why sport is important for health essay

Essay on Importance of Sports for Students and Children

500+ words essay on importance of sports.

First of all, Sport refers to an activity involving physical activity and skill . Here, two or more parties compete against each other. Sports are an integral part of human life and there is great importance of sports in all spheres of life. Furthermore, Sports help build the character and personality of a person. It certainly is an excellent tool to keep the body physically fit. Most noteworthy, the benefits of Sports are so many that books can be written.  Sports have a massive positive effect on both the mind and body.

Physical Benefits of Sports

First of all, Sports strengthen the heart. Regular Sports certainly make the heart stronger. Hence, Sport is an excellent preventive measure against heart diseases . This certainly increases the life expectancy of individuals. Furthermore, a healthy heart means a healthy blood pressure.

Sports involve physical activity of the body. Due to this physical activity, blood vessels remain clean. Sports reduces the amount of cholesterol and fats in the body. This happens because of the increase of flexibility of the wall of the blood vessels. The flexibility increases due to physical exertion, which is the result of Sports.

Furthermore, the sugar level in blood also gets lower thanks to Sports. The sugar certainly does not accumulate in the blood due to physical activity.

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A person experiences a good quality of breathing because of Sports. Sports strengthen the lungs of the body. Sports certainly escalate the lung capacity and efficiency of the body. Hence, more oxygen enters the blood which is extremely beneficial. Furthermore, there are fewer chances of developing lung diseases due to Sports.

Appropriate body weight is easy to maintain because of sports. A Sports playing person probably does not suffer from obesity or underweight problems. Sports certainly help the body remain fit and slim.

Furthermore, Sports also improves the quality of bones. A person who plays sports will have strong bones even in old age. Several scientific research reports that Sports prevent many diseases. For example, many researchers conclude that Sports prevent the development of cancer.

Other Benefits of Sports

Sport is certainly an excellent tool to build self-confidence . Playing Sports increases confidence to talk properly. A sport certainly improves the skills of communicating with others. Furthermore, the person experiences confidence in sitting, standing, and walking properly. Hence, Sports enriches the social life of an individual.

Sports bring discipline in life. It certainly teaches the values of dedication and patience. Sports also teach people how to handle failure. Furthermore, the importance of following a time schedule is also present in Sports.

Above all, Sports improves the thinking ability of individuals. Sports certainly sharpen the mind. Children who play Sports probably perform better at exams than those who don’t.

Finally, Sports reduces the stress of mind . A Sports playing person would certainly experience less depression. Sports ensure the peace of mind of those playing it. Most noteworthy, Sports brings happiness and joy in the life of individuals.

A sport is an aspect of human life that is of paramount importance. It certainly increases the quality of human life. Sports must be made mandatory in schools. This is because it is as important as education. Everyone must perform at least one Sport activity on a regular basis.

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How sport can have a positive impact on mental and physical health

It’s not always easy to start a workout, but research shows that sport and exercise are beneficial not only for your physical health, but your mental well-being, too. Let us help!

Health experts and Olympic athletes agree: Your mental and physical health benefit when you get active and participate in sport – whatever that means for you.

From daily exercise to choosing a sport to practice or play, the body and mind are worked in new and different ways each time you move your body.

On June 23rd every year we come together to celebrate that, as part of Olympic Day.

For the 2020 edition, we connected with Olympians around the world for Olympic Day 2020 at-home workouts – and a reminder: We’re stronger together, especially when we stay active!

And those are still available online to help inspire you today.

Sport benefits: Both the physical and mental

While the physical benefits are numerous (more on that below), the UK's National Health Service (NHS) report that people who take part in regular physical activity have up to a 30 percent lower risk of depression.

Additionally, exercise can help lower anxiety, reduce the risk of illness and increase energy levels. Want better sleep? Work up a good sweat!

Exercise can help you fall asleep faster and sleep for longer, research says.

It was in June 2020 that the IOC partnered with the World Health Organization and United Nations to promote the #HEALTHYTogether campaign , which highlights the benefits of physical activity in the face of the pandemic.

Over 50 at-home workouts are searchable across Olympics.com for you, each which help further the idea that moving and challenging the body can only prove beneficial for your physical and mental well-being.

The athletes' perspective: 'I used this strength to survive'

“If I had sat doing nothing, I would have gone crazy,” says Syria's Sanda Aldass , who fled the trauma of civil war in her country, leaving behind her husband and infant child.

Instead, she had judo - and has been selected for the IOC Refugee Olympic Team Tokyo 2020 for the Games in 2021.

“Running around and doing some exercises filled up my time and also kept me in good mental health,” Sanda said of the impact of sport on her life during nine months spent in a refugee camp in the Netherlands in 2015.

The same power of sport goes for Iranian taekwondo athlete Ali Noghandoost.

"When I had to leave my family and my home in Iran, the first things I packed in my bag were my belt, my dobok, my shoes and my mitt for taekwondo," Noghandoost said . "I took some documents that said I was a champion in Iran and in a national team, so I could prove I was a fighter and continue to train in any city I went to."

"Taekwondo did not only help me physically; mentally, it stopped me from thinking about giving up and that we wouldn’t make it. I used this strength to survive," he added.

Noghandoost has worked as a coach for refugees in Croatia, where he has tried to pass the power of sport on to the next generation.

"When you’re living in a refugee camp, it’s a really hard situation, but when you play sport, you can release any negative energy and feel free. It’s a space – a paradise – for them to be themselves."

A member of the IOC Refugee Olympic Team Rio 2016, Yiech Pur Biel says that the team provided a message of hope for those watching around the world.

"We were ambassadors for a message of hope, that anything is possible," Biel said . "A good thing had come out of our situations. The world understood. I am called a refugee, but you never know when someone else might become a refugee, through war or persecution. We wanted to show that we responded positively. So that made me very happy. Through sport, we can unite and make the world better."

Sport as a tool for much - including mental health

Sport is a powerful tool no matter from what angle you look at it, including mental health. The Olympic Refugee Foundation (ORF) has recently launched two different programs that are aimed at helping young refugees dream of a brighter future - through sport.

One of those programs, Game Connect, is a three-year initiative that was launched in August 2020 and aims to "improve the mental health and psychosocial wellbeing of young refugees by improving their access to safe sport," as explained on Olympics.com last year.

We are "embarking on a three-year project to improve the psychosocial wellbeing and mental health of young refugees, working together with well-trained community-based coaches to deliver a Sport for Protection program and activities," explained Karen Mukiibi of Youth Sport Uganda, which has partnered with the ORF.

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The health benefits of sport and physical activity

Although research interest on physical activity and health dates back to the 1950s, the breakthrough in the scientific evidence on health benefits of physical activity largely took place during the 1980s and 1990s. There is an overwhelming amount of scientific evidence on the positive effects of sport and physical activity as part of a healthy lifestyle. The positive, direct effects of engaging in regular physical activity are particularly apparent in the prevention of several chronic diseases, including: cardiovascular disease, diabetes, cancer, hypertension, obesity, depression and osteoporosis.

The Report from the United Nations Inter-Agency Task Force on Sport for Development and Peace states that young people can benefit from physical activity as it contributes to developing healthy bones, efficient heart and lung function as well as improved motor skills and cognitive function. Physical activity can help to prevent hip fractures among women and reduce the effects of osteoporosis. Remaining physically active can enhance functional capacity among older people, and can help to maintain quality of life and independence.

Physical activity and psychosocial health

The WHO has estimated that “one in four patients visiting a health service has at least one mental, neurological or behavioural disorder, but most of these disorders are neither diagnosed nor treated”. A number of studies have shown that  exercise may play a therapeutic role in addressing a number of psychological disorders . Studies also show that exercise has a positive influence on depression. Physical self-worth and physical self-perception, including body image, has been linked to improved self-esteem. The evidence relating to health benefits of physical activity predominantly focuses on intra-personal factors such as physiological, cognitive and affective benefits, however, that does not exclude the social and inter-personal benefits of sport and physical activity which can also produce positive health effects in individuals and communities.

Sport and physical activity as part of a healthy lifestyle

A number of factors influence the way in which sport and physical activity impacts on health in different populations. Sport and physical activity in itself may not directly lead to benefits but, in combination with other factors, can promote healthy lifestyles. There is evidence to suggest that changes in the environment can have a significant impact on opportunities for participation and in addition, the  conditions under which the activity is taking place can heavily impact on health outcomes . Elements that may be determinants on health include nutrition, intensity and type of physical activity, appropriate footwear and clothing, climate, injury, stress levels and sleep patterns.

Sport and physical activity can make a substantial contribution to the well-being of people in  developing countries . Exercise, physical activity and sport have long been used in the  treatment and rehabilitation of communicable and non-communicable diseases . Physical activity for individuals is a strong means for the  prevention of diseases  and for nations is a cost-effective method to improve public health across populations.

Key Reading

• Health Benefits of Physical Activity: the evidence
• Health and Development Through Physical Activity and Sport

Steering Board Members

• Open access
• Published: 21 May 2024

The bright side of sports: a systematic review on well-being, positive emotions and performance

• David Peris-Delcampo 1 ,
• Antonio Núñez 2 ,
• Paula Ortiz-Marholz 3 ,
• Aurelio Olmedilla 4 ,
• Enrique Cantón 1 ,
• Javier Ponseti 2 &
• Alejandro Garcia-Mas 2  

BMC Psychology volume  12 , Article number:  284 ( 2024 ) Cite this article

Metrics details

The objective of this study is to conduct a systematic review regarding the relationship between positive psychological factors, such as psychological well-being and pleasant emotions, and sports performance.

This study, carried out through a systematic review using PRISMA guidelines considering the Web of Science, PsycINFO, PubMed and SPORT Discus databases, seeks to highlight the relationship between other more ‘positive’ factors, such as well-being, positive emotions and sports performance.

The keywords will be decided by a Delphi Method in two rounds with sport psychology experts.

Participants

There are no participants in the present research.

The main exclusion criteria were: Non-sport thema, sample younger or older than 20–65 years old, qualitative or other methodology studies, COVID-related, journals not exclusively about Psychology.

Main outcomes measures

We obtained a first sample of 238 papers, and finally, this sample was reduced to the final sample of 11 papers.

The results obtained are intended to be a representation of the ‘bright side’ of sports practice, and as a complement or mediator of the negative variables that have an impact on athletes’ and coaches’ performance.

Conclusions

Clear recognition that acting on intrinsic motivation continues to be the best and most effective way to motivate oneself to obtain the highest levels of performance, a good perception of competence and a source of personal satisfaction.

Peer Review reports

Introduction

In recent decades, research in the psychology of sport and physical exercise has focused on the analysis of psychological variables that could have a disturbing, unfavourable or detrimental role, including emotions that are considered ‘negative’, such as anxiety/stress, sadness or anger, concentrating on their unfavourable relationship with sports performance [ 1 , 2 , 3 , 4 ], sports injuries [ 5 , 6 , 7 ] or, more generally, damage to the athlete’s health [ 8 , 9 , 10 ]. The study of ‘positive’ emotions such as happiness or, more broadly, psychological well-being, has been postponed at this time, although in recent years this has seen an increase that reveals a field of study of great interest to researchers and professionals [ 11 , 12 , 13 ] including physiological, psychological, moral and social beneficial effects of the physical activity in comic book heroes such as Tintin, a team leader, which can serve as a model for promoting healthy lifestyles, or seeking ‘eternal youth’ [ 14 ].

Emotions in relation to their effects on sports practice and performance rarely go in one direction, being either negative or positive—generally positive and negative emotions do not act alone [ 15 ]. Athletes experience different emotions simultaneously, even if they are in opposition and especially if they are of mild or moderate intensity [ 16 ]. The athlete can feel satisfied and happy and at the same time perceive a high level of stress or anxiety before a specific test or competition. Some studies [ 17 ] have shown how sports participation and the perceived value of elite sports positively affect the subjective well-being of the athlete. This also seems to be the case in non-elite sports practice. The review by Mansfield et al. [ 18 ] showed that the published literature suggests that practising sports and dance, in a group or supported by peers, can improve the subjective well-being of the participants, and also identifies negative feelings towards competence and ability, although the quantity and quality of the evidence published is low, requiring better designed studies. All these investigations are also supported by the development of the concept of eudaimonic well-being [ 19 ], which is linked to the development of intrinsic motivation, not only in its aspect of enjoyment but also in its relationship with the perception of competition and overcoming and achieving goals, even if this is accompanied by other unpleasant hedonic emotions or even physical discomfort. Shortly after a person has practised sports, he will remember those feelings of exhaustion and possibly stiffness, linked to feelings of satisfaction and even enjoyment.

Furthermore, the mediating role of parents, coaches and other psychosocial agents can be significant. In this sense, Lemelin et al. [ 20 ], with the aim of investigating the role of autonomy support from parents and coaches in the prediction of well-being and performance of athletes, found that autonomy support from parents and coaches has positive relationships with the well-being of the athlete, but that only coach autonomy support is associated with sports performance. This research suggests that parents and coaches play important but distinct roles in athlete well-being and that coach autonomy support could help athletes achieve high levels of performance.

On the other hand, an analysis of emotions in the sociocultural environment in which they arise and gain meaning is always interesting, both from an individual perspective and from a sports team perspective. Adler et al. [ 21 ] in a study with military teams showed that teams with a strong emotional culture of optimism were better positioned to recover from poor performance, suggesting that organisations that promote an optimistic culture develop more resilient teams. Pekrun et al. [ 22 ] observed with mathematics students that individual success boosts emotional well-being, while placing people in high-performance groups can undermine it, which is of great interest in investigating the effectiveness and adjustment of the individual in sports teams.

There is still little scientific literature in the field of positive emotions and their relationship with sports practice and athlete performance, although their approach has long had its clear supporters [ 23 , 24 ]. It is comforting to observe the significant increase in studies in this field, since some authors (e.g [ 25 , 26 ]). . , point out the need to overcome certain methodological and conceptual problems, paying special attention to the development of specific instruments for the evaluation of well-being in the sports field and evaluation methodologies.

As McCarthy [ 15 ] indicates, positive emotions (hedonically pleasant) can be the catalysts for excellence in sport and deserve a space in our research and in professional intervention to raise the level of athletes’ performance. From a holistic perspective, positive emotions are permanently linked to psychological well-being and research in this field is necessary: firstly because of the leading role they play in human behaviour, cognition and affection, and secondly, because after a few years of international uncertainty due to the COVID-19 pandemic and wars, it seems ‘healthy and intelligent’ to encourage positive emotions for our athletes. An additional reason is that they are known to improve motivational processes, reducing abandonment and negative emotional costs [ 11 ]. In this vein, concepts such as emotional intelligence make sense and can help to identify and properly manage emotions in the sports field and determine their relationship with performance [ 27 ] that facilitates the inclusion of emotional training programmes based on the ‘bright side’ of sports practice [ 28 ].

Based on all of the above, one might wonder how these positive emotions are related to a given event and what role each one of them plays in the athlete’s performance. Do they directly affect performance, or do they affect other psychological variables such as concentration, motivation and self-efficacy? Do they favour the availability and competent performance of the athlete in a competition? How can they be regulated, controlled for their own benefit? How can other psychosocial agents, such as parents or coaches, help to increase the well-being of their athletes?

This work aims to enhance the leading role, not the secondary, of the ‘good and pleasant side’ of sports practice, either with its own entity, or as a complement or mediator of the negative variables that have an impact on the performance of athletes and coaches. Therefore, the objective of this study is to conduct a systematic review regarding the relationship between positive psychological factors, such as psychological well-being and pleasant emotions, and sports performance. For this, the methodological criteria that constitute the systematic review procedure will be followed.

Materials and methods

This study was carried out through a systematic review using PRISMA (Preferred Reporting Items for Systematic Reviews) guidelines considering the Web of Science (WoS) and Psycinfo databases. These two databases were selected using the Delphi method [ 29 ]. It does not include a meta-analysis because there is great data dispersion due to the different methodologies used [ 30 ].

The keywords will be decided by the Delphi Method in two rounds with sport psychology experts. The results obtained are intended to be a representation of the ‘bright side’ of sports practice, and as a complement or mediator of the negative variables that have an impact on athletes’ and coaches’ performance.

It was determined that the main construct was to be psychological well-being, and that it was to be paired with optimism, healthy practice, realisation, positive mood, and performance and sport. The search period was limited to papers published between 2000 and 2023, and the final list of papers was obtained on February 13 , 2023. This research was conducted in two languages—English and Spanish—and was limited to psychological journals and specifically those articles where the sample was formed by athletes.

Each word was searched for in each database, followed by searches involving combinations of the same in pairs and then in trios. In relation to the results obtained, it was decided that the best approach was to group the words connected to positive psychology on the one hand, and on the other, those related to self-realisation/performance/health. In this way, it used parentheses to group words (psychological well-being; or optimism; or positive mood) with the Boolean ‘or’ between them (all three refer to positive psychology); and on the other hand, it grouped those related to performance/health/realisation (realisation; or healthy practice or performance), separating both sets of parentheses by the Boolean ‘and’’. To further filter the search, a keyword included in the title and in the inclusion criteria was added, which was ‘sport’ with the Boolean ‘and’’. In this way, the search achieved results that combined at least one of the three positive psychology terms and one of the other three.

Results (first phase)

The mentioned keywords were cross-matched, obtaining the combination with a sufficient number of papers. From the first research phase, the total number of papers obtained was 238. Then screening was carried out by 4 well-differentiated phases that are summarised in Fig.  1 . These phases helped to reduce the original sample to a more accurate one.

Phases of the selection process for the final sample. Four phases were carried out to select the final sample of articles. The first phase allowed the elimination of duplicates. In the second stage, those that, by title or abstract, did not fit the objectives of the article were eliminated. Previously selected exclusion criteria were applied to the remaining sample. Thus, in phase 4, the final sample of 11 selected articles was obtained

Results (second phase)

The first screening examined the title, and the abstract if needed, excluding the papers that were duplicated, contained errors or someone with formal problems, low N or case studies. This screening allowed the initial sample to be reduced to a more accurate one with 109 papers selected.

Results (third phase)

This was followed by the second screening to examine the abstract and full texts, excluding if necessary papers related to non-sports themes, samples that were too old or too young for our interests, papers using qualitative methodologies, articles related to the COVID period, or others published in non-psychological journals. Furthermore, papers related to ‘negative psychological variables’’ were also excluded.

Results (fourth phase)

At the end of this second screening the remaining number of papers was 11. In this final phase we tried to organise the main characteristics and their main conclusions/results in a comprehensible list (Table  1 ). Moreover, in order to enrich our sample of papers, we decided to include some articles from other sources, mainly those presented in the introduction to sustain the conceptual framework of the concept ‘bright side’ of sports.

The usual position of the researcher of psychological variables that affect sports performance is to look for relationships between ‘negative’ variables, first in the form of basic psychological processes, or distorting cognitive behavioural, unpleasant or evaluable as deficiencies or problems, in a psychology for the ‘risk’ society, which emphasises the rehabilitation that stems from overcoming personal and social pathologies [ 31 ], and, lately, regarding the affectation of the athlete’s mental health [ 32 ]. This fact seems to be true in many cases and situations and to openly contradict the proclaimed psychological benefits of practising sports (among others: Cantón [ 33 ], ; Froment and González [ 34 ]; Jürgens [ 35 ]).

However, it is possible to adopt another approach focused on the ‘positive’ variables, also in relation to the athlete’s performance. This has been the main objective of this systematic review of the existing literature and far from being a novel approach, although a minority one, it fits perfectly with the definition of our area of knowledge in the broad field of health, as has been pointed out for some time [ 36 , 37 ].

After carrying out the aforementioned systematic review, a relatively low number of articles were identified by experts that met the established conditions—according to the PRISMA method [ 37 , 38 , 39 , 40 ]—regarding databases, keywords, and exclusion and inclusion criteria. These precautions were taken to obtain the most accurate results possible, and thus guarantee the quality of the conclusions.

The first clear result that stands out is the great difficulty in finding articles in which sports ‘performance’ is treated as a well-defined study variable adapted to the situation and the athletes studied. In fact, among the results (11 papers), only 3 associate one or several positive psychological variables with performance (which is evaluated in very different ways, combining objective measures with other subjective ones). This result is not surprising, since in several previous studies (e.g. Nuñez et al. [ 41 ]) using a systematic review, this relationship is found to be very weak and nuanced by the role of different mediating factors, such as previous sports experience or the competitive level (e.g. Rascado, et al. [ 42 ]; Reche, Cepero & Rojas [ 43 ]), despite the belief—even among professional and academic circles—that there is a strong relationship between negative variables and poor performance, and vice versa, with respect to the positive variables.

Regarding what has been evidenced in relation to the latter, even with these restrictions in the inclusion and exclusion criteria, and the filters applied to the first findings, a true ‘galaxy’ of variables is obtained, which also belong to different categories and levels of psychological complexity.

A preliminary consideration regarding the current paradigm of sport psychology: although it is true that some recent works have already announced the swing of the pendulum on the objects of study of PD, by returning to the study of traits and dispositions, and even to the personality of athletes [ 43 , 44 , 45 , 46 ], our results fully corroborate this trend. Faced with five variables present in the studies selected at the end of the systematic review, a total of three traits/dispositions were found, which were also the most repeated—optimism being present in four articles, mental toughness present in three, and finally, perfectionism—as the representative concepts of this field of psychology, which lately, as has already been indicated, is significantly represented in the field of research in this area [ 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. In short, the psychological variables that finally appear in the selected articles are: psychological well-being (PWB) [ 53 ]; self-compassion, which has recently been gaining much relevance with respect to the positive attributional resolution of personal behaviours [ 54 ], satisfaction with life (balance between sports practice, its results, and life and personal fulfilment [ 55 ], the existence of approach-achievement goals [ 56 ], and perceived social support [ 57 ]). This last concept is maintained transversally in several theoretical frameworks, such as Sports Commitment [ 58 ].

The most relevant concept, both quantitatively and qualitatively, supported by the fact that it is found in combination with different variables and situations, is not a basic psychological process, but a high-level cognitive construct: psychological well-being, in its eudaimonic aspect, first defined in the general population by Carol Ryff [ 59 , 60 ] and introduced at the beginning of this century in sport (e.g., Romero, Brustad & García-Mas [ 13 ], ; Romero, García-Mas & Brustad [ 61 ]). It is important to note that this concept understands psychological well-being as multifactorial, including autonomy, control of the environment in which the activity takes place, social relationships, etc.), meaning personal fulfilment through a determined activity and the achievement or progress towards goals and one’s own objectives, without having any direct relationship with simpler concepts, such as vitality or fun. In the selected studies, PWB appears in five of them, and is related to several of the other variables/traits.

The most relevant result regarding this variable is its link with motivational aspects, as a central axis that relates to different concepts, hence its connection to sports performance, as a goal of constant improvement that requires resistance, perseverance, management of errors and great confidence in the possibility that achievements can be attained, that is, associated with ideas of optimism, which is reflected in expectations of effectiveness.

If we detail the relationships more specifically, we can first review this relationship with the ‘way of being’, understood as personality traits or behavioural tendencies, depending on whether more or less emphasis is placed on their possibilities for change and learning. In these cases, well-being derives from satisfaction with progress towards the desired goal, for which resistance (mental toughness) and confidence (optimism) are needed. When, in addition, the search for improvement is constant and aiming for excellence, its relationship with perfectionism is clear, although it is a factor that should be explored further due to its potential negative effect, at least in the long term.

