self control during physical activity essay

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• Published: 06 March 2024

The association between physical activity, self-efficacy, stress self-management and mental health among adolescents

• Ge Zhang 1 ,
• Wanxuan Feng 1 ,
• Liangyu Zhao 1 ,
• Xiuhan Zhao 1 &
• Tuojian Li 1  

Scientific Reports volume  14 , Article number:  5488 ( 2024 ) Cite this article

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This study aimed to explore the interplay between physical activity, self-efficacy, stress self-management and mental health among adolescents. The study gathered data from an online survey conducted among 400 Chinese middle school students (mean age = 13.74 years). The collected data were analyzed using SPSS 27.0 and PROCESS 4.1. The findings indicated a positive and significant relationship between physical activity, self-efficacy, stress self-management, and mental health. Notably, the association between physical activity and mental health was entirely mediated by self-efficacy and stress self-management. Moreover, self-efficacy and stress self-management exhibited a chain mediation effect on the relationship between physical activity and mental health. It is suggested that interventions focusing on physical activity should prioritize strategies for enhancing students’ self-efficacy and stress self-management skills as integral components of promoting adolescents’ mental health. Future research should delve into identifying specific types of physical activities that have a greater potential to enhance self-efficacy and stress self-management abilities.

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Introduction

According to the WHO, 14% 10–19 year-olds experience mental health conditions, accounting for 13% of the global burden of disease in this age group. Depression, anxiety and behavioural disorders are among the leading causes of illness and disability among adolescents. By 2030, depression alone is projected to become the primary cause of disability and reduced life expectancy 1 . Adolescents are immature in physiological and psychological development and facing greater pressures in various aspects such as higher education, self and peer, are observed to be more susceptible to experiencing mental health issues 2 , 3 . Moreover, psychological challenges during adolescence can significantly influence mental health in adulthood, leading to adverse outcomes 4 . Understanding the pathways that contribute to adolescents’ stress self-management levels and mental health is crucial for implementing effective measures to prevent and alleviate serious issues like anxiety and depression.

Physical activity is recognized as a significant means to foster the holistic development of adolescents, encompassing both physical and mental health. Prior studies have indicated that engaging in moderate-to-vigorous physical activity is linked to reduced depression and anxiety 5 , 6 . Consistently participating in physical activity has been correlated with improved mental health 7 , 8 , 9 . Regular engagement in physical activity implies that adolescents develop better self-management skills and time allocation, often characterized by increased autonomy. This behavior reduces the likelihood of engaging in activities detrimental to their mental well-being, such as excessive screen time 10 . In addition, they can cope with the emergency stressors better which makes them keep more stable mental health 11 . However, a recent study discovered that adolescents engaging exclusively in individual physical activities reported higher psychological issues like anxiety and depression compared to non-participants 12 . Furthermore, a study demonstrated that individuals with high rumination stress exhibited heightened negative emotional responses after a solitary riding intervention subsequent to stress-inducing stimuli 13 . Variations in the type of physical activity appear to yield distinct effects on mental health, with individuals’ characteristics also influencing how physical activity impacts their mental well-being 14 . The precise psychological processes altered by physical activity remain to be clearly delineated.

Self-efficacy, a key component of Bandura’s social cognitive theory, is considered integral to social competence. It encompasses individuals’ belief in their ability to effectively navigate the demands of dynamic societal conditions and to tackle challenges in evolving societies 15 . Connolly discovered a connection between one’s behavior, social environment, and self-efficacy 16 . Furthermore, the exercise and self-esteem models suggest that physical activity is linked to the process of self-perception and self-evaluation. Individuals who engage in regular physical activity consistently demonstrate elevated levels of self-efficacy 17 . Furthermore, a previous study indicated that individuals with initially high levels of physical activity, even if declining, exhibited greater self-efficacy than those with low physical activity levels that were also declining 18 . This phenomenon could be attributed to the consistent accomplishment of self-set physical activity goals, contributing to heightened self-confidence and self-perception. Consequently, individuals may develop an enhanced sense of self-efficacy. Elevated levels of self-efficacy correlate with reduced depression and anxiety, as well as an increased sense of subjective well-being 19 . Earlier investigations demonstrated that typically developing adolescents exhibited higher self-efficacy in contrast to emotionally disturbed counterparts 16 . Individuals with greater self-efficacy exhibit increased confidence in addressing unforeseen life challenges, approach problems with a positive attitude, thereby fostering a heightened stability in their mental health. Physical activity potentially enhances mental well-being via the intermediary of self-efficacy, achieved by heightening the pleasure and emotional states during acute exercise sessions 20 .

Stress management involves techniques aimed at helping individuals recognize and cope with stressors through a range of strategies 21 . In contrast to general stress management, stress self-management pertains specifically to stress management behaviors undertaken voluntarily by individuals 22 . Earlier research categorized stress management strategies into dimensions of problem-focused, emotion-focused, and avoidance strategies 23 . Optimal selection of stress management strategies appears contingent upon the nature of the stressor. Broadly, problem-focused and emotion-focused strategies are adaptive coping mechanisms, while avoidance strategies tend to be maladaptive 23 , 24 , 25 . Individuals capable of selecting adaptive stress management strategies for particular stressors demonstrate enhanced stress self-management skills. Currently, adolescents primarily contend with substantial stressors arising from academic demands, which have exhibited a gradual upward trend over the past two decades 26 . Physical activity is recognized as a crucial stress management strategy. Research indicates that individuals engaging in regular physical activity exhibit improved cognitive and executive functions 27 , 28 . They are also more inclined to employ adaptive coping strategies for daily stressors and demonstrate enhanced resilience in facing unexpected challenges. Regular participation in physical activity is typically linked to elevated levels of stress self-management. Hampel’s research revealed that adolescents often employ maladaptive stress self-management strategies to address life stressors, interestingly, adaptive problem-solving and emotion-focused stress management strategies exhibited a decline with advancing age 29 . Research suggests that adolescents who predominantly resort to maladaptive stress self-management strategies are at a heightened risk of developing depression and anxiety 30 . Prioritizing stress management that centers on addressing the stressor directly for problem resolution, rather than avoiding or redirecting attention has been linked to improved mental health 31 . Consistent engagement in physical activity is believed to enhance cognitive and executive capacities in adolescents 27 . Consequently, adolescents acquire improved stress management skills, enabling them to address stressors directly and subsequently fostering positive impacts on mental health.

Self-efficacy and stress self-management may mediate the association between physical activity and mental health, but there is also an association between them. Drawing from self-efficacy theory, individuals tend to steer clear of tasks and situations they perceive as exceeding their capabilities, while engaging in activities they believe they are competent at 32 . Individuals with higher self-efficacy possess greater confidence in their abilities, leading them to embrace adaptive stress self-management strategies instead of avoidance tactics. As a result, they generally exhibit enhanced stress self-management skills. Prior studies have demonstrated that individuals with elevated self-efficacy are more inclined to employ constructive stress coping strategies 29 , 33 . Collectively, the mentioned studies reveal that self-efficacy and stress self-management, integral aspects of self-perception and self-competence, are regarded as significant protective factors for mental health 19 , 31 . It appears that the link between physical activity and mental health might be influenced initially by self-efficacy and subsequently by stress self-management.

Despite frequent exploration of the association between physical activity and mental health, the underlying mechanisms of this relationship largely remain elusive. Specifically, uncertainties persist regarding the impact of regular participation in physical activity on stress self-management ability, and whether self-efficacy and stress self-management act as mediators in the connection between physical activity and mental health. Consequently, there is a compelling need to investigate these interrelationships among adolescents. Furthermore, adolescents encounter stressors from various dimensions, and these stressors stand as significant contributors to psychological issues. Exploring protective factors influencing adolescents’ stress self-management levels and mental health statuses is pivotal for effective interventions aimed at enhancing adolescent mental well-being. Hence, the present study aimed to explore the correlation between physical activity, self-efficacy, stress self-management, and mental health among adolescents. Furthermore, it seeks to delve into the potential mediating roles of self-efficacy and stress self-management. Drawing from previous research, we have formulated a theoretical model (Fig.  1 ) and put forth the following hypotheses: (1) physical activity is positive related to mental health. (2) self-efficacy mediate the relationship between physical activity and mental health. (3) stress self-management mediate the relationship between physical activity and mental health. (4) self-efficacy and stress self-management play a chain mediation role between physical activity and mental health.

Hypothesis model.

Materials and methods

Participants and procedures.

In March 2023, a cross-sectional study was conducted using a convenient sampling method to collect data from 400 middle school students in Jinan, Shandong province. All methods were performed in accordance with the Declaration of Helsinki-Ethical Principles for Medical Research Involving Human Subjects and other relevant laws, regulations and ethical norms. Prior to the investigation, all participating investigators underwent formal training to ensure the study’s integrity. Students interested in participating were provided with an explanation of the study’s concept and purpose by the investigators. Upon agreeing to participate, students were given access to an electronic questionnaire, which they completed diligently. The questionnaire covered various aspects, including basic sociodemographic information, levels of physical activity, self-efficacy, stress self-management, and mental health indicators. I have followed the STROBE checklist of cross-sectional studies. The study protocol received ethical approval from the Ethics Committee of the School of Basic Medical Sciences, Shandong University (Approval No. ECSBMSSDU2023-1-74).

400 participants completed the questionnaire, and 43 of them were excluded due to miss values with an effective rate of 89.25%. Among them, 198 (55.5%) were male and 159 (44.5%) were female, 140 (39.2%) were grade 1, 98 (27.5%) were grade 2, 119 (33.3%) were grade 3, 17 (4.8%) came from single-parent family, all came from city. The average age of participants was 13.74 (SD = 1.037) from age 12–16 years.

• Physical activity

The Health Promotion Lifestyle Profile includes Six dimensions that describe self-initiated actions and perceptions of health promotion behaviours 34 . In this study, we used physical activity dimension that include eight items to evaluate how often they adopt promotion physical activity. A 4-point Likert scale was used for quantification, with a score of 1 (never) to 4 (routinely) for each item. The scoring interval is 8 to 32 points. Higher scores indicated better exercise habits. In current study, Cronbach’s alpha coefficient is 0.9.

Self-efficacy

The Chinese version of the General Self-Efficacy Scale revised by Wang et al. was used to measure global self-efficacy of adolescents. The GSES consists of 10 items with 4-point score ranging from 1 (not at all true) to 4 (completely true) 35 . The range of the total scale was 10–40 points. Higher scores indicated higher levels of general self-efficacy. In this study, the Cronbach’s alpha coefficient is 0.92.

• Stress self-management

The Health Promotion Lifestyle Profile (HPLP) stress management subscale was used to measure the adolescent stress self-management level 34 . The questionnaire on stress self-management includes 8 items and asked respondents to indicate how often they adopted health-promoting stress management behaviours. A 4-point Likert scale ranging from 1 (never) to 4 (routinely) was used to quantification. The range of total scale was 8–32 points. Higher the scores indicated higher levels of stress self-management. The Cronbach’s alpha coefficient is 0.87.

• Mental health

The Kessler 10 Psychological Distress Scale (K10) is a short self-management rating scale that can detect the risk of psychological conditions in a population 36 . The 10-item scale measured the frequency of non-specific mental health-related symptoms such as anxiety and depression levels experienced in the previous 4 weeks. Likert’s 5-point scoring method was used for each question, and 1 (all the time) to 5 (hardly) points were scored. Higher the scores indicated better mental health. The Cronbach’s alpha coefficient is 0.95.

Statistical analysis

The data initially collected through the questionnaire platform, specifically the Questionnaire Star platform ( https://www.wjx.cn/ ), was exported for analysis. Descriptive statistics, Cronbach’s alpha test, reliability assessments, and spearman correlation analyses were conducted using SPSS version 27. For the mediation analysis, Hayes’ PROCESS macro in SPSS (version 4.1) was employed. The bootstrap method, involving 5000 resampling iterations to establish robustness and accuracy, was utilized to establish 95% confidence intervals (CIs) for determining the significance of mediating effects. Significance was attributed to direct or indirect effects when the CI did not encompass zero. Gender, age, grade and family structure were included as control variables in the model.ALL variables were standardized before their inclusion in the mediation model.

Institutional review board statement

All materials and procedures of this study were approved by the Ethics Committee of the School of Basic Medical Sciences, Shandong University (Approval No. ECSBMSSDU2023-1-74).

Informed consent statement

Written informed consent has been obtained from the patients.

