A Systematic Review of the Relationship Between Physical Activity and Happiness

Abstract

This study aimed to examine the relationship between physical activity and happiness through systematically reviewing the existing literature. A systematic search of major databases including PubMed/Medline, PsychInfo, SportDiscus, and Embase was performed in 2017 for original research articles published post-1980 with the related keywords of happiness and physical activity. From 1142 retrieved records, fifteen observational studies (thirteen cross-sectional studies and two longitudinal studies) and eight intervention studies (six randomized controlled trials and two non-randomized trials) were included for further analysis. These studies involved a wide range of population from various countries and areas. All the observational studies reported positive associations between physical activity and happiness. As little as 10-min physical activity per week or 1 day of doing exercise per week might result in increased levels of happiness. Mediation effects were examined in two studies indicating the positive relationship between physical activity and happiness might be mediated by health and social functioning. The randomized controlled trials mostly focused on older adults and cancer survivors, and suggested that both aerobic exercise and stretching/balancing exercise were effective in improving happiness. Evidence showed a consistent positive relationship between physical activity and happiness. However, due to the limited number of randomized controlled trials, we cannot draw firm conclusions regarding the causal relationship between physical activity and happiness. Future research is suggested to explore the mechanism of how physical activity influences happiness and to determine the optimal dose and type of physical activity for gaining the benefits of happiness.

Full text

J Happiness Stud
https://doi.org/10.1007/s10902-018-9976-0
1 3
REVIEW ARTICLE
A Systematic Review oftheRelationship Between
Physical Activity andHappiness
ZhanjiaZhang1· WeiyunChen1
© Springer Science+Business Media B.V., part of Springer Nature 2018
Abstract This study aimed to examine the relationship between physical activity and
happiness through systematically reviewing the existing literature. A systematic search of
major databases including PubMed/Medline, PsychInfo, SportDiscus, and Embase was
performed in 2017 for original research articles published post-1980 with the related key-
words of happiness and physical activity. From 1142 retrieved records, fifteen observational
studies (thirteen cross-sectional studies and two longitudinal studies) and eight intervention
studies (six randomized controlled trials and two non-randomized trials) were included for
further analysis. These studies involved a wide range of population from various coun-
tries and areas. All the observational studies reported positive associations between physi-
cal activity and happiness. As little as 10-min physical activity per week or 1day of doing
exercise per week might result in increased levels of happiness. Mediation effects were
examined in two studies indicating the positive relationship between physical activity and
happiness might be mediated by health and social functioning. The randomized controlled
trials mostly focused on older adults and cancer survivors, and suggested that both aerobic
exercise and stretching/balancing exercise were effective in improving happiness. Evidence
showed a consistent positive relationship between physical activity and happiness. How-
ever, due to the limited number of randomized controlled trials, we cannot draw firm con-
clusions regarding the causal relationship between physical activity and happiness. Future
research is suggested to explore the mechanism of how physical activity influences happi-
ness and to determine the optimal dose and type of physical activity for gaining the benefits
of happiness.
Keywords Exercise· Positive psychology· Subjective well-being· Mental health
* Weiyun Chen
chenwy@umich.edu
1 School ofKinesiology, University ofMichigan, 1402 Washington Heights, 3145 OBL, AnnArbor,
MI48109, USA

