As little as 75 minutes of moderate physical activity per week can have significant benefits for brain health and severe mental illnesses such as schizophrenia, according to Canadian researchers who reviewed evidence from multiple studies. The findings support the idea that exercise should be prescribed like a drug, with a clear plan for type, frequency, intensity, and duration.
Exercise as a Prescription
Dr Carl Zhou, of the University of Ottawa's department of psychiatry, said: "We still tend to treat exercise as general lifestyle advice. The evidence we reviewed supports something more deliberate: a prescription that names the type of activity, the frequency, the intensity, the duration, the safety considerations, and a plan for follow-up, just as we would for a medication."
The review highlighted research linking physical activity to improved memory and reduced symptoms of depression. People with schizophrenia and other severe mental health problems typically have higher rates of sedentary behaviour, weight-related conditions affecting the heart, and early death.
Evidence on Cognition and Physical Health
The researchers found evidence that physical activity could improve brain health in people with schizophrenia, including working memory and attention. They also noted that some research suggested exercise could improve memory, although this was less certain.
Dr Stanley Wong, of the University of Toronto's Department of Psychiatry, said: "In schizophrenia, exercise can work on psychiatric symptoms, cognition, and physical health at the same time, in a population with substantial unmet needs in all three. But the cognition findings rest on a limited set of modest trials, and adequately powered studies are what the field needs next."
Guidance for Patients
Writing in the journal Genomic Press, the review authors said doctors should help patients who could benefit "engage in movement that is safe, meaningful, and sustainable". They said most patients should start with a low-risk activity before increasing the volume and intensity gradually. Some patients with conditions such as frailty or respiratory conditions may need extra support.
The review added: "Compared with many medical interventions, exercise can be scalable and low-cost when access barriers are addressed."
NHS Recommendations
The NHS recommends that adults aged 19-64 do at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity per week. Moderate aerobic activity includes brisk walking, water aerobics, cycling, dancing, or pushing a lawn mower.
People who have not exercised for some time or who have medical conditions or concerns can speak to their GP for support to ensure their activity and its intensity are appropriate. The health service also recommends doing strengthening activities that work all the major muscle groups at least twice a week, and reducing sedentary time.