Common method bias analysis

The data for this study were gathered through an online self-assessment approach, which has the potential to introduce common method bias. To address this concern, Harman’s one-way analysis of variance test was conducted to scrutinise the factors associated with all the items encompassed in the study. Through exploratory factor analysis, 7 factors emerged with eigenvalues surpassing 1. However, the variance explained by the first factor was 30.06%, which is below the critical threshold of 40%. This analysis suggests that there is no significant common method bias 37 .

Descriptive statistics and correlation analysis

Descriptive statistics of the study variables and their bivariate correlations are shown in Table 1 . When r ≥ 0.4, there is a moderate and strong correlation 38 . The results indicated that physical activity was significantly and positively associated with self-efficacy (r = 0.409, p < 0.01), stress self-management (r = 0.716, p < 0.01) and mental health (r = 0.224, p < 0.01). Self-efficacy (r = 0.256, p < 0.01) was positively and significantly related to stress self-management (r = 0.406, p < 0.01) and mental health. In addition, there was a positive and significant association between self-efficacy and stress self-management (r = 0.373, p < 0.01).

Multicollinearity test

Since there was a significant correlation among all variables, multicollinearity problem may existed leading to unstable results. Therefore, this study conducted multicollinearity diagnostics and standardized the predictor variables in each subsequent equation (to Z-scores). The results found that the tolerance (1–17.7) of all predictor variables is greater than 0.1, and the Variance Inflation Factor (1.240–2.128) is less than 5. Therefore, there is no serious multicollinearity problem in the data, which meets the conditions for further chain mediation analyses.

Mediation analyses

After controlled variables such as gender, age, grade, and family structure among adolescents, a mediation effect test procedure was employed to assess the indirect impact of physical activity on mental health. This indirect effect was found to be mediated by self-efficacy and stress self-management 39 . The model’s fit and the significance of each path coefficient were evaluated using the PROCESS macro program in SPSS, as outlined by Hayes (2017).

Table 2 shows the regression coefficients for the self-efficacy and stress self-management mediators. The results showed that physical activity was positively and significantly associated with self-efficacy (β = 0.2797, p < 0.001) and stress self-management (β = 0.5535, p < 0.001). Self-efficacy and stress self-management (β = 0.1545, p < 0.001) and mental health (β = 0.2858, p < 0.001) was positively and significantly related. In addition, stress self-management and mental health was positively and significantly related (β = 0.6188, p < 0.001). No significant association was observed between physical activity and mental health.

Table 3 and Fig.  2 illustrates the results of the mediation analysis. The direct effect of physical activity on mental health was not significant, but the indirect effect was significant (95% CI: 0.3061-0.6065). The indirect effects of physical activity on mental health via self-efficacy and stress self-management were 0.0799 (95% CI: 0.0041-0.1801) and 0.3425 (95% CI: 0.2044-0.4948) significantly. In addition, the chained mediating effect of self-efficacy and stress self-management was 0.0267 (95% CI: 0.0070-0.0560). Therefore, self-efficacy and stress self-management play a complete mediating role between physical activity and mental health.

Effect of the chain-mediating model of self-efficacy and stress self-management on physical activity and mental health. ***p＜0.001.

This study explored the underlying mechanisms that link physical activity, self-efficacy, stress self-management, and mental health. The findings affirmed a noteworthy positive correlation between physical activity and mental health, thereby substantiating hypothesis H1. These results align with the findings of Doré et al. and consequently provide additional confirmation that physical activity stands as a crucial protective factor for mental health 7 .

Simultaneously, this study revealed that the link between physical activity and mental health lost its significance once the two mediating variables of self-efficacy and stress self-management were introduced. Moreover, the comprehensive indirect effect of these two mediating variables was deemed significant, and the indirect effect significantly outweighed the direct effect. This pattern indicated that self-efficacy and stress self-management jointly mediated the connection between physical activity and mental health. The outcomes indicated that physical activity initially predicted mental health without accounting for mediating variables. However, when self-efficacy and stress self-management were considered as mediating variables, their presence mediated the relationship between physical activity and mental health. This suggests that physical activity serves as a more distal factor influencing mental health, potentially due to its intrinsic nature. Physical activity is a consciously planned behavior rooted in personal intentions and motivations 40 . It also constitutes a behaviour shaped by external environmental influences, serving personal development or external incentives 41 . Positive outcomes or experiences gained from physical activity, particularly when proportional gains and positive experiences are achieved, are more likely to yield enhanced effects on mental health 42 , 43 , 44 . When adolescents were unable to obtain a good experience from physical activity or fail to meet their motivations, it may not have an impact on their mental health 45 . Physical activity experiences varied among individuals, and the effects of physical activity are not immediately perceptible 46 , 47 . Mental health improvements required prolonged intervention and was influenced by a multitude of factors 48 , with physical activity being just one of them. The time lag in observing the effects of physical activity on mental health can lead to its influence being overshadowed or affected by other factors, such as stressors and unexpected events in life 49 . Therefore, making adolescents more promptly aware of the benefits of physical activity is a core element in promoting their mental health.

The findings further substantiate the assertion that physical activity can influence mental health via the autonomous mediation of self-efficacy and stress self-management, as well as through the interconnected mediation of both. Hypotheses H2, H3, and H4 were confirmed. This underscores the significance of bolstered self-efficacy and proficient stress self-management as fundamental routes through which physical activity exerts its impact on mental health. In contemporary times, the Resilience Portfolio Model has emerged as a vital framework for comprehending the holistic landscape of protective factors and mental health processes among individuals navigating adversity 50 , 51 , 52 . This model delineates protective factors into three domains: regulation, meaning-making, and interpersonal factors, highlighting the pivotal role of enhancing self-worth, refining self-regulation, and fostering positive interpersonal relationships as crucial protective mechanisms for mental health 44 . Previous studies have illuminated the mediating role of resilience in connecting physical activity with mental health 53 . Likewise, research has identified self-efficacy and stress self-management, integral components of personal value and self-regulation, respectively as correlates of regular physical activity 32 , 33 . Self-efficacy theory posits that self-efficacy levels correlate with the perception of one’s capabilities and the mobilization of intrinsic cognitive resources, significantly influencing coping efficacy. Individuals endowed with high self-efficacy are inclined to harness their internal resources to confront life’s changes, thus showcasing enhanced stress management prowess. Conversely, individuals with lower self-efficacy often perceive themselves as incapable of effectively managing various life stressors, which may lead to passive coping strategies and reduced stress management efficacy. Further investigations have highlighted the association between self-efficacy and the behavioral stages of stress management, as outlined by the transtheoretical model 54 . The decrement in self-efficacy coincides with diminished engagement in stress self-management behaviors. Consequently, the impact of physical activity on mental health is channeled through the pathways of personal value and self-regulation, as well as through the intricate chain mediation involving personal value and self-regulation.

Indeed, the mediating role of self-efficacy can be illuminated from two key perspectives, both centered on the reinforcement of the personal value of physical activity. From this vantage point, self-efficacy operates through the lenses of individual perceptions regarding the effects and experiences derived from engaging in physical activity. Physical activity yields direct associations with a host of favorable outcomes encompassing physical fitness, body image, subjective physical well-being, positive emotional experiences, self-esteem, and overall life satisfaction 42 . This amalgamation of factors collectively constitutes a cognitive resource reservoir that bolsters mental health and fosters positive well-being. Those individuals who experience positive outcomes and emotions stemming from physical activity are more inclined to consistently take part in it. This sustained engagement fosters heightened self-perceptions, thereby contributing to elevated self-efficacy. As adolescents’ self-efficacy gains traction, the net result is a mitigation of negative emotions and a more optimistic approach to confronting life’s challenges. Previous research has underscored that mental health has direct links to positive and negative memory biases and positive interpretation biases, while the relationship with negative interpretation biases remains non-significant 55 . Consequently, individuals who reap positive exercise experiences and outcomes through physical activity tend to manifest heightened self-efficacy. This self-efficacy equips them with the tools to confront life’s stressors with a more optimistic disposition, thereby cultivating a more favorable and resilient psychological well-being.

From an alternative standpoint, the mediation effect of stress self-management can be illuminated through the lens of augmented self-regulation. A multitude of studies have underscored that physical activity engenders positive emotional experiences and exhibits a positive correlation with favorable responses to external stimuli 12 , 27 . When confronted with stress-inducing stimuli, individuals who engage in regular physical activity are more inclined to opt for adaptive coping mechanisms. Rooted in prior research, heightened levels of habitual physical activity are linked to an elevated capacity for stress self-management, for two plausible rationales. Firstly, individuals who consistently partake in physical activity tend to perceive lower levels of stress 24 . This, in turn, translates into a milder stress response. Such individuals are apt at emotional regulation, consequently manifesting a greater self-perceived efficacy in managing stress. Secondly, physical activity constitutes a deliberate behavior driven by intentions and goals, necessitating the coordinated functioning of an individual’s cognitive and executive systems. The self-regulatory system, meanwhile, is built on an individual’s cognitive response to intricate external contexts. Individuals who routinely engage in physical activity generally engage in positive cognitive reappraisal, enabling them to navigate changes in their external environment through adaptive means 27 . This skill set is indicative of heightened stress self-management capability.

In conclusion, this study holds noteworthy significance on multiple fronts. Theoretically, it constructs a comprehensive chain mediation model, unraveling potential mechanisms through which physical activity influences mental health. This contribution bears substantial theoretical implications for understanding the intricate underpinnings of mental health outcomes. Moreover, this research represents the pioneering exploration of the interplay between physical activity, self-efficacy, stress self-management, and mental health within the context of Chinese adolescents, thereby extending the application of The Resilience Portfolio Model. From a practical standpoint, this study offers valuable guidance for fostering the mental health of adolescents.

The outcomes of this study provide actionable insights into enhancing adolescent mental health. First, educational bodies, schools, and parents should prioritize the cultivation of adolescents’ awareness and habits related to physical activity. This strategic emphasis can effectively mitigate negative emotions through exercise, thereby nurturing robust mental health among adolescents. Furthermore, educational settings, especially physical education, should concentrate on instructing students to set goals for their physical activity endeavors. Conducting assessments of exercise objectives and outcomes, accompanied by timely encouragement, can notably bolster adolescents’ self-efficacy. Finally, schools were advised to disseminate information on the positive influence of consistent participation in physical activities on the enhancement of stress self-management aptitude and mental well-being. Schools can proactively broaden the scope of physical activity offerings that align with adolescents’ physiological attributes and preferences, thereby providing multifaceted stress-relief avenues and facilitating the ongoing improvement of mental health.

Limitation and implications

Despite the valuable insights provided by this study, it is important to acknowledge its inherent limitations. First and foremost, the study design employed was cross-sectional in nature, thus precluded the establishment of causal relationships. To establish causal inferences, future research endeavors could incorporate experimental methodologies or longitudinal follow-up investigations. Another limitation stems from the questionnaire-based approach utilized in this study, with subjects self-reporting their experiences. This method introduces the potential for self-report bias, subsequently impacting the accuracy and reliability of the gathered data. In subsequent studies, a combination of questionnaire and interview methods might yield more comprehensive and accurate measurements of the variables under investigation. Furthermore, the study’s focus on the mediating role of self-efficacy and stress self-management leaves room for the inclusion of additional relevant moderating variables in future research. By incorporating these variables, a more comprehensive understanding of how physical activity influences mental health can be achieved, allowing for a more nuanced exploration of the underlying dynamics.

In summary, this study elucidated the intricate relationship between physical activity and mental health, revealing the mediating roles of self-efficacy and stress self-management. This study underscores that the impact of physical activity on adolescents’ mental health operates through independent mediation of self-efficacy, independent mediation of stress self-management, and chain mediation involving both self-efficacy and stress self-management. These findings enrich our understanding of the predictive influence of physical activity on mental health. The implications of these findings extend to interventions aimed at fostering physical activity engagement, enhancing self-efficacy, and promoting effective stress self-management, all of which have the potential to positively contribute to enhancing adolescents’ mental health. As the field advances, future research endeavours could delve deeper into discerning which specific types of physical activity are particularly effective in bolstering self-efficacy and stress self-management abilities. This could provide valuable insights into crafting targeted and efficacious interventions to improve adolescent mental health.

Data availability

The data supporting this study’s findings are available from the corresponding author upon reasonable request.

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Acknowledgements

We thank all the participants for their efforts in our study.

