Zusammenfassung
Das in der westlichen Welt verbreitete problematische Gesundheitsverhalten (Bewegungsmangel, ungesunde Ernährung, Übergewicht, Umgang mit Stress) kann als Risikofaktor für Herz-Kreislauferkrankungen und psychische Störungen (speziell Depressionen) angesehen werden, welche zu den häufigsten und teuersten Krankheiten gehören. Depressive Störungen und metabolische Syndrome weisen zudem einige pathophysiologische Gemeinsamkeiten auf und stehen in wechselseitiger Beziehung zueinander, was Mehrfacheffekte diesbezüglicher prophylaktischer und therapeutischer Maßnahmen in Aussicht stellt. Regelmäßige körperliche Aktivität im Sinne der aeroben dynamischen Ausdauer wirkt antidepressiv, reduziert Stress bzw. erhöht die Stresstoleranz, scheint demenziellen Prozessen vorzubeugen und beeinflusst das kardiovaskuläre Risikoprofil günstig. In Zeiten knapper finanzieller Ressourcen erscheint es demzufolge umso erstaunlicher, dass auf eine präventive Maßnahme, die derart kostengünstig und wenig aufwändig zu realisieren ist und deren Wirkungsweisen aus neurobiologischer Sicht in diesem Paper skizziert werden, bisher so wenig Wert gelegt wird.
Summary
The health behaviour prevailing in our western world (lack of exercise, unhealthy diet, overweight, coping with stress) can be considered a risk factor for cardiovascular diseases as well as for mental disorders (especially with depressive symptoms), which both are among the most frequent and most expensive diseases. Depressive disorders and metabolic syndromes exhibit some pathophysiological similarities and are mutually interrelated - a fact that induces multiple effects of corresponding prophylactic and therapeutic interventions: Regular physical activity in terms of aerobic dynamic endurance whose neurobiological effects will be communicated in this paper has the potential of reducing depression and stress, of increasing stress tolerance, of improving cardiovascular health, and, eventually, of protecting against the risks of dementia. In times of scarce financial resources the lack of emphasis on physical exercise as an important and inexpensive preventive measure is really surprising.
Schlüsselwörter
körperliche Aktivität - Prävention - Stress - Krankheitsrisiko - metabolisches Syndrom - Depression
Key words
physical exercise - prevention - stress - morbidity - metabolic syndrome - depression
Literatur
-
1
Bjornebekk A, Mathe A A, Brene S.
The antidepressant effect of running is associated with increased hippocampal cell proliferation.
Int J Neuropsychopharmacol.
2005;
8
357-368
-
2
Boniface D R, Cottee M J, Neal D, Skinner A.
Social and demographic factors predictive of change over seven years in CHD-related behaviours in men aged 18 - 49 years.
Public Health.
2001;
115
246-252
-
3
Briones T L.
Environment, physical activity, and neurogenesis: implications for prevention and treatment of Alzheimer’s disease.
Curr Alzheimer Res.
2006;
3
49-54
-
4 Broocks A. Die Bedeutung von Sport für Prävention und Behandlung psychischer Erkrankungen. In: Reimers CD, Broocks A (Hrsg) Neurologie, Psychiatrie und Sport. Thieme Stuttgart, New York 2003: 4-7
-
5
Cotman C W, Berchtold N C.
Exercise: A behavioral intervention to enhance brain health and plasticity.
Trends Neurosci.
2002;
25
295-301
-
6
Dekker J M, Girman C, Rhodes T. et al .
Metabolic Syndrome and ten-year cardiovascular disease risk in the Hoorn Study.
Circulation.
2005;
112
666-673
-
7
Dishman R K.
Brain monoamines, exercise and behavioural stress: animal models.
Med Sci Sports Exerc.
1997;
29
63-74
-
8
Dishman R K, Berthoud H R, Booth F W. et al .
Neurobiology of exercise.
Scand J Med Sci Sports.
2006;
16
470
-
9
Elder G A, De Gasperi R, Gama Sosa M A.
Research update: neurogenesis in adult brain and neuropsychiatric disorders.
Mt Sinai J Med.
2006;
73
31-40
-
10
Ernst C, Olson A K, Pinel J P, Lam R W, Christie B R.
Antidepressant effects of exercise: evidence for an adult-neurogenesis hypothesis?.
J Psychiatry Neurosci.
2006;
31
84-92
-
11
Ford E S, Wayne H G, Mokdad A H.
Increasing prevalence of the metabolic syndrome among US adults.
Diab Care.
2004;
27
2444-2449
-
12
Ford E S, Li C.
Physical activity or fitness and the metabolic syndrome.
Expert Rev Cardiovasc Ther.
2006;
4
897-915
-
13
Fried L P, Kronmal R A, Newman A B. et al .
Risk factors for 5-year mortality in older adults: the cardiovascular health study.
J Am Med Ass.
1998;
279
585-592
-
14
Fuchs E, Czeh B, Kole M HP. et al .
Alterations of neuroplasticity in depression: the hippocampus and beyond.
Eur Neuropsychopharmacol.
2004;
14
(Suppl 5)
481-490
-
15
Gans R O.
The metabolic syndrome, depression and cardiovascular disease: interrelated conditions that share pathophysiologic mechanism.
Med Clin North Am.
2006;
90
573-591
-
16
Gronli J, Bramham C, Murison R. et al .
Chronic mild stress inhibits BDNF protein expression and CREB activation in the dentate gyrus but not in the hippocampus proper.
Pharmcol Biochem Behav.
2006;
86
842-849
-
17
Heiskanen T H, Niskanen L K, Hintikka J J. et al .