The relationship between well-being and satisfaction with life is almost tautological, in the precise sense that what produces well-being is the perception of a relationship or positive balance between effort (or the perception of control, if we use stricter terminology) and the results thereof (or the effectiveness of such control). This direct link is especially important when assessing achievement in personally relevant activities, which, in the case of the subjects evaluated in the papers, specifically concern athletes of a certain level of performance, which makes it a more valuable objective than would surely be found in the general population. And precisely because of this effect of the value of performance for athletes of a certain level, it also allows us to understand how well-being is linked to self-compassion, since as a psychological concept it is very close to that of self-esteem, but with a lower ‘demand’ or a greater ‘generosity’, when we encounter failures, mistakes or even defeats along the way, which offers us greater protection from the risk of abandonment and therefore reinforces persistence, a key element for any successful sports career [ 62 ].

It also has a very direct relationship with approach-achievement goals, since precisely one of the central aspects characterising this eudaimonic well-being and differentiating it from hedonic well-being is specifically its relationship with self-determined and persistent progress towards goals or achievements with incentive value for the person, as is sports performance evidently [ 63 ].

Finally, it is interesting to see how we can also find a facet or link relating to the aspects that are more closely-related to the need for human affiliation, with feeling part of a group or human collective, where we can recognise others and recognise ourselves in the achievements obtained and the social reinforcement of those themselves, as indicated by their relationship with perceived social support. This construct is very labile, in fact it is common to find results in which the pressure of social support is hardly differentiated, for example, from the parents of athletes and/or their coaches [ 64 ]. However, its relevance within this set of psychological variables and traits is proof of its possible conceptual validity.

Analysing the results obtained, the first conclusion is that in no case is an integrated model based solely on ‘positive’ variables or traits obtained, since some ‘negative’ ones appear (anxiety, stress, irrational thoughts), affecting the former.

The second conclusion is that among the positive elements the variable coping strategies (their use, or the perception of their effectiveness) and the traits of optimism, perfectionism and self-compassion prevail, since mental strength or psychological well-being (which also appear as important, but with a more complex nature) are seen to be participated in by the aforementioned traits.

Finally, it must be taken into account that the generation of positive elements, such as resilience, or the learning of coping strategies, are directly affected by the educational style received, or by the culture in which the athlete is immersed. Thus, the applied potential of these findings is great, but it must be calibrated according to the educational and/or cultural features of the specific setting.

Limitations

The limitations of this study are those evident and common in SR methodology using the PRISMA system, since the selection of keywords (and their logical connections used in the search), the databases, and the inclusion/exclusion criteria bias the work in its entirety and, therefore, constrain the generalisation of the results obtained.

Likewise, the conclusions must—based on the above and the results obtained—be made with the greatest concreteness and simplicity possible. Although we have tried to reduce these limitations as much as possible through the use of experts in the first steps of the method, they remain and must be considered in terms of the use of the results.

Future developments

Undoubtedly, progress is needed in research to more precisely elucidate the role of well-being, as it has been proposed here, from a bidirectional perspective: as a motivational element to push towards improvement and the achievement of goals, and as a product or effect of the self-determined and competent behaviour of the person, in relation to different factors, such as that indicated here of ‘perfectionism’ or the potential interference of material and social rewards, which are linked to sports performance—in our case—and that could act as a risk factor so that our achievements, far from being a source of well-being and satisfaction, become an insatiable demand in the search to obtain more and more frequent rewards.

From a practical point of view, an empirical investigation should be conducted to see if these relationships hold from a statistical point of view, either in the classical (correlational) or in the probabilistic (Bayesian Networks) plane.

The results obtained in this study, exclusively researched from the desk, force the authors to develop subsequent empirical and/or experimental studies in two senses: (1) what interrelationships exist between the so called ‘positive’ and ‘negative’ psychological variables and traits in sport, and in what sense are each of them produced; and, (2) from a global, motivational point of view, can currently accepted theoretical frameworks, such as SDT, easily accommodate this duality, which is becoming increasingly evident in applied work?

Finally, these studies should lead to proposals applied to the two fields that have appeared to be relevant: educational and cultural.

Application/transfer of results

A clear application of these results is aimed at guiding the training of sports and physical exercise practitioners, directing it towards strategies for assessing achievements, improvements and failure management, which keep them in line with well-being enhancement, eudaimonic, intrinsic and self-determined, which enhances the quality of their learning and their results and also favours personal health and social relationships.

Data availability

There are no further external data.

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Peris-Delcampo, D., Núñez, A., Ortiz-Marholz, P. et al. The bright side of sports: a systematic review on well-being, positive emotions and performance. BMC Psychol 12 , 284 (2024). https://doi.org/10.1186/s40359-024-01769-8

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20 Sport, Health, and Well-Being

Parissa Safai is an associate professor in the School of Kinesiology and Health Science in the Faculty of Health at York University. Her research interests focus on the critical study of sport at the intersection of risk, health, and healthcare, including the social determinants of athletes’ health. Her interests also center on sport and social inequality, with attention to the impact of gender, socioeconomic, and ethnocultural inequities on accessible physical activity for all.

• Published: 21 September 2022
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Sport is often touted by many as good for one’s health and well-being; in fact, Hippocrates is thought to have once said that “sport is the preserver of health.” And yet there is a substantial amount of scholarly research, across a range of disciplines, that problematizes this commonplace assumption. This chapter explores the central question: Is sport participation healthful for well-being? Organized in three parts, the chapter first examines key conceptual challenges associated with unpacking this question. For example, what do we mean when we refer to the concepts of sport, health, and well-being? The second section explores the challenges faced by critical social scientists in disrupting the commonplace notion of sport as good for one’s health, and the third section highlights the questions: Can contemporary sport be good for one’s health, and if so, how?

At the risk of stating a cliché, the world is currently in the midst of the most unprecedented public health, social, political, economic, and human rights crisis in human history. According to data from Johns Hopkins University’s COVID-19 Dashboard, and at the time of reviewing this chapter proof (mid-April 2022), over 504 million cases and nearly 6.2 million deaths have occurred around the world as a consequence of COVID-19. These figures are widely recognized as underestimates of the actual number of cases and deaths as effective, reliable, and sustained testing in countries around the world has been virtually absent, at best variable, and highly dependent on trust and cooperation (or lack thereof) between governments, the medico-scientific community, and the public at large (e.g., see Balmford, Annan, Hargreaves, Altoè, & Bateman, 2020 ).

There have been other global pandemics over the course of human history (e.g., the 1918 influenza [H1N1] pandemic). Yet the complexities and complications of the COVID-19 pandemic have proven to be much more pronounced due to a range of factors. For example, the ease and speed of transmission of SARS-CoV-2 (the virus that causes COVID-19) within and across regions as well as within and among particular groups of individuals (e.g., the elderly, Black and Indigenous people of color, those in poverty) has rendered COVID-19 particularly virulent. Another confounding issue is the host of still relatively unknown factors that shape the epidemiological patterns and clinical presentations of those infected and suffering with COVID-19. Simply put, despite huge advances in our scientific understanding of the virus and the disease in a relatively short span of time, we still do not know why some infected individuals are asymptomatic, why some are viral super-spreaders, and why some are long-haulers and suffer extraordinarily long aftereffects of the disease. And unlike other pandemics, the impact of COVID-19 has been unmatched given the near complete disruption of heightened and more intensive interdependencies that exist between populations, cultures, and economies in our contemporary globalized world.

There is no avoiding the metaphoric “elephant in the room” with this chapter—exploring the relationships between sport, health, and well-being during this time of a global pandemic is, simply put, weird. On one hand, at a time when so many people are sick or dying, and even more are trying to simply survive lockdowns and isolation, staggering job losses and economic instability, social unrest and political protest, increased food insecurity, interrupted education, and exponential increases in anxiety, depression, and stress, unpacking the common belief that sport is good for you feels like an exercise (no pun intended) in futility. And yet, on the other hand, there may be no more opportune time to do so, as the profound disruption of our daily lives as a consequence of COVID-19 demands of us to take fuller and more critical stock of the real or imagined sport-health dyad. In so doing, we may open and shift thought and praxis to re-create our beliefs, associations, and practices about sport and health. We may, in fact, take up Arundhati Roy’s (2020) call to conceptualize the pandemic as “a portal, a gateway between one world and the next” and as providing the impetus to “break with the past and imagine [our] world anew.”

This chapter explores the central questions: Is sport healthy, and can it contribute to well-being? Organized in three parts, the chapter will first examine key conceptual challenges associated with answering this question. For example, what do we mean when we refer to the concepts of sport, health, and well-being? The second section will explore the challenges faced by critical social scientists in disrupting the commonplace notion of sport as good for one’s health, and the third section will highlight the wicked questions: Can contemporary sport be good for one’s health, and if so, how?

Famous quotes about the healthfulness of sport are plentiful. The ancient Greek physician Hippocrates is credited with saying that “sport is the preserver of health,” while American essayist Ralph Waldo Emerson (1883 , p. 204) once wrote, “Sport is the bloom and glow of a perfect health.” It should be no surprise that famous athletes and sport leaders have oft made a causal link between sport and health. For example, Indian cricketer Kapil Dev enthused, “Apart from education, you need good health, and for that, you need to play sports,” and English decathlete Daley Thompson declared, “Sport and health are so important to our nation that they deserve to be right at the front of people’s minds” (quoted in Bryant, 2008 ). And one could be forgiven for thinking that sport is the magical cure for all of humanity’s problems when the president of the International Olympic Committee Juan Antonio Samaranch, in his address during the Opening Ceremony of the 1996 Olympic Games, espoused, “Sport is friendship, sport is health, sport is education, sport is life, sport brings the world together.”

Such quotes can be easily dismissed as just fodder for motivational posters or inspirational greeting cards. What is of much greater concern, however, is the way such rhetoric is routinely woven into the policies and resource-distributing decisions of national and international governments and public-, private- and third-sector organizations (see the 2016 special issue of the International Journal of Sport Policy and Politics on “sport, physical activity and public health” ( Mansfield & Piggin, 2016 ) for a range of national and international examples). Certainly, the website for sportanddev.org (2020) , an online platform dedicated to resources and communications on sport and development, is rife with sport-health associations, including such definitive statements as the following:

There is an overwhelming amount of scientific evidence on the positive effects of sport and physical activity as part of a healthy lifestyle. The positive, direct effects of engaging in regular physical activity are particularly apparent in the prevention of several chronic diseases, including: cardiovascular disease, diabetes, cancer, hypertension, obesity, depression and osteoporosis. (para. 1)

Sport and physical activity can make a substantial contribution to the well-being of people in developing countries. Exercise, physical activity and sport have long been used in the treatment and rehabilitation of communicable and non-communicable diseases. Physical activity for individuals is a strong means for the prevention of diseases and for nations is a cost-effective method to improve public health across populations. (para. 5)

In 2003, the United Nations adopted Resolution 58/5, Sport as a Means to Promote Education, Health, Development and Peace, “[noting] that sport and physical education are a major tool not only for health and physical development but also for acquiring values necessary for social cohesion and intercultural dialogue” (para. 8). More recently, and right in the midst of the pandemic, the World Health Organization (2020 , para. 1) formalized its partnership with the IOC, signing “an agreement to work to promote health through sport and physical activity.” The press release for the partnership hails the WHO-IOC collaboration as especially relevant for the following reason:

The current COVID-19 pandemic is particularly affecting people with noncommunicable diseases (NCDs). The agreement has a special focus on preventing NCDs through sport. Physical activity helps lower blood pressure and reduce the risk of hypertension, coronary heart disease, stroke, diabetes, and various types of cancer (including breast cancer and colon cancer). (para. 3)

Where Dr. Tedros Adhanom Ghebreyesus, WHO’s director-general, states that “physical activity is one of the keys to good health and well-being” ( World Health Organization, 2020 , para. 2), IOC President Thomas Bach notes, “Over the last few months in the current crisis, we have all seen how important sport and physical activity are for physical and mental health. Sport can save lives” (para. 6). He goes further to state, “The IOC calls on the governments of the world to include sport in their post-crisis support programmes because of the important role of sport in the prevention of NCDs, but also of communicable diseases” (para. 6).

Although it is premature to know if or how governments will “include sport in their post-crisis support programmes,” current national legislation and sport policies give us insight into existing understandings of the sport-health relationship and suggest the possible (perhaps even likely) directions in which sport systems in pandemic/postpandemic times may head (cf. Misener & Misener, 2016 ). For example, in Canada, the very first statement in the preamble to the Physical Activity and Sport Act states, “[T]he Government of Canada recognizes that physical activity and sport are integral parts of Canadian culture and society and produce benefits in terms of health, social cohesion, linguistic duality, economic activity, cultural diversity and quality of life” (Government of Canada, 2003, para. 5). The 2012 Canadian Sport Policy ( CSP), which operationalizes the Act and was endorsed by federal and provincial-territorial ministers of sport until 2022, frames “improved health and wellness” as a societal outcome of participation in sport: “Canadians participate in sport activities in a manner that strengthens their personal development, provides enjoyment and relaxation, reduces stress, improves physical and mental health, physical fitness and general well-being, and enables them to live more productive and rewarding lives” ( Sport Information Resource Center, 2012 , p. 4). In addition, and of particular note for this chapter, as will be discussed below, the CSP also draws linkages between sport, personal health, and the economy. “Increased economic development and prosperity” is identified as another societal outcome of sport participation among Canadians, “where sport delivers benefits, for increasing numbers, to individual health and well-being, and contributes to socio-economic outcomes” (p. 5). In sum, the CSP aims to advance a vision of sport whereby “Canadians improve their standard of living and economic well-being through sport; communities benefit from healthier citizens and the reduction of health care costs; and the sport and tourism sectors benefit from legacies of hosting of local, regional, national and international sport events” (p. 4).

For critical sport scholars, red flags with these statements, legislative acts, and policies abound—not just with the loftiness and presumptuousness of these suggested connections between sport and health, but also with the discursive slipperiness embedded in these texts and the implications of such fuzzy definitions for the ways in which material resources are distributed (cf. Piggin, 2020 ). It has been well recognized by sport scholars that sport is routinely yoked together and used interchangeably with such terms as physical activity, physical literacy, physical education, exercise, fitness, tourism, and play (for example, and not an exhaustive list, Bloyce & Smith, 2009 ; Coalter, 2007 ; Green, 2004 ; Grix & Carmichael, 2012 ; Malcolm, 2016 ; Mansfield & Malcolm, 2014 ; Oliver, Hanson, Lindsey, & Dodd-Reynolds, 2016 ; Waddington, 2000 ; Weed, 2016 ). The challenge in collapsing these terms together is captured well by Safai and Malcolm (2016 , p. 159):

Sport is a physical activity; sport is often used in physical education curricula; it incorporates exercise; and may even involve an element of play. However, this does not mean that sport is the same as physical education, exercise or play. The conflation of sport with physical education, exercise and play obscures its differences in intensity, frequency and duration of participation from other forms of physical activity. We must be cognisant of these differences since the institutionalised, competitive, rigorous and complex nature of sport has markedly different consequences for health than physical education, exercise or play.

To be clear, critical sport scholars do not suggest that organized and competitive sport is completely incapable of being healthful for individuals, groups, or communities. Rather, concerns have been and are being raised about the seemingly wholescale promotion of such definitive sport = health statements (i.e., sport is healthful for all, as is implicit in many national “sport for all” programs) that poorly distinguish between and yet still blend together sport, physical activity, physical literacy, physical education, exercise, fitness, tourism, and play in the service of health.

Similar conceptual concerns arise with the terms “health” and “well-being” or “wellness,” which are routinely used synonymously and interchangeably in public consciousness and in public or social policy- and program-making circles (alongside “healthcare” and “medicine,” which are also often used as though identical to one another) (see Dodge, Daly, Huyton, & Sanders, 2012 ). There are numerous examples of the tautological quality in definitions of “health” and “well-being.” For example, in efforts to move away from the more narrow biomedical understanding of health (as the absence of disease), the World Health Organization’s (1948) canonized definition of health situates it as a state of well-being (specifically, “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”). In the Oxford English Dictionary , health is defined in part as “[w]ell-being, welfare, safety; deliverance” ( “Health,” 2020 ), and well-being is defined as “the state of being healthy, happy, or prosperous; physical, psychological, or moral welfare” ( “Well-being,” 2020 ). It is important to note that even the term “welfare” poses similar challenges as it too is often employed synonymously with health and well-being. In the following, we can see Melanie Lang, editor of the 2021 Routledge Handbook of Athlete Welfare fall back on using these concepts to define each other even though she is attempting to disentangle them from one another (personal communication, March 2018):

Well-being is a quality or emotional state of being comfortable, healthy, or happy and is linked to being satisfied with a particular thing/aspect of life. Welfare is a broader term that comprises health, safety, happiness, prosperity etc. and that relates to the overall quality of life and concerns about this. As such, well-being is a component of the broader concept of welfare, with well-being being a contributing factor in an individual’s overall welfare.

There are not enough pages in this chapter to be able to properly, or perhaps even adequately discuss the attempts to define health and well-being. Scholars from a multitude of disciplinary areas across the range of humanities and natural, medical, and social sciences have dedicated tomes to different interpretations of what is and is not health and well-being (e.g., see Godlee, 2011 ; Huber et al., 2011 ; La Placa, McNaught, & Knight, 2013 ; Larson, 1999 ; Wiseman & Brasher, 2008 ). With tongue in cheek, Smith (2008) captures his dissatisfaction with the WHO’s unrealistic definition of health as a state of “complete” well-being when he writes, “It’s a ludicrous definition that would leave most of us unhealthy most of the time.” The key takeaway from this discussion on this confusing state of affairs is that such discursive slipperiness “may set the limits to what it is possible to think, and thus the understandings of the choices that can be made’ ( Newman, 2005 , p. 128) and leaves wide open the opportunity for governing bodies (whether governments, health agencies, sport organizations, or corporations) to manipulate such fuzzy language to suit specific agendas at specific times ( Grix & Carmichael, 2012 ).

The good news for critical sport and health scholars is that more nuanced characterizations of health and well-being are multidimensional (i.e., from the health of our cells to the health of our planet) in conceptualization and much more sensitive to the wider and intersectional determinants of health and the material conditions of social life that constrain or facilitate health and well-being for individuals and groups (cf. Marmot & Wilkinson, 1999 ; Naci & Ioannidis, 2015 ; Raphael, Bryant, & Rioux, 2010 ). For example, the Canadian Index of Wellbeing (2020) defines well-being thus:

The presence of the highest possible quality of life in its full breadth of expression focused on but not necessarily exclusive to: good living standards, robust health, a sustainable environment, vital communities, an educated populace, balanced time use, high levels of democratic participation, and access to and participation in leisure and culture.

In this example, we can see—via the association to standards of living, the environment, education, and engaged citizenship—well-being (and health) situated as a collective and political issue. These attempts to understand health and well-being as one’s capacity to cope, adapt, and manage life (cf. Huber et al., 2011 ), as helped or hindered by broader social structures and processes, challenge the more individualistic and inward-looking focus of extant definitions as well as the over-/medicalization of social life, which some suggest is stimulated by the pathologization of “incomplete” states of well-being (see Godlee, 2011 ). In this vein, health and well-being are not limited to lifestyle choices, or the consequences of biological advantage conferred upon someone by their good genes, or even access to good healthcare services. Rather health and well-being are political because they are resources of power that possess dimensions of quality and quantity, they can be shaped by political institutions and interventions (or their lack), they are linked to social relations such that some enjoy more health and well-being than others, and they are elements of our human rights (cf. Bambra, Fox, & Scott-Samuel, 2005 ). The bad news, however, is that these more diverse, interconnected, multidimensional, and power-sensitive understandings of health and well-being do not necessarily translate into the ways health and well-being—and even sport—are being promoted and lived in the day-to-day. The following section expands on these points.

Despite the availability of fresher and more refined notions of health and well-being—ones that connect the personal to the communal and to the political—mainstream approaches to the operationalization or enacting of health and well-being (and even sport, as will be discussed below) in our daily lives remain quite entrenched in individualistic ideologies of good health as personal responsibility and as evidence of good moral conduct. This approach is commonly referred to as “healthism” ( Crawford, 1980 ), whereby health is wholly conceived as a product of individual choice and practice, and where such “concepts as willpower, self-discipline and lifestyle operate to define health as a personal trouble rather than public issue” ( Safai, Johnson, & Bryans, 2016 , p. 271). Poor health is not understood as a result of or even a symptom of systemic or structural disadvantage and inequity between individuals and/or groups, but rather as a product of an individual’s inability to be disciplined, hard-working, in control, or to “do the right thing” ( Crawford, 1977 ; Greenhalgh & Wessely, 2004 ; Howell & Ingham, 2001 ).

Healthism flourishes within neoliberalism, which is defined in this chapter in the broadest terms possible—from a concretized political economic approach to governance in many nation-states to a governing rationality and “an everyday experience” ( Hamann, 2009 , p. 39) that cuts across social and cultural dimensions of life. Both healthism and neoliberalism encourage individuals to think and act solely about and through themselves (particularly through their wallets and bank accounts) and encourage the hollowing out of public government and the public sector in the name of fiscal responsibility and/or the need to stimulate and protect business and industry above all ( Ingham, 1985 ). In so doing, healthism (as situated within and buttressing neoliberalism) minimizes a government’s capacity to equitably foster and be responsible for the health and well-being of its citizens and, perhaps more profoundly, undermines the belief that the determinants of health and well-being are connected to and derive from social relations and the ways in which power and material resources are distributed (or not) among individuals and/or groups in our communities ( Armstrong, Armstrong & Coburn, 2001 ; Skrabanek, 1994 ). In a healthist approach to health, it doesn’t matter if you vote for or against racist and fascist political regimes in national elections; it matters only that you purchase and use a membership to the fitness club without question ( Wiest, Andrews, & Giardina, 2015 ). And it doesn’t matter whether the fitness club and its instructors encourage patrons to ask critical questions about access, privilege, and health inequalities; it matters only that muscles are kept toned and that fat is controlled (see Markula & Chikinda, 2016 ).

Within the logics of these neoliberal times, well-being is similarly influenced by healthism and its ideology of personal responsibility. Conservative estimates of the global wellness movement suggest it is a multitrillion-dollar industry annually, with devotees paying for such things as detoxifications, juice cleanses, coffee enemas, specialized fitness classes, biometric technologies, silent meditative spa retreats, controlled diets, life coaching, beauty regimes, chakra healing, customized tonics and skin oils, healing crystals, and the list goes on ( Global Wellness Institute, 2018 ). Critics of the modern wellness movement offer scathing assessments of the ways in which false and at times outright dangerous misinformation is peddled to people, especially women, in the pursuit of “health, happiness, and prosperity.” Gunter (2018) routinely attacks the wellness-industrial complex for “grifting off desperate women” looking for health information, care, or even just validation of their health concerns, by reproducing long-ingrained patriarchal beliefs that women’s bodies are impure, flawed, and in need of help from outside experts ( Wiseman, 2019 , para. 15). In an editorial that is as much about the rise of anti-intellectualism as it is about the dangers of the cult of wellness, McCartney (2019) similarly notes:

Of course, the ultimate irony of the wellness industry is that it is aimed at the people least likely to benefit from it. It is not the well-off people with gym memberships, fitness trackers and a regular Whole Foods habit who are most likely to die young. It is the people whose social disadvantage make it more likely that they will smoke, to suffer more of the adverse consequences of alcohol, who have less access to green spaces to exercise, have jobs with less control and often more stress. It is citizens who are most wealthy, and healthy, who are invited to spend their money on accumulating interventions that don’t work. Yet they can paradoxically be harmed and easily become anxious patients as they accumulate the side effects of too much medicine. Marketing and advertising can make people into patients unnecessarily, while people who really could benefit from becoming a patient are left with less resource to do so. This paradox makes everyone sicker.