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1 Introduction
The benefits of physical activity (PA) on mental health have been well documented
(Saxena etal. 2005). For instance, there is a large body of literature demonstrating that
PA effectively reduces depression and anxiety (Ströhle 2009). However, previous stud-
ies have predominantly focused on the effects of PA on the negative aspects of mental
health and concerned the use of PA as a preventive or curative approach for mental
disorders (Rosenbaum etal. 2014). The investigation of the relationship between PA
and mental disorders is of importance because mental disorders are linked to increased
morbidity, premature mortality, and greater medical cost (Alexopoulos 2005; Katon
etal. 2003). In contrast, the relationship between PA and positive mental constructs
has remained largely unexplored. The World Health Organization has stressed the pos-
itive dimension of mental health and defined that “health is a state of complete physi-
cal, mental and social well-being and not merely the absence of disease or infirmity”
(WHO 2014). At the beginning of 21st century, Seligman and Csikszentmihalyi (2000)
pointed out the psychology’s empirical focus should shift from “only preparing the
worst things in life to also building positive qualities”. Therefore, attention should not
only be given to the negative aspects when examining the relationship between PA and
mental health.
Happiness, as a positive component of mental well-being, is generally defined as a
subjective state of mind characterized by enjoyment and contentment reflecting indi-
vidual’s overall subjective well-being (Diener 2000; Veenhoven 2010). People rate
happiness as one of the most fundamental goals of their lives (Diener and Seligman
2004). A growing literature has emerged highlighting the health benefits of happiness.
For instance, a 15-year follow-up study suggested that higher levels of happiness are
related with lower mortality and morbidity (Koopmans etal. 2010). Recently, several
countries such as France, Canada, and the UK even included national happiness index
as an indicator of national progress (Ghent 2011).
Among the factors associated with happiness, PA has received increasing attention
among psychologists. Recent cross-sectional studies based on large general population
have shown that PA is associated with happiness (Lathia etal. 2017; Richards et al.
2015). Some reviews indicate that the PA might be an important correlate of happi-
ness and the investigation of the effects of PA on happiness would be a very promis-
ing research area (Diener and Tay 2012; Dolan etal. 2008). Such investigation is also
thought to enable new channels to apply health promotion models to PA interventions
(Huppert 2009).
Would PA also have beneficial effects on happiness as it does on other mental health
constructs such as depression and anxiety? To answer this question, a review of exist-
ing literature concerning the relationship between PA and happiness seems timely. To
the best of our knowledge, there has been no systematic review focusing exclusively
on the relationship between PA and happiness. The primary aim of this study was to
examine the association between PA and happiness through providing a meaningful
synthesis of extant literature. Specifically, two research questions guide this review:
(1) what type, duration, frequency, intensity or domain of PA is more consistently
associated with higher levels of happiness, and (2) which groups of population are
more likely to benefit from such associations.

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2 Methods
2.1 Search Strategy
In June 2017, we comprehensively searched for original research articles published post-
1980 in major databases including PubMed/Medline, PsychInfo, SportDiscus, and Embase.
Terms and their variants used to identify relevant articles included: physical activity, exer-
cise, happiness, subjective well-being, psychological well-being. The exact term combina-
tions are: [((exercise*) OR (physical activit*)) AND ((happi*) OR (happy) OR (subjective
well-being) OR (psychological well-being))]. Titles and abstracts were screened to pre-
exclude articles that did not meet the selection criteria. Full texts of the remaining arti-
cles were obtained and then screened by two independent reviewers for eligibility. Cohen’s
kappa (Cohen 1960) was reported as an index of agreement between reviewers. Reference
lists of included articles were further examined to complete the search.
2.2 Selection Criteria
2.2.1 Types ofStudies
Studies represented in original research articles and published in English-language journals
were considered for inclusion. The review included both observational studies (cross-sec-
tional and longitudinal) and intervention studies (randomized and nonrandomized). Unpub-
lished articles, abstracts, and dissertations were not included in this review.
2.2.2 Participants
Since one goal of this review was to identify the populations that might benefit more from
the effects of PA on happiness, there was no limit regarding the type and the age of par-
ticipants. Both healthy populations and populations with certain diseases or chronic condi-
tions were included in the review.
2.2.3 Outcome Measures
Studies considered for inclusion were required to have a specific assessment for individ-
ual’s happiness level. Studies whose assessment tools were initially designed for mental
health or well-being but later interpreted as happiness were excluded. Additionally, all the
included studies should examine PA as an outcome either objectively or subjectively and
incorporate at least one indicator for PA such as domain and frequency (for observational
studies), or use PA programs as interventions (for intervention studies). All studies should
clearly report the associations between PA and happiness or the effects of PA on happiness.
2.3 Data Extraction
The following information was extracted and summarized using a structured template by
two reviewers independently: author details, year of publication; type of study, characteris-
tics of participants (age, health status), sample size, measures of happiness, measures of PA
or intervention details (type, duration, and intensity of PA), and main findings. In studies

Z.Zhang, W.Chen
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that included outcomes other than PA and happiness, we only focus our analysis on PA and
happiness. Disagreements in coding were resolved through discussion by two reviewers.
No attempt was made to contact the authors of included articles for missing information.
3 Results
3.1 Search Results
Through the systematic search, a total of 1142 records were initially retrieved. After
removal of duplicates 741 distinct records were identified for screening phase. The process
of inclusion of the studies is presented in Fig.1. After reviewing the title and abstracts, 29
studies were considered potentially eligible for inclusion. For these studies, full-text articles
were obtained and assessed for eligibility, with 23 studies ultimately accepted for inclu-
sion. The main reasons for exclusion were no specific measure for PA, no specific measure
for happiness, or other constructs (mental health issues, life satisfaction, and quality of life)
Fig. 1 Flowchart of study selection