Metabolic syndrome and depression: a cross-sectional analysis.
J Clin Psychiatr.
2006;
67
1422-1427
-
18
Hollmann W, Strüder H K, Tagarakis C VM.
Körperliche Aktivität fördert Gehirngesundheit und -leistungsfähigkeit - Übersicht und eigene Befunde.
Nervenheilkunde.
2003;
9
467-474
-
19
Kujala U M, Kaprio J, Sarna S, Koskenvuo M.
Relationship of leisure-time physical activity and mortality. The finnish twin cohort.
J Am Med Ass.
1998;
279
440-444
-
20
Larson E B, Wang L, Bowen J D. et al .
Exercise is associated with reduced risk of incident dementia among persons 65 years of age and older.
Ann Intern Med.
2006;
144
73-81
-
21
Lee I M, Paffenbarger R S.
Associations of light, moderate and vigorous intensity physical activity with longevity. The Harvard Alumni Health Study.
Am J Epidemiol.
2000;
151
293-299
-
22
Lee I M, Skerrett P J.
Physical activity and all-cause mortality: what is the dose-response relation?.
Med Sci Sports Exerc.
2001;
33
(Suppl 6)
459-471
-
23
Kilian R, Becker T, Krüger K, Schmid S, Frasch K.
Health behavior in psychiatric inpatients compared with a German general population sample.
Acta Psychiatr Scand.
2006;
114
242-248
-
24
McEwen B S.
Protective and damaging effects of stress mediators.
N Engl J Med.
1998;
338
171-179
-
25
Neumann N U, Frasch K.
Biologische Mechanismen antidepressiver Wirksamkeit von körperlicher Aktivität.
Psychoneuro.
2005;
31
513-518
-
26
Neumann N U, Frasch K.
Die Prävention muss deutlich verbessert werden.
ZNS & Schmerz.
2005;
1
36-40
-
27
Neumann N U, Frasch K.
Prävention und Therapie demenzieller Erkrankungen mittels körperlicher Aktivität.
Krankenhauspsychiatrie.
2006;
17
155-159
-
28
Oja P.
Dose response between total volume of physical activity and health and fitness.
Med Sci Sports Exerc.
2001;
3
(Suppl)
428-437
-
29
Paffenbarger R S, Hyde R T, Wing A L. et al .
The association of changes in physical activity level and other life-style characteristics with mortality among men.
N Engl J Med.
1993;
328
538-545
-
30
Pate R R, Pratt M, Blair S N. et al .
Physical activity and public health. A recommendation from the centers of disease control and prevention and the American college of sports medicine.
J Am Med Ass.
1995;
275
402-407
-
31
Ramasubbu R.
Insulin resistance: a metabolic link between depressive disorder and atherosclerotic vascular diseases.
Med Hypoth.
2002;
59
537-551
-
32 Reimers C D. Gesundheitliche Auswirkungen körperlicher Aktivität. In: Reimers CD, Broocks A (Hrsg) Neurologie, Psychiatrie und Sport. Thieme Stuttgart, New York 2003: 46-55
-
33
Rovio S, Kareholt I, Helkala E L. et al .
Leisure-time physical activity at midlife and the risk of dementia and Alzheimer’s disease.
Lancet Neurol.
2005;
11
705-711
-
34
Russo-Neustadt A A, Beard R C, Huang Y M. et al .
Physical activity and antidepressant treatment potentiate the expression of specific brain-derived neurotrophic factor transcripts in the rat hippocampus.
Neuroscience.
2000;
101
305-312
-
35
Sapolsky R M.
Why stress is bad for your brain.
Science.
1996;
273
749-750
-
36
Spirduso W W, Cronin D L.
Exercise dose-response effects on quality of life and independent living in older adults.
Med Sci Sports Exerc.
2001;
3
(Suppl)
598-608
-
37
Steffen L M, Arnett D K, Blackburn H. et al .
Population trends in leisure-time physical activity: Minnesota Heart Survey, 1980 - 2000.
Med Sci Sports Exerc.
2006;
38
1716-1723
-
38
Ströhle A.
Die Neuroendokrinologie von Stress und die Pathophysiologie und Therapie von Depression und Angst.
Nervenarzt.
2003;
74
279-292
-
39
Timonen M, Laakso M, Jokelainen J. et al .
Insulin resistance and depression: cross sectional study.
Brit Med J.
2005;
330
17-18
-
40
Tsatsoulis A, Fountoulakis S.
The protective role of exercise on stress system dysregulation and comorbidities.
Ann N Y Acad Sci.
2006;
1083
196-213
-
41
Vitale D epres JP, Lamrache B, Mauriege P. et al .
Hyperinsulinemia as an independent risk factor for ischemic heart disease.
N Engl J Med.
1996;
334
952-957
-
42
Wirth A.
Adipositas und Metabolisches Syndrom.
Cardiovasc.
2003;
3
22-30
-
43
Wittchen H U, Jacobi F.
Die Versorgungssituation psychischer Störungen in Deutschland. Eine klinisch-epidemiologische Abschätzung anhand des Bundes-Gesundheitssurveys 1998.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz.
2001;
44
993-1000
-
44 World Health Organization .Reducing risks, promoting healthy life. The World Health Report 2002. Geneva. 2002
PD med. N.-U. Neumann
Abt. Allgemeine Psychiatrie und Psychotherapie des BKH Günzburg n der Donau-Ries-Klinik
Neudegger Allee 6
86609 Donauwörth
Phone: 0906/9990510
Fax: 0906/9990517
Email: norbert.neumann@bkh-guenzburg.de