The cult of wellness implies that people can make their own “health, happiness, and prosperity” if only they believe enough and buy enough—an approach that seamlessly dovetails with consumer capitalism and neoliberalism. Healthism deflects attention away from the health-compromising determinants of social life that are often beyond the control of the average individual to focus only on seeing the world through rose-tinted glasses or a “pull yourself up by the bootstraps” mentality ( Tirado, 2015 ). In her exploration of the dangers of relentlessly pushing people to think, feel, and act optimism and happiness, Ehrenreich (2009 , p. 8) writes:

[P]ositive thinking has made itself useful as an apology for the crueler aspects of the market economy. If optimism is the key to material success, and if you can achieve an optimistic outlook through the discipline of positive thinking, then there is no excuse for failure. The flip side of positivity is thus a harsh insistence on personal responsibility: if your business fails or your job is eliminated, it must be because you didn’t try hard enough, didn’t believe firmly enough in the inevitability of your success.

For example, the rise of precarious labor markets and the gig economy results in many workers not being able to enjoy health and dental benefits that accompany stable, permanent, and full-time jobs—let alone enough disposable income or free time to pursue sport or any form of physical activity. This holds dangerous consequences in the event of illness or injury for many individuals and communities, and yet there is seemingly little critical or sustained attention paid to this issue in the public sector as governments shift toward new public management and the embrace of an entrepreneurial ethos ( Connell, Fawcett & Meagher, 2009 ; Diefenbach, 2009 ; McSweeney & Safai, 2020 ; Vosko, 2006 ). In other words, the answer to addressing the precarity of the contemporary job market is not in enacting and enforcing labor policies and workplace legislation that ensures material and health stability for workers but, rather, encouraging workers to work harder and to persevere. As Bambra, Smith, Garthwaite, Joyce, and Hunter (2011 , p. 403) note, however, such approaches and such policies “attempt to tackle health inequalities by trying to ‘empower’ people or encouraging them to feel happier, more confident or more responsible, without necessarily addressing the key, underlying issue.”

Sport is implicated in the promotion of this ideology of personal responsibility as it is most typically posed as a lifestyle choice that morally good people should adopt. In large part, the weaving of sport in healthist doctrine is facilitated by the easy conflation of physical activity, physical literacy, physical education, exercise, fitness, tourism, and such with sport. As noted earlier, the blurring of sport with any and all forms of physical culture renders sport, as one specific form of physical culture and as one area of social or public policy, amenable to manipulation by those who want to fit it into their agendas—including those who are trying to advance or reinforce neoliberal, healthist agendas. Mansfield (2016 , p. 714) makes this point clear when she states, “Sport can also be thought of as a relatively cheap and malleable policy tool which helps to explain its continued appeal as a simple solution to complex, deeper-seated social problems like health inequalities.” Yet, just as it is problematic to equate sport to physical activity, play, exercise, and so on, it is bizarre to suggest that sports participation will adequately address or redress serious personal and/or social health issues. If we set aside COVID-19 for a moment, the top causes of death globally are chronic conditions (e.g., diabetes, cancers, malnutrition, heart disease) that are multifactorial in causation and treatment ( Roser & Ritchie, 2016 ). Proponents of the social determinants of health (SDOH) paradigm know that there is no way that playing rugby can solve such conditions. Rather, critical sport and health scholars urge attention to the cleanliness of the air in which the rugby pitch is located, to the aesthetic appeal to and safety of green spaces for local citizens, to the accessibility of public transit to get a player to and from practice, and to the stability and sensitivity of the job market so that people can eat regularly, live in a safe home, and have time to play football.

Furthermore, as many critical sport sociologists note, conflating physical activity, physical education, exercise, fitness, and so on with sport results in everything getting operationalized as sport, with its heightened focus on performance and competition (e.g., Green, 2007 ; Kirk, 2010 ; Murphy & Bauman, 2007 ; Ressler, Richards, & Wright, 2016 ). Critical sport scholars have long known that the performance principle and the culture of risk (i.e., a culture that produces and reproduces the tolerance of health-compromising beliefs, behaviors, and practices) that underpin organized, competitive sport often endanger good health (see the chapter in this volume by Dominic Malcolm and Emma Pullen for a fuller discussion). The potential public health benefits that may be seen from getting individuals and communities engaged at some level of active living or physical activity more broadly (i.e., not in just organized, competitive sport) get taken up in extraordinarily functionalist ways. There is no shortage of dose-response studies that attempt to ascertain how many minutes of physical activity at what level of intensity and frequency are needed for some beneficial physiological effect on the body. Indeed, in the Canadian context, guidelines from the Canadian Society for Exercise Physiology (n.d.) on movement, sleep, and screen time dominate public health messaging. Parents are repeatedly told that their children should be getting at least 60 minutes of moderate to vigorous physical activity each day and that they themselves should be logging at least 150 minutes of moderate to vigorous physical activity each week!

My intent is not to suggest that these guidelines are inappropriate or lacking in scientific rigor or credibility, or even that sport cannot be healthful for individuals and communities. Rather, I want to draw attention to how unquestioningly sport, organized in the narrow terms of performance and competition, gets taken up as healthful for all, as well as how broader physical activity guidelines are reductive and disconnected from well-established and long-standing insights on the impact of the material conditions of life on health ( Kay, 2016 ). In the guidelines from the Canadian Society for Exercise Physiology, which seem to have a remarkably sticky and enduring quality given how long and how well they have been taken up by all levels of Canadian government and in the public sector more broadly (cf. Bercovitz, 2000 ), it is the number of minutes one sleeps, watches a screen, and moves that seem to matter the most. Absent in these guidelines is the fact that the minutes in our days are contained and structured by broader social, cultural, political, and economic institutions, forces, and processes that operate to the advantage of some more than others. More critical relational analyses that foreground power between individuals and groups need to be layered into these prescriptive guidelines, and to this end, there must be more engagement with and input from critical sport and health scholars who advance an SDOH approach to the study and operationalization of sport, health, and well-being in the service of public/population health. Kay (2016 , p. 555) states:

Social scientists within the academic sport science community can help bridge this chasm, by contributing social scientific theories, methodologies and knowledge to this area. Such offers must be constructive: to dismiss health behaviourists as not addressing “context” is not adequate, when their theoretical frameworks do; to argue that they do not address it “properly” is not sufficient without elucidation and to elucidate by only offering grand theory is not only unhelpful but actively counterproductive, reinforcing the notion that “social influences” exist only as some abstraction that is beyond translation into practice. Tangible specifics are required to demonstrate how social science knowledge can enhance understanding of health behaviour and efforts to enhance it.

Kay’s words are prescient, but calling on just the “academic sport science community” to mobilize is limiting. Advancing the critical sociocultural study of sport, health, and well-being so as to make a difference in public-sector guidelines, policies, and programs is about advancing a “relevant and engaged” public sociology of sport that

can contribute to “the terms of the debate,” not just by adding to the body of knowledge, but also by having researchers who specifically draw the connections between their work and the larger debates and problems, and by seeking ways to engage various publics when disseminating that research. ( Donnelly, 2015 , p. 422; see also Bairner, 2009 ; Cooky, 2017 ; Ingham & Donnelly, 1990 )

This represents a prime, albeit challenging opportunity for critical sport and health scholars. It is one, however, that is certainly not supported by the functionalist, positivist, and managerial paradigms of the moving body and classic and healthist health promotion prescriptions that dominate the research and teaching agendas of many (if not most) kinesiology departments in higher education—departments where more critical social, cultural, and historical interrogations of sport, health, and well-being are increasingly being pushed to the wayside ( Safai, 2016 ; see Andrews, Silk, Francombe, & Bush, 2013 ).

This section will explore the questions: Can sport be good for one’s health, and if so, how? Such questions “exhibit the characteristics of ‘wicked problems,’ in that they are difficult to define/interpret, are based in competing/uncertain causes, and generate further issues when solutions are applied” ( Sam, 2009 , p. 499). It is important to note that any attempts I offer here to answer these questions must begin with my own admission that I like sport, as do most (if not all) sport sociologists, even those who engage a critical standpoint. I think it is safe for me to suggest, on behalf of the wider sociology of the sport community, that we are not “anti-sport” as much as we are uncomfortable with and resistant to the current ways in which the sport system—from grassroots to the highest levels of national and international competition—is predominantly structured, organized, and delivered. We are extraordinarily concerned by how the mainstream sport agenda is set in ways that do not adequately attend to remediating the conditions that make sport inaccessible or unhealthy for some individuals and groups, or that do not legitimately develop or sustain humane and healthy sport for all.

In some cases, it is blatantly clear why the “sport is healthful for all people all the time” message is misleadingly and inappropriately trotted out by individuals and groups. When former FIFA president Sepp Blatter is the first author of a peer-reviewed paper in the Scandinavian Journal of Medicine & Science in Sports titled “Football for Health—Science Proves That Playing Football on a Regular Basis Contributes to the Improvement of Public Health” ( Blatter & Dvorak, 2014 ), we know that the unspoken yet obvious agenda of the piece is to promote FIFA and its version of football, not public health. For critical sport and health scholars, it is not that football holds no potential to contribute to the improvement of public health but that corrupt sport leaders such as Blatter, and the sport governing bodies and governments that have been shown to be in cahoots with these criminals, fail to safeguard the health and lives of people around the world ( Jennings, 2011 ; Masters, 2015 ). The deaths of numerous migrant construction workers involved in the building of venues for the Qatar FIFA World Cup scheduled for 2022—the exact number of which still remains shrouded in mystery to this day, but ranging anywhere from 34 to over 1,200 depending on the source ( Gibson & Pattison, 2014 ; Ingraham, 2015 ; Pattison, 2020 )—negate any “proof” of football’s ability to contribute to public health as public health is far more dependent upon sound and enforced labor laws, occupational health regulations, workplace safety standards, and labor reform when needed than on playing a game of football or hosting a sporting mega-event.

The Blatter example is admittedly sensational, but questioning how sport-health agendas get set is vital for our better understanding of if and how sport can be good for one’s health. As noted earlier, functionalist, positivist, and managerial approaches dominate much of government and public-sector discourse on sport and health. Such approaches endure not because of nefarious backroom wheeling and dealing between, for example, exercise physiologists and policymakers, but because of such factors as the capacity for individuals and groups to define key issues and put forth persuasive “evidence” that supports their definitions in ways that capture and hold the attention and support of key government actors; the presence and strength of advocacy coalitions and their successful (or not) lobbying of government decision-makers; the opening of “policy windows” amid welcoming political environments; or even just the heightened capacity of some individuals and groups to take advantage of circumstantial geopolitical or economic opportunities to advance their vision of the “ways things should be” ( Bundon & Hurd-Clarke, 2015 ; Green, 2004 , 2007 ; Green & Houlihan, 2004 ; Milton & Grix, 2015 ; Mansfield, 2017 ; Misener & Misener, 2016 ; Weiss, 1989 ).

A prime example of the way such factors play out in the setting of sport-health agendas is close to home for me, as colleagues from my own academic department were recruited by a coalition of the Canadian Off-Highway Vehicle Distributors Council, the All Terrain Quad Council of Canada, the Motorcyclists Confederation of Canada, and the Government of Nova Scotia to determine if riding all-terrain vehicles (ATVs) and off-road machines (ORMs) offered fitness and health benefits to participants. The research team found that “off-road riding was found to impose a true physiological demand that would be expected to have beneficial effects on health and fitness according to current [physical activity] recommendations” and that the “metabolic demand of off-road riding is at an intensity level associated with health and fitness benefits in accord with the guidelines of both Health Canada and the [American College of Sports Medicine]” ( Burr, Jamnik, Shaw, & Gledhill, 2010 , pp. 1350, 1353). The authors conclude:

[O]ff-road vehicle riding is similar in aerobic demand to many other recreational, self-paced, sporting activities such as golf, rock climbing, and alpine skiing. This examination of off-road vehicle riding is valuable for understanding the physical demands of this alternative mode of recreational [physical activity] in the context of potential health-related fitness outcomes. (p. 1353)

And in yet another publication, the authors suggest that ATV and off-road riding may even positively influence one’s sense of well-being:

[I]t is possible that the higher levels of vitality, general happiness and [quality of life] of recreational off-road vehicle riders is a consequence of participation in the sport and thus further research is warranted to determine if this type of alternative activity should be recognized as a means to increase the health and [quality of life] of Canadians. ( Burr, Jamnik, & Gledhill, 2010 , p. 10)

Not surprisingly, these findings have also been challenged (see Bissix, MacCormick, & Milburn, 2013 ), but, also not surprisingly, these types of findings have been welcomed and robustly taken up by proponents of ATV and ORM riding as the evidence that such activities boost health and as the evidence that such activities should be supported more by government through, at minimum, the establishment of more trails for ATV and ORM use. However, more critical sociocultural readings of the setting of the pro-ATV/ORM agenda highlight a range of issues that rub against the supposed fitness and health benefits, including the exclusionary nature of off-road riding (in general, riders tend to be middle- to upper-class men), injury concerns arising from off-road riding accidents and traumas (especially among youth riders), and risks to the environment (e.g., see Muller, 2016 ).

This example highlights the point that we must acknowledge, a priori : that the question “Can sport be good for one’s health and, if so, how?” can be answered only when we have a clear understanding of who is posing the question and what agenda they hope to advance. In his exploration of the Kieran Pathways Society, a human-powered active transportation (i.e., walking, cycling, skiing, canoeing, using a wheelchair, etc.) group in Nova Scotia struggling to advance the development of trails/corridors that exclude motorized vehicles and to push back against their provincial government’s collaborations with off-highway vehicle groups, Pitter (2009 , p. 347, emphasis added) states:

The dynamics surrounding the production and consumption of space in this case study illustrate how the state, civil society, and commercial institutions play various roles in the creation of recreational sport spaces. The commercial manufacturers and distributors of [off-highway vehicles] have played a significant role through corporate funding/sponsorship. Their influence appears to have been greatest through their collective actions via the Canadian Off-Highway Vehicle Distributors Council that works to legitimize the sport through various public relation initiatives and research .

The movement (if we can call it that) promoting ATV riding for health highlights the breadth and depth of the lobbying and persuasive efforts of specific stakeholders—who tap into and call upon particular forms of sport science and scientific evidence that favor their interests—on governments that, in the context of public roadways and community trails, “have an implicit duty of care to manage risks prudently to reduce harm, and to mitigate financial and reputational impairment to its corporate body” ( Bissix, 2015 , p. 346). The wicked problem permeating the question “Can sport be good for one’s health, and if so, how?” arises, in part, from how such concepts as sport, health, well-being, risk, and harm get defined and whose definition gets understood as most legitimate; these are problems of power and social relations. As such, and continuing in the context of leisure and recreation, Tink, Peers, Nykiforuk, and Mayan’s (2019 , pp. 454–455) observations are particularly poignant:

Paying attention to the ways expert discourses of science, medicine, and public health have supported, and continue to support, various forms of institutionalized governance, conversations between philosophers and practitioners of leisure and recreation could begin by interrogating the relationship between the governors and the governed. That is, philosophers and practitioners of leisure and recreation could interrogate how particular knowledge(s) and power relations have resulted in recreation spaces being oriented toward certain bodies or subjects.

For many critical sociologists, sport, health, and well-being are issues of equity, related more to access and opportunity than to measures of performance, biological processes, or lifestyle choice. In this line of argument, sport can be healthy for individuals and communities only if the social, cultural, political, and economic conditions necessary for personal and community health have been met. As such, any sport program that is disconnected from the social and material conditions of life and one’s political right to health has limited potential to positively influence health and well-being (cf. Safai, Johnson, & Bryans, 2016 ). Take for example, one of Sport Canada’s recent initiatives to increase sport participation among girls and women, LGBTQ2+ identifying individuals and groups, persons with disabilities, and newcomers to Canada: the Sport Support Program—Innovation Initiative (SSP-II). Fully embracing an entrepreneurial ethos, the SSP-II provides financial support to individuals or organizations for the development and testing of “innovative quality sport approaches in order to develop evidence-based solutions to improve sport participation” (Government of Canada, 2019, para. 5). This attempt to improve sport participation for these commonly underrepresented groups is commendable, but as McSweeney and Safai (2020 , p. 12) note, the federal government’s turn to public entrepreneurship (PE) and new public management (NPM) to advance accessibility in sport is problematic for Canadians:

NPM and PE, as embedded in and reproductive of neoliberalism, assume that all individuals are equally motivated and have equal opportunity and means with which to navigate through and be successful in society while, at the same time, hollowing out the very public supports and services that ensure some degree of safety for those who struggle to survive or thrive in neoliberal regimes.

The SSP-II’s focus on girls and women is particularly worrisome given that it attempts to employ tactics that are informed by neoliberal and market-centric modes of thinking in efforts to address the consequences of problems very much created by a neoliberal and market-centric political economy:

The SSP-II may encourage initiatives to boost girls’ and women’s participation in sport, but it does [so] in a political economic system that continues to depend upon the unpaid labour of girls and women outside of the formal economy, and the inequitable social relations that arise from this arrangement. ( McSweeney & Safai, 2020 , p. 14)

Just knowing and stating that these paradoxes exist is insufficient for critical sport and health scholars. In this vein, let us heed Kay’s (2016) call to better translate and communicate our perspectives and our evidence to the relevant decision-making bodies and to the public at large. In so doing, we move forward our research and advocacy for accessible, equitable, humane, and healthy sport for all outside of “a Phantom Zone of irrelevance,” “divorced from everyday public policy activity, media discourse and public awareness” ( Raphael, 2009 , p. 193).

In this chapter, I have endeavored to unsettle the commonplace notion that sport is good for one’s health and well-being all the time by examining key conceptual challenges embedded in the associations made between sport and health, by exploring the challenges faced by critical social scientists in disrupting this widely held belief, and by questioning whether contemporary sport can be good for one’s health and, if so, how? I prefaced this work, however, by acknowledging the surreal feel of writing about sport and health amid the unprecedented and most consequential global health crisis of our times. This concluding section returns to the issue of COVID-19 as there can be no doubt that the pandemic will impact and set the sport and health research agenda for years to come. In fact, it takes but a fraction of a second on any good search engine to see that it already has. Special issues in top-tier journals are in the process of being crafted, edited book collections are being proposed, virtual colloquia are being dedicated to the topic, and calls on what should be the focus for critical sport sociologists are already being offered (e.g., Evans et al., 2020 ).

In the critical sociocultural study of sport scholarship, researchers from all over the world are already actively interrogating the ways in which people, communities, organizations, and government have been impacted by and are responding to COVID-19 in sport, specifically, and in social life more broadly. Researchers are making plain both (1) the ways in which the pandemic and the response to the pandemic contribute to the continued (if not amplified or accelerated) marginalization and disempowerment of already vulnerable groups and communities that, de facto, disproportionately suffer higher levels of illness and death (e.g., Malcolm & Velija, 2020 ) and (2) the ways in which people—especially athletes—are mobilizing together against irresponsible governing bodies that value their own vested interests over human lives. In describing the ways in which Canadian Olympic athletes banded together in the early months of the pandemic to push back against the IOC’s indecision about postponing the Tokyo Olympic Games, Donnelly (2020 , p. 39) states, “We all hope that the pandemic is creating the possibility of new alternatives for societies, for a new social contract. And we hope that athletes’ voices have now been released from the culture of control to continue their demands for fairness, equity, and human and labour rights” (see also Mann, Clift, Boykoff, & Bekker, 2020 ).

COVID-19 has forced many people to step out of their taken-for-granted routines and to critically examine—from a “social distance”—those sport norms, behaviors, and practices that were commonly accepted without question. Rowe (2020 , p. 7) explains:

[I]t is in the general interest for sport to resume service. But that does not mean repeating its mistakes—as in other areas of social life, the pandemic provided an opportunity for reflection. If sport is, as so many have loudly proclaimed, a vital part of social life, then it must bend to the will of the social, not override it.

Sport and health scholars play a vital role here. “Creating the possibility of new alternatives for societies” requires information, advocacy, and action from vocal and engaged critical sport and health scholars committed to offering and insisting upon conceptual clarity; advancing health paradigms sensitive to the wider social, political, and economic determinants of health; recognizing health as a political right of all people; and working with and through government and public sector policy circles. Rowe (2020 , p. 7) writes, “It is unlikely that sport after the pandemic will be transformed, but it will certainly be changed.” At the risk of stating the obvious, we must do all that we can to ensure that it will change for the better of all.

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Exercise: 7 benefits of regular physical activity.

You know exercise is good for you, but do you know how good? From boosting your mood to improving your sex life, find out how exercise can improve your life.

Want to feel better, have more energy and even add years to your life? Just exercise.

The health benefits of regular exercise and physical activity are hard to ignore. Everyone benefits from exercise, no matter their age, sex or physical ability.

Need more convincing to get moving? Check out these seven ways that exercise can lead to a happier, healthier you.

1. Exercise controls weight

Exercise can help prevent excess weight gain or help you keep off lost weight. When you take part in physical activity, you burn calories. The more intense the activity, the more calories you burn.

Regular trips to the gym are great, but don't worry if you can't find a large chunk of time to exercise every day. Any amount of activity is better than none. To gain the benefits of exercise, just get more active throughout your day. For example, take the stairs instead of the elevator or rev up your household chores. Consistency is key.

2. Exercise combats health conditions and diseases

Worried about heart disease? Hoping to prevent high blood pressure? No matter what your current weight is, being active boosts high-density lipoprotein (HDL) cholesterol, the "good" cholesterol, and it decreases unhealthy triglycerides. This one-two punch keeps your blood flowing smoothly, which lowers your risk of heart and blood vessel, called cardiovascular, diseases.

Regular exercise helps prevent or manage many health problems and concerns, including:

• Metabolic syndrome.
• High blood pressure.
• Type 2 diabetes.
• Depression.
• Many types of cancer.

It also can help improve cognitive function and helps lower the risk of death from all causes.

3. Exercise improves mood

Need an emotional lift? Or need to lower stress after a stressful day? A gym session or brisk walk can help. Physical activity stimulates many brain chemicals that may leave you feeling happier, more relaxed and less anxious.

You also may feel better about your appearance and yourself when you exercise regularly, which can boost your confidence and improve your self-esteem.

4. Exercise boosts energy

Winded by grocery shopping or household chores? Regular physical activity can improve your muscle strength and boost your endurance.

Exercise sends oxygen and nutrients to your tissues and helps your cardiovascular system work more efficiently. And when your heart and lung health improve, you have more energy to tackle daily chores.

5. Exercise promotes better sleep

Struggling to snooze? Regular physical activity can help you fall asleep faster, get better sleep and deepen your sleep. Just don't exercise too close to bedtime, or you may be too energized to go to sleep.

6. Exercise puts the spark back into your sex life

Do you feel too tired or too out of shape to enjoy physical intimacy? Regular physical activity can improve energy levels and give you more confidence about your physical appearance, which may boost your sex life.

But there's even more to it than that. Regular physical activity may enhance arousal for women. And men who exercise regularly are less likely to have problems with erectile dysfunction than are men who don't exercise.

7. Exercise can be fun — and social!

Exercise and physical activity can be fun. They give you a chance to unwind, enjoy the outdoors or simply do activities that make you happy. Physical activity also can help you connect with family or friends in a fun social setting.

