{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T16:23:57Z","timestamp":1794327837733,"version":"4.9.0"},"reference-count":43,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Mens Health"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>\n            Bipolar disorder (BD) is a prevalent psychiatric condition characterized by extreme mood fluctuations between manic and depressive episodes, significantly affecting social and occupational functioning. The etiology of BD is multifactorial, involving genetic, environmental, and lifestyle factors. While previous research has focused on the genetic and environmental contributors to BD, the role of physical activity as a modifiable lifestyle factor remains underexplored. This study investigates the causal relationship between different types of physical activity, particularly heavy do-it-yourself (DIY) activities, and BD using Mendelian randomization (MR). The study employs MR to examine the causal link between physical activity and BD. Genetic variants associated with various forms of physical activity were selected from large-scale genome-wide association studies. The study uses several MR techniques, including inverse variance weighting (IVW), MR-Egger, and weighted median methods, to analyze the relationship between physical activity (e.g., heavy DIY, light DIY, vigorous exercise, and walking) and BD. Instrumental variables were chosen based on their strong association with physical activity and their independence from other potential confounders. The MR analysis revealed a significant causal relationship between heavy DIY activities and reduced BD risk (\n            <jats:italic>OR<\/jats:italic>\n            \u2009=\u20090.333; 95% CI [0.111, 0.997];\n            <jats:italic>p<\/jats:italic>\n            \u2009=\u2009.049). In contrast, no significant causal associations were found for the other types of physical activity examined. The IVW method indicated significant heterogeneity, prompting the use of a random-effects model, which confirmed that the results were not biased by heterogeneity or pleiotropy. Sensitivity analyses, including MR-Egger and MR-PRESSO, showed no significant pleiotropy, reinforcing the reliability of the findings. Leave-One-Out analysis and funnel plots further supported the robustness of the causal estimate. This study provides compelling evidence for the protective role of heavy DIY activities in reducing the risk of BD, suggesting that high-intensity physical activities may have a beneficial impact on mood regulation and the prevention of BD. The findings highlight the importance of considering gender differences in physical activity interventions for BD prevention and management. Future research should explore the neurobiological mechanisms underlying this association and further investigate the effectiveness of different types of physical activities in BD prevention and treatment strategies.\n          <\/jats:p>","DOI":"10.1177\/15579883251359452","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:12:42Z","timestamp":1756728762000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Physical Activities on Men\u2019s Mental Health: A Focus on Bipolar Disorder Prevention"],"prefix":"10.1177","volume":"19","author":[{"given":"jie","family":"Liu","sequence":"first","affiliation":[{"name":"Langfang Polytechnic Institute,China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng","family":"Zheng","sequence":"additional","affiliation":[{"name":"Beijing Children\u2019s Palace, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiqi","family":"Yu","sequence":"additional","affiliation":[{"name":"School of Physical Education and Training, Capital University of Physical Education and Sports, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2666-4371","authenticated-orcid":false,"given":"Xiaomeng","family":"Shi","sequence":"additional","affiliation":[{"name":"Cultural Foundation