title: Physical activity: does environment make a difference for tension, stress, emotional outlook, and perceptions of health status?
abstract: BACKGROUND
  The importance of physical activity for health is well-established. Questions remain whether outdoor exercise additionally benefits overall mental and physical well-being.
  
  
  METHODS
  Using cross-sectional data from the Aerobics Center Longitudinal Study, we examined relationships of physical activity environment (PAE) with reported tension, stress, emotional outlook, and health.
  
  
  RESULTS
  11,649 participants were included. 18% exercised indoors, 54% outdoors, and 28% in both. Participants who exercised partially or entirely outdoors exercised more. In fully adjusted models, for women combined PAE was protective for worse emotional outlook (OR: 0.72; 95% CI: 0.52-0.98). Combined PAE was also protective for reported poor health (OR for women: 0.63; 95% CI: 0.44-0.91; OR for men: 0.75; 95% CI: 0.61-0.92). Amount of physical activity modified PAE relationships with outcomes. Combined and outdoor PAE were more consistently protective for worse outcomes among high activity participants. Regardless of PAE, better outcomes were observed in active versus inactive participants.
  
  
  CONCLUSIONS
  The current study suggests addition of outdoor PAE may be linked with better stress management, outlook and health perceptions for more active populations, whereas indoor PAE may be more important for low active populations. Further research should examine the order of causation and whether type of outdoor PAE (eg, urban, natural) is important.
authors.affiliation: Maryland Institute for Applied Environmental Health, University of Maryland, College Park, MD.
authors.forename: Robin
authors.initials: R
authors.lastname: Puett
authors.forename: Jane
authors.initials: J
authors.lastname: Teas
authors.forename: Vanesa
authors.initials: V
authors.lastname: España-Romero
authors.forename: Enrique Garcia
authors.initials: EG
authors.lastname: Artero
authors.forename: Duck-chul
authors.initials: DC
authors.lastname: Lee
authors.forename: Meghan
authors.initials: M
authors.lastname: Baruth
authors.forename: Xuemei
authors.initials: X
authors.lastname: Sui
authors.forename: Jessica
authors.initials: J
authors.lastname: Montresor-López
authors.forename: Steven N
authors.initials: SN
authors.lastname: Blair
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004777:Environment; D015444:Exercise / Q000502:physiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010465:Perception; D012111:Residence Characteristics; D013315:Stress, Psychological / Q000453:epidemiology*