So take a dance class, hit the hiking trails or join a soccer team. Find a physical activity you enjoy, and just do it. Bored? Try something new, or do something with friends or family.

Exercise to feel better and have fun

Exercise and physical activity are great ways to feel better, boost your health and have fun. For most healthy adults, the U.S. Department of Health and Human Services recommends these exercise guidelines:

Aerobic activity. Get at least 150 minutes of moderate aerobic activity. Or get at least 75 minutes of vigorous aerobic activity a week. You also can get an equal combination of moderate and vigorous activity. Aim to spread out this exercise over a few days or more in a week.

For even more health benefits, the guidelines suggest getting 300 minutes a week or more of moderate aerobic activity. Exercising this much may help with weight loss or keeping off lost weight. But even small amounts of physical activity can be helpful. Being active for short periods of time during the day can add up and have health benefits.

• Strength training. Do strength training exercises for all major muscle groups at least two times a week. One set of each exercise is enough for health and fitness benefits. Use a weight or resistance level heavy enough to tire your muscles after about 12 to 15 repetitions.

Moderate aerobic exercise includes activities such as brisk walking, biking, swimming and mowing the lawn.

Vigorous aerobic exercise includes activities such as running, swimming laps, heavy yardwork and aerobic dancing.

You can do strength training by using weight machines or free weights, your own body weight, heavy bags, or resistance bands. You also can use resistance paddles in the water or do activities such as rock climbing.

If you want to lose weight, keep off lost weight or meet specific fitness goals, you may need to exercise more.

Remember to check with a health care professional before starting a new exercise program, especially if you have any concerns about your fitness or haven't exercised for a long time. Also check with a health care professional if you have chronic health problems, such as heart disease, diabetes or arthritis.

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• AskMayoExpert. Physical activity (adult). Mayo Clinic; 2021.
• Physical Activity Guidelines for Americans. 2nd ed. U.S. Department of Health and Human Services. https://health.gov/our-work/physical-activity/current-guidelines. Accessed June 25, 2021.
• Peterson DM. The benefits and risk of aerobic exercise. https://www.uptodate.com/contents/search. Accessed June 24, 2021.
• Maseroli E, et al. Physical activity and female sexual dysfunction: A lot helps, but not too much. The Journal of Sexual Medicine. 2021; doi:10.1016/j.jsxm.2021.04.004.
• Allen MS. Physical activity as an adjunct treatment for erectile dysfunction. Nature Reviews: Urology. 2019; doi:10.1038/s41585-019-0210-6.
• Tips for starting physical activity. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/weight-management/tips-get-active/tips-starting-physical-activity. Accessed June 25, 2021.
• Laskowski ER (expert opinion). Mayo Clinic. June 16, 2021.

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The Health Benefits of Exercise and Physical Activity

• Gastroenterology, Critical Care, and Lifestyle Medicine (SA McClave, Section Editor)
• Published: 14 July 2016
• Volume 5 , pages 204–212, ( 2016 )

Cite this article

• Keith R. Miller 1 ,
• Stephen A. McClave 2 ,
• Melina B. Jampolis 3 ,
• Ryan T. Hurt 4 ,
• Kristine Krueger 2 ,
• Sarah Landes 2 &
• Bryan Collier 5  

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Physical inactivity is a modifiable risk factor (similar to dyslipidemia and hypertension) for a variety of chronic diseases, including cancer and cardiovascular disease. Exercise provides a clear health benefit, which serves in the primary and secondary prevention of these disease processes (the most important being a reduction in cardiovascular disease and premature death). The physiologic mechanisms for such a benefit occur at both a cellular and multisystem level. Prolonged periods of occupational or leisure-time sitting have adverse health effects independent of exercise performed before or after. Almost any form of physical activity (PA) is beneficial, whether part of a regular exercise program or as a series of intermittent, incidental, non-purposeful, lifestyle-embedded activity (causing non-exercise activity thermogenesis or NEAT). The health benefits of exercise appear to be dose-dependent. Physicians should recommend near daily exercise which includes at various times strength training, stretching, and aerobic activity in addition to emphasizing adjustments that allow for reduced sitting and increased activity during daily routines. Patients should understand that for optimal health, exercise is no longer optional.

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Introduction

Physical inactivity is a modifiable risk factor for cardiovascular disease, obesity, depression, cancer, diabetes mellitus, hypertension, and osteoporosis. Physical exercise reduces the risk of premature death and prolongs longevity, and is an important treatment modality in the primary and secondary prevention of the above disorders [ 1 ]. For most states in this country, less than half of the population meets CDC exercise recommendations [ 2 •]. The decline in physical activity (PA) occurs both at work and in leisure time, and may have at least partially contributed to the increase in obesity over the past 30 years. Low recreational physical activities have been associated with a threefold increase for major weight gain in men and a fourfold increase in women [ 3 ]. Surveys of PA across the lifecycle show that physical exercise peaks in the middle high-school age range and begins declining through high school and into adult life. A vicious cycle of decline occurs between inactivity and loss of skeletal muscle mass which accelerates with age. With avoidance of activity requiring effort, there is increased loss of exercise capacity. This loss causes the perception of effort associated with even sub-maximal work to worsen, as the anaerobic threshold decreases. The vicious cycle contributes to further inactivity and deterioration of physical function. The only treatment that can break the cycle is exercise.

Impact of Exercise on Aging

Exercise provides powerful health benefits for quality of life, physical function, and independent living throughout the life cycle. Exercise impedes the aging process and promotes longevity. Observational studies have shown that even in the presence of disease processes such as hypertension (HTN), chronic obstructive pulmonary disease (COPD), diabetes, smoking, high body mass index (BMI), and hypercholesterolemia, increasing PA has a dose-dependent effect in decreasing relative risk of death [ 4 ]. In a study of subjects over a 13-year time period, both baseline fitness, and improvement in physical fitness through exercise and PA was associated with significant increases in longevity [ 4 ]. Functional independence with advanced age relates to the overall level of physical fitness. Physical fitness is most affected by the status of the cardiorespiratory and vascular systems, as well as muscle function [ 5 •].

Garatachea et al. provide an excellent review of the effect of exercise on the physiologic changes associated with aging [ 5 •]. Exercise exerts its positive influence on both a cellular level and at the level of organ systems. At the cellular level, exercise helps reduce genomic instability, epigenetic alteration, loss of proteostasis, dysregulated nutrient sensing, cellular senescence, and altered intracellular communication that leads to inflammation. These effects alter the way the body performs transcellular signaling in the skeletal muscle, the turning on and off of genes through epigenetics, and the manner in which the system manages reactive oxygen species [ 5 •]. On a multisystem level, the benefits of exercise include improvement in brain, cardiovascular, lung, and muscle function, favorable alterations in body composition, and advantageous changes in metabolic responses. The report concludes by suggesting that in the future, pharmaceuticals should be designed which mimic the effects of exercise on the aging process [ 5 •].

Effect of Exercise on Treatment of Disease

Robert Butler from the National Institute on Aging has said that “If exercise could be put in a bottle, it would be the strongest medicine money could buy” [ 6 ]. Exercise helps prevent common chronic diseases (primary prevention), and often plays an important role in the treatment of these disease processes (secondary prevention). Specific benefits from exercise have been seen with cardiovascular disease, stroke, diabetes mellitus, depression, cancer, obesity, and osteoporosis [ 7 , 8 ]

Cardiovascular Disease

Increased levels of PA and physical fitness have a graded effect in reducing the risk of death from cardiovascular disease. The relative risk from all cause and cardiovascular disease mortality is reduced 20–35 % by exercise and PA [ 9 ]. In an observational study, subjects in the lowest quintile of exercise had a relative risk of 3.4 in men and 4.7 in women for death compared to those in the highest quintile [ 10 ]. An increase in activity-related energy expenditure by as little as 1000 kcal or 1 metabolic equivalent (MET)-hour of exercise per week has a mortality benefit of 20 % [ 11 ]. Physically inactive women have a 52 % increase in death, a cardiovascular disease-related death that is doubled, and a cancer-related death rate that is increased by 29 % [ 11 ]. These risks on mortality from inactivity are similar to other modifiable risk factors such as HTN, hypercholesterolemia, and obesity. In randomized controlled trials (RCT)s, exercise and PA are valuable for the secondary prevention of cardiovascular disease. Whereas in the past, traditional recommendations for patients with a heart attack included rest and physical inactivity. Newer information demonstrates that exercise actually attenuates or reverses risk of cardiovascular disease [ 12 ]. The benefit of exercise is seen in cardiac rehabilitation, where increasing PA reduces the risk of premature death following a myocardial infarction [ 12 ]. Added energy expenditure of 1600 kcal/week from exercise may halt the progression of heart disease and energy expenditure of >2200 kcal/week can lead to plaque reduction [ 13 ]. The minimum training recommendation for patients following myocardial infarction is to reach 45 % of their heart rate reserve through cardiac rehabilitation [ 12 , 13 ].

Multiple mechanisms have been identified whereby exercise reduces the risk of premature death [ 4 ]. Exercise affects body composition by decreasing abdominal adiposity and improving weight control. Exercise enhances lipid profiles by reducing serum triglyceride levels, raising HDL, and reducing the LDL/HDL ratio. In addition, a recent meta-analysis showed beneficial changes in lipoprotein subclasses associated with regular exercise including a reduction in small LDL-p and an increase in large LDL-p [ 14 ]. Exercise enhances hemodynamics by decreasing blood pressure, increasing cardiac function, and improving coronary blood flow. Autonomic tone is enhanced and shear stress-mediated endothelial function is improved. Exercise reduces systemic inflammation, as evidenced by reduced C-reactive protein (CRP) levels. Improved psychological well-being in response to exercise is associated with reduced stress, anxiety, and depression [ 4 ].

PA is inversely correlated with risk of incident stroke as shown in a large nurses’ health study [ 15 ]. Habitual exercise reduces risk of stroke by 40–50 % at the highest level of PA. Change in PA is protective against stroke as evidenced by the fact that an increase of 3.5 h of exercise or PA per week is associated with a 29 % reduction in ischemic stroke [ 15 ].

Diabetes Mellitus

Exercise is valuable in both the primary and secondary prevention of diabetes mellitus. Aerobic and resistant-type exercise reduces the likelihood of developing type-2 diabetes mellitus. For each 500 kcal of energy expended per week, there is an associated 6 % reduction in the likelihood of type-2 diabetes (which may be even greater with increasing BMI) [ 16 ]. In patients already diagnosed to have diabetes mellitus, walking 2 h per week is associated with a 39–54 % reduction in all-cause mortality from diabetes mellitus, and a 34–53 % reduction in mortality related to cardiovascular disease [ 17 ]. The benefit of exercise on glycemic control appears to be greater with resistance training than aerobic exercise. A meta-analysis of exercise and PA in diabetes showed that exercise reduces hemoglobin A1C by 0.66 %, an effect similar to intensive glucose-lowering pharmacologic therapy [ 18 ]. The mechanisms by which exercise benefits diabetes relate to the fact that exercise increases glycogen synthetase and hexokinase activity [ 4 ]. Exercise reduces GLUT-4 protein and messenger RNA expression and increases muscle capillary density, which helps improve glucose delivery to the muscle [ 4 ].

Increasing PA, either occupational or at leisure, has been shown to exert a primary preventative effect on two cancers—breast and colon cancer [ 19 ]. Moderate exercise of as little as 4–5 METs (equivalent to mowing the lawn or brisk walking), is required to achieve this effect [ 20 ]. Exercise is associated with a 20–30 % reduction in the incidence of breast cancer in women, and a 30–40 % reduction in the incidence of colon cancer in both men and women [ 20 ]. In those patients already diagnosed to have one of these cancers, exercise reduces the likelihood for cancer recurrence and reduces risk from cancer death by as much as 26–40 % [ 21 ]. PA improves quality of life and overall health status in cancer patients. The mechanisms by which exercise improves risk from cancer may relate to reduced fat stores, an increase in energy expenditure offsetting a high-fat diet, activity-related changes in sex hormone levels, improvement in immune function, and reduced generation of free oxygen radicals [ 4 ].

Osteoporosis

Exercise has a valuable effect in the primary prevention of osteoporosis. Routine PA minimizes age-related bone loss. Weight-bearing exercise (especially resistance exercise) increases bone density compared to low impact non-weight-bearing exercise. Exercise prevents 1 % of bone loss per year, an effect which is greater in post-menopausal than pre-menopausal women [ 22 ]. In RCTs, exercise reduces the risk and number of falls, as well as the risk of fracture [ 22 ]. Even in men, PA reduces the risk of fracture by 62 % over the age of 21 years [ 23 ]. Exercise is also valuable in the secondary prevention of osteoporosis. RCTs in the past have shown that exercise with resistance training increases bone density in older osteoporotic women by as much as 1.4 %, while agility training alone increases bone density by 0.5 % [ 24 ]. Stretching, which was used as sham control, was shown to have no effect on the expected decrease in bone density with age [ 24 ]. In a 12-year follow up of over 60,000 post-menopausal women, risk of hip fracture was lowered 6 % for each increase of three MET-hours per week of activity (the equivalent of walking three miles in 1 h) [ 25 ]. Active women with at least 24 met-hours of exercise per week had a 55 % lower risk of hip fracture than sedentary women with no other exercise. Walking at least 4 h per week was associated with a 41 % lower risk of hip fracture than walking less than one hour per week [ 25 ].

Exercise has a valuable therapeutic effect on the treatment on multiple types of depression, including dysthymic, seasonal, bipolar, post-natal, pre-menstrual, atypical, and major depression [ 26 ]. The value in treating depression comes from an innate anti-depressive effect from exercise. Combining exercise with psychotropic medications achieves better treatment results than the same medications alone [ 26 ]. Exercise is relatively inexpensive, safe, and has minimal side effects when done correctly. Exercise may help reduce the dose of anti-depressive medications required. Subjects are less likely to relapse with an active exercise program [ 26 ].

The patients with depression who are most likely to benefit from exercise include those with age <20 or >40 years, higher education, higher baseline physical status, females, untrained subjects, and those with mild to moderate depression [ 26 ]. There are a number of aspects of exercise that get the optimal results in treating depression including programs that are structured, individually tailored to the patient, low to moderate intensity, when it is used as an adjunct to medication therapy, and exercise that is a combination of aerobic or resistive training performed 3–4 times per week [ 26 ]. The mechanism of effect from exercise on depression occurs on a systemic level as well as a direct effect on central nervous system (CNS) function. Exercise appears to increase serotonin, ACTH, endorphins, and endocannabinoids within the CNS. On a systemic level, exercise increases norepinephrine and reduces cortisol, tumor necrosis factor (TNF), and interleukin-6 [ 26 ].

In a controversial article that appeared in Time magazine in 2009, the journalist John Cloud wrote about “The Myth of Exercise” and its effect on treating obesity [ 27 ]. The article suggested that exercise was not good for weight management in obesity. The author pointed out that exercise leads to increased appetite and intake of food and causes a decrease in non-exercise energy expenditure, and therefore that exercise was a poor strategy for weight loss [ 27 ]. A number of letters to the editor of Time magazine followed the publication of this article, including letters from the American Society for Sports Medicine, arguing that facts were misrepresented and that the article gave the wrong message about the health benefits of exercise.

A recent review by Swift clarified the role of exercise in managing or preventing obesity, and suggested that Cloud’s article was in fact an accurate portrayal of the facts [ 28 ]. The key issue of Swift’s review is that exercise without caloric restriction is unlikely to succeed in weight loss [ 28 ]. Increasing PA can prevent weight gain, but it requires 150–250 min per week of moderate to vigorous exercise or 1200–2000 kcal/week expended through exercise to accomplish this feat [ 29 ]. Aerobic exercise by itself is minimally helpful in promoting weight loss, successful in loss of only 0–2 kg total [ 29 ]. Extreme high-volume aerobic exercise can achieve significant weight loss, but this is usually unsustainable by most obese patients. Moderate intensity, surprisingly, is no different than vigorous intensity in achieving weight loss, unless subjects are matched for exercise duration. Resistance training by itself has no impact on weight loss, and aerobic training combined with resistant training has no greater effect than aerobic training alone. However, adding caloric restriction to aerobic training does result in successful weight loss of 9–13 kg, and higher intensity of exercise has the potential for even greater weight loss [ 29 ]. Some obese subjects do experience weight compensation in response to exercise, defined by the circumstances where less weight is lost than expected with the amount of exercise sustained, often a factor related to an increase in caloric intake [ 28 , 30 ]. This is more likely to occur in women performing 150 % of weekly recommendations (compared to women performing only 100 % or 50 % of weekly recommendations) [ 28 , 30 ]. Even if minimal or no weight loss occurs in response to exercise, obese subjects still benefit from the increase in PA due to increased cardiorespiratory fitness, glucose control, endothelial function, improvements in hyperlipidemia, quality of life, and a reduction in future weight gain [ 28 ].

Caloric restriction is better than exercise for significant weight loss initially, and the weight loss is not necessarily enhanced significantly by adding exercise [ 28 ], although exercise training plus caloric restriction does improve body composition by increasing fat loss and decreasing loss of lean body mass [ 31 ]. The greatest value of exercise in the management of obesity occurs not in the initial weight loss, but in the situation where obese patients have lost weight successfully and now require substantial PA to maintain that weight loss [ 28 ]. Interestingly, an “energy gap” has been identified as the difference in energy expenditure before and after weight loss [ 32 ]. The energy gap is estimated to be approximately 8 kcal per day per pound of weight lost. An energy gap, for example, of 40 lbs lost would be associated with 320 kcal of energy. Sustaining this weight loss successfully would require either a continued reduction in energy consumption by 320 kcal per day, or increasing activity-associated energy expenditure by the same amount [ 32 ]. Based on the Set Point theory, both biological and environmental pressures oppose the strategy of food restriction in keeping weight off, but the same effect does not occur with increased PA [ 32 ]. Therefore, while food restriction is the key to weight loss, PA is the key to successful maintenance of the weight lost [ 32 ]. The ACSM has identified that people who successfully maintain weight loss average at least 250 min of PA per week [ 29 ].

Low Back Pain

A 2016 systematic review and meta-analysis reviewed 23 randomized controlled trials evaluating the prevention of low back pain [ 33 ]. Over 30,000 patients were involved in these studies. Ultimately, the combination of exercise (varying regimens of abdominal strengthening, core stability, cardiovascular, and isometrics) plus education regarding prevention of low back pain was found to reduce the risk of low back pain as well as sick leave related to low back pain. Exercise alone was also found to have an impact but had a more short term effect (<12 months), thought to be due to cessation of exercise following the intervention. Other interventions, including back belts, insoles, and education alone were not found to have any impact [ 33 ].

Not All Exercise is Created Equal

Physical activity versus physical fitness.

The lay public tends to use the terms PA and physical fitness interchangeably, but subtle differences between the two exist. Physical fitness is a physiologic state of being with regard to daily living and/or sports performance [ 4 ]. Physical fitness is comprised of cardiovascular, musculoskeletal, body composition, and metabolic components [ 4 ]. Physical fitness is similar to PA, but is more predictive of health outcomes. For example, a high-fit versus a low-fit person is estimated to have a 50 % lower mortality [ 34 ]. Physical fitness, therefore, becomes a better measure of PA than self-reporting. From a public health standpoint, however, it is better and more productive to encourage the public to be physically active and not push the need to be physically fit. Eventually, increased activity should lead to physical fitness.

In the past, guidelines for optimal health seemed to have had a singular focus on aerobic fitness. But a new paradigm shift has occurred with the addition of the concept of musculoskeletal fitness [ 4 ]. In other words, health status can improve due to increased PA in the absence of changes in aerobic fitness. Regular PA can decrease risk factors from chronic disease and disability without changing cardiac output or oxidative potential, especially in the elderly [ 4 ]. The shift has been to focus on the health benefits of musculoskeletal fitness, which may be a critical factor in the functional threshold for dependence with the aging population. Loss of muscular fitness can result in loss of capacity for daily living, and a cycle of decline can ensue [ 4 ]. Improvement in musculoskeletal function can delay the onset of disability, dependence, and chronic disease [ 35 ]. Musculoskeletal fitness is associated with fewer functional limitations and a reduced incidence of cardiovascular disease, diabetes, degenerative joint disease, and coronary artery disease [ 35 ]. Therefore, resistance training that works all the major muscle groups (including legs, hips, back, abdomen, chest, shoulders, and arms) and flexibility exercise, which are necessary to achieve musculoskeletal fitness, are recommended to be done at least twice weekly, to complement aerobic fitness and optimize overall health status.

Adverse Health Risk from Sitting

In an effort to delineate those factors which contribute to the obesity epidemic, researchers are increasingly focused on the adverse health risk from prolonged sitting [ 36 •]. A newly recognized occupational hazard has evolved because of workers needing to sit at a computer screen throughout the workday. Each mean hour of sitting after a total mean of 7 h per day is associated with a 5 % increase in premature death [ 36 •]. More time sitting at work has been shown to correlate with more sitting in leisure time. Prolonged sitting while watching TV at home, for example, has adverse effects on mental health, well-being, and muscle strength. Long sedentary hours have been linked to a twofold increase in diabetes, a twofold increase in cardiovascular disease, a 13 % increase in the incidence of cancer, and a 17 % increase in mortality related to cancer [ 36 •]. It is estimated that the average worker in the USA and England spends 60–70 % of waking hours in a sedentary sitting position. The effect of sitting has been likened to the transmission of a car. Sitting for such a prolonged period is like putting a car in reverse, causing one’s overall health status to go in the wrong direction [ 36 •]. Approximately 20–30 % of the time is spent in light intensity activity, described as postural changes, standing and movement, or ambulation. For less than 5–10 % of waking hours, individuals spend in moderate to vigorous PA. The adverse effect of sitting on health status is independent of the exercise or PA done before or after [ 36 •]. In other words, no amount of PA later can overcome the negative health effects of prolonged sitting.

Changes in the workplace environment may be the key issue to minimizing the negative effects of prolonged sitting. Particularly, in the UK, recommendations and guidelines have been developed to avoid this health hazard [ 36 •]. Workers are encouraged to accumulate up to 2 h per day at work standing or performing light walking, with the goal to progress ultimately to 4 h per day. Workers should interrupt seat-based work with standing-based work. However, workers should avoid both prolonged periods of standing as well as prolonged periods of sitting. Adaptation of these guidelines may lead to musculoskeletal complaints and fatigue, which should be monitored by managers in the workplace. Such health promotion strategies should eventually extend from the workplace to the leisure time [ 36 •].