Department, Beijing Health Vocational College, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","unstructured":"Alizadeh Pahlavani H. (2024). Possible role of exercise therapy on depression: Effector neurotransmitters as key players. Behavioural Brain Research 459 114791. https:\/\/doi.org\/10.1016\/j.bbr.2023.114791","DOI":"10.1016\/j.bbr.2023.114791"},{"key":"e_1_3_2_3_1","doi-asserted-by":"crossref","unstructured":"Arnold L. M. (2003). Gender differences in bipolar disorder. Psychiatric Clinics of North America 26(3) 595\u2013620. https:\/\/doi.org\/10.1016\/s0193-953x(03)00036-4","DOI":"10.1016\/S0193-953X(03)00036-4"},{"key":"e_1_3_2_4_1","doi-asserted-by":"crossref","unstructured":"Bauer M. S. (2022). Bipolar disorder. Annals of Internal Medicine 175(7) ITC97\u2013ITC112. https:\/\/doi.org\/10.7326\/AITC202207190","DOI":"10.7326\/AITC202207190"},{"key":"e_1_3_2_5_1","doi-asserted-by":"crossref","unstructured":"Bayes A. Parker G. Paris J. (2019). Differential diagnosis of bipolar II disorder and borderline personality disorder. Current Psychiatry Reports 21(12) 125. https:\/\/doi.org\/10.1007\/s11920-019-1120-2","DOI":"10.1007\/s11920-019-1120-2"},{"key":"e_1_3_2_6_1","doi-asserted-by":"crossref","unstructured":"Birney E. (2022). Mendelian randomization. Cold Spring Harbor Perspectives in Medicine 12(4) a041302. https:\/\/doi.org\/10.1101\/cshperspect.a041302","DOI":"10.1101\/cshperspect.a041302"},{"key":"e_1_3_2_7_1","doi-asserted-by":"crossref","unstructured":"Bowden J. Del Greco M. F. Minelli C. Davey Smith G. Sheehan N. A. Thompson J. R. (2016). Assessing the suitability of summary data for two-sample Mendelian randomization analyses using MR-Egger regression: The role of the I2 statistic. International Journal of Epidemiology 45(6) 1961\u20131974. https:\/\/doi.org\/10.1093\/ije\/dyw220","DOI":"10.1093\/ije\/dyw220"},{"key":"e_1_3_2_8_1","doi-asserted-by":"crossref","unstructured":"Bowen R. S. Turner M. J. Lightfoot J. T. (2011). Sex hormone effects on physical activity levels: Why doesn\u2019t Jane run as much as Dick? Sports Medicine 41(1) 73\u201386. https:\/\/doi.org\/10.2165\/11536860-000000000-00000","DOI":"10.2165\/11536860-000000000-00000"},{"key":"e_1_3_2_9_1","doi-asserted-by":"crossref","unstructured":"Buoli M. Cesana B. M. Dell\u2019Osso B. Fagiolini A. de Bartolomeis A. Bondi E. Maina G. Bellomo A. Altamura A. C. (2019). Gender-related differences in patients with bipolar disorder: A nationwide study. CNS Spectrums 24(6) 589\u2013596. https:\/\/doi.org\/10.1017\/S1092852918001529","DOI":"10.1017\/S1092852918001529"},{"key":"e_1_3_2_10_1","doi-asserted-by":"crossref","unstructured":"Chan W. S. Ng C. F. Pang B. P. S. Hang M. Tse M. C. L. Iu E. C. Y. Ooi X. C. Yang X. Kim J. K. Lee C. W. Chan C. B. (2024). Exercise-induced BDNF promotes PPARdelta-dependent reprogramming of lipid metabolism in skeletal muscle during exercise recovery. Science Signaling 17(828) eadh2783. https:\/\/doi.org\/10.1126\/scisignal.adh2783","DOI":"10.1126\/scisignal.adh2783"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2022.07.186"},{"key":"e_1_3_2_12_1","doi-asserted-by":"crossref","unstructured":"Conio B. Martino M. Magioncalda P. Escelsior A. Inglese M. Amore M. Northoff G. (2020). Opposite effects of dopamine and serotonin on resting-state networks: Review and implications for psychiatric disorders. Molecular Psychiatry 25(1) 82\u201393. https:\/\/doi.org\/10.1038\/s41380-019-0406-4","DOI":"10.1038\/s41380-019-0406-4"},{"key":"e_1_3_2_13_1","doi-asserted-by":"crossref","unstructured":"Diflorio A. Jones I. (2010). Is sex important? Gender differences in bipolar disorder. International Review of Psychiatry 22(5) 437\u2013452. https:\/\/doi.org\/10.3109\/09540261.2010.514601","DOI":"10.3109\/09540261.2010.514601"},{"key":"e_1_3_2_14_1","doi-asserted-by":"crossref","unstructured":"Ding L. Chen Q. Liang H. Shen M. Zheng M. Li Z. (2024). Physical activities