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were measured but later interpreted as happiness. The Cohen’s kappa was 0.89, indicating
high agreement between reviewers according to criteria suggested by Cohen (1960).
3.2 Characteristics ofIncluded Studies
Among the 23 studies, fifteen were observational studies and eight were intervention stud-
ies. Except two articles were published in 2000, the rest of the included articles were pub-
lished after 2007. The included studies were conducted at widely distributed countries,
with eight from North America, eight from Europe, five from Asia, and one from South
America and Australia each. Due to the different study designs, the results of observational
studies and intervention studies were presented separately below.
3.3 Observational Studies
The comprehensive search identified thirteen cross-sectional and two longitudinal studies
examining the relationship between PA and happiness (Table1). The sample size of the
observational studies ranged from 70 to 370,568, with the median sample size of 3461.
Most of the studies comprised healthy population covering adolescents, adults, and older
adults, except three studies targeting special population including children and adolescents
with cerebral palsy (Maher etal. 2016), drug abusers (Nani etal. 2017), and ovarian cancer
survivors (Stevinson etal. 2009). Happiness level was measured by single-item question
in eight studies, such as “Over the past 4weeks have you been a happy person?” and “In
general, how would you describe your happiness?” (Barreto 2014; Baruth etal. 2011; Kye
et al. 2016; Lera-López et al. 2016; Maher et al. 2016; Min et al. 2017; Richards et al.
2015; Wang etal. 2012). Other methods for assessing happiness level included Subjective
Happiness Scale in three studies (Piqueras et al. 2011; Rasmussen and Laumann 2014;
Stubbe etal. 2007), Fordyce Happiness Scale in two studies (Moljord etal. 2011; Stevin-
son etal. 2009), Oxford Happiness Questionnaire in one study (Nani etal. 2017), and scale
on mood adjectives in the other study (Lathia etal. 2017), which all consisted of multiple
items.
Among the fifteen observational studies, PA has been mostly assessed using self-
reported measures with only one exception (Lathia et al. 2017) that adopted smart-
phone sensors to collect PA data. The self-reported measures included International
Physical Activity Questionnaire (Lera-López etal. 2016; Richards etal. 2015), Godin
Leisure-Time Exercise Questionnaire (Nani etal. 2017; Stevinson etal. 2009), Physi-
cal Activity Questionnaire for Older Adults (Barreto 2014), Physical Activity Question-
naire for Adolescents (Maher etal. 2016), Youth Risk Behavior Surveillance System
questionnaire (Min etal. 2017), Self-developed Historical Physical Activity Question-
naire (Baruth et al. 2011), Canadian National Population Health Survey (Wang etal.
2012), and single-item question on PA frequency (Kye etal. 2016; Moljord etal. 2011;
Piqueras et al. 2011) or PA volume (Rasmussen and Laumann 2014; Stubbe et al.
2007). Derived from these self-reported measures, the outcomes of PA included total
time spent doing PA per week (Lera-López etal. 2016; Rasmussen and Laumann 2014;
Richards etal. 2015; Stevinson etal. 2009; Stubbe et al. 2007), metabolic equivalent
(MET)-min/week (Barreto 2014; Baruth etal. 2011), number of days doing moderate or
vigorous intensity PA per week (Kye etal. 2016; Min etal. 2017; Moljord etal. 2011;
Nani etal. 2017), categories of PA levels (i.e. active or inactive) (Wang etal. 2012),
extent of PA frequency (i.e. always or not always) (Piqueras etal. 2011), average score

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Table 1 Main characteristics of observational studies investigating the relationship between physical activity and happiness
Author (year), country Study design Participants Sample size Measure of happiness Measure of PA Main findings
Barreto (2014), France Cross-sectional Older adults, mean
age = 72.9
323 Single-item question Physical Activity Ques-
tionnaire for Older
Adults (QAPPA)
PA was indirectly associ-
ated to happiness, which
was mediated by health
status and social function-
ing
Baruth etal. (2011), USA Longitudinal Sedentary adults, aged
21–75
2132 Single-item question Self-developed Historical
Physical Activity Ques-
tionnaire
Men who were happier
at baseline had greater
increases in PA compared
to men who were not
happy; no relationship
between happiness and
PA was found in women
Kye etal. (2016), Korea Cross-sectional Adolescents, aged 12–18 72,435 Single-item question Single-item question on
PA frequency
A positive relationship
between PA and happi-
ness was found in boys
but not in girls
Lathia etal. (2017), UK Cross-sectional General public, aged
15–44
12,838 Two dimensional affect
grid; 7-point scale on
mood adjectives
Real time self-report;
smartphone sensor/built-
in accelerometer
Both self-reported PA and
objectively measured PA
were positively associated
with happiness
Lera-López etal. (2016),
Spain
Cross-sectional Adults, aged 50–70 765 Single-item question International Physical
Activity Questionnaire
(IPAQ)
Leisure time PA was
positively associated with
happiness; this relation-
ship is partially mediated
by perceived health
Maher etal. (2016),
Australia
Cross-sectional Children and adolescents
with cerebral palsy,
mean age = 13.9
70 Single-item question Physical Activity Ques-
tionnaire for Adoles-
cents (PAQ-A)
PA was weakly associated
with happiness in young
people with cerebral palsy