Non-Exercise Activity Thermogenesis

Non-exercise activity thermogenesis (NEAT) has been described as unstructured PA, energy expended unrelated to sleeping, eating, or sports exercise. NEAT is energy expended outside of purposeful exercise [ 37 ]. Surprisingly, this incidental, non-purposeful lifestyle-embedded PA can have tremendous health benefits. Three components of NEAT include body posture, ambulation, and all other movements (the most important of which may be fidgeting) [ 38 ]. Researchers involved in the study of obesity are finding that in some cases what delineates the lean subject from an obese one is a difference in NEAT, not exercise-associated activity thermogenesis [ 38 ]. Early experiments which helped identify NEAT came from studies where energy requirements were measured and all subjects were placed on a diet of 1000 cal over requirements [ 39 ]. Subjects were then videotaped, and in a blinded fashion designated as fidgeters or non-fidgeters. At the end of the trial, those patients who were designated as fidgeters failed to gain weight, while those identified to be non-fidgeters sustained significant weight gain. The increase in kilocalories of energy expenditure attributed to NEAT was inversely proportional to fat gain in pounds [ 39 ]. NEAT ranges from 15 % of total energy expenditure (TEE) in sedentary subjects to as much as 50 % of TEE in fidgeting physically active people [ 39 ]. Fidgeting has been shown in twin studies to be genetic, with an estimated >62 % heritability [ 40 ]. Simply standing or lightly ambulating can increase energy expenditure by an average of 350 kcal/day (range 269–477 kcal/day) [ 37 ]. NEAT tends to be greater in men than women, in obese subjects rather than lean, and in those with more education than those with less [ 38 , 39 ]. NEAT tends to be seasonal and overall, declines with age [ 39 ]. The concept of an energy gap is pertinent to NEAT. An average citizen in the USA has been shown to gain 1–2 lbs each year through their adult life. An energy gap of 100 kcal additional energy consumed each day would account for this weight gain [ 41 ]. NEAT can be an important contributor to TEE, such that increases in NEAT of as little as 100–150 kcal of activity per day could prevent such weight gain (by offsetting the energy gap) in the vast majority of people [ 41 ]. Recommendations now suggest that if you were not lucky enough to inherit fidgeting, you should “act like a fidgeter,” standing often, getting up from sitting, pacing, parking at the back of a parking lot, and taking stairs instead of elevators [ 40 ].

Continuous Versus Interval Exercise

Long bouts of continuous exercise as a strategy for weight loss or weight maintenance can be a contentious and challenging recommendation for the general public. Longer duration, continuous exercise may be difficult and not particularly enjoyable for patients and may not fit as well with work or home schedules. Research now has shown that interval exercise, which involves alternating short bouts of high-intensity exercise with lower-intensity exercise that allows for partial recovery, can match the health benefits of continuous exercise [ 42 ]. Studies in patients with class-1 obesity (BMI 30–34.9 kg/m 2 ), walking at a moderate level of intensity, randomized to two 15-min intervals of walking versus one 30-min interval, showed essentially the same improvements in overall health status [ 42 ]. Both intermittent and continuous exercise resulted in improvement of maximum oxygen consumption, body composition, and lipid profiles. In some categories, interval exercise even exceeded the benefit seen with continuous exercise (such as VLDL levels and percent fat lost) [ 42 ]. The value of these findings for intermittent exercise stems from three factors: there is less attrition with recommendations for interval exercise, time constraints, and short periods of interval exercising may allow for greater intensity of PA [ 42 ]. An additional study involving 28 sedentary overweight or obese men compared five 45- to 60-min sessions of continuous moderate intensity cycling per week for 6 weeks with three 20-min sessions of high-intensity interval exercise per week (for a total of 60 min) for 6 weeks. Similar improvements in cardio-metabolic risk factors including improved insulin sensitivity, cardiovascular fitness, and a reduction in blood lipids and body fat percentage were observed in the groups [ 43 ]. While cardiovascular fitness was improved to a greater extent in the continuous exercise group, this study, along with numerous other studies of interval exercise showing similar outcomes in different populations, are encouraging in that they show many of the same improvements in overall health with a substantially reduced time commitment [ 43 ]. This is especially relevant as lack of time is cited as the most common reason for not exercising by many. In addition, interval exercise can be easily adapted to an individual’s starting fitness level by adjusting either the duration or intensity (or both) of the high-intensity component of exercise. This may be especially beneficial for sedentary overweight or obese individuals who are new to exercise. In light of both the potential health and time saving benefits, interval exercise training appears to be an appealing and worthwhile exercise option in addition to, or instead of, continuous exercise. The good news for public health is that short walks on a subject’s lunch break or brief periods of activity before and after work all count, and the sum of their duration may have similar benefits to a single continuous interval of exercise of the same duration.

Success of Pedometers

The use of pedometers to increase PA was generated years ago in Japanese walking clubs. The rationalization for the pedometer was that the average stride was estimated to be 2.5 ft. Therefore, 2000 steps should approximately equal a mile, 10,000 equaling about 5 miles [ 44 ]. Based on this rationalization, PA can be classified as sedentary (<5000 steps per day), low active (5000 to 7500 steps), somewhat active (7500 to 10,000 steps), and active (>10,000 steps per day). Highly active physical exercise is associated with >12,500 steps per day [ 44 ]. This is an arbitrary categorization, however, and 10,000 steps per day may be too little for children or too much for the elderly. Weight loss using a pedometer without caloric restriction is associated with minimal to modest weight loss of <2 kg [ 44 ]. Health benefits associated with use of the pedometer may be limited to a reduction in blood pressure, with not much change in cholesterol, triglycerides, or fasting glucose [ 44 ].

Exercise in the Intensive Care Unit

Exercise is becoming increasingly important in one of the least expected circumstances, that of a critically ill patient in the intensive care unit (ICU). Researchers have found that exercising muscle increases the uptake of amino acid fuel and promotes greater protein synthesis [ 45 , 46 ]. Patients in the ICU on a ventilator in some centers are gotten out of bed and encouraged to walk with assistance in the hallway. Other centers have used a pedaling device, some of which can even be adapted for passive activity in a patient who is otherwise sedated and minimally responsive. Exercise in the critical care setting helps maintain muscular strength, reduces the risk for long-term neuromuscular weakness, shortens rehabilitation, and is more likely to result in the patient being discharged to their home [ 45 , 46 ].

Recommendations for Public Health

Similar to the Food Guide Pyramid designed by the USDA, an activity pyramid has been created to guide the public in strategies to increase flexibility, muscular strength, and aerobic capacity ( www.wellspan.org/media/3648/activitypyramid-2009.pdf ). Every day, subjects are encouraged to increase activity in leisure and at work. Three to five times per week, aerobic activity should occur, accumulating 150 min each week ( www.wellspan.org/media/3648/activitypyramid-2009.pdf ). Two to three times per week, muscular activity focusing on flexibility and strength training should be scheduled. Sitting more than 30 min at a time, watching TV, or staring at a computer screen should be minimized or reduced as much as possible ( www.wellspan.org/media/3648/activitypyramid-2009.pdf ).

Guidelines differentiate between moderate and vigorous intensity of PA. Moderate intensity is defined by a 3–5 MET level of effort, and includes activities that cause some increase in breathing and heart rate (such as walking 3–4 miles per hour, bicycling on level ground, light swimming, gardening, or mowing a lawn) [ 4 ]. Vigorous intensity is defined by ≥6 METs, and is exemplified by activities causing large increases in breathing, heart rate, and sweating. Such activities of vigorous intensity would include jogging or running at faster than a 10 min mile, aerobic dancing, competitive sports, heavy yard or construction work, brisk swimming, or fast bicycling [ 4 ].

The amount of PA needed to optimize health is not clear. The particular dose of exercise required to achieve benefits with regard to a particular disease process is difficult to ascertain. For cardiovascular disease, the intensity of PA is inversely and linearly associated with increased mortality, with the biggest effect seen as a reduction of premature death [ 47 ]. PA of >2000 kcal per week extends life by 1–2 years by age 80 [ 47 ]. An average energy expenditure of 1000 kcal per week is associated with a 20–30 % decrease in all-cause mortality. Beginning at a minimum of 1000 kcal per week, increasing benefits are seen with increasing energy expenditure, suggesting a dose-response gradient to the effect of exercise on cardiovascular health [ 47 ]. For diabetes mellitus, there is decreased risk from this disease process with PA of >5.5 METs for at least 40 min per week [ 48 ]. Walking 2 h per week decreases the risk of premature death from diabetes [ 48 ]. Moderate exercise defined by a >4.5 METs for 30–60 min per day reduces both the risk of colon cancer and breast cancer [ 19 ]. For women in particular, >7 h per week of moderate exercise has been shown to be successful in reducing risk of breast cancer (TI01). For osteoporosis, the dose-response gradient is less clear, with recommendations simply emphasizing that osteogenic adaptation is load-dependent and site-specific [ 4 ]. The Center for Disease Control (CDC), the American College of Sports Medicine, and the Healthy People 2010 recommendations provide guidelines for aerobic activity for public health purposes [ 49 ]. Adults should engage in PA of moderate intensity for at least 150 min per week or engage in PA of vigorous intensity for at least 75 min per week. Bouts of exercise may be broken up into smaller increments lasting at least 10 min [ 49 ].

Should Anyone Not be Exercising?

Jim Fixx was a celebrity journalist who helped contribute to the running craze seen in the 1980s in the USA. His sudden death from cardiovascular disease, while jogging, raised questions as to the need for medical evaluation prior to engaging in a program of increasing PA. Moderately strenuous PA may trigger ischemic events, particularly among sedentary people. There is an increased incidence of primary heart attack in high-intensity exercise. In competitive athletes, 80 % of deaths are caused by coronary artery disease. Some subjects do need to have their health risks assessed prior to engaging in an aggressive program.

The degree to which a person is evaluated prior to exercise depends on the presence or absence of cardiovascular disease risk factors and whether the exercise will be moderate or vigorous in intensity [ 50 ]. Subjects at low risk would be those who are young in age (<45 years for male, <55 years for female), are asymptomatic, and have ≤1 cardiovascular risk disease factors. These patients do not need a medical evaluation or stress test for moderate or even vigorous exercise. Subjects at moderate risk are older (men >45 years, women >55 years), or have ≥2 risk factors for cardiovascular disease. For moderate exercise, no medical evaluation may be needed, but these subjects should undergo a stress test. If exercise of vigorous intensity is planned, both a medical evaluation and a stress test should be performed. For those patients at high risk, however, defined by ≥1 sign or symptom of cardiovascular, pulmonary, or metabolic disease, both a full medical evaluation and stress test should be performed before any program is undertaken [ 50 ].

Specifically, those subjects who should not be exercising are those experiencing an acute myocardial infarction, subjects with unstable angina, systolic blood pressure >180, diastolic pressure >110 ml/Hg, uncontrolled diabetes mellitus, poorly controlled congestive heart failure, or thrombophlebitis [ 50 ].

While formal studies have shown that physician counseling is time-intensive and only minimally effective in changing behavior, physicians should no longer avoid the subject of recommendations for exercise as part of the healthcare they deliver to their patients. Physicians can begin by suggesting lifestyle changes such as climbing stairs at work, parking further away from the door on errands, walking regularly, and doing chores at home and in the yard. Clinicians should write on a prescription pad for the patient, specifying the type of exercise, duration, frequency, and intensity. The physician upon discharge from an office visit should determine plans for support and follow up to encourage success, manage obstacles, and prevent relapses. Clinicians should encourage their outpatients to involve community services such as physical therapy, mall-walking programs, school tracks, safe neighborhoods, the YMCA, and walk-a-thon’s.

Physicians should counsel that exercise is not an option. The exercise does not have to be continuous to be effective, and any physical activity counts. Patients should sit less, stand more, and plan their exercise activity at the beginning of each week. Subjects should be encouraged to find activities which they enjoy and involve others to maintain compliance. As Edward Stanley, the Earl of Derby in 1873 said, “Those who think they have not time for bodily exercise will sooner or later have to find time for illness” [ 51 ].

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Keith R. Miller

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Stephen A. McClave, Kristine Krueger & Sarah Landes

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Miller, K.R., McClave, S.A., Jampolis, M.B. et al. The Health Benefits of Exercise and Physical Activity. Curr Nutr Rep 5 , 204–212 (2016). https://doi.org/10.1007/s13668-016-0175-5

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Health Benefits of Different Sports: a Systematic Review and Meta-Analysis of Longitudinal and Intervention Studies Including 2.6 Million Adult Participants

• Pekka Oja 1 ,
• Aamir Raoof Memon   ORCID: orcid.org/0000-0002-3203-418X 2 ,
• Sylvia Titze   ORCID: orcid.org/0000-0001-6125-7182 3 ,
• Danijel Jurakic   ORCID: orcid.org/0000-0002-4861-4066 4 ,
• Si-Tong Chen   ORCID: orcid.org/0000-0002-8975-7565 2 ,
• Nipun Shrestha   ORCID: orcid.org/0000-0003-3542-8130 5 ,
• Sowannry Em 3 ,
• Tena Matolic 4 ,
• Tommi Vasankari   ORCID: orcid.org/0000-0001-7209-9351 1 , 6 ,
• Ari Heinonen   ORCID: orcid.org/0000-0002-3681-9953 7 ,
• Jozo Grgic   ORCID: orcid.org/0000-0002-6929-2844 2 ,
• Pasi Koski   ORCID: orcid.org/0000-0001-5352-3698 8 ,
• Sami Kokko   ORCID: orcid.org/0000-0001-9436-5681 7 ,
• Paul Kelly 9 ,
• Charlie Foster   ORCID: orcid.org/0000-0002-5041-0601 10 ,
• Hrvoje Podnar   ORCID: orcid.org/0000-0003-1719-6970 4 &
• Zeljko Pedisic   ORCID: orcid.org/0000-0003-2886-3556 2  

Sports Medicine - Open volume  10 , Article number:  46 ( 2024 ) Cite this article

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Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated.

To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports.

Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability.

A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength ( p  < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness ( p  < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness ( p  < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids ( p  < 0.010).

Conclusions

A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports.

PROSPERO registration number CRD42021234839.

We found a reduced risk of all-cause mortality associated with cycling (–21%), running (–23%) and swimming (–24%).

Running also improves body composition, cardiovascular function at rest and cardiorespiratory fitness, while swimming also improves body composition and blood lipids.

Football improves body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength, while handball improves body composition and cardiorespiratory fitness.

Introduction

According to the latest Eurobarometer survey, 55% of European Union citizens participate in sports, usually with the aim to improve health and/or fitness [ 1 ]. A large majority of them do not do it regularly [ 1 ]. Studies have shown that, by participating in sports, adults can reap a range of health benefits, such as reduced risk of premature mortality, type 2 diabetes and cardiovascular disease and improved lipid profile, body composition, muscle strength and functional capacity [ 2 , 3 , 4 , 5 ]. Therefore, recreational sports participation has a large potential to improve the health of the population.

Specific types of sport (e.g. endurance sports and strength sports) may have distinct health benefits owing to their differences in biomechanical characteristics and physiological demands [ 6 , 7 ]. For example, while endurance sports are more likely to improve cardiovascular function and aerobic fitness, strength sports are generally more likely to improve muscle function and bone health [ 8 , 9 ]. There may also be differences in health benefits between specific sports disciplines (e.g. tennis and basketball) because each sport entails a unique set of movements that are performed in specific physical, psychological, social and environmental contexts. Therefore, from a public health perspective, it is important to determine health outcomes associated with participation in specific sports. Experts argue that creating ‘health profiles’ of different sports would also facilitate the implementation of health-enhancing programmes in sports clubs [ 8 , 9 ]. Such evidence may also motivate individuals to increase their participation in sports [ 1 ].

Previously, we conducted a systematic review and meta-analysis of health benefits associated with different sports [ 6 ]. The review included 47 cross-sectional, 9 longitudinal and 13 intervention studies covering 26 sports and various health outcomes. However, sufficient data were available only for meta-analyses of the associations of football participation with maximal oxygen uptake (VO 2max ), resting heart rate and fat mass, while evidence for other sports and health outcomes needed to be summarised narratively. The meta-analyses found that football is associated with increased VO 2max and resting heart rate, while its association with fat mass was not found to be significant. More recently, several reviews examined health benefits of sports participation. They have covered a range of sports, such as baseball [ 10 ], cricket [ 11 ], cross-country skiing [ 12 ], cycling [ 13 ], downhill skiing [ 5 ], football [ 14 , 15 ], golf [ 3 ], judo [ 16 ], rugby [ 17 ], running [ 18 ] and swimming [ 19 ], generally suggesting favourable health outcomes associated with recreational sports participation. For example, a narrative review suggested that playing football is associated with improved cardiovascular, metabolic and musculoskeletal fitness [ 14 ], while a systematic review showed that running is associated with 27% lower risk of all-cause mortality [ 18 ].

However, large differences in the methods (e.g. study design, inclusion criteria and data synthesis) used in these reviews make the comparison of their findings challenging. Also, given that most of them were focused on a single sport and that some of them examined only specific outcomes, they could not assess the totality of evidence on health benefits of sports and comprehensively identify research gaps in this area. Importantly, literature searches in most of these reviews were completed several years ago and new primary studies on the health benefits of these sports have since been published. Therefore, the aim of this paper was to systematically review, summarise and appraise the evidence on physical health benefits of participation in different recreational sports.

Search Strategy

The protocol for this systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (registration number: CRD42021234839). The review was written according to the updated Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist [ 20 ].

The search for relevant studies was performed in the following databases: PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. The keyword ‘sport’ was combined with the keywords for ‘health’ and ‘fitness’ and with a range of keywords describing the study design (Additional file 1 ). The initial search was performed on 31 May 2020 and covered peer-reviewed articles published after 2012. The search was updated on 30 May 2022. For studies published before 2013, we referred to our earlier systematic review [ 6 ]. Two authors independently conducted the study selection from the references obtained in the initial (PO and SE) and updated (ARM and STC) searches. We also performed secondary searches by screening the reference lists of all included papers, lists of papers that cited the included papers, relevant review papers on the associations between sport and health and the authors’ personal database. Two authors independently conducted the initial secondary searches (NS and TM) and updated secondary searches (ARM and STC). Any potential disagreements in study selection were resolved by a third author (DJ).

Inclusion Criteria

Studies were considered for inclusion against the following criteria: (i) the study participants were generally healthy adults without disability (18 + years old); (ii) the study design was either longitudinal (cohort and case–control studies) or interventional (randomised controlled trials and quasi-experimental studies); (iii) the study included a group or groups of people participating in a specific sport (or in multiple sports of which each was represented by a separate group of participants in the analysis) and a comparison group of people who did not participate in the given sport; (iv) the study outcomes were related to physical health; and (v) the study was published in English, German or Finnish. We excluded studies in which the participants were top-level/elite/professional athletes and individuals with disability, frailty or chronic illness. We also excluded studies in which the participation in another sport was the only comparison group, and studies in which the outcome variables were injuries or other acute health problems.

Data Extraction

The following data were extracted from the included intervention studies: (1) the type of study design; (2) the number, sex and age of the participants in each comparison group; (3) the type, length, intensity and frequency of all interventions; and (4) the mean and standard deviation of each outcome variable before and after the intervention in the intervention and control groups. The data extraction was performed by one author (PO) and checked for accuracy by another author (ST).

The following data were extracted from the included longitudinal studies: (1) the type of study design; (2) the number, sex and age of the participants; (3) the duration of the follow-up; (4) the type of sports discipline(s) included in the analyses and the definition of the comparison group; (5) the name and measurement units of each outcome variable; (6) the data analysis method(s) and adjustments for confounding; and (7) the effect size (and its statistical significance and/or confidence interval [CI]) of the association between the participation in a specific sport and the outcome variable. The data extraction was performed by one author (ARM) and checked for accuracy by another author (ZP).

Risk of Bias and Certainty of Evidence

The quality of intervention studies was assessed using the Effective Public Health Practice Project Quality Assessment Tool [ 21 ]. The tool assesses six components of a study: (1) selection bias, (2) study design, (3) confounders, (4) blinding, (5) data collection methods and (6) withdrawals and drop-outs. Two authors (PO and AH) performed this evaluation. Any disagreements were resolved by a third author (SK).

The risk of bias in longitudinal studies was assessed using the Newcastle–Ottawa Quality Assessment Scale (NOS) for cohort studies [ 22 ]. This scale rates the risk of bias across three domains: (1) selection, (2) comparability and (3) outcome. The evaluation was performed by one author (ARM).

The certainty of evidence was assessed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria [ 23 ]. The evaluation was performed by two authors (NS and ZP) and checked by one author (HP). Given the large number of exposure and outcome variables covered in the meta-analyses, the assessment of certainty of evidence was performed only for cycling, running and swimming participation in relation to all-cause mortality, as a key health indicator.

Statistical Analysis

Random-effects meta-analyses with restricted maximum likelihood estimation were conducted to summarise the effects of participating in a specific sport (compared with no exercise) on a health outcome reported in intervention studies. The effect sizes were presented as the mean difference between the intervention and control group in changes from baseline to follow-up. For studies that did not report Pearson’s correlation between baseline and follow-up scores in the outcome variable, we used a weighted pooled correlation calculated from other studies on the given outcome. In the meta-analyses for which less than two correlation coefficients were reported across studies (i.e. in the analyses with mean arterial pressure, maximal heart rate, VO 2max in L/min and peak ventilation as outcome variables), we replaced the missing correlations with 0.50. We did the same in sensitivity meta-analyses for all the remaining outcomes.

To summarise the adjusted hazard ratios (HRs) from longitudinal studies, we conducted random-effects meta-analyses with restricted maximum likelihood estimation. For longitudinal studies that conducted dose–response analyses (e.g. HRs for specific durations of activity) and did not report HRs for comparisons of ‘any’ versus ‘no’ participation in a given sport, in the meta-analysis we included the HR for the lowest dose of activity. We also conducted sensitivity meta-analyses in which we included HRs for the highest dose of activity.

We used the I 2 , τ 2 , Cochran’s Q test and prediction intervals to assess the heterogeneity of effect sizes. Low, moderate, substantial and high degree of heterogeneity was indicated by I 2 values of 0–40%, 30–60%, 50–90% and 75–100%, respectively [ 24 ]. For the meta-analyses that included 10 or more effect sizes, we assessed the publication bias using the contour-enhanced funnel plot and the Egger’s asymmetry test [ 25 ]. We also calculated the pooled mean differences using the ‘trim and fill’ method and fail-safe N using the ‘general method’ [ 26 ].

The meta-analyses were conducted in R (R Foundation for Statistical Computing, Vienna, Austria), using the ‘metafor’ package [ 26 ].

Search Results

The database search yielded 27,429 papers and an additional 32,250 papers were identified through secondary searches. Following removal of duplicates, and title and abstract screening, 199 papers were left for full-text screening. A total of 80 papers [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 ] from 46 intervention studies and 56 papers [ 7 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 ] from 30 longitudinal studies were included in the analysis (Fig.  1 ).

Flowchart of the search and study selection process

Study Characteristics

The intervention studies included ~ 2400 participants and covered the following 19 different sport disciplines: football/soccer (hereafter referred to as ‘football’), running, swimming, alpine skiing, handball, cycling, climbing, volleyball, karate, rugby, basketball, floorball, badminton, tennis, table tennis, judo, golf, equestrian sports and taekwondo. In total, 29 papers from intervention studies included men only, 27 included women only and 24 included both men and women. The health outcomes covered in the intervention studies were: (1) cardiovascular function at rest; (2) cardiorespiratory fitness; (3) body composition; (4) metabolic fitness; (5) muscular fitness; (6) bone strength; and (7) physical performance. A descriptive summary of the intervention studies is presented in Additional file 2 .