and breast cancer: A Mendelian randomization study. Archives of Medical Science 20(6) 1957\u20131967. https:\/\/doi.org\/10.5114\/aoms\/195271","DOI":"10.5114\/aoms\/195271"},{"key":"e_1_3_2_15_1","doi-asserted-by":"crossref","unstructured":"Espinoza S. M. Brown C. Gower A. L. Eisenberg M. E. McPherson L. E. Rider G. N. (2023). Sport and physical activity among transgender gender diverse and questioning adolescents. Journal of Adolescent Health 72(2) 303\u2013306. https:\/\/doi.org\/10.1016\/j.jadohealth.2022.09.020","DOI":"10.1016\/j.jadohealth.2022.09.020"},{"key":"e_1_3_2_16_1","doi-asserted-by":"crossref","unstructured":"Feldman R. (2023). Father contribution to human resilience. Development and Psychopathology 35(5) 2402\u20132419. https:\/\/doi.org\/10.1017\/S0954579423000354","DOI":"10.1017\/S0954579423000354"},{"key":"e_1_3_2_17_1","doi-asserted-by":"crossref","unstructured":"Feraco A. Gorini S. Camajani E. Filardi T. Karav S. Cava E. Strollo R. Padua E. Caprio M. Armani A. Lombardo M. (2024). Gender differences in dietary patterns and physical activity: An insight with principal component analysis (PCA). Journal of Translational Medicine 22(1) 1112. https:\/\/doi.org\/10.1186\/s12967-024-05965-3","DOI":"10.1186\/s12967-024-05965-3"},{"key":"e_1_3_2_18_1","doi-asserted-by":"crossref","unstructured":"Gabriel F. C. Oliveira M. Bruna De M. M. Berk M. Brietzke E. Jacka F. N. Lafer B. (2023). Nutrition and bipolar disorder: A systematic review. Nutritional Neuroscience 26(7) 637\u2013651. https:\/\/doi.org\/10.1080\/1028415X.2022.2077031","DOI":"10.1080\/1028415X.2022.2077031"},{"key":"e_1_3_2_19_1","doi-asserted-by":"crossref","unstructured":"Garg S. (2023). Gender differences in pathways influencing leisure time physical activity: A structural equation analysis. Diabetes & Metabolic Syndrome 17(5) 102761. https:\/\/doi.org\/10.1016\/j.dsx.2023.102761","DOI":"10.1016\/j.dsx.2023.102761"},{"key":"e_1_3_2_20_1","doi-asserted-by":"crossref","unstructured":"Goodarzi S. Teymouri Athar M. M. Beiky M. Fathi H. Nakhaee Z. Omran S. P. Shafiee A. (2024). Effect of physical activity for reducing anxiety symptoms in older adults: A meta-analysis of randomized controlled trials. BMC Sports Science Medicine and Rehabilitation 16(1) 153. https:\/\/doi.org\/10.1186\/s13102-024-00947-w","DOI":"10.1186\/s13102-024-00947-w"},{"key":"e_1_3_2_21_1","doi-asserted-by":"crossref","unstructured":"Grabowski T. Jaroszewski J. J. Sasinowska-Motyl M. (2012). Leave-one-out procedure in the validation of elimination rate constant analysis. Arzneimittelforschung 62(12) 682\u2013689. https:\/\/doi.org\/10.1055\/s-0032-1331194","DOI":"10.1055\/s-0032-1331194"},{"key":"e_1_3_2_22_1","doi-asserted-by":"crossref","unstructured":"Hoaglin D. C. (2016). Misunderstandings about Q and \u2018Cochran\u2019s Q test\u2019 in meta-analysis. Statistics in Medicine 35(4) 485\u2013495. https:\/\/doi.org\/10.1002\/sim.6632","DOI":"10.1002\/sim.6632"},{"key":"e_1_3_2_23_1","doi-asserted-by":"crossref","unstructured":"Hu F. H. Jia Y. J. Zhao D. Y. Fu X. L. Zhang W. Q. Tang W. Hu S. Q. Wu H. Ge M. W. Du W. Shen W. Q. Chen H. L. (2023). Gender differences in suicide among patients with bipolar disorder: A systematic review and meta-analysis. Journal of Affective Disorders 339 601\u2013614. https:\/\/doi.org\/10.1016\/j.jad.2023.07.060","DOI":"10.1016\/j.jad.2023.07.060"},{"key":"e_1_3_2_24_1","doi-asserted-by":"crossref","unstructured":"Kandola A. Stubbs B. (2020). Exercise and anxiety. Advances in Experimental Medicine and Biology 1228 345\u2013352. https:\/\/doi.org\/10.1007\/978-981-15-1792-1_23","DOI":"10.1007\/978-981-15-1792-1_23"},{"key":"e_1_3_2_25_1","doi-asserted-by":"crossref","unstructured":"Kim J. Choi J. Y. Kim H. Lee T. Ha J. Lee S. Park J. Jeon G. S. Cho S. I. (2023). Physical activity pattern of adults with metabolic syndrome risk factors: Time-series cluster analysis. JMIR mHealth and uHealth 