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Category: Exercise

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Views about exercise and aging have really changed over the last century. Bottom line: walk  - it's good for cognitive health, especially as you age. Try for at least 1 mile per day (1 mile = approx. 20 minutes brisk walk).

From The Atlantic: Walking for a Better Brain

 A “nerve specialist” from New York named J. Leonard Corning said in 1909 that he was opposed to “excessive exercise,” ... He thought that with the “over-cultivation of the physique the mentality suffered.” Corning wrote during a period when experts widely believed that brain cells didn’t regenerate. As a result, graceful aging was in large part a matter of learning to cope with gradually diminishing brain capacity. Modern science has shown that’s not the case; we do generate new brain cells throughout our lives, although the process can become increasingly imperfect and less efficient with age, as it does with much cellular activity.

One of the largest studies ever conducted was on a group of 121,000 nurses, who were surveyed on a wide range of their health and lifestyle habits starting in 1976. The survey was repeated every two years. This established a trove of valuable information, which public-health researchers have been fruitfully mining since. Among them is Rush University assistant professor Jennifer Weuve, who studied the data collected on 18,766 of the nurses, who were then ages 70 to 81, to unearth connections between exercise and cognitive ability. The results, published in The Journal of the American Medical Association, suggested that those who exercised the most—the group that maintained a median level of walking for six hours a week—were 20 percent less likely to show cognitive impairment than those who exercised the least.

Other long-term studies also show that even modest exercise can serve
 as a bulwark against dementia. A study started in 1989 with 299 elderly 
volunteers in the Pittsburgh area tracked mental acuity and exercise habits....The results, published in the journal Neurology, were sweeping and conclusive: Those who walked the most cut in half their risk of developing memory problems. The optimal exercise for cognitive health benefits, the 
researchers concluded, was to walk six to nine miles each week. That’s a mile to a mile and a half a day, without walking on Sundays if you’re inclined to follow Weston’s example of resting on the Sabbath. (This study concluded that walking an additional mile didn’t help all that much.)

A study written up in the Archives of Internal Medicine in 2001 tracked nearly six thousand women ages 65 and older for six to eight years. The women were given a cognitive test at the study’s beginning and end, the results of which were then correlated with how many blocks they walked daily. Those who walked the least had a drop of 24 percent in cognition. Those who walked the most still showed a decline, but of a lesser degree: 17 percent. The results were clear: “Women with higher levels of baseline physical activity were less likely to develop cognitive decline.”

Peter Snyder of Brown University’s Alpert Medical School, who studies the effects of aging on the brain, recently told National Public Radio that “what we’re finding is that of all of these noninvasive ways of intervening, it is exercise that seems to have the most efficacy at this point—more so than nutritional supplements, vitamins and cognitive interventions ... The literature on exercise is just tremendous,” he said.

Indeed, a 20-year-long study in 2010 found that walking just five miles per week “protects the brain structure” over a 10-year period in people with Alzheimer’s disease and in those who exhibit signs of mild cognitive impairment. “The findings showed across the board that greater amounts of physical activity were associated with greater brain volume,” the researchers concluded.

While different studies arrive at moderately different conclusions via various routes, the recent research of dozens of scientists more often than not converges at a single intersection. And that consistently suggests that if you exercise, your brain will be fitter than if you don’t. This applies to the young, those in the prime of their days, and especially to the elderly.

The 20-year 2010 study mentioned above, results from which were released by Cyrus Raji of the University of Pittsburgh, followed 426 older adults, including healthy people along with those showing mild cognitive impairment or the actual onset of Alzheimer’s. Across test subjects, more walking was shown to result in greater brain volume. “Unfortunately, walking is not a cure,” Raji said. “But walking can improve your brain’s resistance to [Alzheimer’s] disease and reduce memory loss over time.”

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Two articles which together point out that there are alternative approaches to the treatment of depression.

From Medscape: Patient Expectations Largely Dictate Antidepressant Response

People's expectations about how effective their antidepressant medication is going to be almost entirely predicts their response to it, such that giving patients a placebo pill as active therapy during an 8-week period results in very similar reductions in symptoms, new research shows.

Investigators at the David Geffen School of Medicine at the University of California, Los Angeles, found that patients assigned to either active antidepressant therapy or placebo pills had better clinical outcomes than supportive care alone and that there was little difference between outcomes for the medication and placebo groups.

"Supportive interaction with the subject helped them get better, and antidepressant therapy helped them get better, but I think our key finding was that patients' belief in the effectiveness of medication was a unique factor that contributed to them getting well. So belief in the power or effectiveness of the medication may be a contributor to placebo responses in the treatment of depression."