The work was supported by Social Science Planning Project of Shandong province, grant number 21DTYJ01.

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Ge Zhang, Wanxuan Feng, Liangyu Zhao, Xiuhan Zhao & Tuojian Li

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Study design and data collection: T.L., X.Z.; Analysis and interpretation of the data: G.Z., W.F.; Writing original draft: G.Z. Writing-review and editing: L.Z., T.L., G.Z. All authors have read and agreed to the published version of the manuscript.

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Zhang, G., Feng, W., Zhao, L. et al. The association between physical activity, self-efficacy, stress self-management and mental health among adolescents. Sci Rep 14 , 5488 (2024). https://doi.org/10.1038/s41598-024-56149-4

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How Exercise Might Increase Your Self-Control

By Gretchen Reynolds

• Sept. 27, 2017

For most of us, temptations are everywhere, from the dessert buffet to the online shoe boutique. But a new study suggests that exercise might be a simple if unexpected way to increase our willpower and perhaps help us to avoid making impulsive choices that we will later regret.

Self-control is one of those concepts that we all recognize and applaud but do not necessarily practice. It requires forgoing things that entice us, which, let’s face it, is not fun. On the other hand, lack of self-control can be consequential for health and well-being, often contributing to problems like weight gain, depression or money woes.

Given these impacts, scientists and therapists have been interested in finding ways to increase people’s self-restraint. Various types of behavioral therapies and counseling have shown promise. But such techniques typically require professional assistance and have for the most part been used to treat people with abnormally high levels of impulsiveness.

There have been few scientifically validated options available to help those of us who might want to be just a little better at resisting our more devilish urges.

So for the new study, which was published recently in Behavior Modification , a group of researchers at the University of Kansas in Lawrence began wondering about exercise.

Exercise is known to have considerable psychological effects. It can raise moods, for example, and expand people’s sense of what they are capable of doing. So perhaps, the researchers speculated, exercise might alter how well people can control their impulses.

To find out, the scientists decided first to mount a tiny pilot study, involving only four men and women.

These volunteers, who had been sedentary and overweight, were told they would be taking part in an exercise program to get them ready to complete a 5K race, and that the study would examine some of the effects of the training, including psychological impacts.

The volunteers began by completing a number of questionnaires, including one that quantified their “delay discounting,” a measure that psychologists use to assess someone’s ability to put off pleasures now for greater enjoyments in the future. It tests, for instance, whether a person would choose to accept $5 today or $15 a week from now.

The delay-discounting questionnaire is generally accepted in research circles as a valid measure of someone’s self-control.

The volunteers then undertook a two-month walking and jogging regimen, meeting three times a week for 45 minutes with the researchers, who coached them through the sessions, urging them to maintain a pace that felt difficult but sustainable. Each week the men and women also repeated the questionnaires.

Finally, a month after the formal training had ended, the volunteers returned to the university for one more round of testing. (Later, two of them also ran 5K races.)

The results were intriguing, the researchers felt. Three of the four participants had developed significantly greater self-control, according to their delay-discounting answers, and maintained those gains a month after the formal training had ended. But one volunteer, who had missed multiple sessions, showed no changes in impulsivity.

A four-person study is too small to be meaningful, though, so the researchers next repeated the experiment with 12 women of varying ages, weights and fitness levels.

The results were almost identical to those in the pilot study. Most of the women gained a notable degree of self-control, based on their questionnaires, after completing the walking and jogging program. (In this experiment, they were told they were training for better fitness.)

But the increases were proportional; the more sessions a woman attended or the more her average jogging pace increased, the greater the improvement in her delay-discounting score.

These gains lingered a month after the training had ended, although most of the women had tapered off their exercise routines by then.

The upshot of these results would seem to be that exercise could be a simple way to help people shore up their self-restraint, says Michael Sofis, a doctoral candidate in applied behavioral science at the University of Kansas who led the study.

These two experiments cannot tell us, though, how exercise helps us to ignore a cupcake’s allure. But Mr. Sofis says that many past studies have concluded that regular exercise alters the workings of portions of the brain involved in higher-level thinking and decision-making, which, in turn, play important roles in impulse control.

Exercise also may have more abstract psychological impacts on our sense of self-control, he says. It is, for many of us, a concentrated form of delayed gratification. Exerting ourselves during a workout is not always immediately pleasurable. But it can feel marvelous afterward to know that we managed to keep going, a sensation that could spill over into later decision-making.

Of course, with a total of only 16 participants, these experiments remained small-scale and limited, relying on a fundamentally artificial, mathematical measure of self-control. The scientists did not, for example, track whether the volunteers became less impulsive in their actual daily lives. Mr. Sofis and his colleagues hope to conduct follow-up studies that will look at the real-world impacts of exercise on self-control.

But for now, he says, these results suggest that normal people “can change and improve their self-control with regular physical activity.”

Let Us Help You Pick Your Next Workout

Looking for a new way to get moving we have plenty of options..

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Viral online exercise challenges might get you in shape in the short run, but they may not help you build sustainable healthy habits. Here’s what fitness fads get wrong .

Does it really matter how many steps you take each day? The quality of the steps you take might be just as important as the amount .

Is your workout really working for you? Take our quiz to find out .

To help you start moving, we tapped fitness pros for advice on setting realistic goals for exercising  and actually enjoying yourself.

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Pick the Right Equipment With Wirecutter’s Recommendations

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The Effects of Stress on Physical Activity and Exercise

• Systematic Review
• Published: 13 September 2013
• Volume 44 , pages 81–121, ( 2014 )

Cite this article

• Matthew A. Stults-Kolehmainen 1 &
• Rajita Sinha 1  

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Psychological stress and physical activity (PA) are believed to be reciprocally related; however, most research examining the relationship between these constructs is devoted to the study of exercise and/or PA as an instrument to mitigate distress.

The aim of this paper was to review the literature investigating the influence of stress on indicators of PA and exercise.

A systematic search of Web of Science, PubMed, and SPORTDiscus was employed to find all relevant studies focusing on human participants. Search terms included “stress”, “exercise”, and “physical activity”. A rating scale (0–9) modified for this study was utilized to assess the quality of all studies with multiple time points.

The literature search found 168 studies that examined the influence of stress on PA. Studies varied widely in their theoretical orientation and included perceived stress, distress, life events, job strain, role strain, and work–family conflict but not lifetime cumulative adversity. To more clearly address the question, prospective studies ( n  = 55) were considered for further review, the majority of which indicated that psychological stress predicts less PA (behavioral inhibition) and/or exercise or more sedentary behavior (76.4 %). Both objective (i.e., life events) and subjective (i.e., distress) measures of stress related to reduced PA. Prospective studies investigating the effects of objective markers of stress nearly all agreed (six of seven studies) that stress has a negative effect on PA. This was true for research examining (a) PA at periods of objectively varying levels of stress (i.e., final examinations vs. a control time point) and (b) chronically stressed populations (e.g., caregivers, parents of children with a cancer diagnosis) that were less likely to be active than controls over time. Studies examining older adults (>50 years), cohorts with both men and women, and larger sample sizes ( n  > 100) were more likely to show an inverse association. 85.7 % of higher-quality prospective research (≥7 on a 9-point scale) showed the same trend. Interestingly, some prospective studies (18.2 %) report evidence that PA was positively impacted by stress (behavioral activation). This should not be surprising as some individuals utilize exercise to cope with stress. Several other factors may moderate stress and PA relationships, such as stages of change for exercise. Habitually active individuals exercise more in the face of stress, and those in beginning stages exercise less. Consequently, stress may have a differential impact on exercise adoption, maintenance, and relapse. Preliminary evidence suggests that combining stress management programming with exercise interventions may allay stress-related reductions in PA, though rigorous testing of these techniques has yet to be produced.

Conclusions

Overall, the majority of the literature finds that the experience of stress impairs efforts to be physically active. Future work should center on the development of a theory explaining the mechanisms underlying the multifarious influences of stress on PA behaviors.

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Acknowledgments

National Institute of Health grants UL1-DE019586 and PL1-DA024859 supported the preparation of this manuscript. The authors would like to extend appreciation to the late Rafer Lutz, Ph.D. for his thorough and thoughtful critiques of this manuscript just before his passing in 2012. Dr. Lutz’s work made a special contribution to advances in this literature.

The authors declare no conflict of interest.

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Stults-Kolehmainen, M.A., Sinha, R. The Effects of Stress on Physical Activity and Exercise. Sports Med 44 , 81–121 (2014). https://doi.org/10.1007/s40279-013-0090-5

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ORIGINAL RESEARCH article

The influence of physical exercise on college students’ life satisfaction: the chain mediating role of self-control and psychological distress.

• Department of Physical, College of Education and Sports Sciences, Jingzhou, China

Objective: To explore the relationship between physical exercise and life satisfaction among college students and test the dual mediating role of self-control and psychological distress between them.

Methods: A sample of 526 Chinese college students completed questionnaires regarding physical exercise, life satisfaction, self-control and psychological distress, of which 38.4% were boys.

Results: Path analyzes indicated that physical exercise was positively correlated with life satisfaction, and this link could be mediated by self-control and psychological distress.

Conclusion: The present study identifies the potential underlying mechanism by which physical exercise is associated with the life satisfaction of college students, which has important implications for theory and prevention.

1. Introduction

Life satisfaction is an individual’s overall evaluation of his or her nearest living environment and living conditions ( Shin and Johnson, 1978 ) and is an individual’s overall evaluation of the environment ( Teodora et al., 2021 ). An individual’s positive satisfaction with their life as a whole or with specific components of their life plays a key role in achieving their life goals ( Teodora et al., 2021 ). At the freshman stage of university, students are in a special period of cognitive development. Students’ evaluation of their living situation is an important assessment indicator of their well-being, and good life satisfaction can help them to enhance their studies and promote physical and mental monitoring of their development ( Hui et al., 2021 ). Therefore, it is of positive significance to study the level of life satisfaction and the factors influencing it in a group of Chinese university students.

Previous studies have shown that the level of personal life satisfaction is not only influenced by the individual’s internal emotions (such as anger, frustration), but also influenced by external social factors (such as work environment) and behavioral lifestyles (such as physical and cultural activities) ( Cruz-Ferreira et al., 2011 ). Among these influences, people’s behavior and lifestyles are of wide concern to society ( Arslan and Akkas, 2014 ; Liu et al., 2021 ). Physical exercise is a physical activity that aims to develop physical fitness, improve physical and mental health and enrich the diversity of one’s life through a variety of reasonable physical means according to one’s needs ( Han, 2015 ). Physical exercise strengthens an individual’s immune system, maintains vigor and reduces the incidence of disease ( Yang and Liang, 2011 ). At the same time, physical exercise can also relieve negative heart emotions such as tension and anxiety caused by negative life events and help them develop a positive and optimistic attitude toward life ( Cao et al., 2021 ). During exercise, the brain secretes glucagon, which stimulates the hypothalamus to produce a pleasurable emotional experience. Therefore, physical activity will alleviate individuals’ negative emotions and help them develop their mental health in a positive direction ( Cao et al., 2021 ).

1.1. The association between physical exercise and life satisfaction

Data from previous studies point to a strong link between physical activity and life satisfaction among university students ( Liu et al., 2021 ). In recent years, there has been an increase in research on the relationship between physical activity and life satisfaction, and the positive effects of physical activity on life satisfaction are gaining attention from researchers ( Chen, 2005 ). Mehmet and Fatih (2018) proposed that regular physical activity actively increases personal satisfaction with life, Jetzke and Mutz (2020) physical activity was found to have an important role in improving the well-being of young people. At the same time, studies have shown that university students who participate in sports show higher levels of satisfaction with themselves than their peers who do not participate in sports ( Arslan and Akkas, 2014 ). Therefore, it is relevant to study the issue of the effect of physical activity on life satisfaction among university students from a physical and mental perspective. Based on the research, this study inferred that physical activity significantly and positively predicted life satisfaction among university students.