The longitudinal studies included ~ 2.64 million participants and covered 18 different sport disciplines, including: badminton, basketball, cycling, boxing/karate, football, golf, hockey, ice skating, racquetball, rowing, running, baseball, skiing, swimming, table tennis, tennis and volleyball. In total, 9 papers from the longitudinal studies referred to men only, 5 referred to women only and 42 referred to both men and women. One of the included longitudinal studies was international, with participants from Austria, Belgium, England, Italy, Spain, Sweden and Switzerland. Overall, 2 included papers from longitudinal studies were from Australia, 1 from Canada, 4 from China, 13 from Denmark, 6 from Finland, 1 from France, 5 from the Netherlands, 1 from Russia, 5 from Sweden, 6 from the UK and 11 from the USA. The following health outcomes were covered in the included longitudinal studies: (1) all-cause mortality, (2) cardiovascular mortality, (3) respiratory mortality, (4) diabetes mortality, (5) cancer mortality, (6) mortality from other causes, (7) cancer, (8) colon cancer, (9) breast cancer, (10) venous thromboembolism, (11) atrial fibrillation, (12) aortic stiffness, (13) cardiovascular disease, (14) coronary heart disease, (15) ischemic heart disease, (16) myocardial infarction, (17) stroke, (18) hypertension, (19) obesity or change in body composition, (20) hypertriglyceridemia, (21) impaired glucose tolerance, (22) diabetes, (23) respiratory diseases, (24) chronic obstructive pulmonary disease, (25) asthma, (26) joint diseases, (27) eye diseases, (28) chronic kidney disease, (29) allergies, (30) varicose veins and (31) diseases of the urogenital system. A descriptive summary of longitudinal studies is presented in Additional file 3 .

Risk of Bias

The overall methodological quality was rated as moderate for 8 and weak for 72 papers from intervention studies (Additional file 4 ). The overall methodological quality was rated as fair for 15 and good for 41 papers from longitudinal studies (Additional file 5 ).

Meta-Analyses of Intervention Studies

Effects of cycling on health.

We did not find significant effects of cycling on body mass, body mass index (BMI), systolic blood pressure and diastolic blood pressure ( p  > 0.05 for all; Table  1 and Additional file 6 ). There was high heterogeneity between the studies on body mass. We did not find significant heterogeneity among the studies on the remaining health outcomes ( p  > 0.05). The sensitivity analyses confirmed the findings (Additional file 7 ).

Effects of Football on Health

We found favourable effects of football on body mass, BMI, body fat mass, body fat percentage, total and low-density lipoprotein (LDL) cholesterol, fasting blood glucose, systolic and diastolic blood pressure, mean arterial pressure, resting heart rate, VO 2max , peak ventilation, absolute measures of bone mineral content (total and in legs) and osteocalcin ( p  < 0.050 for all; Table  2 ). The sensitivity analyses confirmed the findings for all outcomes except for total cholesterol and LDL cholesterol (Additional file 8 ). In the main meta-analyses, we did not find significant effects of football on the remaining seven health outcomes ( p  > 0.05 for all). However, in the sensitivity analysis, we found a favourable effect of football on performance in the countermovement jump test ( p  = 0.031). There was high heterogeneity between the studies on all measures of body composition except for lean mass of legs. High heterogeneity was also found between the studies on high-density lipoprotein (HDL) cholesterol, VO 2max (ml/kg/min) and countermovement jump. For most of the remaining health outcomes, heterogeneity between the studies was not found to be significant ( p  < 0.05). However, in most of the meta-analyses, prediction intervals were relatively wide.

Effects of Handball on Health

We found favourable effects of handball on body fat mass, body fat percentage and VO 2max ( p  < 0.050 for all; Table  3 ). The sensitivity analyses did not confirm the findings for body fat mass and body fat percentage (Additional file 9 ). We did not find significant effects of handball on the remaining nine health outcomes ( p  > 0.05 for all). There was substantial heterogeneity between the studies on HDL cholesterol and VO 2max and high heterogeneity between the studies on resting heart rate. For the remaining health outcomes, heterogeneity between the studies was not found to be significant ( p  < 0.05).

Effects of Running on Health

We found favourable effects of running on body fat mass, body fat percentage, resting heart rate, VO 2max and peak ventilation ( p  < 0.010 for all; Table  4 ). In the main meta-analyses, we did not find significant effects of running on the remaining nine health outcomes ( p  > 0.05 for all). However, in the sensitivity analysis, we found a favourable effect of running on BMI ( p  = 0.003; Additional file 10 ). There was high heterogeneity between the studies on body mass, BMI, body fat mass, lean body mass and VO 2max . For the remaining health outcomes, heterogeneity between the studies was not found to be significant ( p  < 0.05). However, in most of the meta-analyses, prediction intervals were relatively wide.

Effects of Swimming on Health

We found favourable effects of swimming on body fat percentage, total cholesterol and HDL cholesterol ( p  < 0.010 for all; Table  5 ). The sensitivity analysis did not confirm the findings for body fat mass and total cholesterol (Additional file 11 ). In the main meta-analyses, we did not find significant effects of swimming on LDL cholesterol ( p  = 0.120) and triglycerides ( p  = 0.007). However, in the sensitivity analysis, we found a favourable effect of swimming on LDL cholesterol ( p  = 0.002). There was substantial heterogeneity between the studies on body fat percentage. For the remaining health outcomes, heterogeneity between the studies was not found to be significant ( p  < 0.050).

Meta-Analyses of Longitudinal Studies

Health outcomes associated with cycling.

Cycling was associated with 21%, 10% and 20% lower risk of all-cause, cancer and cardiovascular mortality, respectively, over the follow-up periods ( p  ≤ 0.001 for all; Table  6 ). Cycling was also associated with 16% lower risk of coronary heart disease over the follow-up periods ( p  < 0.001). We did not find a significant association between cycling and the risk of cardiovascular disease ( p  = 0.230). Sensitivity analyses confirmed all the findings (Additional file 12 ). There was substantial heterogeneity between the studies on the risk of all-cause mortality and cardiovascular disease. For the remaining health outcomes, heterogeneity between the studies was not found to be significant ( p  < 0.05).

Health Outcomes Associated with Running

Running was associated with 23%, 20% and 27% lower risk of all-cause, cancer and cardiovascular mortality, respectively, over the follow-up periods ( p  < 0.05 for all; Table  6 ). There was substantial heterogeneity between the studies on the risk of all-cause mortality and high heterogeneity between the studies on the risk of cardiovascular mortality. Heterogeneity between the studies on cancer mortality was not found to be significant ( p  = 0.218). However, prediction intervals were relatively wide in all three meta-analyses.

Health Outcomes Associated with Swimming

Swimming was associated with 24% lower risk of all-cause mortality over the follow-up periods ( p  = 0.005; Table  6 ). There was substantial heterogeneity between the studies included in the meta-analysis.

Publication Bias

The Egger’s asymmetry test (Additional files 13 , 14 , 15 and 16 ) did not show significant publication bias for the studies included in the meta-analyses of the effects of football on body mass ( p  = 0.579), body fat percentage ( p  = 0.796), systolic blood pressure ( p  = 0.940) and diastolic blood pressure ( p  = 0.460). In the meta-analyses for body mass and diastolic blood pressure, the pooled mean differences estimated using the ‘trim and fill’ method were the same as the pooled mean differences calculated from the studies included in the original meta-analyses. For body fat percentage and systolic blood pressure, similar results were obtained using the ‘trim and fill’ method when compared with the original meta-analyses (pooled mean difference calculated using the ‘trim and fill’ method [ d tf ] =  –1.69; 95% CI: –2.42, –0.97; p  < 0.001 versus pooled mean difference [ d ] =  –1.98; 95% CI: –2.68, –1.28; p  < 0.001 for body fat percentage and d tf   =  –3.75; 95% CI: –6.29, –1.21; p  = 0.004 versus d  =  –4.44; 95% CI: –6.78, –2.09; p  < 0.001 for systolic blood pressure). The fail-safe N s indicated that the number of potential unpublished studies averaging null results needed to increase the p -value for the pooled effect size to 0.05 (i.e. above the statistical significance threshold) would be 16 for body mass, 37 for body fat percentage, 17 for systolic blood pressure and 10 for diastolic blood pressure. The tests were not performed for other meta-analyses owing to the small number of included studies ( n  < 10).

Certainty of Evidence

The certainty of evidence on the associations of cycling and running with the risk of all-cause mortality was assessed as ‘moderate’, because of substantial heterogeneity between studies (Additional file 17 ). The certainty of evidence on the association between swimming and the risk of all-cause mortality was assessed as ‘low’, because of high heterogeneity between studies.

Key Findings

The key findings of this review are that: (1) cycling is associated with a reduced risk of coronary heart disease and all-cause, cancer and cardiovascular mortality; (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength; (3) handball has favourable effects on body composition and cardiorespiratory fitness; (4) running is associated with a reduced risk of all-cause, cancer and cardiovascular mortality and has favourable effects on body composition, cardiovascular function at rest and cardiorespiratory fitness; and (5) swimming is associated with a reduced risk of all-cause mortality and has favourable effects on body composition and blood lipids.

Comparison with Previous Studies

A previous systematic review [ 162 ] showed a 16% lower risk of cardiovascular disease and a 17% lower risk of cardiovascular mortality associated with cycling. We found a somewhat weaker association between cycling and cardiovascular disease and a somewhat stronger association between cycling and a cardiovascular mortality, probably because of additional studies included in the data synthesis. Another systematic review [ 163 ] indicated a 23% lower all-cause mortality risk and a 24% lower cardiovascular mortality risk associated with cycling. These results are closely comparable with our findings. Unlike in our review, a previous systematic review [ 164 ] found that cycling is associated with lower BMI. This discrepancy between findings may be owing to the fact that our meta-analysis was peformed exclusively on intervention studies in adults, while the previous review also included observational studies and studies conducted among adolescents.

Meta-analyses in our earlier systematic review have shown that football is associated with increased VO 2max and lower resting heart rate [ 6 ]. Previous reviews also found favourable associations of football with physical and cardiorespiratory fitness, body fat mass, blood pressure, LDL cholesterol and indices of bone health [ 165 , 166 ]. In the current review, we confirmed these results and additionally found favourable associations between football and body mass, BMI and fasting blood glucose. Unlike a previous review [ 165 ], we did not find a significant association between football and performance in the countermovement jump test, possibly because the meta-analysis in the previous review included studies conducted among children and prostate cancer patients in addition to studies conducted among healthy adults.

We did not find any previous review on health benefits of handball that could be used for comparative purposes. We expanded the body of evidence on this topic by conducing meta-analyses on the association between handball and 12 health outcomes and finding favourable associations with body fat and VO 2max .

In our previous review [ 6 ], we did not find enough studies to conduct meta-analyses on the health benefits of running. Meta-analyses conducted as part of a more recent systematic review [ 18 ] found that running is associated with 27%, 30% and 23% lower risk of all-cause, cardiovascular and cancer mortality, respectively. In the current review, we conducted the meta-analyses with larger pooled samples and found very similar effect sizes, which confirmed previous results. Additional studies published since our previous review [ 6 ] also enabled us to conduct meta-analyses of the associations of running with 14 other health outcomes and to find that running is beneficial for body composition and cardiorespiratory fitness.

A recent systematic review [ 167 ] found favourable associations of swimming with cardiorespiratory fitness and body composition. Our meta-analyses confirmed the finding for body composition and provided additional evidence on the benefits of swimming for blood lipid profile and all-cause mortality risk.

Implications for Clinicians and Policy Makers

Our findings suggest that sports participation can be promoted as part of ‘lifestyle medicine’, to help prevent a range of chronic diseases. This should be facilitated by policy makers through the development and implementation of adequate sports policies with a focus on ‘sport for all’ [ 8 , 9 ], and by clinicians through direct promotion of sports among their clients.

Previous studies found that the rates of sport related injuries are relatively low but certainly not negligible [ 6 , 168 ]. The benefits of sports found in the current review likely outweigh the risks; however, a formal evaluation of the health benefits/risks would need to be conducted for different sport disciplines to confirm this. Evidence on health risks associated with sports highlights the need for effective injury prevention measures. A summary of preventive solutions is provided in a recent review [ 169 ].

The potential of sports to promote public health remains under-utilised [ 170 ]. A recent paper found that medical representatives of international Olympic sport federations rated the importance of preventing chronic diseases in the general population relatively low compared with other health themes/programmes within their federations [ 171 ]. Evidence presented in the current review suggests that chronic disease prevention through sports participation should receive greater priority on the agenda of sports organisations.

Strengths and Limitations of the Review and Included Studies

The strengths of the current review include: (1) an extensive literature search that included both backward and forward citation tracking, (2) a large number of included studies that covered various sports and health outcomes and (3) a large number of meta-analyses that were conducted.

The current review also has several limitations. First, in the literature search, we did not use keywords for specific sports and health outcomes, as this would have made it unfeasible. Although this was compensated for by comprehensive secondary searches, it is possible that we missed some relevant studies. Second, while the methodological quality of included longitudinal studies was generally good, most of the included intervention studies rated poorly in terms of blinding and selection bias. The selection bias is very common in intervention trials on the effects of sports participation, because participants are often recruited from those who expressed their interest to participate in a given sport. The blinding of participants is highly impractical or impossible in such intervention trials. Hence, the low scores in these two aspects of study quality were expected. Third, we did not perform dose–response analyses. Given that we conducted 68 meta-analyses of overall effects of sports participation, further dose–response analyses were beyond the scope of this review. Dose–response analyses of the associations between sports participation and health outcomes can be found in previous reviews that were focused on a single sport [ 18 , 163 , 172 ]. Fourth, we considered only physical health outcomes of sports participation. Specific sports may also have distinct associations with various economic, environmental, psychological and social outcomes. Finally, the certainty of evidence was assessed only for the associations of cycling, running and swimming participation with the risk of all-cause mortality. However, this is in accordance with the recommendation that in comprehensive systematic reviews that include many outcome variables, certainty of evidence should be assessed for selected outcomes only [ 24 ].

On the basis of the pooled findings from 136 papers, the following can be concluded for recreational sports: (1) cycling reduces the risk of coronary heart disease and all-cause, cancer and cardiovascular mortality; (2) football may help in reducing weight and improving blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength; (3) handball may help in reducing weight and improving cardiorespiratory fitness; (4) running reduces the risk of all-cause, cancer and cardiovascular mortality and may help in reducing weight and improving cardiovascular function at rest and cardiorespiratory fitness; and (5) swimming reduces the risk of risk of all-cause mortality and may help in reducing weight and improving blood lipids.

More studies are needed to enable meta-analyses of physical health benefits of other sports. The quality of future intervention studies in this area could be improved by blinding the assessors, making more appropriate adjustments for confounding, and reducing the drop-out rates.

Availability of Data and Materials

All data relevant to the study are included in the article or uploaded as supplementary information. Further information is available upon reasonable request.

Abbreviations

Grading of Recommendations Assessment, Development and Evaluation

High-density lipoprotein

Hazard ratio

Low-density lipoprotein

Newcastle–Ottawa Quality Assessment Scale

International Prospective Register of Systematic Reviews

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Maximal oxygen uptake

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The European Commission support for the production of this publication does not constitute endorsement of the contents which reflects the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein.

This manuscript was prepared as part of the “Creating Mechanisms for Continuous Implementation of the Sports Club for Health Guidelines in the European Union” project, funded by the Erasmus + Collaborative Partnerships grant (reference number: 613434-EPP-1-2019-1-HR-SPO-SCP).

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Contributions

P.O. contributed to study conceptualisation, study selection, data extraction, quality assessment, interpretation of results and write-up of the introduction, results and discussion sections; A.R.M. contributed to study selection, data extraction, quality assessment, interpretation of results and write-up of the introduction and results section; S.T. contributed to study selection, data extraction, quality assessment and write-up of the results section; D.J. contributed to study conceptualisation and study selection; S-T.C. contributed to study selection; N.S. contributed to study selection and certainty of evidence assessment; S.E. contributed to study selection; T.M. contributed to study selection; T.V. contributed to study selection; A.H. contributed to quality assessment; J.G. contributed to the write-up of the methods section; S.K. contributed to quality assessment; P.Ko. contributed to study selection; P.Ke. contributed to literature search and conceptualisation of data analysis; C.F. contributed to conceptualisation of data analysis; H.P. contributed to certainty of evidence assessment; Z.P. conducted data analyses, contributed to study conceptualisation, literature search, data extraction, interpretation of results and write-up of the introduction, methods, results and discussion sections, and led the correspondence with editors and reviewers. All authors contributed to revising the manuscript and read and approved its final version.

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Supplementary Information

Additional file 1:.

Search syntax.

Additional file 2:

Summary of intervention trials on health effects of participation in specific sports.

Additional file 3:

Summary of longitudinal studies on the association between participation in specific sports and health.

Additional file 4:

Methodological quality appraisal of intervention studies using the Effective Public Health Practice Project Quality Assessment Tool.

Additional file 5:

Methodological quality appraisal of longitudinal studies using the Newcastle-Ottawa Quality Assessment Scale.

Additional file 6:

Forest plots from main meta-analyses.

Additional file 7:

The effects of cycling on health outcomes: results of four sensitivity meta-analyses in which missing correlations were replaced with 0.50.

Additional file 8:

The effects of football on health outcomes: results of 20 sensitivity meta-analyses in which missing correlations were replaced with 0.50

Additional file 9:

The effects of handball on health outcomes: results of 12 sensitivity meta-analyses in which missing correlations were replaced with 0.50.

Additional file 10:

The effects of running on health outcomes: results of 13 sensitivity meta-analyses in which missing correlations were replaced with 0.50.

Additional file 11:

The effects of swimming on health outcomes: results of five sensitivity meta-analyses in which missing correlations were replaced with 0.50.

Additional file 12:

The longitudinal associations between cycling and the risk of mortality and morbidity: results of 5 sensitivity meta-analyses of hazard ratios for any participation or the highest reported dose of activity.

Additional file 13:

Funnel plot for the meta-analysis on the effects of football on body mass.

Additional file 14:

Funnel plot for the meta-analysis on the effects of football on body fat percentage.

Additional file 15:

Funnel plot for the meta-analysis on the effects of football on systolic blood pressure.

Additional file 16:

Funnel plot for the meta-analysis on the effects of football on diastolic blood pressure.

Additional file 17:

Certainty of evidence on the associations of cycling, running, and swimming participation with the risk of all-cause mortality.

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Oja, P., Memon, A.R., Titze, S. et al. Health Benefits of Different Sports: a Systematic Review and Meta-Analysis of Longitudinal and Intervention Studies Including 2.6 Million Adult Participants. Sports Med - Open 10 , 46 (2024). https://doi.org/10.1186/s40798-024-00692-x

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The increasing importance of sports science and medicine

The notion that exercise has a multitude of benefits, especially for health, has been around for millennia. 1 Physicians’ traditional focus on the prevention of disease and the maintenance of health requires them to find interventions that will help patients, with as few adverse effects and reactions as possible. Only lately has the focus shifted towards acute illnesses and treating patients according to their complaints. 1 In any case, diet and exercise have almost always been part of the regimen emphasised by physicians. 1 Even ancient physicians recognised the importance of these two aspects of care in the formulation of their treatments. 2 This understanding suggests that maintaining health in a preventative manner may be a more appropriate medical approach than treating patients at the doorway of disease.

Most modern diseases can be said to be preventable. 2 Almost half of the mortality rate in the United States can be traced to behavioural causes. 2 The main causes of early death in the country are smoking and diseases attributable to physical inactivity linked to obesity. 2 Physicians should consider returning to an approach of prescribing lifestyle changes before prescribing medication. Prescribing exercise can indeed maximise the health of patients. 1 Clearly, exercise is relatively inexpensive yet massively effective for multiple bodily systems. Exercise can be considered a medication, and physicians should be encouraged to start treating physical activity as a prescription that they can recommend to their patients. As more people are beginning to recognise, the benefits of exercise will usually outweigh the risks, and each person should be able to perform at least a minimum amount of exercise. 2

There is a growing opinion that, in the near future, lack of exercise may be the most important public health problem. 2 Physicians should consider it their duty to modify patients’ lifestyles in ways that lead to the health benefits that science has now confirmed are clear and undeniable. Many conditions, such as depression, osteoarthritis, hypertension, obesity, cancer, and diabetes mellitus have outcomes that are obviously ameliorated by increased physical activity. 3

The United States is in love with sports, with 60% of Americans describing themselves as sports fans. 4 Billions of dollars are generated every year by various US-based sports leagues, such as the National Hockey League, the National Basketball Association, Major League Baseball, and the National Football League. 4 Collegiate sports are a multimillion-dollar business as well. 4 As the earnings increase, so do the investments that these leagues make in the best players. Because of the financial impact of these various sports, it has become a priority for the leagues to keep their players healthy. As such, optimising performance, improving the best players’ availability, and decreasing the risk of injury have become the main thrusts of sports science and sports medicine when tied to high-performance teams. 5

Sports science research can help lead to evidence-based approaches that will allow athletes and active individuals to exercise in optimal ways. There is a continuing gap between current practices in athletics and the latest scientific evidence, compounded by an era of anti-intellectualism and ‘fake news’, as well as a burgeoning disbelief in fact and science. 4 Non-peer-reviewed articles are proliferating, as are so-called ‘predatory’ journals and conferences, which can contribute to the dilution of good science that could be used for the benefit of athletes, active individuals, and indeed, all patients who are trying to exercise more.

Coaches and athletes need to listen more carefully and more often to sports scientists, whose findings can be supported and dispersed by sports medicine physicians. Widespread support for the use of unproven supplements in sports, or wearing specific bracelets or anklets to supposedly improve athletic ability, are but a few of the pseudoscientific practices that coaches and athletes need to discuss further with scientists and physicians. Conversely, those engaged in the science of sports medicine and the provision of health care need to improve their ability to translate terms and ideas that may not be easily understood by those engaged or about to engage in sports and exercise activities.

Knowledge transfer is key, and sports communities all over the world should be able to engage with sports scientists and medical providers more directly. We now have the ability to leverage social media, application software, and other forms of technology to achieve this. Our use of these evolving tools should focus on sports physicians and athletes being proactive, using exercise as prevention, rather than reactive, treating maladies as needed. The idea that ‘exercise is medicine’ should become second nature in the world of primary care and sports medicine. 1

Declaration of conflicting interest

The authors declare that there is no conflict of interest.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

George G.A. Pujalte https://orcid.org/0000-0002-7537-7457

• Systematic review update
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The impact of sports participation on mental health and social outcomes in adults: a systematic review and the ‘Mental Health through Sport’ conceptual model

• Narelle Eather   ORCID: orcid.org/0000-0002-6320-4540 1 , 2 ,
• Levi Wade   ORCID: orcid.org/0000-0002-4007-5336 1 , 3 ,
• Aurélie Pankowiak   ORCID: orcid.org/0000-0003-0178-513X 4 &
• Rochelle Eime   ORCID: orcid.org/0000-0002-8614-2813 4 , 5  

Systematic Reviews volume  12 , Article number:  102 ( 2023 ) Cite this article

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Sport is a subset of physical activity that can be particularly beneficial for short-and-long-term physical and mental health, and social outcomes in adults. This study presents the results of an updated systematic review of the mental health and social outcomes of community and elite-level sport participation for adults. The findings have informed the development of the ‘Mental Health through Sport’ conceptual model for adults.

Nine electronic databases were searched, with studies published between 2012 and March 2020 screened for inclusion. Eligible qualitative and quantitative studies reported on the relationship between sport participation and mental health and/or social outcomes in adult populations. Risk of bias (ROB) was determined using the Quality Assessment Tool (quantitative studies) or Critical Appraisal Skills Programme (qualitative studies).

The search strategy located 8528 articles, of which, 29 involving adults 18–84 years were included for analysis. Data was extracted for demographics, methodology, and study outcomes, and results presented according to study design. The evidence indicates that participation in sport (community and elite) is related to better mental health, including improved psychological well-being (for example, higher self-esteem and life satisfaction) and lower psychological ill-being (for example, reduced levels of depression, anxiety, and stress), and improved social outcomes (for example, improved self-control, pro-social behavior, interpersonal communication, and fostering a sense of belonging). Overall, adults participating in team sport had more favorable health outcomes than those participating in individual sport, and those participating in sports more often generally report the greatest benefits; however, some evidence suggests that adults in elite sport may experience higher levels of psychological distress. Low ROB was observed for qualitative studies, but quantitative studies demonstrated inconsistencies in methodological quality.