From Science Daily:

Sport, physical activity help against depression

Depression is the most frequently diagnosed mental illness. In the western industrial nations, at least every tenth person suffers from depression once in the course of their life. Depression influences physical health more than diabetes or arthritis, clinicians say. Treatment of depression traditionally occurs with antidepressants and psychotherapy. But as research has shown, sport and physical activity partially encounters the same neurophysiological changes as antidepressants. That is why a large number of meta-analyses showed a positive effect of sport and physical activity on depression.

Sport and physical activity bring about various changes in the brain which are otherwise achieved only through drugs. Similar to sport and physical activity, drugs for treatment of depressions act on the brain's capacity to absorb serotonin. They strengthen the epinephrine activity and ensure the release of various factors for nerve growth. These factors promote cell growth in the brain and prevent the death of cells in the hippocampus which is otherwise caused by depression. Together with these changes, sport and physical activity also lead to a reduced activity of the stress hormone cortisol and therefore have an effect similar to psychotropic drugs.

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Interesting term "actively sedentary", which may describe many of us. From Medscape:

Walking Is the Superfood of Fitness, Experts Say

NEW YORK (Reuters) - Walking may never become as trendy as CrossFit, as sexy as mud runs or as ego-boosting as Ironman races but for fitness experts who stress daily movement over workouts and an active lifestyle over weekends of warrior games, walking is a super star.

For author and scientist Katy Bowman, walking is a biological imperative like eating. In her book, "Move Your DNA: Restore Your Health Through Natural Movement," she suggests there are movement nutrients, just like dietary nutrients, that the body needs. "Walking is a superfood. It's the defining movement of a human," said Bowman, a biomechanist based in Ventura, California. 

Researchers say emerging evidence suggests that combined physical activity and inactivity may be more important for chronic disease risk than physical activity alone. "Actively sedentary is a new category of people who are fit for one hour but sitting around the rest of the day," Bowman said. "You can't offset 10 hours of stillness with one hour of exercise."

She added that a small study of non-obese men published in the journal Medicine & Science in Sports and Exercise by scientists at Indiana University suggests that three five-minute walks done throughout three hours of prolonged sitting reverses the harmful effects of prolonged sitting on arteries in the legs.

Three miles (5 kilometers) per hour is a good beginning, gradually working to 4 miles per hour, she said about walking.

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According to a recent large Swedish study, a healthy lifestyle lowers the risk of ischemic stroke (caused by a blood clot) - up to 54% lower risk. But unfortunately it does not lower the risk for a hemorrhagic stroke.

A healthy lifestyle was considered to be: healthy diet, moderate alcohol consumption, not smoking, being physically active, and being a normal weight (not overweight or obese). The more healthy life-style factors, the lower the risk for an ischemic stroke. In this study, healthy foods were considered to be: fruits, vegetables, legumes (beans), nuts, low-fat dairy foods, whole grain foods, and fish. 

From Science Daily: Healthy lifestyle may cut stroke risk in half for women

Women with a healthy diet and lifestyle may be less likely to have a stroke by more than half, according to a study. The study looked at five factors that make up a healthy lifestyle: healthy diet; moderate alcohol consumption; never smoking; physically active; and healthy body mass index (BMI). Compared with women with none of the five healthy factors, women with all five factors had a 54-percent lower risk of stroke.

For the study, 31,696 Swedish women with an average age of about 60 completed a 350-item questionnaire about their diet and lifestyle. They were then followed for an average of 10 years. A healthy diet was defined as within the top 50 percent of a recommended food score measuring how often the participants ate healthy foods such as fruits, vegetables and low-fat dairy products. Moderate alcohol consumption was defined as three to nine drinks per week. Physically active was defined as walking or biking at least 40 minutes a day along with more vigorous exercise at least one hour per week. Healthy BMI was considered below 25.

Most of the women had two or three of the healthy factors. Only 589 women had all five healthy factors, and 1,535 had none. There were 1,554 strokes among study participants. The risk of stroke steadily decreased with each additional healthy lifestyle factor.

Women who had a healthier diet were 13 percent less likely to have a type of stroke called a cerebral infarction than those whose diet was not as healthy. Women with healthier diets had a rate of 28 strokes per 10,000 women per year compared to 43 strokes per 10,000 women per year among those with a less healthy diet.

Cerebral infarction is the most common cause of stroke, accounting for up to 80 to 85 percent of all strokes. Cerebral infarction is caused by a blockage in a blood vessel preventing blood and oxygen from getting to an area of the brain.