1.2. Self-control as a mediator

Research has found that people with high self-control tend to have better social adjustment skills (such as interpersonal skills and emotional regulation), which leads to better performance in their daily studies or work and therefore higher subjective well-being ( Tan and Guo, 2008 ). Life satisfaction is considered to be an important cognitive component of subjective well-being ( Diener, 1996 ). Self-control is a process by which individuals wish to improve their original behavior and thinking by reducing their own undesirable desires, a process by which new ways of behaving and thinking replace old ways of behaving and thinking ( Tan and Guo, 2008 ). On the other hand, it has been found in self-control studies that self-control can be induced through physical exercise ( Zhang et al., 2018 ). Baumeister et al. (2007) proposes in the self-control model theory that ‘self-control as an energy resource is depleted by the continuous performance of self-control tasks’. Therefore, if university students are able to control their behavior or thoughts in the process of participating in physical exercise, they will be able to improve their level of self-control in the process of completing physical exercise within the prescribed time ( Cheng and Wang, 2020 ). Based on the studies, this study infers that self-control plays a mediating role in the effect of physical activity on college students’ life satisfaction.

1.3. Psychological distress as a mediator

Psychological distress, also known as psychological distress, is an unpleasant emotional experience caused by a variety of factors, including psychological, social and spiritual dimensions, and can develop from the common fear, sadness, and vulnerability to anxiety, depression, and fear ( Hamer et al., 2009 ). Research shows that physical activity is a significant negative predictor of psychological distress ( Sun and Dai, 2007 ). For college students, active participation in physical activity is beneficial in regulating mood, enhancing sensory perception and enhancing internal motivation ( McMahon et al., 2017 ). Psychological measures were administered to subjects after participation in exercise and the data showed a significant decrease in both depressive states, anxiety and stress or psychological disorders ( Best, 2010 ). Individuals who do not participate in physical activity will experience anxiety and depression over a longer period of time than those who are physically active and regular ( Sun and Dai, 2007 ). The study also found that individuals with low levels of psychological distress had high levels of life satisfaction ( Yennurajalingam et al., 2018 ). Happiness is an essential characteristic of mental health, and when individuals have fewer negative emotions, they achieve a higher level of subjective well-being ( Yu, 2022 ), in other words, have better life satisfaction. Based on the findings, this study infers that psychological distress mediates the effect of physical activity on life satisfaction among university students.

1.4. The chain mediating effect of self-control and psychological distress

Self-control has been studied as an important component of mental health ( Duckworth et al., 2019 ). Self-controlled, temptation-denying decision-making provides clear positive self-signals ( Dhar and Wertenbroch, 2012 ), and self-control within an individual is navigated from different aspects using various elements of psychology ( Ge and Ho, 2021 ). Research has shown that self-control has two effects on mental states, one that promotes positive mental states (such as efficacy, self-esteem and life satisfaction) and one that inhibits negative mental states (such as anxiety, stress and suicidal ideation) ( Qi and Zhang, 2014 ). Research shows that self-control inhibits negative mental states more than it facilitates positive mental states ( de Ridder et al., 2012 ). And, individuals with high self-control have lower levels of psychological distress ( Ge et al., 2021 ; Shi and Ma, 2021 ). Therefore, this study infers that self-control and psychological distress play a chain mediating role in the effect of physical activity on life satisfaction among university students.

1.5. The present study

Although it has been suggested that self-control and psychological distress are associated with physical activity and life satisfaction among university students, it remains unclear how self-control and psychological distress affect this relationship. To our knowledge, this is the first study to consider the mediating effects of self-control and psychological distress. The present study contributes to a better understanding of the relationship between physical activity and life satisfaction among university students and contributes to the generalization of social control theory and general stress theory in the field of life satisfaction.

In many schools in China, at the end of the semester, in order for students to excel in exams, teachers of specialist subjects often take time away from PE lessons for students to revise. Teachers of specialist subjects believe that less PE lessons are irrelevant to their students. The purpose of this study is to raise awareness of the importance of physical exercise, to change the past disdain for physical exercise and physical education classes, to make society more aware of students’ psychological problems and to have practical implications for the reform and development of the education sector.

In short, using Chinese college students as participants, this study tested the mediating effect of self-control and psychological distress on the relationship between physical exercise and life satisfaction. Based on previous empirical research, we put forward four hypotheses: (1) physical exercise may be positively correlated with life satisfaction; (2) self-control may be the intermediary between physical exercise and life satisfaction; (3) psychological distress may be the intermediary between physical exercise and life satisfaction and (4) self-control and psychological distress play a chain mediating role between physical exercise and life satisfaction.

2.1. Participants

The participants in this study were recruited from two middle schools in Hubei, China through random cluster sampling. A total of 600 questionnaires were distributed, of which 526 were valid, and the effective recovery rate was 87.67%. There were 202 boys and 324 girls, with an average age of 18.82 (range = 17–19; SD = 1.706).

2.2. Procedures

The present study was approved by the Research Ethics Committee of the College of Education and Sports Sciences, Yangtze University. Convenience sampling was adopted to choose six to seven classes in each grade. Participants and their parents or legal guardians were provided with written consent forms, which informed them that personal information would be kept confidential and their responses would be used only for research purposes. The data were collected by trained senior students majoring in psychology during class time. To encourage honest reporting, college students were given approximately 30 min to complete the anonymous questionnaires.

2.3. Measures

2.3.1. physical exercise.

The physical training of college students was assessed using the “Physical Activity Rating Scale” developed by Liang (1994) . The scale assesses the physical exercise activity level from three aspects: exercise intensity, exercise time and exercise frequency, each of which is divided into five levels, scored from 1 to 5. Calculated as: amount of physical activity = exercise intensity × (exercise time-1) × exercise frequency; maximum score 100 points, minimum score 0 points and higher score means higher individual exercise. The physical activity level can be divided into 3 levels by the conversion of scores, and the classification criteria are as follows: small exercise ≤19 points, 20 points ≤ moderate exercise ≤42 points and large exercise ≥43 points. In order to facilitate the classification of sports activity levels, according to previous studies, the original ≤19 small exercise levels were divided into two criteria: no exercise ≤4 points and 5 points ≤ small exercise ≤19 points, so the sports activity levels in this study were divided into four levels ( Xia et al., 2018 ). Cronbach’s alpha coefficient for this questionnaire in this study was 0.60.

2.3.2. Life satisfaction

Observed using the Life Satisfaction Scale used by Pavot and Diener (1993) . There are 5 questions in this scale, which are scored by 7 points (“Strongly disagree” to “Strongly agree”). The level of life satisfaction was determined by the cumulative score of the questions. Cronbach’s alpha coefficient for this questionnaire in this study was 0.86.

2.3.3. Self-control

Tan used the “self-control scale” for measurement ( Tan and Guo, 2008 ). The scale consists of 19 topics, including five dimensions: individual impulse control level, lifestyle habits, resistance to temptation, focus on work, or study and rational entertainment. The scale is scored on a 5-point scale (“not at all” to “very much”). They are reverse scored except questions 1, 5, 11, and 14. The higher the score, the stronger the self-control ability. Cronbach’s alpha coefficient for this questionnaire in this study was 0.88.

2.3.4. Psychological distress

The simplified Chinese version of the Depression Anxiety Stress Scale revised by Gong et al. (2010) was used, which consists of 21 questions and contains three dimensions: depression, stress, and anxiety. A 4-point score (“not met” to “very met”) was used, and the higher the score, the stronger the degree of psychological distress. The Cronbach’s alpha coefficient for this questionnaire in this study was 0.95.

2.4. Statistical analysis

Statistical analysis was performed using SPSS 24. Common method deviance testing was performed first, followed by descriptive statistical analysis and Pearson’s correlational analysis of physical exercise, life satisfaction, self-control, and psychological distress. And finally, we employed the SPSS macro PROCESS (model 6) suggested by Hayes to test the proposed mediation model ( Hayes, 2013 ). This SPSS macro has been used to test mediating models in several studies, in which this SPSS macro showed higher statistical testability ( Lian et al., 2018 , 2021 ).

2.5. Common method deviation test

Exploratory factor analysis was used to test common method deviations ( Zhou and You, 2004 ). Taking all the questions of each questionnaire as the items for exploratory factor analysis, the explanation rate of the first common factor precipitated is 28.87%, which is much less than the critical criterion of 40%, so there is no serious common method deviation in the data of this study.

3.1. Descriptive statistics and associated analyzes

The results of correlation analysis of each variable (see Table 1 ) showed that physical exercise was significantly positively correlated with life satisfaction and self-control, and significantly negatively correlated with psychological distress; life satisfaction was significantly positively correlated with self-control and significantly negatively correlated with psychological distress and psychological distress was significantly negatively correlated with self-control.

Table 1 . Descriptive statistics and associated analysis results.

3.2. Mediation model testing analysis

Bootstrap ( Fang et al., 2012 ) was used to analyze the mediating effect of self-control and psychological distress. After controlling for gender, age and grade, 5,000 samples were randomly selected to estimate the 95% confidence interval of the mediation effect to analyze the mediation effect of self-control and psychological distress in the effect of physical exercise on life satisfaction, and the analysis results are shown in Table 2 .

Table 2 . Regression analysis of relationships among variables.

The overall effect of physical exercise on life satisfaction was significant ( β  = 0.10, p  < 0.05), but the predictive effect on life satisfaction was no longer significant when the mediating variable was added ( β  = −0.01, p  > 0.05). Physical exercise positively predicted self-control ( β  = 0.30, p  < 0.001). Psychological distress negatively predicted life satisfaction ( β  = −0.25, p  < 0.001).

Mediation effect analysis showed (see Figure 1 ; Table 3 ). Bootstrap 95% confidence intervals for the mediation effects of psychological distress and self-control did not include 0, indicating that psychological distress and self-control were mediating variables for physical exercise affecting life satisfaction. Among them, the mediating effect of self-control accounted for 60% of the total effect, and the chained mediating effect of self-control and psychological distress accounted for 30% of the total effect.

Figure 1 . Schematic diagram of chain mediation. * P  < 0.05.

Table 3 . Mediation effect test.

4. Discussion

This study investigated the effect of physical exercise on life satisfaction in college students and the mechanisms of self-control and psychological distress. The results showed that physical exercise had no significant predictive effect on college students’ life satisfaction, but it could indirectly affect college students’ life satisfaction through the intermediary effect of self-control and the chain intermediary effect of self-control and psychological distress. In addition, in the regression analysis of psychological distress, it is also found that the degree of psychological distress in women is greater than that in men. This phenomenon may be due to the fact that women do not feel as secure as men in the university environment and therefore can possess more psychological distress ( Etopio et al., 2019 ).

The direct effect of physical exercise on life satisfaction found in this study was not significant, consistent with the findings of McAuley et al. (2006) and Dai and Yao (2012) . In McAuley et al. (2006) study, by constructing an empirical model of the relationship between physical exercise and individual life satisfaction, it was found that reducing the number of times an individual participates in physical exercise decreases an individual’s chances of having a successful experience in physical exercise, which leads to a reduction in self-efficacy. Subsequently, it is accompanied by a decline in health status, which ultimately affects people’s quality of life. Self-efficacy is closely linked to self-control ( Chen et al., 2021 ). Therefore, physical exercise does not have a direct impact on life satisfaction as shown by previous findings but ultimately impacts life satisfaction through self-control and mental health status in turn.

This study further confirmed that self-control plays a completely mediating role between physical exercise and college students’ life satisfaction. On the one hand, college students’ physical exercise can significantly positively predict self-control. As an energy resource, self-control is continuously consumed in sports. If physical exercise is performed for a long time, this energy of self-control will be greatly increased in the body, so physical exercise will promote the improvement of self-control ( Baumeister et al., 2007 ; Cheng and Wang, 2020 ). On the other hand, self-control significantly predicted college students’ life satisfaction. Self-control is one of the most powerful abilities of the human mind to benefit most from the human mind because people can adjust themselves to improve their fit with the self and environment, and when people feel happiest and healthiest is when they match perfectly ( Tangney et al., 2004 ). People with high self-control adapt better to stress in life and work, and as a result, they have a higher sense of life satisfaction ( Tangney et al., 2004 ; Tavis et al., 2007 ).

The intermediate link of the path “physical exercise–self-control–psychological distress–life satisfaction” is the chain intermediary composed of “self-control–psychological distress” and is an important bridge for physical exercise to affect college students’ life satisfaction. This suggests that in addition to self-control alone playing a mediating role between physical exercise and life satisfaction in college students, physical exercise can also affect psychological distress by affecting self-control and then play a role in life satisfaction. Through long-term effective physical exercise, individuals can improve their own self-control level ( Zhang et al., 2018 ). In the process of physical exercise, with the individual requirements for self-movement and reasonable management of their own time, they can also improve their own self-control level. When individuals possess a high level of self-control, it will have a positive impact on their psychological state, thereby reducing the negative emotions of individuals and alleviating the adverse psychological state of the self ( Yu, 2022 ). Therefore, individuals with a high level of self-control tend to produce less adverse psychological states, which, in turn, reduce the degree of psychological distress. When individuals have low levels of psychological distress, subjectively, people will have a positive attitude toward life, so individuals will obtain a good emotional experience and then obtain a high level of life satisfaction ( Yu, 2022 ).