11 e50663. https:\/\/doi.org\/10.2196\/50663","DOI":"10.2196\/50663"},{"key":"e_1_3_2_26_1","doi-asserted-by":"crossref","unstructured":"Kim Y. Wijndaele K. Sharp S. J. Strain T. Pearce M. White T. Wareham N. Brage S. (2019). Specific physical activities sedentary behaviours and sleep as long-term predictors of accelerometer-measured physical activity in 91 648 adults: A prospective cohort study. International Journal of Behavioral Nutrition and Physical Activity 16(1) 41. https:\/\/doi.org\/10.1186\/s12966-019-0802-9","DOI":"10.1186\/s12966-019-0802-9"},{"key":"e_1_3_2_27_1","doi-asserted-by":"crossref","unstructured":"Lane N. M. Smith D. J. (2023). Bipolar disorder: Diagnosis treatment and future directions. Journal of the Royal College of Physicians of Edinburgh 53(3) 192\u2013196. https:\/\/doi.org\/10.1177\/14782715231197577","DOI":"10.1177\/14782715231197577"},{"key":"e_1_3_2_28_1","doi-asserted-by":"crossref","unstructured":"Levin M. G. Burgess S. (2024). Mendelian randomization as a tool for cardiovascular research: A review. JAMA Cardiology 9(1) 79\u201389. https:\/\/doi.org\/10.1001\/jamacardio.2023.4115","DOI":"10.1001\/jamacardio.2023.4115"},{"key":"e_1_3_2_29_1","doi-asserted-by":"crossref","unstructured":"Li R. Huang G. Li Y. Huang M. Huang Y. Li Y. Li G. Wu S. (2024). Assessing the role of statin therapy in bladder cancer: Evidence from a Mendelian Randomization study. Frontiers in Pharmacology 15 1427318. https:\/\/doi.org\/10.3389\/fphar.2024.1427318","DOI":"10.3389\/fphar.2024.1427318"},{"key":"e_1_3_2_30_1","doi-asserted-by":"crossref","unstructured":"Li R. Peng L. Deng D. Li G. Wu S. (2024). Causal relationship between Alzheimer\u2019s disease and prostate cancer: A bidirectional Mendelian randomization analysis. Frontiers in Endocrinology 15 1354528. https:\/\/doi.org\/10.3389\/fendo.2024.1354528","DOI":"10.3389\/fendo.2024.1354528"},{"key":"e_1_3_2_31_1","doi-asserted-by":"crossref","unstructured":"Liu G. Kong L. Baweja R. Ba D. Saunders E. F. H. (2022). Gender disparity in bipolar disorder diagnosis in the United States: A retrospective analysis of the 2005\u20132017 MarketScan Commercial Claims database. Bipolar Disorders 24(1) 48\u201358. https:\/\/doi.org\/10.1111\/bdi.13082","DOI":"10.1111\/bdi.13082"},{"key":"e_1_3_2_32_1","doi-asserted-by":"crossref","unstructured":"Malhi G. S. Jadidi M. Bell E. (2023). The diagnosis of bipolar disorder in children and adolescents: Past present and future. Bipolar Disorders 25(6) 469\u2013477. https:\/\/doi.org\/10.1111\/bdi.13367","DOI":"10.1111\/bdi.13367"},{"key":"e_1_3_2_33_1","doi-asserted-by":"crossref","unstructured":"McCartan C. J. Yap J. Best P. Breedvelt J. Breslin G. Firth J. Tully M. A. Webb P. White C. Gilbody S. Churchill R. Davidson G. (2024). Factors that influence participation in physical activity for people with bipolar disorder: A synthesis of qualitative evidence. Cochrane Database of Systematic Reviews 6(6) CD013557. https:\/\/doi.org\/10.1002\/14651858.CD013557.pub2","DOI":"10.1002\/14651858.CD013557.pub2"},{"key":"e_1_3_2_34_1","doi-asserted-by":"crossref","unstructured":"Nierenberg A. A. Agustini B. Kohler-Forsberg O. Cusin C. Katz D. Sylvia L. G. Peters A. Berk M. (2023). Diagnosis and treatment of bipolar disorder: A review. JAMA 330(14) 1370\u20131380. https:\/\/doi.org\/10.1001\/jama.2023.18588","DOI":"10.1001\/jama.2023.18588"},{"key":"e_1_3_2_35_1","doi-asserted-by":"crossref","unstructured":"Philippot A. Dubois V. Lambrechts K. Grogna D. Robert A. Jonckheer U. Chakib W. Beine A. Bleyenheuft Y. De Volder A. G. (2022). Impact of physical exercise on depression and anxiety in adolescent inpatients: A randomized controlled trial. Journal of Affective Disorders 301 145\u2013153. https:\/\/doi.org\/10.1016\/j.jad.2022.01.011","DOI":"10.1016\/j.jad.2022.01.011"},{"key":"e_1_3_2_36_1","doi-asserted-by":"crossref","unstructured":"Retamal C. P. Vandeputte M. F. Massman