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Table 1 (continued)
Author (year), country Study design Participants Sample size Measure of happiness Measure of PA Main findings
Min etal. (2017), Korea Cross-sectional Adolescents, mean
age = 15.1
370,568 Single-item question Youth Risk Behavior
Surveillance System
questionnaire (YRBSS)
There was a positive
relationship between PA
frequency and happiness;
this relationship was
stronger among overweigh
adolescents
Moljord etal. (2011),
Norway
Cross-sectional Adolescents, mean
age = 14.9
1508 Fordyce happiness scale Single-item question on
PA frequency
PA frequency was positively
associated with happiness
Nani etal. (2017), Greece Cross-sectional Drug abusers, aged > 20 73 Oxford Happiness Ques-
tionnaire
Godin Leisure-Time Exer-
cise Questionnaire
PA frequency was slightly
positively associated
with the respondents’
happiness; no relationship
between PA intensity and
happiness was found
Piqueras etal. (2011),
Chile
Cross-sectional College students, mean
age = 19.89
3461 Subjective happiness scale Single-item question on
PA frequency
PA frequency was positively
associated with happiness
Rasmussen and Laumann
(2014), Norway
Cross-sectional Adults, mean age = 24.86 438 Subjective happiness scale Single-item question on
PA volume
PA level during adolescence
was positively associated
with happiness in adult
Richards etal. (2015),
European Union
Cross-sectional General public, aged > 15 11,637 Single-item question International Physical
Activity Questionnaire
(IPAQ) short from
PA volume was positively
associated with happi-
ness; the association was
domain-specific
Stevinson etal. (2009),
Canada
Cross-sectional Ovarian cancer survivors,
mean age = 60.2
359 Fordyce happiness scale Godin Leisure-Time Exer-
cise Questionnaire
Meeting PA guidelines was
positively associated with
happiness.
Stubbe etal. (2007),
Netherland
Cross-sectional Adults from twin families,
aged 18–65
8306 Subjective happiness scale Single-item question on
PA volume
PA was associated with
higher levels of happiness.

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Table 1 (continued)
Author (year), country Study design Participants Sample size Measure of happiness Measure of PA Main findings
Wang etal. (2012),
Canada
Longitudinal Household residents,
aged > 12
17,276 Single-item question National population health
survey
Leisure time PA had a
long—term positive asso-
ciation with happiness