On the whole, this study explains the psychological mechanism of college students’ physical exercise affecting life satisfaction: physical exercise indirectly affects life satisfaction through independent mediation of self-control and chain mediation of self-control and psychological distress. Compared with previous studies, this study found that physical exercise does not directly affect individual life satisfaction, but indirectly affects individual life satisfaction through its effects on individual self-control and psychological distress. This study has important implications for improving college students’ life satisfaction. On the one hand, the educational administrators of colleges and universities should pay more attention to the daily physical exercise of college students, and at the same time, they should increase the publicity of the benefits of physical exercise to students. By strengthening the physical exercise of college students, they can reduce the negative psychological state of the students and improve their life satisfaction level. On the other hand, society and schools can pay more attention to the psychological state of college students and reduce the adverse events caused by their physical and mental conditions on campus or off campus.

5. Limitations and future directions

Limitations of this study and future directions should be noted. First, due to our cross-sectional research design, causality cannot be established. Future longitudinal or experimental studies can further examine the causal relationship between Physical Exercise and life Satisfaction. Second, self-reports may be subject to increased biases. Future studies should allow for a multidimensional approach to collect more objective. Finally, the results of the present study also need to be extended to a more representative sample of Chinese adolescents and to adolescents from other cultural backgrounds for a wider test.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics statement

The studies involving human participants were reviewed and approved by the Research Ethics Committee of the College of Education and Sports Sciences, Yangtze University. The patients/participants provided their written informed consent to participate in this study.

Author contributions

G-YZ and W-YC designed the work. G-YZ collected the data. G-YZ and HL analyzed and drafted the manuscript. G-YZ, BY, HL, and Q-SF revised the manuscript. All authors contributed to the article and approved the submitted version.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Tangney, J. P., Baumeister, R. F., and Boone, A. L. (2004). High self-control predicts good adjustment, less pathology, better grades, and interpersonal success. J. Pers. 72, 271–324. doi: 10.1111/J.0022-3506.2004.00263.X

Tavis, G., Chad, W. C., and Edessa, J. (2007). Alcohol self-control behaviors of adolescents. Addict. Behav. 32

Teodora, S., Dragan, B., Dejana, P., and Valentina, V. (2021). Academic performance and physical activities as positive factors for life satisfaction among university students. Sustainability 13:497. doi: 10.3390/SU13020497

Xia, X.-W., Huang, J.-L., and Liu, D. (2018). Investigation and study of university graduate students’ physical exercise behavior affecting factors. J. Phys. Educ. 25, 102–108. doi: 10.16237/j.cnki.cn44-1404/g8.2018.05.010

Yang, Z.-F., and Liang, L.-H. (2011). The influence and mechanism of physical training on the health of body and mind. J. Beijing Sport Univ. 34, 138–140. doi: 10.19582/j.cnki.11-3785/g8.2011.06.038

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Keywords: physical exercise, life satisfaction, self-control, psychological distress, undergraduate

Citation: Zhou G-Y, Yang B, Li H, Feng Q-S and Chen W-Y (2023) The influence of physical exercise on college students’ life satisfaction: The chain mediating role of self-control and psychological distress. Front. Psychol . 14:1071615. doi: 10.3389/fpsyg.2023.1071615

Received: 16 October 2022; Accepted: 10 January 2023; Published: 24 January 2023.

Reviewed by:

Copyright © 2023 Zhou, Yang, Li, Feng and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Bin Yang, ✉ [email protected]

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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How to Improve Your Self-Control

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Emily is a board-certified science editor who has worked with top digital publishing brands like Voices for Biodiversity, Study.com, GoodTherapy, Vox, and Verywell.

Verywell / Cindy Chung

Types of Self-Control

• Why It Is Important

Delaying Gratification

Ego depletion.

• Health Benefits

Motivation and Monitoring

How to improve self-control, frequently asked questions.

Self-control is the ability to regulate and alter your responses to avoid undesirable behaviors, increase desirable ones, and achieve long-term goals. Research has shown that possessing self-control can be important for health and well-being.

Psychologists typically define self-control as:

• The ability to control behaviors to avoid temptations and achieve goals
• The ability to delay gratification and resist unwanted behaviors or urges
• A limited resource that can be depleted

People use various terms for self-control, including discipline , determination, grit, willpower , and fortitude. Some researchers believe that self-control is partly determined by genetics, but it is also a skill you can strengthen with practice.

Self-control is one aspect of executive function, a set of abilities that helps people to plan, monitor, and achieve their goals. People with attention-deficit attention disorder (ADHD) often have characteristics linked to problems with executive function.

This article discusses how self-control is defined, why it is important, and some of the health benefits of having self-control. It also covers how to improve yourself and your ability to manage your behavior and resist temptation.

There are three primary types of self-control:

• Impulse control refers to the ability to manage urges and impulses. People who struggle with impulse control may act first without thinking about the consequences of their actions.
• Emotional control refers to the ability to regulate emotional responses. Someone who struggles with emotional control may find it hard to manage strong emotions. They may overreact, experience lasting bad moods, and get overwhelmed by the intensity of their feelings.
• Movement control refers to the ability to control how and when the body moves. A person who has difficulty with movement control may experience restlessness and find it difficult to remain still.

A self-controlled person exhibits a great deal of willpower and personal control. They don't act impulsively and can regulate their emotions and actions effectively.

Importance of Self-Control

How important is self-control in your day-to-day life? A Stress in America survey conducted by the American Psychological Association (APA) found that 27% of respondents identified a lack of willpower as the primary factor keeping them from reaching their goals. The majority of people surveyed (71%) believed that self-control can be both learned and strengthened.

Researchers have found that people who have better self-control tend to be healthier and happier, both in the short term and in the long term.

In one influential experiment, students who exhibited greater self-discipline had better grades, higher test scores, and were more likely to be admitted to a competitive academic program. The study also found that when it came to academic success, self-control was a more important factor than IQ scores .

The benefits of self-control are not limited to academic performance. One long-term health study found that high levels of self-control during childhood predicted greater cardiovascular, respiratory, and dental health in adulthood, as well as improved financial status.

Examples of Self-Control

Setting goals to exercise regularly, eat a balanced diet, be more productive, give up bad habits, and save money are just a few actions requiring self-control. More examples of self-control include:

• Avoiding social media when you are at work so that it doesn't hurt your productivity
• Not purchasing something you want because you are trying to stick to a budget
• Skipping sweet treats because you are trying to reduce your sugar intake
• Managing your emotional response when someone does something that makes you feel angry or upset

The ability to delay gratification , or to wait to get what you want, is an important part of self-control. People are often able to control their behavior by delaying the gratification of their urges.

For instance, someone who wants to attend an expensive concert might avoid spending their money on weekend shopping trips. They want to have fun, but they know that by waiting and saving their money, they can afford the exhilarating concert instead of the everyday mall trip.

Delaying gratification involves putting off short-term desires in favor of long-term rewards. Researchers have found that the ability to delay gratification is important not only for attaining goals but also for well-being and overall success in life.

The Marshmallow Test

The psychologist Walter Mischel conducted a series of well-known experiments during the 1960s and 1970s that investigated the importance of delayed gratification. In these experiments, children were offered a choice: They could choose to eat one treat right away (usually a cookie or a marshmallow), or they could wait a brief period of time in order to get two treats.

At this point, the researcher would leave the child alone in a room with a single treat. Not surprisingly, many of the kids chose to eat the single treat the moment the experimenters left the room. However, some of the kids were able to wait for the second treat.

Researchers found that children who were able to delay gratification in order to receive a greater reward were also more likely to have better academic performance than the kids who gave in to temptation immediately.

However, it has since been shown (through present-day studies that included a much wider array of test subjects than the very limited pool in the initial experiment) that a child's ability to delay gratification in this way is directly connected to their socioeconomic circumstances; that is, that if a child is experiencing poverty, neglect, or hunger at home, they are more likely to eat the marshmallow, as they've learned from experience that more food may not be coming.

The "Hot-and-Cool" System

Based on his research, Mischel proposed what he referred to as a "hot-and-cool" system to explain the ability to delay gratification. The hot system refers to the part of our willpower that is emotional and impulsive and urges us to act upon our desires. When this system takes over, we may give in to our momentary desires and act rashly without considering the potential long-term effects.

The cool system is the part of our willpower that is rational and thoughtful and enables us to consider the consequences of our actions in order to resist our impulses. The cool system helps us look for ways to distract us from our urges and find more appropriate ways to deal with our desires.

The ability to delay gratification is linked to a number of benefits, including better goal attainment and positive life outcomes. Finding ways to distract yourself from temptation can help you strengthen your ability to delay gratification.

Research has found that self-control is a limited resource. In the long term, exercising self-control tends to strengthen it. Practicing self-control allows you to improve it over time. However, self-control in the short term is limited.

Focusing all of your self-control on one goal makes it more difficult to exercise your self-control on subsequent tasks throughout your day.

Psychologists refer to this tendency as ego depletion . This happens when people use up their reservoir of willpower on one task, making them unable to muster any self-control to complete the next task.

Health Benefits of Self-Control

Self-control is also important for maintaining healthy behaviors. What you eat for breakfast, how often you work out, and whether you have a consistent sleep schedule are all decisions that can be affected by your levels of self-control.

Researchers have found that self-control can have a number of potential influences on health and well-being. One longitudinal study found that adults who had greater self-control in childhood were less likely to have:

• Airflow obstruction
• Elevated inflammation
• Metabolic abnormalities
• Periodontal disease
• Sexually transmitted infections
• Substance dependence or addiction to tobacco, alcohol, or cannabis

While it is clear that self-control is critical for maintaining healthy behaviors, some experts believe that overemphasizing the importance of willpower can be damaging.

The belief that self-control alone can help us reach our goals can lead people to blame themselves when their health is influenced by factors beyond their control. It may also lead to feelings of learned helplessness . If people feel that they cannot do anything to change a situation, they may give up quickly or simply stop trying in the face of obstacles.

According to psychologist and researcher Roy Baumeister, lack of willpower is not the only factor that affects goal attainment. If you are working toward a goal, three critical components must be present:

• There needs to be a clear goal and the motivation to change . Having an unclear or overly general goal (such as "getting stronger") and insufficient motivation can lead to failure. You are more likely to achieve a clearly defined goal (like bench-pressing 150 pounds) with a specific motivation.
• You need to track your actions toward the achievement of the goal . Simply setting the goal is not enough. You need to monitor your behavior each day to ensure that you are doing the things that need to be done in order to reach your goal.
• You need to have willpower . Being able to control your behavior is a critical part of achieving any goal. Fortunately, research suggests that there are steps people can take in order to make the most of their available willpower.

Willpower alone doesn't determine whether or not you will reach a goal. A range of other factors, including your motivation and ability to monitor your progress, also play a critical role.

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While research suggests self-control has its limitations, psychologists have also found that it can be strengthened with certain strategies.  

Avoid Temptation

This is an effective way of making the most of your available self-control. Avoiding temptation ensures that you do not "use up" your available self-control before it is really needed.

Whether it's the desire to eat, drink, spend, or indulge in some other undesired behavior, one way to avoid temptation is to find a healthy distraction.

Go for a walk, call a friend, throw in a load of laundry, or do whatever it takes to get your mind off whatever is tempting you at the moment.

Consider possible situations that might break your resolve. If you are faced with temptation, what actions will you take to avoid giving in? Research has found that planning ahead can improve willpower even in situations where people have experienced the effects of ego depletion.

For example, if you are trying to reduce your sugar intake and you have a hard time controlling late afternoon hunger pangs, eat a well-balanced lunch packed with plenty of fiber, protein, and whole grains that will keep you full longer.

Practice Using Self-Control

While your control might become depleted in the short term, regularly engaging in behaviors that require you to exert self-control will improve your willpower over time. Think of self-control as a muscle. While hard work may exhaust the muscle in the short term, the muscle will grow stronger over time as you continue to work it.

The classic games "red light, green light" or "freeze dance" can help children practice self-control from an early age.