There was no relationship between the healthy factors and the risk of hemorrhagic stroke. Hemorrhagic stroke, which is caused by bleeding in and around the brain, accounts for about 15 to 20 percent of all strokes.

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What if a doctor said you could avoid years of taking medication (and all their side effects and cost), better heart health, and avoid a heart attack by adopting some lifestyle changes. Could you do it? Would you? How to avoid 4 out 5 heart attacks, from Medical Xpress:

Healthy lifestyle choices may dramatically reduce risk of heart attack in men

Following a healthy lifestyle, including maintaining a healthy weight and diet, exercise, not smoking and moderating alcohol intake, could prevent four out of five coronary events in men, according to a new study publishing today in the Journal of the American College of Cardiology.

While mortality from heart disease has declined in recent decades, with much of the reduction attributed to medical therapies, the authors said prevention through a healthy lifestyle avoids potential side effects of medication and is more cost effective for population-wide reductions in coronary heart disease. 

For the study, researchers examined a population of 20,721 healthy Swedish men aged 45-79 years of age and followed them for 11 years. Lifestyle choices were assessed through a questionnaire exploring diet, alcohol consumption, smoking status, level of physical activity and abdominal adiposity (belly fat). Men in the study with the lowest risk were non-smokers, walked or cycled for at least 40 minutes per day, exercised at least one hour per week, had a waist circumference below 95 centimeters, consumed moderate amounts of alcohol, and followed a healthy diet with a regular consumption of fruits, vegetables, legumes, nuts, reduced-fat dairy products, whole grains and fish.

The researchers found a clear reduction in risk for heart attack for each individual lifestyle factor the participants practiced. For instance having a low-risk diet together with a moderate alcohol consumption led to an estimated 35 percent lower risk of heart attack compared to the high-risk group, those who practice none of the low-risk factors.

Men who combined the low-risk diet and moderate alcohol consumption with not smoking, being physically active and having a low amount of abdominal fat, had 86 percent lower risk. Researchers found similar results in men with hypertension and high cholesterol levels.

The burden of cardiovascular disease could be significantly reduced through programs targeted to men and promoting low-risk lifestyle choices. Even in those who take medication, an additional reduction in risk for chronic heart disease has been observed in those with a healthy lifestyle.

From John M., a cardiac electrophysiologist, who expressed his frustration with unnecessary heart disease, and commented on this study on drjohnm.org:

Let’s stop the unnecessary treatment of heart disease

There are many reasons doctors suffer from burnout and compassion fatigue. One of the least-mentioned of these reasons is that much of what we do is so damn unnecessary. In the US, the land of excess everything, caregivers, especially cardiologists, spend most of our time treating human beings that didn’t need to have disease.

Let’s be clear and honest: Lifestyle-related disease is largely unnecessary.

These days, there is so much unnecessary disease that caregivers, especially cardiologists, rarely see it. We look past the obesity right to the cholesterol number and ECG. And then we pull out the prescription pad for the guideline-directed pills. Just typing that causes me angst.

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A small, but interesting study of 46 young adults (about 20 to 21 years old).

From Medical Xpress: Lift weights, improve your memory

Here's another reason why it's a good idea to hit the gym: it can improve memory. A new Georgia Institute of Technology study shows that an intense workout of as little as 20 minutes can enhance episodic memory, also known as long-term memory for previous events, by about 10 percent in healthy young adults.

While many existing studies have demonstrated that months of aerobic exercises such as running can improve memory, the current study had participants lift weights just once two days before testing them. The Georgia Tech researchers also had participants study events just before the exercise rather than after workout. They did this because of extensive animal research suggesting that the period after learning (or consolidation) is when the arousal or stress caused by exercise is most likely to benefit memory.

"Our study indicates that people don't have to dedicate large amounts of time to give their brain a boost," said Lisa Weinberg, the Georgia Tech graduate student who led the project.

But why does it work? Existing, non-Georgia Tech human research has linked memory enhancements to acute stress responses, usually from psychological stressors such as public speaking. Other studies have also tied specific hormonal and norepinephrine releases in rodent brains to better memory. Interestingly, the current study found that exercise participants had increased saliva measures of alpha amylase, a marker of central norepinephrine.

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More research on the benefits of exercise. From Medical Xpress:

An hour of moderate exercise a day may decrease heart failure risk

In a new study reported in the American Heart Association journal Circulation: Heart Failure, researchers say more than an hour of moderate or half an hour of vigorous exercise per day may lower your risk of heart failure by 46 percent. Heart failure is a common, disabling disease that accounts for about 2 percent of total healthcare costs in industrialized countries. Risk of death within five years of diagnosis is 30 percent to 50 percent, researchers said.