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of the questionnaire (Maher etal. 2016). Most studies controlled for potential confound-
ing variables such as gender, age, body mass index (BMI), economic status and so forth.
Two studies examined the mediation effect of the social functioning and health status
(Barreto 2014), perceived health (Lera-López etal. 2016) on the relationship between
PA and happiness.
The results from the included observational studies generally support the beneficial
relationship between PA and happiness. All these studies found happiness was positively
associated with PA, either directly or indirectly. Richards etal. (2015) found that there
was a positive dose–response relationship between PA and happiness among citizens in
15 European countries. Compared with inactive people, the odds ratio of being happy
was 20, 29, and 52% higher for people being insufficiently active, sufficiently active,
and very active, respectively. Similarly, Lathia etal. (2017) found that PA measured by
accelerometer in smartphones was positively related to happiness in 10370 smartphone
users, although the correlation coefficient was only r = 0.03. Two longitudinal studies
provided stronger evidence. Baruth etal. (2011) examined the change in physical activ-
ity for at least 6months among 2132 sedentary adults and found that men who were
happy at baseline had greater increases in PA than those were not happy at baseline.
The results indicated greater level of happiness might lead to greater level of PA. Wang
et al. (2012) examined both the leisure time PA and happiness at baseline and after
2 years among 17,276 Canadian household residents. The results showed that people
who remained inactive at baseline and 2-year follow-up had 3 times the odds of being
unhappy than those who were inactive at baseline but became active at 2-year follow-
up. And those who were active at baseline but went inactive after 2years had 1.7 times
the odds of being unhappy than those who remained active at both baseline and 2-year
follow-up.
Several studies investigated the relationship between happiness and PA exclusively
among youth or adolescents. Min etal. (2017) and Kye etal. (2016) both found that the
number of days doing moderate or vigorous intensity PA per week was positively asso-
ciated with happiness among Korean adolescents. Engaging PA at least once per week,
compared to none, had 1.4 times the odds of being happy in normal-weight adolescents
and 1.5 times the odds in overweight adolescents. Likewise, Moljord etal. (2011) found
that adolescents who participated PA two or more times per week had significantly
higher happiness level than those engaged PA 1day or less per week. Besides, Piqueras
etal. (2011) found that college students who always participated PA had 1.3 times the
odds of being happy than their peers who did not.
Three studies examined the relationship between happiness and PA in older adults.
Barreto (2014) found that increased MET-min/week was associated with higher levels
of happiness in older adults. However, this positive association was mediated by the
health status and social functioning of older adults. Similarly, Lera-López etal. (2016)
found that the total time in PA per week was positively related to happiness level in
older adults and the relationship was partially mediated by perceived health.
Additionally, three studies investigated the relationship between PA and happiness
among special population. Specifically, Stevinson etal. (2009) found that meeting pub-
lic health PA guidelines (150min of moderate/vigorous PA) was significantly associ-
ated with happiness level among ovarian cancer survivors. Maher etal. (2016) found
that PA significantly predicted happiness level in children and adolescents with cerebral
palsy. Nani etal. (2017) found that the times of exercise per week, regardless of inten-
sity, were slightly associated with the happiness among drug abusers.

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3.4 Intervention Studies
A total of eight intervention studies were identified in which six were RCTs and two
were non-randomized trials (Table2). The sample size ranged from 46 to 400, with
the median sample size of 123.5. Participants in RCTs included older adults (Khazaee-
Pool etal. 2015; McAuley etal. 2000; Tse etal. 2014), cancer survivors (Cadmus etal.
2009; Courneya etal. 2009), and postmenopausal women (Courneya etal. 2017). The
two non-randomized trials targeted the study population of college students (Mack etal.
2000) and primary school children (Yook etal. 2017). The happiness measures of these
studies included Fordyce Happiness Scale (Cadmus etal. 2009; Courneya et al. 2009,
2017), Oxford Happiness Questionnaire (Khazaee-Pool etal. 2015), Subjective Happi-
ness Scale (Tse etal. 2014), Emotional Assessment Scale (Mack etal. 2000), Memorial
University of Newfoundland Scale of Happiness (McAuley etal. 2000), Psychological
Well-being Scale (Yook etal. 2017).
The types of PA programs implemented in the intervention studies included aerobic
exercises (Cadmus etal. 2009; Courneya etal. 2009, 2017; McAuley etal. 2000), mixed
school PA classes (Mack et al. 2000; Yook et al. 2017), and stretching and balance
exercises (Khazaee-Pool etal. 2015; Tse et al. 2014). All these studies clearly speci-
fied the time, frequency, and duration of the PA programs, with the time ranging from
30 to 75min, frequency from once per week to five times per week, and duration from
7weeks to 12months. The intensity of PA programs was reported in four studies by
indicating the percentage of maximum heart rate (Cadmus etal. 2009; Courneya etal.
2017) or the percentage of maximum rate of oxygen consumption (Courneya etal. 2009;
McAuley etal. 2000).
Overall, the intervention studies that investigated the effects of PA on happiness
showed inconsistent results, with 3 RCTs (Courneya etal. 2009; Khazaee-Pool etal.
2015; Tse etal. 2014) and 1 non-randomized trial (Yook etal. 2017) reporting a sig-
nificant difference in the change of happiness between intervention group and control
group.
Four RCTs have investigated the effects of aerobic exercise on happiness, with two
studies using no intervention or usual care as control (Cadmus etal. 2009; Courneya
etal. 2009), one study using stretching exercise as control (McAuley etal. 2000), and
the other study comparing high volume aerobic exercise and moderate volume aerobic
exercise (Courneya etal. 2017). Cadmus etal. (2009) compared the effects of 30-min
moderate to—vigorous intensity aerobic exercises with 5 times per week for 6months
with that of usual care among breast cancer survivors. The results showed that happi-
ness level, which was measured by Fordyce Happiness Scale, was remained consist-
ent in both intervention and control groups after 6-month intervention. On the contrary,
Courneya etal. (2009) used the same assessment for happiness as Cadmus etal. (2009)
did and found that happiness level improved significantly in intervention group but not
in control group after 12-week intervention of 45-min aerobic exercise with three times
per week among lymphoma patients. More recently, Courneya etal. (2017) compared
the effects of different PA volumes (30 vs. 60min of moderate-intensity aerobic exer-
cise, both 5 times per week) on happiness among postmenopausal women and found
that there was no difference in the improvement of happiness between moderate vol-
ume group and high volume group after 12-month intervention. Besides, McAuley etal.
(2000) compared effects of moderate intensity aerobic exercise with stretching exer-
cise among sedentary older adults, with 40min each time and three times per week for