Conclusions

The findings of this review confirm that participation in sport of any form (team or individual) is beneficial for improving mental health and social outcomes amongst adults. Team sports, however, may provide more potent and additional benefits for mental and social outcomes across adulthood. This review also provides preliminary evidence for the Mental Health through Sport model, though further experimental and longitudinal evidence is needed to establish the mechanisms responsible for sports effect on mental health and moderators of intervention effects. Additional qualitative work is also required to gain a better understanding of the relationship between specific elements of the sporting environment and mental health and social outcomes in adult participants.

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Introduction

The organizational structure of sport and the performance demands characteristic of sport training and competition provide a unique opportunity for participants to engage in health-enhancing physical activity of varied intensity, duration, and mode; and the opportunity to do so with other people as part of a team and/or club. Participation in individual and team sports have shown to be beneficial to physical, social, psychological, and cognitive health outcomes [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. Often, the social and mental health benefits facilitated through participation in sport exceed those achieved through participation in other leisure-time or recreational activities [ 8 , 9 , 10 ]. Notably, these benefits are observed across different sports and sub-populations (including youth, adults, older adults, males, and females) [ 11 ]. However, the evidence regarding sports participation at the elite level is limited, with available research indicating that elite athletes may be more susceptible to mental health problems, potentially due to the intense mental and physical demands placed on elite athletes [ 12 ].

Participation in sport varies across the lifespan, with children representing the largest cohort to engage in organized community sport [ 13 ]. Across adolescence and into young adulthood, dropout from organized sport is common, and especially for females [ 14 , 15 , 16 ], and adults are shifting from organized sports towards leisure and fitness activities, where individual activities (including swimming, walking, and cycling) are the most popular [ 13 , 17 , 18 , 19 ]. Despite the general decline in sport participation with age [ 13 ], the most recent (pre-COVID) global data highlights that a range of organized team sports (such as, basketball, netball volleyball, and tennis) continue to rank highly amongst adult sport participants, with soccer remaining a popular choice across all regions of the world [ 13 ]. It is encouraging many adults continue to participate in sport and physical activities throughout their lives; however, high rates of dropout in youth sport and non-participation amongst adults means that many individuals may be missing the opportunity to reap the potential health benefits associated with participation in sport.

According to the World Health Organization, mental health refers to a state of well-being and effective functioning in which an individual realizes his or her own abilities, is resilient to the stresses of life, and is able to make a positive contribution to his or her community [ 20 ]. Mental health covers three main components, including psychological, emotional and social health [ 21 ]. Further, psychological health has two distinct indicators, psychological well-being (e.g., self-esteem and quality of life) and psychological ill-being (e.g., pre-clinical psychological states such as psychological difficulties and high levels of stress) [ 22 ]. Emotional well-being describes how an individual feels about themselves (including life satisfaction, interest in life, loneliness, and happiness); and social well–being includes an individual’s contribution to, and integration in society [ 23 ].

Mental illnesses are common among adults and incidence rates have remained consistently high over the past 25 years (~ 10% of people affected globally) [ 24 ]. Recent statistics released by the World Health Organization indicate that depression and anxiety are the most common mental disorders, affecting an estimated 264 million people, ranking as one of the main causes of disability worldwide [ 25 , 26 ]. Specific elements of social health, including high levels of isolation and loneliness among adults, are now also considered a serious public health concern due to the strong connections with ill-health [ 27 ]. Participation in sport has shown to positively impact mental and social health status, with a previous systematic review by Eime et al. (2013) indicated that sports participation was associated with lower levels of perceived stress, and improved vitality, social functioning, mental health, and life satisfaction [ 1 ]. Based on their findings, the authors developed a conceptual model (health through sport) depicting the relationship between determinants of adult sports participation and physical, psychological, and social health benefits of participation. In support of Eime’s review findings, Malm and colleagues (2019) recently described how sport aids in preventing or alleviating mental illness, including depressive symptoms and anxiety or stress-related disease [ 7 ]. Andersen (2019) also highlighted that team sports participation is associated with decreased rates of depression and anxiety [ 11 ]. In general, these reviews report stronger effects for sports participation compared to other types of physical activity, and a dose–response relationship between sports participation and mental health outcomes (i.e., higher volume and/or intensity of participation being associated with greater health benefits) when adults participate in sports they enjoy and choose [ 1 , 7 ]. Sport is typically more social than other forms of physical activity, including enhanced social connectedness, social support, peer bonding, and club support, which may provide some explanation as to why sport appears to be especially beneficial to mental and social health [ 28 ].

Thoits (2011) proposed several potential mechanisms through which social relationships and social support improve physical and psychological well-being [ 29 ]; however, these mechanisms have yet to be explored in the context of sports participation at any level in adults. The identification of the mechanisms responsible for such effects may direct future research in this area and help inform future policy and practice in the delivery of sport to enhance mental health and social outcomes amongst adult participants. Therefore, the primary objective of this review was to examine and synthesize all research findings regarding the relationship between sports participation, mental health and social outcomes at the community and elite level in adults. Based on the review findings, the secondary objective was to develop the ‘Mental Health through Sport’ conceptual model.

This review has been registered in the PROSPERO systematic review database and assigned the identifier: CRD42020185412. The conduct and reporting of this systematic review also follows the Preferred Reporting for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [ 30 ] (PRISMA flow diagram and PRISMA Checklist available in supplementary files ). This review is an update of a previous review of the same topic [ 31 ], published in 2012.

Identification of studies

Nine electronic databases (CINAHL, Cochrane Library, Google Scholar, Informit, Medline, PsychINFO, Psychology and Behavioural Sciences Collection, Scopus, and SPORTDiscus) were systematically searched for relevant records published from 2012 to March 10, 2020. The following key terms were developed by all members of the research team (and guided by previous reviews) and entered into these databases by author LW: sport* AND health AND value OR benefit* OR effect* OR outcome* OR impact* AND psych* OR depress* OR stress OR anxiety OR happiness OR mood OR ‘quality of life’ OR ‘social health’ OR ‘social relation*’ OR well* OR ‘social connect*’ OR ‘social functioning’ OR ‘life satisfac*’ OR ‘mental health’ OR social OR sociolog* OR affect* OR enjoy* OR fun. Where possible, Medical Subject Headings (MeSH) were also used.

Criteria for inclusion/exclusion

The titles of studies identified using this method were screened by LW. Abstract and full text of the articles were reviewed independently by LW and NE. To be included in the current review, each study needed to meet each of the following criteria: (1) published in English from 2012 to 2020; (2) full-text available online; (3) original research or report published in a peer-reviewed journal; (4) provides data on the psychological or social effects of participation in sport (with sport defined as a subset of exercise that can be undertaken individually or as a part of a team, where participants adhere to a common set of rules or expectations, and a defined goal exists); (5) the population of interest were adults (18 years and older) and were apparently healthy. All papers retrieved in the initial search were assessed for eligibility by title and abstract. In cases where a study could not be included or excluded via their title and abstract, the full text of the article was reviewed independently by two of the authors.

Data extraction

For the included studies, the following data was extracted independently by LW and checked by NE using a customized Google Docs spreadsheet: author name, year of publication, country, study design, aim, type of sport (e.g., tennis, hockey, team, individual), study conditions/comparisons, sample size, where participants were recruited from, mean age of participants, measure of sports participation, measure of physical activity, psychological and/or social outcome/s, measure of psychological and/or social outcome/s, statistical method of analysis, changes in physical activity or sports participation, and the psychological and/or social results.

Risk of bias (ROB) assessment

A risk of bias was performed by LW and AP independently using the ‘Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies’ OR the ‘Quality Assessment of Controlled Intervention Studies’ for the included quantitative studies, and the ‘Critical Appraisal Skills Programme (CASP) Checklist for the included qualitative studies [ 32 , 33 ]. Any discrepancies in the ROB assessments were discussed between the two reviewers, and a consensus reached.

The search yielded 8528 studies, with a total of 29 studies included in the systematic review (Fig.  1 ). Tables  1 and 2 provide a summary of the included studies. The research included adults from 18 to 84 years old, with most of the evidence coming from studies targeting young adults (18–25 years). Study samples ranged from 14 to 131, 962, with the most reported psychological outcomes being self-rated mental health ( n  = 5) and depression ( n  = 5). Most studies did not investigate or report the link between a particular sport and a specific mental health or social outcome; instead, the authors’ focused on comparing the impact of sport to physical activity, and/or individual sports compared to team sports. The results of this review are summarized in the following section, with findings presented by study design (cross-sectional, experimental, and longitudinal).

Flow of studies through the review process

Effects of sports participation on psychological well-being, ill-being, and social outcomes

Cross-sectional evidence.

This review included 14 studies reporting on the cross-sectional relationship between sports participation and psychological and/or social outcomes. Sample sizes range from n  = 414 to n  = 131,962 with a total of n  = 239,394 adults included across the cross-sectional studies.

The cross-sectional evidence generally supports that participation in sport, and especially team sports, is associated with greater mental health and psychological wellbeing in adults compared to non-participants [ 36 , 59 ]; and that higher frequency of sports participation and/or sport played at a higher level of competition, are also linked to lower levels of mental distress in adults . This was not the case for one specific study involving ice hockey players aged 35 and over, with Kitchen and Chowhan (2016) Kitchen and Chowhan (2016) reporting no relationship between participation in ice hockey and either mental health, or perceived life stress [ 54 ]. There is also some evidence to support that previous participation in sports (e.g., during childhood or young adulthood) is linked to better mental health outcomes later in life, including improved mental well-being and lower mental distress [ 59 ], even after controlling for age and current physical activity.

Compared to published community data for adults, elite or high-performance adult athletes demonstrated higher levels of body satisfaction, self-esteem, and overall life satisfaction [ 39 ]; and reported reduced tendency to respond to distress with anger and depression. However, rates of psychological distress were higher in the elite sport cohort (compared to community norms), with nearly 1 in 5 athletes reporting ‘high to very high’ distress, and 1 in 3 reporting poor mental health symptoms at a level warranting treatment by a health professional in one study ( n  = 749) [ 39 ].

Four studies focused on the associations between physical activity and sports participation and mental health outcomes in older adults. Physical activity was associated with greater quality of life [ 56 ], with the relationship strongest for those participating in sport in middle age, and for those who cycled in later life (> 65) [ 56 ]. Group physical activities (e.g., walking groups) and sports (e.g., golf) were also significantly related to excellent self-rated health, low depressive symptoms, high health-related quality of life (HRQoL) and a high frequency of laughter in males and females [ 60 , 61 ]. No participation or irregular participation in sport was associated with symptoms of mild to severe depression in older adults [ 62 ].

Several cross-sectional studies examined whether the effects of physical activity varied by type (e.g., total physical activity vs. sports participation). In an analysis of 1446 young adults (mean age = 18), total physical activity, moderate-to-vigorous physical activity, and team sport were independently associated with mental health [ 46 ]. Relative to individual physical activity, after adjusting for covariates and moderate-to-vigorous physical activity (MVPA), only team sport was significantly associated with improved mental health. Similarly, in a cross-sectional analysis of Australian women, Eime, Harvey, Payne (2014) reported that women who engaged in club and team-based sports (tennis or netball) reported better mental health and life satisfaction than those who engaged in individual types of physical activity [ 47 ]. Interestingly, there was no relationship between the amount of physical activity and either of these outcomes, suggesting that other qualities of sports participation contribute to its relationship to mental health and life satisfaction. There was also some evidence to support a relationship between exercise type (ball sports, aerobic activity, weightlifting, and dancing), and mental health amongst young adults (mean age 22 years) [ 48 ], with ball sports and dancing related to fewer symptoms of depression in students with high stress; and weightlifting related to fewer depressive symptoms in weightlifters exhibiting low stress.

Longitudinal evidence

Eight studies examined the longitudinal relationship between sports participation and either mental health and/or social outcomes. Sample sizes range from n  = 113 to n  = 1679 with a total of n  = 7022 adults included across the longitudinal studies.

Five of the included longitudinal studies focused on the relationship between sports participation in childhood or adolescence and mental health in young adulthood. There is evidence that participation in sport in high-school is protective of future symptoms of anxiety (including panic disorder, generalised anxiety disorder, social phobia, and agoraphobia) [ 42 ]. Specifically, after controlling for covariates (including current physical activity), the number of years of sports participation in high school was shown to be protective of symptoms of panic and agoraphobia in young adulthood, but not protective of symptoms of social phobia or generalized anxiety disorder [ 42 ]. A comparison of individual or team sports participation also revealed that participation in either context was protective of panic disorder symptoms, while only team sport was protective of agoraphobia symptoms, and only individual sport was protective of social phobia symptoms. Furthermore, current and past sports team participation was shown to negatively relate to adult depressive symptoms [ 43 ]; drop out of sport was linked to higher depressive symptoms in adulthood compared to those with maintained participation [ 9 , 22 , 63 ]; and consistent participation in team sports (but not individual sport) in adolescence was linked to higher self-rated mental health, lower perceived stress and depressive symptoms, and lower depression scores in early adulthood [ 53 , 58 ].

Two longitudinal studies [ 35 , 55 ], also investigated the association between team and individual playing context and mental health. Dore and colleagues [ 35 ] reported that compared to individual activities, being active in informal groups (e.g., yoga, running groups) or team sports was associated with better mental health, fewer depressive symptoms and higher social connectedness – and that involvement in team sports was related to better mental health regardless of physical activity volume. Kim and James [ 55 ] discovered that sports participation led to both short and long-term improvements in positive affect and life satisfaction.

A study on social outcomes related to mixed martial-arts (MMA) and Brazilian jiu-jitsu (BJJ) showed that both sports improved practitioners’ self-control and pro-social behavior, with greater improvements seen in the BJJ group [ 62 ]. Notably, while BJJ reduced participants’ reported aggression, there was a slight increase in MMA practitioners, though it is worth mentioning that individuals who sought out MMA had higher levels of baseline aggression.

Experimental evidence

Six of the included studies were experimental or quasi-experimental. Sample sizes ranged from n  = 28 to n  = 55 with a total of n  = 239 adults included across six longitudinal studies. Three studies involved a form of martial arts (such as judo and karate) [ 45 , 51 , 52 ], one involved a variety of team sports (such as netball, soccer, and cricket) [ 34 ], and the remaining two focused on badminton [ 57 ] and handball [ 49 ].

Brinkley and colleagues [ 34 ] reported significant effects on interpersonal communication (but not vitality, social cohesion, quality of life, stress, or interpersonal relationships) for participants ( n  = 40) engaging in a 12-week workplace team sports intervention. Also using a 12-week intervention, Hornstrup et al. [ 49 ] reported a significant improvement in mental energy (but not well-being or anxiety) in young women (mean age = 24; n  = 28) playing in a handball program. Patterns et al. [ 57 ] showed that in comparison to no exercise, participation in an 8-week badminton or running program had no significant improvement on self-esteem, despite improvements in perceived and actual fitness levels.

Three studies examined the effect of martial arts on the mental health of older adults (mean ages 79 [ 52 ], 64 [ 51 ], and 70 [ 45 ] years). Participation in Karate-Do had positive effects on overall mental health, emotional wellbeing, depression and anxiety when compared to other activities (physical, cognitive, mindfulness) and a control group [ 51 , 52 ]. Ciaccioni et al. [ 45 ] found that a Judo program did not affect either the participants’ mental health or their body satisfaction, citing a small sample size, and the limited length of the intervention as possible contributors to the findings.

Qualitative evidence

Three studies interviewed current or former sports players regarding their experiences with sport. Chinkov and Holt [ 41 ] reported that jiu-jitsu practitioners (mean age 35 years) were more self-confident in their lives outside of the gym, including improved self-confidence in their interactions with others because of their training. McGraw and colleagues [ 37 ] interviewed former and current National Football League (NFL) players and their families about its impact on the emotional and mental health of the players. Most of the players reported that their NFL career provided them with social and emotional benefits, as well as improvements to their self-esteem even after retiring. Though, despite these benefits, almost all the players experienced at least one mental health challenge during their career, including depression, anxiety, or difficulty controlling their temper. Some of the players and their families reported that they felt socially isolated from people outside of the national football league.

Through a series of semi-structured interviews and focus groups, Thorpe, Anders [ 40 ] investigated the impact of an Aboriginal male community sporting team on the health of its players. The players reported they felt a sense of belonging when playing in the team, further noting that the social and community aspects were as important as the physical health benefits. Participating in the club strengthened the cultural identity of the players, enhancing their well-being. The players further noted that participation provided them with enjoyment, stress relief, a sense of purpose, peer support, and improved self-esteem. Though they also noted challenges, including the presence of racism, community conflict, and peer-pressure.

Quality of studies

Full details of our risk of bias (ROB) results are provided in Supplementary Material A . Of the three qualitative studies assessed using the Critical Appraisal Skills Program (CASP), all three were deemed to have utilised and reported appropriate methodological standards on at least 8 of the 10 criteria. Twenty studies were assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, with all studies clearly reporting the research question/s or objective/s and study population. However, only four studies provided a justification for sample size, and less than half of the studies met quality criteria for items 6, 7, 9, or 10 (and items 12 and 13 were largely not applicable). Of concern, only four of the observational or cohort studies were deemed to have used clearly defined, valid, and reliable exposure measures (independent variables) and implemented them consistently across all study participants. Six studies were assessed using the Quality Assessment of Controlled Intervention Studies, with three studies described as a randomized trial (but none of the three reported a suitable method of randomization, concealment of treatment allocation, or blinding to treatment group assignment). Three studies showed evidence that study groups were similar at baseline for important characteristics and an overall drop-out rate from the study < 20%. Four studies reported high adherence to intervention protocols (with two not reporting) and five demonstrated that.study outcomes were assessed using valid and reliable measures and implemented consistently across all study participants. Importantly, researchers did not report or have access to validated instruments for assessing sport participation or physical activity amongst adults, though most studies provided psychometrics for their mental health outcome measure/s. Only one study reported that the sample size was sufficiently powered to detect a difference in the main outcome between groups (with ≥ 80% power) and that all participants were included in the analysis of results (intention-to-treat analysis). In general, the methodological quality of the six randomised studies was deemed low.

Initially, our discussion will focus on the review findings regarding sports participation and well-being, ill-being, and psychological health. However, the heterogeneity and methodological quality of the included research (especially controlled trials) should be considered during the interpretation of our results. Considering our findings, the Mental Health through Sport conceptual model for adults will then be presented and discussed and study limitations outlined.

Sports participation and psychological well-being

In summary, the evidence presented here indicates that for adults, sports participation is associated with better overall mental health [ 36 , 46 , 47 , 59 ], mood [ 56 ], higher life satisfaction [ 39 , 47 ], self-esteem [ 39 ], body satisfaction [ 39 ], HRQoL [ 60 ], self-rated health [ 61 ], and frequency of laughter [ 61 ]. Sports participation has also shown to be predictive of better psychological wellbeing over time [ 35 , 53 ], higher positive affect [ 55 ], and greater life satisfaction [ 55 ]. Furthermore, higher frequency of sports participation and/or sport played at a higher level of competition, have been linked to lower levels of mental distress, higher levels of body satisfaction, self-esteem, and overall life satisfaction in adults [ 39 ].

Despite considerable heterogeneity of sports type, cross-sectional and experimental research indicate that team-based sports participation, compared to individual sports and informal group physical activity, has a more positive effect on mental energy [ 49 ], physical self-perception [ 57 ], and overall psychological health and well-being in adults, regardless of physical activity volume [ 35 , 46 , 47 ]. And, karate-do benefits the subjective well-being of elderly practitioners [ 51 , 52 ]. Qualitative research in this area has queried participants’ experiences of jiu-jitsu, Australian football, and former and current American footballers. Participants in these sports reported that their participation was beneficial for psychological well-being [ 37 , 40 , 41 ], improved self-esteem [ 37 , 40 , 41 ], and enjoyment [ 37 ].

Sports participation and psychological ill-being

Of the included studies, n  = 19 examined the relationship between participating in sport and psychological ill-being. In summary, there is consistent evidence that sports participation is related to lower depression scores [ 43 , 48 , 61 , 62 ]. There were mixed findings regarding psychological stress, where participation in childhood (retrospectively assessed) was related to lower stress in young adulthood [ 41 ], but no relationship was identified between recreational hockey in adulthood and stress [ 54 ]. Concerning the potential impact of competing at an elite level, there is evidence of higher stress in elite athletes compared to community norms [ 39 ]. Further, there is qualitative evidence that many current or former national football league players experienced at least one mental health challenge, including depression, anxiety, difficulty controlling their temper, during their career [ 37 ].

Evidence from longitudinal research provided consistent evidence that participating in sport in adolescence is protective of symptoms of depression in young adulthood [ 43 , 53 , 58 , 63 ], and further evidence that participating in young adulthood is related to lower depressive symptoms over time (6 months) [ 35 ]. Participation in adolescence was also protective of manifestations of anxiety (panic disorder and agoraphobia) and stress in young adulthood [ 42 ], though participation in young adulthood was not related to a more general measure of anxiety [ 35 ] nor to changes in negative affect [ 55 ]). The findings from experimental research were mixed. Two studies examined the effect of karate-do on markers of psychological ill-being, demonstrating its capacity to reduce anxiety [ 52 ], with some evidence of its effectiveness on depression [ 51 ]. The other studies examined small-sided team-based games but showed no effect on stress or anxiety [ 34 , 49 ]. Most studies did not differentiate between team and individual sports, though one study found that adolescents who participated in team sports (not individual sports) in secondary school has lower depression scores in young adulthood [ 58 ].

Sports participation and social outcomes

Seven of the included studies examined the relationship between sports participation and social outcomes. However, very few studies examined social outcomes or tested a social outcome as a potential mediator of the relationship between sport and mental health. It should also be noted that this body of evidence comes from a wide range of sport types, including martial arts, professional football, and workplace team-sport, as well as different methodologies. Taken as a whole, the evidence shows that participating in sport is beneficial for several social outcomes, including self-control [ 50 ], pro-social behavior [ 50 ], interpersonal communication [ 34 ], and fostering a sense of belonging [ 40 ]. Further, there is evidence that group activity, for example team sport or informal group activity, is related to higher social connectedness over time, though analyses showed that social connectedness was not a mediator for mental health [ 35 ].

There were conflicting findings regarding social effects at the elite level, with current and former NFL players reporting that they felt socially isolated during their career [ 37 ], whilst another study reported no relationship between participation at the elite level and social dysfunction [ 39 ]. Conversely, interviews with a group of indigenous men revealed that they felt as though participating in an all-indigenous Australian football team provided them with a sense of purpose, and they felt as though the social aspect of the game was as important as the physical benefits it provides [ 40 ].

Mental health through sport conceptual model for adults

The ‘Health through Sport’ model provides a depiction of the determinants and benefits of sports participation [ 31 ]. The model recognises that the physical, mental, and social benefits of sports participation vary by the context of sport (e.g., individual vs. team, organized vs. informal). To identify the elements of sport which contribute to its effect on mental health outcomes, we describe the ‘Mental Health through Sport’ model (Fig.  2 ). The model proposes that the social and physical elements of sport each provide independent, and likely synergistic contributions to its overall influence on mental health.