Swedish researchers studied 39,805 people 20-90 years old who didn't have heart failure when the study began in 1997. Researchers assessed their total- and leisure time activity at the beginning of the study and followed them to see how this was related to their subsequent risk of developing heart failure. They found that the more active a person, the lower their risk for heart failure. 

From Medical Xpress:

Workers who exercise lower health risks, cost less

Get moving: just 20 minutes of exercise a day dramatically lowers the risk of diabetes and heart disease, even for employees with a high risk of developing those conditions.

A University of Michigan study looked at the impact of exercise on 4,345 employees in a financial services company that had just started a workplace wellness program. Roughly 30 percent of employees were high risk and suffering from metabolic syndrome, a dangerous cluster of risk factors associated with diabetes and heart disease. Overall, about 34 percent of U.S. adults have metabolic syndrome.

The study found that when the high-risk employees accumulated the government-recommended 150 minutes of moderate-intensity exercise a week, their health care costs and productivity equaled that of healthy employees who didn't exercise enough, said Alyssa Schultz, a researcher at the Health Management Research Center in the U-M School of Kinesiology.

"It was a real surprise, the level of protection physical activity gave to people with metabolic syndrome," Schultz said. 

Research done in mice, but may apply to humans. From Science Daily:

How physical exercise protects the brain from stress-induced depression

Physical exercise has many beneficial effects on human health, including the protection from stress-induced depression. However, until now the mechanisms that mediate this protective effect have been unknown. In a new study in mice, researchers show that exercise training induces changes in skeletal muscle that can purge the blood of a substance that accumulates during stress, and is harmful to the brain.

"In neurobiological terms, we actually still don't know what depression is. Our study represents another piece in the puzzle, since we provide an explanation for the protective biochemical changes induced by physical exercise that prevent the brain from being damaged during stress," says Mia Lindskog, researcher at the Department of Neuroscience at Karolinska Institutet.

 

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Two related stories that look at children, exercise, and academic performance. Boys, in general, have higher activity levels than girls, and they need exercise and recess to be able to get through the rest of the school day. Sitting quietly in class and doing classwork is hard when one has lots of excess energy. In fact, sitting still for hours on end is NOT healthy in any way for anyone! Fidget, fidget, fidget... From Science Daily:

High levels of physical activity linked to better academic performance in boys

Higher levels of physical activity are related to better academic achievement during the first three school years, particularly in boys, research shows. For instance, boys with higher levels of physical activity, and especially walking and bicycling to and from school, had better reading skills than less active boys....The findings of the present study highlight the potential of physical activity during recess and participation in organized sports in the improvement of academic achievement in children. 

 Instead of medicine, why aren't doctors prescibing exercise? From The Atlantic:

Exercise Is ADHD Medication

Physical movement improves mental focus, memory, and cognitive flexibility; new research shows just how critical it is to academic performance.

...More insipid but also more clearly critical to addressing what's being called the ADHD epidemic is plain old physical activity.

This morning the medical journal Pediatrics published research that found kids who took part in a regular physical activity program showed important enhancement of cognitive performance and brain function. The findings, according to University of Illinois professor Charles Hillman and colleagues, "demonstrate a causal effect of a physical program on executive control, and provide support for physical activity for improving childhood cognition and brain health." If it seems odd that this is something that still needs support, that's because it is odd, yes. Physical activity is clearly a high, high-yield investment for all kids, but especially those attentive or hyperactive. This brand of research is still published and written about as though it were a novel finding, in part because exercise programs for kids remain underfunded and underprioritized in many school curricula, even though exercise is clearly integral to maximizing the utility of time spent in class.

Earlier this month, another study found that a 12-week exercise program improved math and reading test scores in all kids, but especially in those with signs of ADHD.

Last year a very similar study in the Journal of Attention Disorders found that just 26 minutes of daily physical activity for eight weeks significantly allayed ADHD symptoms in grade-school kids. The modest conclusion of the study was that "physical activity shows promise for addressing ADHD symptoms in young children." 

"If physical activity is established as an effective intervention for ADHD," they continued, "it will also be important to address possible complementary effects of physical activity and existing treatment strategies ..." Which is a kind of phenomenal degree of reservation compared to the haste with which millions of kids have been introduced to amphetamines and other stimulants to address said ADHD. The number of prescriptions increased from 34.8 to 48.4 million between 2007 and 2011 alone. The pharmaceutical market around the disorder has grown to several billion dollars in recent years while school exercise initiatives have enjoyed no such spoils of entrepreneurialism. 

