be merely attending work – “a must” in itself.
It is possible that men with blue-collar jobs did not choose
bicycling for reasons involving health benefits or enjoyment,
but more because of the economy factor. Consequently, the
utility of active transportation might reduce the enjoyment of
this PA and its possible stress-reducing potential. In addition,
the fact that biking to/from work enhances the chances of
encountering stressors (e.g. dealing with traffic) could have
also contributed to this association.
Further, our results suggest that the association between
PA and MH might change across different domains of PA and
different population subgroups. Sports participation appears
to be the single type of PA inversely associated with both
stress and distress; thus, it could be useful to highlight
that even though PAs of any content may be beneficial for
Please cite this article in press as: Asztalos M, et al. Specific associations between types of physical activity and components of mental
health. J Sci Med Sport (2008), doi:10.1016/j.jsams.2008.06.009
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6M. Asztalos et al. / Journal of Science and Medicine in Sport xxx (2008) xxx–xxx
physical health, when targeting psychological benefits, it
might be insufficient to just climb the stairs instead of taking
the elevator, or to engage in housework/gardening. More-
over, certain population subgroups might benefit of sports
participation in terms of less stress (unemployed women,
unemployed young adults, and young adults with blue-collar
jobs); while others (unemployed mid-aged adults) in terms of
less distress. Hence, psychological outcomes of PA depend
on individual characteristics.13 Research suggests that sports
participation results in experience of joy and development of
mastery and autonomy.3,10,24,25 In addition, participation in
many sports implies social interaction. These primary posi-
tive outcomes of sports participation might induce beneficial
effects on MH. Young adults with blue-collar jobs and unem-
ployed people, especially women, should be informed about
this.
Important strengths can be attributed to this study. The
large community-based sample is representative for the
whole Flemish part of Belgium.20 Measures of PA and MH
used are valid, reliable, and thorough. We performed strat-
ified analyses, applying relevant statistics. No other study
has previously investigated the relationship between differ-
ent PAs and components of MH in such a stratified fashion. As
this is the first study detailing about the relationship between
PA and MH, future studies should confirm our results. New
research could analyse the relationship between PA and MH
using similar doses of activity for the different domains of PA.
Such research could elaborate our results, as in our study, the
different types of PA were delivered in different doses and
this could have influenced our results.
One limitation of our study is that the FPACQ was
not tested for differential bias; therefore, we cannot state
whether the questionnaire is equally valid for lower and
higher educated people, or in people with blue-collar, and
white-collar jobs. The greatest limitation of our study is its
cross-sectional design, which prevented us from establishing
causality or directionality. Although we found positive rela-
tionships between PA and good MH, we cannot state that PA
causes good MH, because it is equally possible that PA is
the effect of good MH, as people with good MH may sim-
ply be more likely to be active. Yet another possibility is
that PA and MH vary together, and a third variable mediates
this relationship. Future research should aim to clarify these
issues. The effectiveness of participating in specific types of
sports as intervention for reducing levels of stress/distress,
or as stress-management tool should also be investigated in
different populations.
Finally, our results invite consideration for the utility, and
perhaps the necessity, of differentiated health recommenda-
tions for physical, and mental health in different population
subgroups.
Practical implications
•Sports participation is the PA that relates to less stress
and less distress. The associations are manifest in the
unemployed, especially women, and in young adults with
blue-collar jobs.
•Housework relates to more stress and more distress in
women with blue-collar jobs.
•In young adults with white-collar jobs, housework asso-
ciates inversely with distress.
•Biking to/from work relates to more stress in men with
blue-collar jobs.
Conflict of interest
There is no financial conflict of interest for the authors of
this paper.
Acknowledgement
The authors acknowledge the Flemish Policy Research
Centre Sport, Physical Activity and Health, which is sup-
ported by The Flemish Government.
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health. J Sci Med Sport (2008), doi:10.1016/j.jsams.2008.06.009
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