B. T. (2023). [Understanding bipolar disorder: Risk factors & protective measures]. Revista m\u00e9dica de Chile 151(6) 764\u2013774. https:\/\/doi.org\/10.4067\/s0034-98872023000600764","DOI":"10.4067\/s0034-98872023000600764"},{"key":"e_1_3_2_37_1","doi-asserted-by":"crossref","unstructured":"Robinson N. Ploner A. Leone M. Lichtenstein P. Kendler K. S. Bergen S. E. (2023). Impact of early-life factors on risk for schizophrenia and bipolar disorder. Schizophrenia Bulletin 49(3) 768\u2013777. https:\/\/doi.org\/10.1093\/schbul\/sbac205","DOI":"10.1093\/schbul\/sbac205"},{"key":"e_1_3_2_38_1","doi-asserted-by":"crossref","unstructured":"Sa Filho A. S. Cheniaux E. de Paula C. C. Murillo-Rodriguez E. Teixeira D. Monteiro D. Cid L. Yamamoto T. Telles-Correia D. Imperatori C. Budde H. Machado S. (2020). Exercise is medicine: A new perspective for health promotion in bipolar disorder. Expert Review of Neurotherapeutics 20(11) 1099\u20131107. https:\/\/doi.org\/10.1080\/14737175.2020.1807329","DOI":"10.1080\/14737175.2020.1807329"},{"key":"e_1_3_2_39_1","doi-asserted-by":"crossref","unstructured":"Sanchez-Johnsen L. Dykema-Engblade A. Nava M. Rademaker A. Xie H. (2019). Body image physical activity and cultural variables underlying race and ethnicity among Latino men. Progress in Community Health Partnerships: Research Education and Action 13(5) 85\u201394. https:\/\/doi.org\/10.1353\/cpr.2019.0041","DOI":"10.1353\/cpr.2019.0041"},{"key":"e_1_3_2_40_1","doi-asserted-by":"crossref","unstructured":"Scott M. R. McClung C. A. (2023). Bipolar disorder. Current Opinion in Neurobiology 83 102801. https:\/\/doi.org\/10.1016\/j.conb.2023.102801","DOI":"10.1016\/j.conb.2023.102801"},{"key":"e_1_3_2_41_1","doi-asserted-by":"crossref","unstructured":"Sekula P. Del Greco M. F. Pattaro C. Kottgen A. (2016). Mendelian randomization as an approach to assess causality using observational data. Journal of the American Society of Nephrology 27(11) 3253\u20133265. https:\/\/doi.org\/10.1681\/ASN.2016010098","DOI":"10.1681\/ASN.2016010098"},{"key":"e_1_3_2_42_1","doi-asserted-by":"crossref","unstructured":"Valdez L. A. Morrill K. E. Griffith D. M. Lindberg N. M. Hooker S. P. Garcia D. O. (2019). Mexican origin hispanic men\u2019s perspectives of physical activity-related health behaviors. American Journal of Men\u2019s Health 13(1) 1557988319834112. https:\/\/doi.org\/10.1177\/1557988319834112","DOI":"10.1177\/1557988319834112"},{"key":"e_1_3_2_43_1","doi-asserted-by":"crossref","unstructured":"Yeung S. L. A. Luo S. Iwagami M. Goto A. (2025). Introduction to Mendelian randomization. Annals of Clinical Epidemiology 7(1) 27\u201337. https:\/\/doi.org\/10.37737\/ace.25004","DOI":"10.37737\/ace.25004"},{"key":"e_1_3_2_44_1","doi-asserted-by":"crossref","unstructured":"Zarza-Rebollo J. A. Lopez-Isac E. Rivera M. Gomez-Hernandez L. Perez-Gutierrez A. M. Molina E. (2024). The relationship between BDNF and physical activity on depression. Progress in Neuropsychopharmacology & Biological Psychiatry 134 111033. https:\/\/doi.org\/10.1016\/j.pnpbp.2024.111033","DOI":"10.1016\/j.pnpbp.2024.111033"}],"container-title":["American Journal of Men's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15579883251359452","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15579883251359452","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15579883251359452","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T12:12:48Z","timestamp":1756728768000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15579883251359452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":43,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1177\/15579883251359452"],"URL":"https:\/\/doi.org\/10.1177\/15579883251359452","relation":{},"ISSN":["1557-9883","1557-9891"],"issn-type":[{"value":"1557-9883","type":"print"},{"value":"1557-9891","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]},"article-number":"15579883251359452"}}