Objectives To examine relationships between fitness, physical activity and psychosocial problems among English secondary school pupils and to explore how components of physically active lifestyles are associated with mental health and well-being.
Methods A total of 7385 participants aged 11–13 took a fitness test and completed self-reported measures of physical activity, attitudes to activity, psychosocial problems and self-esteem during the Fit to Study trial. Multilevel regression, which modelled school-level cluster effects, estimated relationships between activity, fitness and psychosocial problems; canonical correlation analysis (CCA) explored modes of covariation between active lifestyle and mental health variables. Models were adjusted for covariates of sex, free school meal status, age, and time and location of assessments.
Results Higher fitness was linked with fewer internalising problems (β=−0.23; 95% CI −0.26 to −0.21; p<0.001). More activity was also related to fewer internalising symptoms (β=−0.24; 95% CI −0.27 to −0.20; p<0.001); the relationship between activity and internalising problems was significantly stronger for boys than for girls. Fitness and activity were also favourably related to externalising symptoms, with smaller effect sizes. One significant CCA mode, with a canonical correlation of 0.52 (p=0.001), was characterised high cross-loadings for positive attitudes to activity (0.46) and habitual activity (0.42) among lifestyle variables; and for physical and global self-esteem (0.47 and 0.42) among mental health variables.
Conclusion Model-based and data-driven analysis methods indicate fitness as well as physical activity are linked to adolescent mental health. If effect direction is established, fitness monitoring could complement physical activity measurement when tracking public health.
- Physical fitness
- Physical activity
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Contributors HJ-B and HD conceived the study. CW, TW and NB acquired the data. TW, PS, TN, HJ-B and CW analysed and interpreted the data. CW drafted the manuscript. All authors critically reviewed the manuscript for important intellectual content and approved the final version for publication.
Funding This work was supported by the Education Endowment Foundation and The Wellcome Trust’s Education and Neuroscience Programme [grant number 2681]. HJ-B is funded by the Wellcome Trust (110027/Z/15/Z) and the NIHR Oxford Biomedical Research Centre. The Wellcome Centre for Integrative Neuroimaging is supported by core funding from the Wellcome Trust (203139/Z/16/Z). HD is supported by the Elizabeth Casson Trust and the NIHR Oxford Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Competing interests None declared.
Ethics approval Central University Research Ethics Committee of the University of Oxford (R48879).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement The authors agree to share anonymised data upon reasonable request.
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