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Table 2 Main characteristics of intervention studies examining the effects of physical activity on happiness
Author (year),
country
Study design Participants Sample size Intervention Control Measure of happi-
ness
Main findings
Cadmus etal. (2009),
USA
RCT Breast cancer
survivors, mean
age = 55.2
125 30min of moderate
to-vigorous physi-
cal activity, 5×/
week, 6months
Usual care Fordyce happiness
scale
Happiness level
remained consistent
in both exercise and
usual care groups
Courneya etal.
(2009), Canada
RCT Lymphoma patients,
mean age = 53.2
122 45min of aerobic
exercise, 3×/week,
12weeks
Usual care Fordyce happiness
scale
Intervention group sig-
nificantly improved
happiness level after
12-week aerobic
exercise program
while control group
did not
Courneya etal.
(2017), Canada
RCT Healthy but inactive
postmenopausal
women, aged
50–74
400 Moderate volume
group: 30min of
aerobic exer-
cise, 5×/week,
12months high
volume group:
60min of aerobic
exercise, 5×/week,
12months
NA Fordyce happiness
scale
There was no differ-
ence in change of
happiness between
moderate volume
group and high
volume group
Khazaee-Pool etal.
(2015), Iran
RCT Older adults, mean
age = 71
120 30min of stretch-
ing and balance
exercise, 3×/week,
8weeks
Regular activities Oxford Happiness
Questionnaire
Intervention group sig-
nificantly improved
happiness level after
8-week PA program
while control group
did not
Mack etal. (2000),
USA
Non-randomized Undergraduate
students, mean
age = 19.6
74 75min of volleyball,
power walking or
jogging class, 2×/
week, 7weeks
NA Emotional assess-
ment scale
Happiness level did not
change significantly
after 7-week PA
courses

Z.Zhang, W.Chen
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Table 2 (continued)
Author (year),
country
Study design Participants Sample size Intervention Control Measure of happi-
ness
Main findings
McAuley etal.
(2000), USA
RCT Sedentary older
adults, mean
age = 65.5
174 40min of aerobic
exercise, 3×/week,
6months
40min of stretch-
ing and toning
exercise, 3×/week,
6months
Memorial University
of Newfoundland
scale of happiness
Both PA groups
improved happiness
after 6-month inter-
vention and there
was no difference in
the change of happi-
ness between groups
Tse etal. (2014),
China
RCT Older adults living
in nursing homes,
mean age = 85.5
396 60min of stretch-
ing and balance
exercises, 1×/week,
8weeks
Usual care Subjective happiness
scale
Intervention group sig-
nificantly improved
happiness level after
8-week PA program
while control group
did not
Yook etal. (2017),
Korea
Non-randomized Primary school
students, mean
age = 10.98
46 40min of yoga,
running activity or
Kin-Ball, 1×/week,
8weeks
Regular activities Psychological well-
being scale
Intervention group sig-
nificantly improved
happiness level after
8-week PA program
while control group
did not