Focus on One Goal at a Time

Setting a lot of goals at once (such as making a list of several New Year's resolutions ) is usually an ineffective approach. Depleting your willpower in one area can reduce self-control in other areas. It is best to choose one specific goal and focus your energy on it.

Once you turn the behaviors needed to reach a goal into habits, you will not need to devote as much effort toward maintaining them. You can then use your resources to work on other goals.

Meditation is a great way to strengthen your self-control muscle. If you're new to meditation, mindfulness meditation is a great place to start learning how to be more self-aware so you can better resist temptations. This technique can also help you learn to slow your thoughts, which can help you control the gut impulses that can get in the way of your self-control.

Remind Yourself of the Consequences

Just like self-control can help you achieve your goals and improve your physical and mental health, a lack of self-control can have adverse effects on your self-esteem , education, career, finances, relationships, and overall health and well-being. Reminding yourself of these consequences can help you stay motivated as you work to increase your self-control.

You can improve your own self-control with effort and practice. Avoiding temptations, making a plan, focusing on specific goals, and remembering the consequences of your actions can help you regulate your behavior more effectively.

Self-control refers to your ability to manage your behavior in order to achieve goals, improve positive outcomes, and avoid negative consequences. Self-control is an important skill that allows us to regulate behavior, and it is vital for attaining goals While self-control is a limited resource, there are things that you can do to improve and strengthen your willpower over time.

A Word From Verywell

Having good self-control can mean a number of benefits, including better academic success, better health, and greater success in life. If you are struggling with self-control, there are steps you can take to get better at managing your impulses, delaying gratification, and regulating your actions in order to achieve your goals.

There are many factors that can influence your self-control. Some mental health conditions can play a role in making self-control more difficult, including ADHD, substance use, sensory processing issues, social skills problems, and impulse control disorders.

It is partially influenced by genetics, but experiences can also play an important part. This means that you can strengthen your abilities to control your own behavior with effort and practice.

Learning how to plan effectively can help with self-control. When you want to accomplish something, think through the steps you will need to follow and develop a plan that will help you stay on track. Thinking about the consequences before you take an action can also help you control yourself in the moment and think more about your long-term goals instead of being swayed by immediate gratification.

It is common for young children to lack self-control because it is an ability that develops as children learn and grow. Different aspects of self-control also begin to emerge at different ages. Research suggests that emotional and behavioral control begins to develop between the ages of three and four years.

Conditions such as ADHD can make it more difficult for kids to control their impulses. Parents can encourage the development of healthy self-control in kids by practicing activities that involve self-control, setting appropriate limits, and using natural consequences.

Moffitt TE, Arseneault L, Belsky D, et al. A gradient of childhood self-control predicts health, wealth, and public safety . Proc Natl Acad Sci USA . 2011;108(7):2693-8. doi:10.1073/pnas.1010076108

Duckworth A, Grant H, Loew B, Oettingen G, Gollwitzer P. Self‐regulation strategies improve self‐discipline in adolescents: Benefits of mental contrasting and implementation intentions .  Educ Psychol (Lond) . 2011;31(1):17-26. doi:10.1080/01443410.2010.506003

Willems YE, Boesen N, Li J, Finkenauer C, Bartels M. The heritability of self-control: a meta-analysis . Neurosci Biobehav Rev . 2019;100:324-334. doi:10.1016/j.neubiorev.2019.02.012

American Psychological Association. Stress in America: Our health at risk .

Hofmann W, Luhmann M, Fisher RR, Vohs KD, Vaumeister RF. Yes, but are they happy? Effects of trait self-control on affective well-being and life satisfaction . J Person . 2014;82(4):265-277. doi:10.1111/jopy.12050

Duckworth AL, Seligman MEP. Self-discipline outdoes IQ in predicting academic performance of adolescents . Psychol Sci . 2005;16(12):939-44. doi:10.1111/j.1467-9280.2005.01641.x

Mischel W. The Marshmallow Test: Mastering Self-Control . Little, Brown and Co.

Watts TW, Duncan GJ, Quan H. Revisiting the Marshmallow Test: A Conceptual Replication Investigating Links Between Early Delay of Gratification and Later Outcomes. Psychol Sci. 2018 Jul;29(7):1159-1177. doi: 10.1177/0956797618761661. Epub 2018 May 25. PMID: 29799765; PMCID: PMC6050075.

Metcalfe J, Mischel W. A hot/cool-system analysis of delay of gratification: dynamics of willpower .  Psychol Review. 1999;106(1):3–19. doi:10.1037/0033-295X.106.1.3

Hagger MS, Wood C, Stiff C, Chatzisarantis NL. Ego depletion and the strength model of self-control: a meta-analysis . Psychol Bull . 2010;136(4):495-525. doi:10.1037/a0019486

Zhang Y, Feng B, Geng W, et al. “Overconfidence” versus “helplessness”: a qualitative study on abstinence self-efficacy of drug users in a male compulsory drug detention center in China . Subst Abuse Treat Prev Policy. 2016;11:29. doi:10.1186/s13011-016-0073-2

American Psychological Association. What you need to know about willpower: The psychological science of self-control .

Friese M, Messner C, Schaffner Y. Mindfulness meditation counteracts self-control depletion . Conscious Cogn. 2012;21(2):1016-22. doi:10.1016/j.concog.2012.01.008

Tao T, Wang L, Fan C, Gao W. Development of self-control in children aged 3 to 9 years: Perspective from a dual-systems model . Sci Rep . 2015;4(1):7272. doi:10.1038/srep07272

Baumeister R, Tierney J. Willpower: Rediscovering the Greatest Human Strength . Penguin Press.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Self-Control

Impulsivity, Willpower, Ego Depletion

Reviewed by Psychology Today Staff

Self-control—or the ability to manage one's impulses, emotions, and behaviors to achieve long-term goals —is what separates humans from the rest of the animal kingdom. Self-control is primarily rooted in the prefrontal cortex—the planning, problem-solving, and decision making center of the brain—which is significantly larger in humans than in other mammals.

The richness of nerve connections in the prefrontal cortex enables people to plan, evaluate alternative actions, and ideally avoid doing things they'll later regret, rather than immediately respond to every impulse as it arises.

• Staying In Control
• Willpower As a Finite Resource
• How to Regulate Your Behavior

The ability to regulate one's emotions and behavior is a key aspect of executive function , the suite of skills that allow an individual to plan, monitor, and attain goals . There is debate surrounding the degree to which self-control is an innate individual difference, versus a learned skill. Most experts believe that people who are disposed to lower levels of less self-control can still cultivate healthy habits and take counter-measures to control their behavior.

The idea of self-control as a stable trait isn’t always true. A person's level of self-control tends to wax and wane over the course of a day, suggesting that self-control is less like a mental capacity such as intelligence and more a fluctuating resource along the lines of physical energy.

Always avoid situations where you know you will confront temptation . For instance, if you’re tempted to eat junk food, stay away from fast-food restaurants, and don’t bother heading down the snack or baked-goods aisles of the supermarket. Avoiding triggers is key.

Self-control is not about self-deprivation, and it’s certainly not about punishment . But it is often about redefining what is pleasurable to you to keep destructive behaviors in check. It is about taking power over your own actions and learning to ignore immediate impulses, no matter how powerful they may be.

The ability to exert self-control is often referred to as willpower. It allows people to direct their attention despite the presence of competing stimuli, and it underlies all kinds of achievement, from school to the workplace. It benefits relationships as well.

There is significant debate in science as to whether willpower is a finite resource. Some studies indicate that exercising willpower makes demands on mental energy. This concept, called ego depletion, is one possible explanation for why individuals are more apt to reach for a chocolate chip cookie when they're feeling overworked.

Recently, however, scientists have failed to replicate some of the studies underlying the concept of ego depletion. A better understanding of why individuals give in to some impulses—but are able to successfully resist others—is critical for helping people who suffer from addictive behaviors, impulsivity, and eating disorders.

In the early 1970s, psychologist Walter Mischel conducted what is now known as the marshmallow test; he found that children who, left alone in a room with a plate containing a marshmallow, were able to resist eating the candy in order to be rewarded with two in the future, later showed numerous positive life outcomes. Notably, these children and fewer behavioral problems and better grades than did those who were unable to delay gratification in the test.

The famous test may not actually reflect self-control, which is a challenge to the long-held notion that the test does just that. There’s a temptation to over-generalize and jump to conclusions about how to give children a competitive advantage. Some researchers favor looking more closely at a variety of developmental influences, instead.

A person who thinks that self-control is a limited resource will be more likely to give in to temptations. Plus, when we perceive a task as effortful, we show poorer self-control. This may mean that you can have more control simply by shifting your perspective .

Whether the temptation is drugs, food, or scrolling through Twitter instead of working, everyone has domains of life in which they wish they could exercise a little more willpower. How can an individual build this critical skill? Recent research points to the use of rewards, routines, and mindfulness practices as possible ways to establish better habits and regulate behavior over the long-term.

Another approach is to develop an awareness of the triggers that derail self-control. The sights and smells emanating from a neighborhood bakery as one walks by can weaken the determination to maintain a healthy diet , but taking a different route that avoids the bakery can fortify it. Strengthening willpower may not always be easy, but doing so can significantly improve health, performance at work, and quality of life.

Practicing good habits is more impactful than having strong willpower. People who have better self-control rely on good habits more than willpower, which leads to better progress on our overall goals.

People who think about “why” they do something are able to exert greater self-control and persist longer at a task than those who think about “how” to do something. When we know the goal we seek, rather than the means of getting there, we’re more likely to put down the slice of pie and build up will

Researchers have found that under certain circumstances, pride increases self-control . But in other circumstances, pride gives people a license to indulge. The difference depends on the source of one’s pride. Self-control gets a boost when pride stems from feeling good about who you are.

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A recent study finds that we consider self-control as more authentic for ourselves but impulsive actions as more authentic for others. Here are some of the implications.

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78 Self-Control Examples

Self-control involves an individual’s conscious, deliberate suppression of impulses, drives, or urges that, if acted upon, could lead to undesirable consequences (Eisenberg, Spinrad, & Mart, 2018).

In essence, self-control signifies the human capacity to override an inner desire, avoiding instant gratification for the sake of long-term goals ( delayed gratification ) or social norms. 

Self-control can range from resisting the temptation to devour a decadent dessert when on a diet, to managing anger upon provocation, or even to resisting an impulsive purchase when on a restrictive budget.

Psychologists tend to associate strong self-control with positive personal and life outcomes. For example, research by Moffitt et al., (2011), in a longitudinal study spanning several decades, showed that individuals with higher levels of self-control during childhood were less likely to develop health problems and had better financial stability in adulthood.

In other words, your ability to exercise self-control from an early age could dramatically shape your life outcomes.

However, while the virtues of self-control seem pretty straightforward, there’s another side to the coin. Excessive self-control can lead to what scientists call “ego depletion” — a state where you’ve exerted so much mental effort trying to control your behaviors that you reach breaking point, and go on a ‘binge’ (Hagger, Wood, Stiff, & Chatzisarantis, 2010).

Self-Control Examples

1. Exercising instead of sleeping in Choosing to exercise rather than sleep in is an example of self-control because it involves consciously fighting the natural inclination to stay comfortable and restful in bed. The individual deliberately suppresses the immediate pleasure of lying in bed for the long-term health and wellness benefits that come from regular physical exercise. This action embodies the sacrifice and discipline often required to practice self-control. 

2. Resisting chocolate cake on a diet When a person on a diet successfully resists the temptation of a delicious chocolate cake, they are practicing self-control. The immediate gratification of eating the cake, which is likely high in sugar and unhealthy fats, is rejected in favor of longer-term health goals. This self-regulation can contribute significantly to a person’s overall well-being and success in following the dietary regimen.

3. Saving money for the future Choosing to save money instead of making unnecessary purchases demands a lot of self-control. The immediate satisfaction of buying something new is deferred in favor of future financial stability or potential investments. This act reflects an understanding of the value of delayed gratification and a prioritization of long-term goals over immediate wants.

4. Studying instead of watching television Choosing to study when you could be watching television is another case of practicing self-control. By putting the need for academic progress and knowledge acquisition above the immediate joy of entertainment, the individual is exercising self-control. This choice, while sometimes difficult, can contribute to academic success and personal growth .

