As discussed in Chapter B1, people with AOD use disorders are at increased risk of physical health problems, such as cardiovascular, respiratory, metabolic, and neurological diseases [450, 451], which have all been associated with unhealthy lifestyles (e.g., smoking, obesity, lack of exercise, poor diet) . As such, treatment interventions that are either based on nutrition, or exercise, or include these as adjunctive interventions, are promising approaches for addressing physical comorbidities . Research has found that people with psychiatric conditions who engaged in regular exercise, report better health-related quality of life .
General population studies have also found significant relationships between mental health and physical activity, with regular exercise significantly associated with decreased prevalence of major depression, panic disorder, agoraphobia, social anxiety, specific phobia, and AOD use disorders [455-457]. People who engaged in regular physical activity were more likely to experience symptom improvement over a three year follow-up study .
Although the mechanisms of action are not entirely clear, research findings indicate that exercise induces changes in neurotransmitters (e.g., serotonin and endorphins) [458, 459] which relate to mood, and can improve reactions to stress [460, 461]. Exercise has also been associated with several psychological benefits, including changes to body and health attitudes and behaviours, social reinforcement, distraction, and improved coping and control strategies [213, 462]. A number of physical health interventions for AOD and specific mental health disorders are described in Chapter B6.