A Systematic Review oftheRelationship Between Physical Activity…
1 3
6months. McAuley etal. (2000) found that happiness level significantly improved in
both aerobic exercise group and stretching exercise group after 6-month intervention
and there was no difference in the change of happiness between the two groups.
Two RCTs examining the effects of stretching, balancing exercises in older adults
reported beneficial effects of PA on happiness. Specifically, Khazaee-Pool etal. (2015)
conducted 30-min stretching and balance exercise with 3 times per week for 8 weeks
among older adults aged 65–89 years. This study found that intervention group signifi-
cantly increased happiness level after 8-week while non-intervention group did not. Like-
wise, Tse etal. (2014) found that 8-week stretching and balancing exercises intervention,
with 60min each time and one time per week, significantly improved happiness level in
intervention group but not in usual care group among older adults living in nursing homes.
Besides the RCTs, two non-randomized studies have investigated the effects of PA
classes in students. Yook etal. (2017) found that happiness level changed significantly over
8-week intervention of PA classes, with 40min each class and one class per week, includ-
ing various sports activities and yoga among primary school students. In contrast, Mack
etal. (2000) involved participants of undergraduate students and found the happiness level
remained unchanged over 7-week intervention of PA classes including volleyball, power
walking, and jogging, with 75min each class and two classes per week.
4 Discussion
This literature review examined the existing evidence concerning the relationship between
PA and happiness. A total of fifteen observational studies and eight intervention stud-
ies were systematically reviewed to identify which aspects of PA were more consistently
associated with happiness and what kinds of population were more likely to benefits from
the effects of PA on happiness. This review extends prior knowledge of the relationship
between PA and mental health by focusing the positive dimension of mental health. The
research findings generally support the beneficial relationship between PA and happiness.
Of the thirteen cross-sectional studies, the positive relationship between PA and happi-
ness was found among a wide range of population. Although the cross-sectional studies
could only provide correlational evidence, potential confounding variables were controlled
in most of the studies, thus adding the additional credibility to their findings. Two longi-
tudinal studies provided stronger evidence demonstrating that PA may have a long-term
positive association with happiness, with one study showing greater level of PA resulted in
higher levels of happiness while the other showing the opposite direction that higher levels
of happiness lead to increased PA. Six RCTs mainly involved cancer survivors and older
adults showing that both aerobic exercises and balancing and stretching exercises were
effective in improving individual’s happiness level. Only one RCT reported no significant
change in happiness after 6-month aerobic exercise intervention in breast cancer survivors.
Two non-randomized trials examined the effects of PA class on happiness in youth and
children but showing inconsistent results.
Our findings suggest that PA frequency and PA volume are essential factors in the rela-
tionship between PA and happiness, and more importantly, even a small change of PA
makes a difference in happiness. Studies showed the significant difference in happiness
levels between doing exercise 1day per week and none per week. As little as 10min PA
per week might greatly increase the odds of being happy. Such pattern that small amounts
of PA yield benefits was similar in the relationship between PA and other aspects of men-
tal health, such as depression and anxiety (Dunn etal. 2001; Teychenne etal. 2008). In

Z.Zhang, W.Chen
1 3
addition, there seems to be a threshold effect for the relationship between PA and happi-
ness. Several cross-sectional studies found that there was no difference in happiness levels
between active individuals (150–300min moderate to—vigorous PA per week) and very
active individuals (> 300min moderate to—vigorous PA per week). This was further sup-
ported by one RCT which compared the moderate volume of PA intervention (150min
aerobic exercise per week) with the high volume of PA intervention (300min aerobic exer-
cise per week) and found no difference in the change of happiness between two groups.
There might not be an optimal type or intensity of PA in the relationship between PA and
happiness. The RCTs have demonstrated aerobic exercise and stretching/balancing exercise
were equally effective in improving happiness. The positive associations between PA and
various intensities of PA (light, moderate, vigorous) were reported across observational
studies. In addition, the relationship between PA and happiness might be domain-specific,
in which leisure time PA showing the most consistent positive association with happiness.
Our findings indicate that overweight population might gain more benefits of PA on
happiness than normal-weight population. It might be because overweight population is
at higher risk of being unhappy and thus has more room to improve (Cornelisse-Vermaat
etal. 2006). Gender difference was found in two studies, with males showing the positive
association between PA and happiness while females not. One possible explanation may be
that the men are more likely to participate in PA for the reason of enjoyment than women
(Azevedo etal. 2007). Only a few studies have explored the potential mechanism of the
effects of PA on happiness. Mediators were found in two studies, in which health status,
social functioning, and perceived health appeared to account for the relationship between
the PA and happiness. It is consistent with previous studies which demonstrated social rela-
tionships and health were important determinants of happiness (Caunt etal. 2013). Previ-
ous studies have shown that there were some differences across cultures in terms of the
causes of happiness, such as the relationship between self-esteem and happiness was mod-
erated by individualism (Diener etal. 2013). Our results indicate that physical activity is
consistently correlated with happiness in countries across various areas, indicating no cul-
tural difference in the relationship between PA and happiness.
4.1 Limitations intheExisting Literature
Although there is a growing trend examining the relationship between PA and happiness,
which could be indicated by the increasing number of publications in the recent years and
by the global range where the studies were conducted, several limitations exist and make
it relatively difficult to draw relatively conclusive inference. First, only a small number of
RCTs has been conducted compared to observational studies. Furthermore, all these RCTs
targeted individuals who were more likely to suffer mental health problems, e.g. older
adults and cancer survivors. Therefore, there is a lack of the RCTs examining the effects
of PA on happiness among healthy population. Second, a myriad of outcome measures was
used in both observational and intervention studies, leading to the difficulties in synthesiz-
ing results across different studies. For example, near half of the studies used one-item
question to measure happiness, which assumed that respondents understood that happiness
was an overall evaluation of life, while other studies adopted well-validated questionnaires
such as Subjective Happiness Scale, which consisted of multiple questions to measure
individual’s happiness level. Although there is no consensus regarding the “gold stand-
ard” of happiness measures, we believe that well-established, multiple-item scales of hap-
piness will provide more credibility to the measurement. We recommend three mostly cited