5. Walking away from a heated argument Choosing to step away from a provoked disagreement demonstrates self-control, as it involves tempering emotions and avoiding the impulse to engage in verbal conflict. This action not only prevents the potential escalation of the argument, but it also exemplifies the individual’s ability to manage their emotions. Exercising self-control in such situations can lead to healthier interpersonal relationships.

6. Limiting screen time Limiting one’s time spent on digital devices, despite the allure of continuous entertainment and social interaction, is another manifestation of self-control. The immediate pleasure of screen activities is controlled to reduce potential negative effects such as disturbed sleep patterns, eye strain, or decreased physical activity. This decision showcases the individual’s ability to prioritize overall wellbeing over immediate pleasure.

7. Not gossiping about others Refraining from participating in gossip, despite the immediate satisfaction it may provide, is a clear example of self-control. By choosing not to spread rumors or share private information about others, the person exercises restraint and maintains respect for other people’s privacy. The practice of this kind of self-control can contribute to a more respectful and harmonious social environment .

8. Avoiding impulsive shopping Resisting the urge to make unnecessary purchases, especially when faced with attractive offers, signifies self-control. Bypassing the immediate gratification that comes from buying new items, the individual prioritizes their financial stability and security. This act of restrained consumer behavior underscores the person’s ability to control impulses.

9. Delaying gratification Delaying gratification, waiting for a greater reward in the future rather than experiencing an immediate one, epitomizes the practice of self-control. This could involve resisting an initial, lesser reward to reach a more significant goal down the line. It displays a strong sense of discipline and the ability to prioritize long-term benefits over short-term satisfaction.

10. Listening rather than interrupting Choosing to listen attentively when you have the impulse to interrupt is another form of self-control. By not giving into the urge to immediately express your thoughts and instead respecting the other person’s speaking time, you’re practicing restraint. Demonstrating such control contributes to productive and respectful communication.

Additional Examples

• Holding back from yelling when angry.
• Not responding to online trolls.
• Following a strict diet plan.
• Finishing tasks before playing games.
• Keeping calm in traffic.
• Taking regular study breaks.
• Managing time effectively.
• Keeping promises.
• Avoiding unhealthy foods.
• Limiting social media usage.
• Resisting urge to procrastinate .
• Avoiding excessive caffeine.
• Not overeating at a buffet.
• Practicing patience in queue.
• Not snapping at annoying people.
• Refraining from swearing.
• Maintaining regular sleep schedule.
• Not binge-watching series.
• Letting someone else speak first.
• Ignoring distracting notifications.
• Not taking the last cookie.
• Ignoring the urge to gossip.
• Taking deep breaths when stressed.
• Avoiding junk food.
• Saying no to peer pressure .
• Forgiving someone who hurt you.
• Not laughing at inappropriate times.
• Going to bed early.
• Not snacking late at night.
• Declining unnecessary social engagements.
• Setting boundaries at work.
• Completing chores before relaxing.
• Sticking to a budget.
• Not honking in traffic.
• Refusing extra dessert.
• Accepting criticism without arguing.
• Choosing water over soda.
• Adhering to a reading schedule.
• Limiting video game time.
• Ignoring the elevator, taking stairs.
• Controlling temper with children.
• Resisting urge to complain.
• Fasting intermittently.
• Conserving water and electricity.
• Staying faithful in a relationship.
• Walking instead of driving.
• Not cheating on a test.
• Resisting office gossip.
• Maintaining good posture.
• Not engaging in heated political debates.
• Waiting for your turn.
• Resisting urge to lie.
• Declining an unhealthy invitation.
• Keeping secrets when entrusted.
• Reading rather than watching TV.
• Working on improving bad habits.
• Reusing, reducing, and recycling.
• Taking care of personal hygiene.
• Meditating regularly.
• Not blaming others for your mistakes.
• Giving others the benefit of doubt.
• Not judging people hastily.
• Practicing gratitude daily.
• Ignoring distractions while working.
• Turning down a second helping.
• Waking up at a consistent time.
• Not checking phone during conversations.
• Prioritizing tasks over entertainment.

The Marshmallow Experiment: A Famous Test of Self-Control

The Stanford marshmallow experiment was a series of psychological studies led by psychologist Walter Mischel at Stanford University in the late 1960s and early 1970s (Mischel, Shoda, & Rodriguez, 1989).

This influential study in psychological research on self-control aimed to scrutinize a critical facet of human psychology — the capacity for delayed gratification, a key aspect of self-control – among young children..

In the experiment, a marshmallow was placed before young children, who were approximately 4-5 years old. These children had been given a difficult choice — they could either consume the marshmallow immediately or wait approximately 15 minutes without eating it, for which they would be rewarded with a second marshmallow.

The challenge, in essence, measured the children’s ability to exercise self-control.

The temptation was physical and immediate (the visible marshmallow), but the reward required patience.

The study found that some children gave into the temptation immediately, while others managed to wait and receive the second marshmallow (Mischel et al., 1989). The researchers inferred this ability to wait as an indicator of self-control.

As the researchers followed up with the participants in their later years, they found that children who were able to wait longer in the marshmallow test generally grew up to be adults with better life outcomes as measured by SAT scores, educational attainment, and even body mass index (Schlam, Wilson, Shoda, Mischel, & Ayduk, 2013).

However, more recent discussions around the Stanford marshmallow experiment have cautioned against oversimplifying self-control and repeatedly pointed out the potential influence of various external and contextual factors . For example, Kidd, Palmeri, and Aslin (2013) argue that the reliability of the environment, rather than inherent self-control, played a critical role in whether children decided to wait for the second marshmallow. In this perspective, self-control is not a fixed trait but is malleable, shaped by specific contexts and experiences. 

Accordingly, while the Stanford marshmallow experiment marked a vital starting point for considering self-control and delayed gratification, its reductionistic view has been increasingly scrutinized by subsequent research.

Eisenberg, N., Spinrad, T. L., & Mart, E. (2018). Prosocial development: A multidimensional approach . Oxford University Press.

Mischel, W., Shoda, Y., & Rodriguez, M. L. (1989). Delay of gratification in children. Science, 244 (4907), 933-938. doi: https://doi.org/10.1126/science.2658056  

Moffitt, T. E., Arseneault, L., Belsky, D., Dickson, N., Hancox, R. J., Harrington, H., … & Hagger, M. S., Wood, C., Stiff, C., & Chatzisarantis, N. L. D. (2010). Ego depletion and the strength model of self-control: a meta-analysis. Psychological bulletin, 136 (4), 495. doi: https://psycnet.apa.org/doi/10.1037/a0019486

Kidd, C., Palmeri, H., & Aslin, R. N. (2013). Rational snacking: Young children’s decision-making on the marshmallow task is moderated by beliefs about environmental reliability. Cognition, 126 (1), 109-114. doi: https://doi.org/10.1016/j.cognition.2012.08.004  

Schlam, T. R., Wilson, N. L., Shoda, Y., Mischel, W., & Ayduk, O. (2013). Preschoolers’ delay of gratification predicts their body mass 30 years later. The Journal of pediatrics, 162 (1), 90-93. doi: https://doi.org/10.1016/j.jpeds.2012.06.049

Chris Drew (PhD)

Dr. Chris Drew is the founder of the Helpful Professor. He holds a PhD in education and has published over 20 articles in scholarly journals. He is the former editor of the Journal of Learning Development in Higher Education. [Image Descriptor: Photo of Chris]

• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 5 Top Tips for Succeeding at University
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 50 Durable Goods Examples
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 100 Consumer Goods Examples
• Chris Drew (PhD) https://helpfulprofessor.com/author/chris-drew-phd/ 30 Globalization Pros and Cons

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• v.15(1); 2023 Jan

Role of Physical Activity on Mental Health and Well-Being: A Review

Aditya mahindru.

1 Department of Psychiatry, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND

Pradeep Patil

Varun agrawal.

In addition to the apparent physical health benefits, physical activity also affects mental health positively. Physically inactive individuals have been reported to have higher rates of morbidity and healthcare expenditures. Commonly, exercise therapy is recommended to combat these challenges and preserve mental wellness. According to empirical investigations, physical activity is positively associated with certain mental health traits. In nonclinical investigations, the most significant effects of physical exercise have been on self-concept and body image. An attempt to review the current understanding of the physiological and psychological mechanisms by which exercise improves mental health is presented in this review article. Regular physical activity improves the functioning of the hypothalamus-pituitary-adrenal axis. Depression and anxiety appear to be influenced by physical exercise, but to a smaller extent in the population than in clinical patients. Numerous hypotheses attempt to explain the connection between physical fitness and mental wellness. Physical activity was shown to help with sleep and improve various psychiatric disorders. Exercise in general is associated with a better mood and improved quality of life. Physical exercise and yoga may help in the management of cravings for substances, especially in people who may not have access to other forms of therapy. Evidence suggests that increased physical activity can help attenuate some psychotic symptoms and treat medical comorbidities that accompany psychotic disorders. The dearth of literature in the Indian context also indicated that more research was needed to evaluate and implement interventions for physical activity tailored to the Indian context.

Introduction and background

Physical activity has its origins in ancient history. It is thought that the Indus Valley civilization created the foundation of modern yoga in approximately 3000 B.C. during the early Bronze Age [ 1 ]. The beneficial role of physical activity in healthy living and preventing and managing health disorders is well documented in the literature. Physical activity provides various significant health benefits. Mechanical stress and repeated exposure to gravitational forces created by frequent physical exercise increase a variety of characteristics, including physical strength, endurance, bone mineral density, and neuromusculoskeletal fitness, all of which contribute to a functional and independent existence. Exercise, defined as planned, systematic, and repetitive physical activity, enhances athletic performance by improving body composition, fitness, and motor abilities [ 2 ]. The function of physical activity in preventing a wide range of chronic illnesses and premature mortality has been extensively examined and studied. Adequate evidence links medical conditions such as cardiovascular disease and individual lifestyle behaviours, particularly exercise [ 3 ]. Regular exercise lowered the incidence of cardiometabolic illness, breast and colon cancer, and osteoporosis [ 4 ]. In addition to improving the quality of life for those with nonpsychiatric diseases such as peripheral artery occlusive disease and fibromyalgia, regular physical activity may help alleviate the discomforts of these particular diseases [ 5 ]. Exercise also helps with various substance use disorders, such as reducing or quitting smoking. As physical exercise strongly impacts health, worldwide standards prescribe a weekly allowance of "150 minutes" of modest to vigorous physical exercise in clinical and non-clinical populations [ 6 ]. When these recommendations are followed, many chronic diseases can be reduced by 20%-30%. Furthermore, thorough evaluations of global studies have discovered that a small amount of physical exercise is sufficient to provide health benefits [ 7 ].

Methodology

In this review article, a current understanding of the underlying physiological and psychological processes during exercise or physical activity that are implicated in improving mental health is presented. Search terms like "exercise" or "physical activity" and "mental health", "exercise" or "physical activity" and "depression", "exercise" or "physical activity" and "stress", "exercise" or "physical activity" and "anxiety", "exercise" or "physical activity" and "psychosis," "exercise" or "physical activity" and "addiction" were used as search terms in PubMed, Google Scholar, and Medline. An overwhelming majority of references come from works published within the past decade.

The impact of physical health on mental health

There is an increasing amount of evidence documenting the beneficial impacts of physical activity on mental health, with studies examining the effects of both brief bouts of exercise and more extended periods of activity. Systematic evaluations have indicated better outcomes for mental diseases with physical activity. Numerous psychological effects, such as self-esteem, cognitive function, mood, depression, and quality of life, have been studied [ 8 ]. According to general results, exercise enhances mood and self-esteem while decreasing stress tendencies, a factor known to aggravate mental and physical diseases [ 9 ]. Studies show that people who exercise regularly have a better frame of mind. However, it should be highlighted that a consistent link between mood enhancement and exercise in healthy individuals has not been established.

Additionally, human beings produce more of these two neurochemicals when they engage in physical activity. Human bodies manufacture opioids and endocannabinoids that are linked to pleasure, anxiolytic effects, sleepiness, and reduced pain sensitivity [ 10 ]. It has been shown that exercise can improve attention, focus, memory, cognition, language fluency, and decision-making for up to two hours [ 11 ]. Researchers state that regular physical activity improves the functioning of the hypothalamus-pituitary-adrenal (HPA) axis, lowering cortisol secretion and restoring the balance of leptin and ghrelin (Figure ​ (Figure1) 1 ) [ 12 ].

HPA: hypothalamus-pituitary-adrenal

This image has been created by the authors.