The Mental Health through Sport conceptual model

The model describes two key pathways through which sport may influence mental health: physical activity, and social relationships and support. Several likely moderators of this effect are also provided, including sport type, intensity, frequency, context (team vs. individual), environment (e.g., indoor vs. outdoor), as well as the level of competition (e.g., elite vs. amateur).

The means by which the physical activity component of sport may influence mental health stems from the work of Lubans et al., who propose three key groups of mechanisms: neurobiological, psychosocial, and behavioral [ 64 ]. Processes whereby physical activity may enhance psychological outcomes via changes in the structural and functional composition of the brain are referred to as neurobiological mechanisms [ 65 , 66 ]. Processes whereby physical activity provides opportunities for the development of self-efficacy, opportunity for mastery, changes in self-perceptions, the development of independence, and for interaction with the environment are considered psychosocial mechanisms. Lastly, processes by which physical activity may influence behaviors which ultimately affect psychological health, including changes in sleep duration, self-regulation, and coping skills, are described as behavioral mechanisms.

Playing sport offers the opportunity to form relationships and to develop a social support network, both of which are likely to influence mental health. Thoits [ 29 ] describes 7 key mechanisms by which social relationships and support may influence mental health: social influence/social comparison; social control; role-based purpose and meaning (mattering); self-esteem; sense of control; belonging and companionship; and perceived support availability [ 29 ]. These mechanisms and their presence within a sporting context are elaborated below.

Subjective to the attitudes and behaviors of individuals in a group, social influence and comparison may facilitate protective or harmful effects on mental health. Participants in individual or team sport will be influenced and perhaps steered by the behaviors, expectations, and norms of other players and teams. When individual’s compare their capabilities, attitudes, and values to those of other participants, their own behaviors and subsequent health outcomes may be affected. When others attempt to encourage or discourage an individual to adopt or reject certain health practices, social control is displayed [ 29 ]. This may evolve as strategies between players (or between players and coach) are discussion and implemented. Likewise, teammates may try to motivate each another during a match to work harder, or to engage in specific events or routines off-field (fitness programs, after game celebrations, attending club events) which may impact current and future physical and mental health.

Sport may also provide behavioral guidance, purpose, and meaning to its participants. Role identities (positions within a social structure that come with reciprocal obligations), often formed as a consequence of social ties formed through sport. Particularly in team sports, participants come to understand they form an integral part of the larger whole, and consequently, they hold certain responsibility in ensuring the team’s success. They have a commitment to the team to, train and play, communicate with the team and a potential responsibility to maintain a high level of health, perform to their capacity, and support other players. As a source of behavioral guidance and of purpose and meaning in life, these identities are likely to influence mental health outcomes amongst sport participants.

An individual’s level of self-esteem may be affected by the social relationships and social support provided through sport; with improved perceptions of capability (or value within a team) in the sporting domain likely to have positive impact on global self-esteem and sense of worth [ 64 ]. The unique opportunities provided through participation in sport, also allow individuals to develop new skills, overcome challenges, and develop their sense of self-control or mastery . Working towards and finding creative solutions to challenges in sport facilitates a sense of mastery in participants. This sense of mastery may translate to other areas of life, with individual’s developing the confidence to cope with varied life challenges. For example, developing a sense of mastery regarding capacity to formulate new / creative solutions when taking on an opponent in sport may result in greater confidence to be creative at work. Social relationships and social support provided through sport may also provide participants with a source of belonging and companionship. The development of connections (on and off the field) to others who share common interests, can build a sense of belonging that may mediate improvements in mental health outcomes. Social support is often provided emotionally during expressions of trust and care; instrumentally via tangible assistance; through information such as advice and suggestions; or as appraisal such feedback. All forms of social support provided on and off the field contribute to a more generalised sense of perceived support that may mediate the effect of social interaction on mental health outcomes.

Participation in sport may influence mental health via some combination of the social mechanisms identified by Thoits, and the neurobiological, psychosocial, and behavioral mechanisms stemming from physical activity identified by Lubans [ 29 , 64 ]. The exact mechanisms through which sport may confer psychological benefit is likely to vary between sports, as each sport varies in its physical and social requirements. One must also consider the social effects of sports participation both on and off the field. For instance, membership of a sporting team and/or club may provide a sense of identity and belonging—an effect that persists beyond the immediacy of playing the sport and may have a persistent effect on their psychological health. Furthermore, the potential for team-based activity to provide additional benefit to psychological outcomes may not just be attributable to the differences in social interactions, there are also physiological differences in the requirements for sport both within (team vs. team) and between (team vs. individual) categories that may elicit additional improvements in psychological outcomes. For example, evidence supports that exercise intensity moderates the relationship between physical activity and several psychological outcomes—supporting that sports performed at higher intensity will be more beneficial for psychological health.

Limitations and recommendations

There are several limitations of this review worthy of consideration. Firstly, amongst the included studies there was considerable heterogeneity in study outcomes and study methodology, and self-selection bias (especially in non-experimental studies) is likely to influence study findings and reduce the likelihood that study participants and results are representative of the overall population. Secondly, the predominately observational evidence included in this and Eime’s prior review enabled us to identify the positive relationship between sports participation and social and psychological health (and examine directionality)—but more experimental and longitudinal research is required to determine causality and explore potential mechanisms responsible for the effect of sports participation on participant outcomes. Additional qualitative work would also help researchers gain a better understanding of the relationship between specific elements of the sporting environment and mental health and social outcomes in adult participants. Thirdly, there were no studies identified in the literature where sports participation involved animals (such as equestrian sports) or guns (such as shooting sports). Such studies may present novel and important variables in the assessment of mental health benefits for participants when compared to non-participants or participants in sports not involving animals/guns—further research is needed in this area. Our proposed conceptual model also identifies several pathways through which sport may lead to improvements in mental health—but excludes some potentially negative influences (such as poor coaching behaviors and injury). And our model is not designed to capture all possible mechanisms, creating the likelihood that other mechanisms exist but are not included in this review. Additionally, an interrelationship exits between physical activity, mental health, and social relationships, whereby changes in one area may facilitate changes in the other/s; but for the purpose of this study, we have focused on how the physical and social elements of sport may mediate improvements in psychological outcomes. Consequently, our conceptual model is not all-encompassing, but designed to inform and guide future research investigating the impact of sport participation on mental health.

The findings of this review endorse that participation in sport is beneficial for psychological well-being, indicators of psychological ill-being, and social outcomes in adults. Furthermore, participation in team sports is associated with better psychological and social outcomes compared to individual sports or other physical activities. Our findings support and add to previous review findings [ 1 ]; and have informed the development of our ‘Mental Health through Sport’ conceptual model for adults which presents the potential mechanisms by which participation in sport may affect mental health.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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We would like to acknowledge the work of the original systematic review conducted by Eime, R. M., Young, J. A., Harvey, J. T., Charity, M. J., and Payne, W. R. (2013).

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Eather, N., Wade, L., Pankowiak, A. et al. The impact of sports participation on mental health and social outcomes in adults: a systematic review and the ‘Mental Health through Sport’ conceptual model. Syst Rev 12 , 102 (2023). https://doi.org/10.1186/s13643-023-02264-8

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Because of these and related benefits, "running can reduce your risk of developing osteoporosis and arthritis," says Austin "Ozzie" Gontang, a clinical psychotherapist and the director of the San Diego Marathon Clinic in California.

Healthy weight management is another quality-of-life advantage associated with running. One reason for this is that running at even a moderate pace of five miles per hour (many runners run in excess of 12 mph) burns 590 calories per hour in a 154-pound person, which is as much or more than any other CDC-measured physical activity including swimming, weightlifting, bicycling, or playing basketball. "Running is a powerful tool for burning calories and is crucial for weight loss and maintenance," says Gontang.

In this regard, it's also helpful that running increases energy expenditure and boosts one's metabolism by helping the body metabolize fats and carbs , "both during exercise and after we eat," says Olenick. In similar fashion, running has also been shown to help with healthy blood-sugar regulation.

Mental health advantages

Running's mental health plusses are no less intriguing. "Running can be done on your own, but often has a social component as well, whether it's running with a friend or being part of a running club or virtual community," says Karmel Choi, a clinical psychologist at Massachusetts General Hospital and Harvard Medical School. "This adds to the emotional benefits by reducing isolation and increasing a sense of support and motivation."

The activity can also be good for depression. Choi points to a recent study that found that individuals with depression who started running regularly "recovered at similar rates to those taking antidepressants." She's published supportive research and notes that her team estimates that if someone swapped just 15 minutes of sitting for 15 minutes of running each day, they could "reduce their risk of depression by as much as 26 percent." Part of the reason for this is because running has been shown to release "feel-good hormones like endorphins and dopamine , that have been linked to better mood, reduced stress, and even the 'runner’s high,'" Choi explains.

Beyond helping one feel better, running is associated with improved cognitive function. "Running can boost brain function by enhancing memory and learning capabilities," says Gontang. He says this occurs because running increases blood flow to the brain and stimulates the production of a molecule known as the brain-derived neurotrophic factor (BDNF), "which supports the growth of new neurons and protects existing brain cells."

Getting started

Perhaps most compelling of all is that there are very low costs and almost no barriers of entry associated with participating in the sport. "Running can seem intimidating because it sometimes seems like people need all the latest watches or gear or tools or shoes to participate, but people can simply start with a road or trail near them, and often things they already own," says Olenick.

To get started, begin slow and then work up to higher and higher fitness levels.

"Try and make it easier to increase physical activity in your daily life and within the context of daily activities you're already doing such as parking a bit further from the grocery store or taking the stairs at work," suggests Rajesh Vedanthan, a physician and population health scientist at NYU Langone Health in New York City. From there, he suggests briskly walking around the block before attempting jogging and then running.

Even after getting used to the movement, Lee suggests alternating running laps with walking or jogging laps. Adopting proper form and posture is also recommended. "Keep your head up and look forward as you run to align your spine," offers Gontang. He also says it's important to keep your shoulders relaxed and to keep your elbows at 90 degrees and to "avoid overstriding."

Developing a running schedule, finding a running buddy (the family dog counts!), and setting realistic and measurable goals are additional ways of staying motivated and keeping yourself accountable. "Proper shoe type and fit are also important," advises Ponzio.

As you go, she suggests listening to your body, avoiding doing too much, too quickly, and varying your surroundings, terrain, and destination. "Eventually, sign up for some races as the adrenaline of being part of something bigger with a community of like-minded runners is really so special," she says. "It keeps runners coming back for more."

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Argumentative Essay: The Importance of Sports

Participation in sports is extremely important, and should be encouraged much more. Children and young people in particular need to do sport so that they develop good habits that they can continue into adulthood. The main benefits of sport are improved health and fitness, and the development of social and communication skills.

With more than a third of adults in the USA being classed as obese, and many more being overweight, it has never been more important to participate in sports. People that do sport on a regular basis are burning more calories than those that don’t, and are therefore less likely to end up overweight. Being a healthy weight means that you will be less likely to die young and suffer from heart disease, strokes, high blood pressure, diabetes and a range of other conditions, and if you already eat well, it can give you an extra calorie allowance so you can treat yourself without feeling guilty about it.

As well as improving cardiovascular health and fitness, exercising is also good for the musculoskeletal system, making muscles more supple and toned, and improving the strength of bones and joints. People who do sports will be stronger and more able to lift and carry heavy things, which is also always useful, and they are less likely to become really weak and frail as they get older because their bodies are strong. Furthermore, doing sports can improve mental health as well as physical health, with exercise being helpful for people with depression and a range of other mental health issues, because it releases good chemicals into our brains. It also makes people feel better about their bodies, which can make them happier, and reduces the risk of eating disorders and crash dieting, as people make more sensible, healthy changes to their lifestyle.

Sports also allow people to develop personally. Social and communication skills can be learned and developed through sport. Teamwork, for example, is naturally learned through participating in team sports and games. Communication skills can really be honed, as they are at the center of any team’s success, and a lack of them leads to failure. Many people will also develop leadership skills through sport, often discovering abilities that they never knew they even had.

Many people’s self-esteem improves through sport as they discover things that they are good at and improve their body. Participating in any competitive sport also improves our ability to handle pressure and still perform well, as well as teaching us how to win and lose graciously. All in all, the fact that playing sport is good for us is completely undeniable, because it helps our minds and bodies, and ultimately means that we will be living longer, happier lives.

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Home — Essay Samples — Psychology — Body Image — Why Sport Is Important For Our Body’s Health

Why Sport is Important for Our Body’s Health

• Categories: Body Image Healthy Lifestyle

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Published: Jul 30, 2019

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The Benefits of Sport

Improving every australian's life through sport.

Sport's impact on the Australian way of life is underestimated. It's at the very heart of every community impacting our culture, society and economy. Sport has the ability to improve the health and wellbeing of all that participate regardless of age, ability, background or gender. 

The benefits of sport go well beyond just health. You can't underestimate the positive impact sport has on our culture, society and economy. Our communities are strengthened when we come together to play sport, building a sense of belonging and feeding our national identity.

Better Health, It's just the Beginning

We all know that physical activity is the key to good health. Regular activity helps prevent a range of diseases, heart attacks, cancer and diabetes, but sport does more than just keep us physically healthy. An entire community benefits from sport participation. From players to family to volunteers, sport brings people together.

This allows new friendships to form and builds a sense of belonging and pride. The confidence that is built from playing sport helps foster important life skills which benefits individuals through to adulthood. Not only do people who play perform better academically, it improves our overall mental health and wellbeing in every aspect of life.

Communities Thrive Through Sport

Sport provides individuals, communities and the nation with benefits that go beyond just health.

Sport brings positivity and calmness into an individual's life. Research has shown it helps reduce anxiety and depression.

Sport improves social connectivity and inclusion. It builds communities, enables diversity through larger social networks and creates friends for life.

Educational

Kids who play sport learn critical life skills, build resilience and confidence which helps them perform better in school.

Sport: Strengthening the Economy of Australia

Sport is a major contributor to the economy of our Nation, generating around $50 billion each year and accounts for 2-3% of Australia’s GDP. Fourteen million Australians participate in sport annually, 1.8 million volunteer 158 million hours each year, and 220,000 are employed across the sector. However, sports economic impact goes much deeper than that. A child playing sport develops critical life skills which helps to produce more balanced and successful adults.

Competition early in life seems to particularly help women in breaking down the barriers in the workforce, with over 94% of women in executive positions having played competitive sport. Sport also encourages mixed ethnic friendship which helps to develop a culturally diverse community where individuals are not locked out from opportunities due to racial and background differences.

Total Economic Value

Sport generates around $50 billion to Australia's economy each year through direct economic, productivity and volunteering benefits.

Improved Cognitive Development

Research has shown playing sport improves a child’s attention, thinking, language, learning, and memory.

Building Success

A study done by espnW found that 94% of women in executive positions played competitive sport.

Building Social Cohesion

People who play sport are 44% more likely to have mixed-ethnic friendship groups than non-participants.

Building a Healthier Australia

It's clear the benefits of sport go way beyond health. But health and sport go hand in hand.  Playing sport has a positive impact on the physical and psychological health of people of all ages and social groups.

of exercise a day

Is all that is needed to reduce your risk of stroke, cardiovascular disease, metabolic syndrome and diabetes.  It helps maintain a healthy weight, improves moods and reduces stress.

reduction in cognitive decline in people who participate in high levels of activity.

People who participate in moderate activity show a 35% reduction compared with those who are sedentary.

150 Minutes

of physical activity each week can increase your life span for up to 7 years.

Higher levels of activity can increase your lifespan more, regardless of your weight, age or gender.

reduced rate of developing kidney cancer if you keep active.

Exercise improves immune systems and prevents high blood pressure levels that are linked to cancer.

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• Importance of Sports Essay for Students in English

Essay on Importance of Sports

Sports are very essential for every human life which keeps them fit and fine and physical strength. It has great importance in each stage of life. It also improves the personality of people. Sports keep our all organs alert and our hearts become stronger by regularly playing some kind of sports. sports has always given priority from old ages and nowadays it has become more fascinating. Due to the physical activity blood pressure also remains healthy, and blood vessels remain clean. Sugar level also reduces and cholesterol comes down by daily activity. Different people have different interests in sports but the action is the same in all sports. Sports are becoming big channels to make more capital/money day by day and the number of people is also increasing. By playing sports even at a young age you can also be better and free from some diseases. By playing sports lung function also improves and becomes healthy because more oxygen is supplied. Sports also improves bone strength even in old age.

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Significance of Sports in Student’s Life

Just like a diet of healthy nutrients is needed for nourishing the body, playing sports holds a great significance in enhancing our lives, especially for growing children. As a student, one has to face many challenges, and playing sports helps them cope with the exam pressure and prepare them for further challenges by providing them with physical and mental strength. 

Children who are indulged in physical activities sustain good values of mutual respect and cooperation. Playing sports teaches them skills such as accountability, leadership, and learning to work with a sense of responsibility and confidence.

Sports help in maintaining Good Health

In today’s era of excessive competition and changing environment, people barely care about our health and have to face its consequences in the later stages of their life. They easily become prey to many life-threatening health issues. Those who are indulged in regular physical activities can easily defend themselves from such diseases. Therefore, playing sports can resolve this concern.

Playing regular sports can help maintain diabetes, improve heart function, and reduce stress and tension in an individual. 

Get rid of Excess Weight

Most of the world’s population is obese, and as a result, many other health issues also arise. Hence, playing sports is one of the most recreational and helpful ways of burning calories. All you have to do is follow a healthy diet and play your favourite sport. You can be saved from exhausting workout routines in the gym by playing sports. 

Playing your favourite sports and shedding kilos, isn’t it like killing two birds with one stone!

Guard Your Heart

The heart is the most important organ of our body. With changing lifestyles, people are facing heart-related problems these days. The life of heart patients becomes difficult with lots of heavy medications and restrictions. Therefore, people need to indulge in outdoor games. Playing for even 30 minutes a day can do wonders for your life. The heart pumps better, and blood circulation improves whenever we play sports. Heart muscles get stronger, and hence it starts functioning at a better rate. 

Enhance Your Immunity

The immune system is the major player of the body in fighting infections. Those who easily catch infections and fall sick frequently can easily get healthier by working on their immune system. 

It becomes really difficult to live with poor immunity, take heavy medications frequently, and spend most of your time indoors just to prevent yourself from the effects of changing environments. Getting indulged in regular sports activities can help build your immunity greatly, and the most amazing part with it is that you can do it by just playing your favourite sport. 

Impact of Sports on an Individual’s Personality

Playing sports builds your personality and teaches you to live life in a better way. Getting involved in such activities teaches good values, ethics, and skills in your life. The person starts to have a positive outlook towards life and can easily deal with obstacles in their life. Not only this, but it also reduces the stress level in the person as such people start taking challenges with positivity. Their efficiency increases, so they can easily take up challenges confidently.

People can learn lots of important skills through their sports. Every sport teaches us the skills of handling difficult situations, quick- decisions making and problem-solving. By playing sports, one can learn the art of living and managing things and taking leads. 

Therefore, if you play sports, you are not just enjoying it; you are also learning many significant life lessons.

Nation’s Pride

All the good values and skills one learns by playing sports can prepare them to conquer any battle-fields. Many eminent sports personalities have brought laurels to our country by proving their mettle on different sports grounds. Some of them are; Sachin Tendulkar, Saina Nehwal, Mary Kom, Sardar Singh, Sania Mirza and many more.

These personalities are inspirations for all those who are passionate about playing sports. Hard work and dedication can help them reach their goals and can become inspirations for others one day.

Common Sports

There are varieties of sports activities you can choose from. Some of the most common sports are; Tennis, Badminton, Volleyball, Cricket, and Basketball.

Learning from Sports:

Sports bring discipline in life. It teaches the way of sitting, talking, walking etc. Without sports in human life it seems too boring, sports activate all the cells and keep the body active, fit and slim. Sports improve thinking ability and reduce the stress of the mind. Those people with not so much interest in sports are less active and also have chances of getting a disease in the early stage of life and also show lethargy in work. Sports should be made mandatory in school, so that at an early age they can know the benefits of sports. People also select their favourite sports players on their more interest in which sports, if we take cricket because in our country India cricket is played more and shown interest by many peoples, many players came but still name like Kapil dev, Sachin Tendulkar, M.S.Dhoni, Virat Kohli will be always favourite for their fans. If we take football players like Messi, Ronaldo and many others, they are an idol for many people who have an interest in football. Sports is generally recognized as a system of activities which are based in athletics such as Olympic games. Sports are always played under government rules which helps to serve fair competition, sports having following criteria like, it should be fair competition, giving no harm to any person, and the winner should be nominated by superior or from the best. In sports like chess improves the mind and thinking capacity. Since from the 21st century, there has been increased in a debate that whether transgender should be able to participate in any sports events.

Benefit of Technology in Sports: 

Nowadays technology also plays an important role in sports to judge the fair game for winners. It helps to judge a car racer by seeing properly on the screen, also in cricket like sometimes when it becomes difficult to make the decision again technology is used. In every sport, it has been utilised for fair play and to announce the winners. Research suggests that sports have the capacity to connect youth with positive thinking and provide positive development. For any sportsman, high education is not mandatory but required to be the best sportsman. It is his interest, strength and skills. We have seen in the last two decades women are also showing more interest in sports and for them also proper matches are arranged by the government. Sports give the feeling of living with a positive attitude. sports can be played in both indoor and outdoor, many indoor games like chess, carrom board, helps to improve the thinking power but the sports which are played in outdoor like football, cricket, Rugby, kabaddi etc helps to improve physical strength, thus the person who does more outdoor games should be more fit and slim. 3-4 decades ago the opportunity in sports was not much-showed interest which is shown by the present youth generation. Sports secure life and give a standard lifestyle. The 10 most popular sports played in the World are Soccer, Cricket, Basketball, Hockey, Tennis, Volleyball, Table Tennis and Baseball where Hockey was first played in India and became our national games. There are also some sports which are shown less interest like Kabaddi, Polo, Archery, Weightlifting etc. Swimming is known as the safest sport. So sports should be played by everyone because it helps our body in movement and gives good health. The study has proved that sports have better well controlled many diseases like heart attack, lung function, obesity, and thinking power. Ice hockey, soccer are the games which have the highest paid sportsmen. Also some sports can be played in small places and also some sports require large places. Sports keep us active and energetic, even in some treatment to recover from the disease sports are advised by the doctors. play sports on a regular basis and keep our self-fit, sports should not be neglected but it should be mandatory for everyone.

FAQs on Importance of Sports Essay for Students in English

1. Why Sports are Important?

Any sports makes you physically fit, increase your immune level and even encourage socialism among different people.

2. What are the Common Sports Played in India?

Cricket and Football are major sports played in India.

3. What is the National Sport of India?

Field Hockey has been considered as the national sport of India.Though it has some historical connect as well as popularity too.

 4. Which sports are the best for students to become more active?

Sports that require them to move about, such as Football and Basketball can be beneficial. Apart from them, students can also engage in Tennis and Martial Arts can also be good options.

5. How can students manage their study and sports times effectively?

Even when studies seem the most important, engaging in active sports is necessary to maintain overall health. So, students can set aside a few hours everyday in the evening to engage in the sports of their choice. This can help them take rest from studies and work towards maintaining their physical health as well.

6. Which home exercises are equally as effective?

When students do not have time to spare to play extensive sports, then home training can be a beneficial tool. Home-based exercises, such as skipping, running on the treadmill, yoga and pilates can be good substitutes for active sports.