A Systematic Review oftheRelationship Between Physical Activity…
1 3
measures of happiness, whose reliabilities and validities have been demonstrated to be high
in different populations and various cultural contexts. These measures are Subjective Hap-
piness Scale (Lyubomirsky and Lepper 1999), Fordyce Happiness Scale (Fordyce 2005),
and Oxford Happiness Questionnaire (Hills and Argyle 2002). For the measures of PA,
except one study used smartphone sensors to measure PA, the other studies used self-report
approaches to assess PA. And among these self-report measures, various aspects of PA
were captured due to different questionnaires used. For example, some studies only meas-
ured leisure-time PA and some only assessed the vigorous PA, and the recall period of PA
also differed across these questionnaires. Third, although most studies reported a positive
association between PA and happiness, only a few studies attempted to explore the mecha-
nism of how PA impacted happiness or, reversely, how happiness impacted PA. Fourth,
the dose–response relationship between PA and happiness remains largely unknown, espe-
cially given the limited evidence by intervention studies.
4.2 Suggestions forFuture Research
According to the limitations, we suggest that future research address the following needs.
First of all, more RCTs are needed to examine the effects of PA on happiness, especially
among the general public and healthy populations. In addition, these future RCTs should
make an effort to compare the effects of different types, frequencies, intensities of PA, and
to explore the dose–response relationship between PA and happiness to determine whether
there is an optimal dose of PA for the improvement of happiness. Second, we suggest that
future studies investigate the underlying mechanism of the effects of PA on happiness, or
the effects of happiness on PA. For example, PA might increase happiness level via several
physiological or psychological pathways, which have already indicated by a few studies.
Disentangling the relationship between PA and happiness might expand the strategies for
the PA intervention in health promotion. Third, objective measure of PA, such as using
accelerometers or smartphone sensors, is needed for both observational and intervention
studies in future research. On the one hand, the objective measures and subjective meas-
ures of PA could lead to largely different results since the subjective measures of PA may
result in self-report bias (Troiano etal. 2008). On the other hand, by objectively measuring
PA, we could separate the effects of PA per se from other elements during the process of
PA, such as social interaction. In addition to addressing these limitations of the existing
studies, we suggest future studies extend the research focus to the relationship between
PA and other positive psychology related concepts, such as life satisfaction, optimism,
and hope. Investigations of the relationships between PA and these concepts help us bet-
ter understand how PA shapes people’s lives in positive ways. Moreover, we recommend
that future research should investigate the relationships of physical fitness and sedentary
behaviors with happiness. Previous studies have shown that sedentary behaviors and lower
physical fitness are associated with increased risks of mental health issues (Hoare et al.
2016; Schuch etal. 2016), but studies of their relationships with positive mental constructs
have been lacking.
4.3 Limitations oftheCurrent Review
This review only included studies published in peer-reviewed journals with English lan-
guage, which might lead to potential publication bias and thus overestimating the posi-
tive relationship between PA and happiness. Although we searched the main databases for

Z.Zhang, W.Chen
1 3
biomedical and psychological research, other databases, such as Scopus and Web of Sci-
ence, may cover extra relevant studies. Due to the limited number of RCTs, we could not
draw causal inference on the relationship between PA and happiness. The quality of the
included studies was not assessed in this review and we did not weight the findings based
on the rigor of individual study. Quantitative synthesis was also not conducted due to the
limited evidence and the large variability across the studies.
5 Conclusion
This review identified fifteen observational and eight intervention studies which inves-
tigated the relationship between PA and happiness. The available evidence indicates the
positive relationship between PA and happiness among wide range of population. As little
as 10min PA per week or 1day of doing exercise per week makes differences in happiness
level. However, numerous aspects have remained largely unexplored. More research is nec-
essary to determine the optimal dose and type of PA for gaining the benefits of happiness,
and explore the pathways through which PA would possibly affect happiness. More RCTs
are warranted for future research in order to draw causal conclusions.
Compliance with Ethical Standards
Conflict of interest The authors declare no conflict of interest.
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