Regular exercise has immunomodulatory effects such as optimising catecholamine, lowering cortisol levels, and lowering systemic inflammation. Physical activity has been shown to increase plasma brain-derived neurotrophic factor (BDNF), which is thought to reduce amyloid-beta toxicity linked to Alzheimer's disease progression [ 13 ].

Although no causal correlations have been proven, methodologically sound research has discovered a related improvement in mentally and physically ill populations. These findings are based on research and studies conducted all across the globe, particularly in the Western Hemisphere. In order to address a widespread health problem in India, it is useful to do a literature review that draws on research conducted in a variety of settings. In addition, the prevalence of these mental illnesses and the benefits of exercise as a complementary therapy might be made clear by a meta-analysis of research undertaken in India [ 14 ].

This review also analysed published literature from India to understand the effects of exercise on mental health and the implications for disease management and treatment in the Indian context. Results from Indian studies were consistent with those found in global meta-analyses. The Indian government has made public data on interventions, such as the effects of different amounts of physical exercise. Exercising and yoga have been shown to be effective adjunct therapies for a variety of mental health conditions [ 12 ]. Though yoga may not require a lot of effort to perform, other aspects of the program, such as breathing or relaxation exercises, may have an impact on a practitioner's mental health at the same time. Due to its cultural significance as a common physical practice among Indians and its low to moderate activity level, yoga would be an appropriate activity for this assessment [ 15 ].

Yoga as an adjunctive treatment 

Although yoga is a centuries-old Hindu practice, its possible therapeutic effects have recently been studied in the West. Mind-body approaches have been the subject of a lot of studies, and some of the findings suggest they may aid with mental health issues on the neurosis spectrum. As defined by the National Center for Complementary and Alternative Medicine, "mind-body interventions" aim to increase the mind's potential to alter bodily functions [ 16 ]. Due to its beneficial effects on the mind-body connection, yoga is used as a treatment for a wide range of conditions. Possible therapeutic benefits of yoga include the activation of antagonistic neuromuscular systems, stimulation of the limbic system, and a reduction in sympathetic tone.

Anxiety and depression sufferers might benefit from practising yoga. Yoga is generally safe for most people and seldom causes unintended negative consequences. Adding yoga to traditional treatment for mental health issues may be beneficial. Many of the studies on yoga included meditation as an integral part of their methodology. Meditation and other forms of focused mental practice may set off a physiological reaction known as the relaxation response. Functional imaging has been used to implicate certain regions of the brain that show activity during meditation. According to a wealth of anatomical and neurochemical evidence, meditation has been shown to have far-reaching physiological effects, including changes in attention and autonomic nervous system modulation [ 17 ]. Left anterior brain activity, which is associated with happiness, was shown to rise considerably during meditation. There's also some evidence that meditation might worsen psychosis by elevating dopamine levels [ 18 - 20 ]. We do not yet know enough about the possible downsides of meditation for patients with mental illness, since this research lacks randomised controlled trials.

Physical activity and schizophrenia

Schizophrenia is a debilitating mental disorder that often manifests in one's early years of productive life (late second decade). Remission of this disorder occurs in just a small fraction of cases. More than 60% will have relapses, and they might occur with or without noticeable deficits. Apart from delusions, hallucinations, and formal thought disorders, many patients exhibit cognitive deficits that emerge in the early stages of the disease and do not respond adequately to therapy [ 21 ].

Treatment for schizophrenia is challenging to master. Extrapyramidal side effects are a problem with first-generation antipsychotic drugs. Obesity and dyslipidemia have been related to second-generation drugs, which may cause or exacerbate these conditions. The majority of patients do not achieve complete remission, and many do not even experience satisfactory symptom relief. Even though certain antipsychotic medications may alleviate or even exacerbate negative and cognitive symptoms, these responses are far less common. This means that patients may benefit from cognitive rehabilitation. Because of their illness or a negative reaction to their medicine, they may also have depressive symptoms. This would make their condition even more disabling. Many patients also deal with clinical and emotional complications. Tardive extrapyramidal illnesses, metabolic syndromes, defect states, and attempted suicide are all in this category. Patient compliance with treatment plans is often poor. The caregivers take on a lot of stress and often get exhausted as a result.

Evidence suggests that increased physical activity can aid in attenuating some psychotic symptoms and treating medical comorbidities that accompany psychotic disorders, particularly those subject to the metabolic adverse effects of antipsychotics. Physically inactive people with mental disorders have increased morbidity and healthcare costs. Exercise solutions are commonly recommended to counteract these difficulties and maintain mental and physical wellness [ 22 ].

The failure of current medications to effectively treat schizophrenia and the lack of improvement in cognitive or negative symptoms with just medication is an argument in favour of utilising yoga as a complementary therapy for schizophrenia. Even without concomitant medication therapy, co-occurring psychosis and obesity, or metabolic syndrome, are possible. The endocrine and reproductive systems of drug abusers undergo subtle alterations. Numerous studies have shown that yoga may improve endocrine function, leading to improvements in weight management, cognitive performance, and menstrual regularity, among other benefits. In this context, the role of yoga in the treatment of schizophrenia has been conceptualized. However, yoga has only been studied for its potential efficacy as a therapy in a tiny number of studies. There might be several reasons for this. To begin with, many yoga academies frown against the practice being adapted into a medical modality. The second misconception is that people with schizophrenia cannot benefit from the mental and physical aspects of yoga practised in the ways that are recommended. Third, scientists may be hesitant to recommend yoga to these patients because of their lack of knowledge and treatment compliance.

In a randomised controlled experiment with a yoga group (n = 21) and an exercise group (n = 20), the yoga group exhibited a statistically significant reduction in negative symptoms [ 2 ]. In accordance with the most recent recommendations of the National Institute for Health and Care Excellence (NICE), the above research provides substantial evidence for the use of yoga in the treatment of schizophrenia. According to a meta-analysis of 17 distinct studies [ 23 ] on the subject, frequent physical activity reduces the negative symptoms associated with schizophrenia considerably.

Physical activity and alcohol dependence syndrome

Substance abuse, namely alcohol abuse, may have devastating effects on a person's mental and physical health. Tolerance and an inability to control drinking are some hallmarks of alcoholism. Research shows that physical activity is an effective supplement in the fight against alcohol use disorder. In addition to perhaps acting centrally on the neurotransmitter systems, physical exercise may mitigate the deleterious health consequences of drinking. Evidence suggests that persons with alcohol use disorder are not physically active and have low cardiorespiratory fitness. A wide number of medical comorbidities, like diabetes mellitus, hypertension, and other cardiovascular illnesses, occur with alcohol use disorders. Physical exercise may be highly useful in aiding the management of these comorbidities [ 24 ].

Physical exercise and yoga may help in the management of cravings for substances when other forms of therapy, such as counselling or medication for craving management are not feasible or acceptable. Physical exercise has been shown to have beneficial effects on mental health, relieve stress, and provide an enjoyable replacement for the substance. However, the patient must take an active role in physical activity-based therapies rather than passively accept the process as it is, which is in stark contrast to the approach used by conventional medicine. Since most substance use patients lack motivation and commitment to change, it is recommended that physical activity-based therapies be supplemented with therapies focusing on motivation to change to maximise therapeutic outcomes.

One hundred seventeen persons with alcohol use disorder participated in a single-arm, exploratory trial that involved a 12-minute fitness test using a cycle ergometer as an intervention. Statistically, significantly fewer cravings were experienced by 40% [ 24 ]. Exercise programmes were found to significantly reduce alcohol intake and binge drinking in people with alcohol use disorder in a meta-analysis and comprehensive review of the effects of such therapies [ 25 ].

Physical activity and sleep

Despite widespread agreement that they should prioritise their health by making time for exercise and sufficient sleep, many individuals fail to do so. Sleep deprivation has negative impacts on immune system function, mood, glucose metabolism, and cognitive ability. Slumber is a glycogenetic process that replenishes glucose storage in neurons, in contrast to the waking state, which is organised for the recurrent breakdown of glycogen. Considering these findings, it seems that sleep has endocrine effects on the brain that are unrelated to the hormonal control of metabolism and waste clearance at the cellular level. Several factors have been proposed as potential triggers for this chain reaction: changes in core body temperature, cytokine concentrations, energy expenditure and metabolic rate, central nervous system fatigue, mood, and anxiety symptoms, heart rate and heart rate variability, growth hormone and brain-derived neurotrophic factor secretion, fitness level, and body composition [ 26 ].

After 12 weeks of fitness training, one study indicated that both the quantity and quality of sleep in adolescents improved. Studies using polysomnography indicated that regular exercise lowered NREM stage N1 (very light sleep) and raised REM sleep (and REM sleep continuity and performance) [ 22 ]. As people age, both short- and long-term activities have increasingly deleterious effects on sleep. In general, both short- and long-term exercise were found to have a favourable effect on sleep quality; however, the degree of this benefit varied substantially among different sleep components. On measures of sleep quality, including total sleep time, slow-wave sleep, sleep onset latency, and REM sleep reduction, acute exercise had no effect. But both moderate and strenuous exercise has been shown to increase sleep quality [ 27 ]. According to a meta-analysis of randomised controlled trials, exercise has shown a statistically significant effect on sleep quality in adults with mental illness [ 28 ]. These findings emphasise the importance that exercise plays in improving outcomes for people suffering from mental illnesses.

Physical activity in depressive and anxiety disorders

Depression is the leading cause of disability worldwide and is a major contributor to the global burden of disease, as per the World Health Organization. However, only 10%-25% of depressed people actually seek therapy, maybe due to a lack of money, a lack of trained doctors, or the stigma associated with depression [ 29 ]. For those with less severe forms of mental illness, such as depression and anxiety, regular physical exercise may be a crucial part of their treatment and management. Exercise and physical activity might improve depressive symptoms in a way that is comparable to, if not more effective than, traditional antidepressants. However, research connecting exercise to a decreased risk of depression has not been analysed in depth [ 30 ]. Endorphins, like opiates, are opioid polypeptide compounds produced by the hypothalamus-pituitary system in vertebrates in response to extreme physical exertion, emotional arousal, or physical pain. The opioid system may mediate analgesia, social bonding, and depression due to the link between b-endorphins and depressive symptoms (Figure ​ (Figure2 2 ).

The "endorphin hypothesis" states that physical activity causes the brain to produce more endogenous opioid peptides, which reduce pain and boost mood. The latter reduces feelings of worry and hopelessness. A recent study that demonstrated endorphins favourably improved mood during exercise, and provided support for these theories suggested that further research into the endorphin theory is required [ 31 ].

Physical activity and exercise have been shown to improve depressive symptoms and overall mood in people of all ages. Exercise has been implicated in lowering depressive and anxious symptoms in children and adolescents as well [ 32 ]. Pooled research worldwide has revealed that physical exercise is more effective than a control group and is a viable remedy for depression [ 33 ]. Most forms of yoga that start with a focus on breathing exercises, self-awareness, and relaxation techniques have a positive effect on depression and well-being [ 34 ]. Despite claims that exercise boosts mood, the optimal kind or amount of exercise required to have this effect remains unclear and seems to depend on a number of factors [ 35 ].

Exercise as a therapy for unipolar depression was studied in a meta-analysis of 23 randomised controlled trials involving 977 subjects. The effect of exercise on depression was small and not statistically significant at follow-up, although it was moderate in the initial setting. When compared to no intervention, the effect size of exercise was large and significant, and when compared to normal care, it was moderate but still noteworthy [ 36 ]. A systematic evaluation of randomised controlled trials evaluating exercise therapies for anxiety disorders indicated that exercise appeared useful as an adjuvant treatment for anxiety disorders but was less effective than antidepressant treatment [ 37 ].

Conclusions

The effects of exercise on mental health have been shown to be beneficial. Among persons with schizophrenia, yoga was shown to have more positive effects with exercise when compared with no intervention. Consistent physical activity may also improve sleep quality significantly. Patients with alcohol dependence syndrome benefit from a combination of medical therapy and regular exercise since it motivates them to battle addiction by decreasing the craving. There is also adequate evidence to suggest that physical exercise improves depressive and anxiety symptoms. Translating the evidence of the benefits of physical exercise on mental health into clinical practice is of paramount importance. Future implications of this include developing a structured exercise therapy and training professionals to deliver it. The dearth of literature in the Indian context also indicates that more research is required to evaluate and implement interventions involving physical activity that is tailored to the Indian context.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.