Over all, the pandemic of physical inactivity, as Hillman and colleagues put it in their Pediatrics journal article today, is "a serious threat to global health" responsible for around 10 percent of premature deaths from noncommincable diseases. 

John Ratey, an associate professor of psychiatry at Harvard, suggests that people think of exercise as medication for ADHD. Even very light physical activity improves mood and cognitive performance by triggering the brain to release dopamine and serotonin, similar to the way that stimulant medications like Adderall do. 

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Well DUH ! Of course children need to run, run, run or somehow exercise to get rid of excess energy. That's why recess is so important (but unfortunately so many schools are eliminating it). It is incredibly hard for children to quietly sit for many, many hours straight like little robots working tirelessly on schoolwork, especially those with high energy levels to start with. From Medscape:

Before-School Exercise May Reduce ADHD Symptoms

Moderate to vigorous aerobic exercise in the morning may reduce symptoms of attention-deficit/hyperactivity disorder (ADHD) in young children at risk for the illness, new research suggests.

A randomized study of 202 kindergarteners, 1st graders, and 2nd graders showed that those who completed 12 weeks of before-school physical activity had significantly higher reductions in inattention and moodiness than those who completed a sedentary classroom-based intervention.In addition, the subgroup of children with elevated ADHD symptoms who went through the before-school exercise program showed reduced impairment associated with ADHD risk in both their school and home settings.

"We need more studies to replicate the results, but I think the take-home message is that aerobic exercise is a health-producing activity ― and there are really no negative side effects from it," added Dr. Hoza.

Past research has shown some positive effects from exercise on patients with ADHD, providing evidence that it may be "a viable strategy for improving symptoms, behavior, achievement, inhibitory control, and neurocognitive function in youth with elevated ADHD symptoms," write the investigators.

In the current study, the researchers enrolled 94 children at risk for ADHD and 108 children deemed "typically developing" to act as their control group....The physical activity involved continuous movement requiring children to breathe hard and included a variety of age-appropriate activities and games.

"Although our findings indicated that all participants showed improvements, children with ADHD risk receiving exercise benefited across a broader range of outcomes than those receiving the sedentary activities," said coinvestigator Alan Smith, PhD, chair of the Department of Kinesiology at Michigan State University in East Lansing, in a release.

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Excerpts from an article by Jane Brody in the NY Times:

Beating Back the Risk of Diabetes

This year, nearly two million American adults and more than 5,000 children and adolescents will learn they have a potentially devastating, life-shortening, yet largely preventable disease: Type 2 diabetes. They will join 29.1 million Americans who already have diabetes.

Diabetes and its complications are responsible for nearly 200,000 deaths a year; the fatality rate among affected adults is 50 percent higher than among similar people without diabetes. Alarmingly, recent studies even have linked diabetes to an increased risk of dementia and Alzheimer's disease. Even people with above-average blood glucose levels, but not diabetes, have an elevated risk.

The Diabetes Prevention Program study, conducted among about 3,800 people who had pre-diabetes, found that moderate weight loss — an average of 12 pounds —  reduced the odds of progression to diabetes by nearly 50 percent.

An excellent discussion of what is known about the effect on diabetes of various foods and supplements appeared recently in Nutrition Action Healthletter at cspinet.org/iceberg.pdf. Some highlights:

Carbohydrates - breads, grains, cereals, sugary drinks and sweets of all kinds — are most problematic for people with diabetes or at risk of developing it. Carbohydrates are eventually metabolized to glucose, which raises the body’s demand for insulin. Consume less of them in general, and choose whole-grain versions whenever possible.

If you must have sweet drinks, select artificially sweetened ones. In two huge studies of nurses and other health professionals who were followed for 22 years, those who drank one or more sugary soft drinks a day had about a 30 percent higher risk of developing diabetes than those who rarely drank them, even after their weight was taken into account.

But there’s good news about coffee. Two or three cups of coffee (but not tea) a day, with or without caffeine, have been consistently linked to a lower risk of Type 2 diabetes. 

For protein, limit consumption of red meat, especially processed meats like sausages, hot dogs and luncheon meats, which are linked to a higher diabetes risk. Instead, choose fish, lean poultry (skinless and not fried), beans and nuts. Low-fat dairy products, including yogurt, and even fatty ones may lower the risk of diabetes; the reason is unclear.

Most protective are green, leafy vegetables — spinach, chard, kale, collards, mustard greens and even lettuce — as well as cruciferous vegetables like cabbage, broccoli and cauliflower. But all vegetables are good and should fill at least two-thirds of your dinner plate.

The nutrients magnesium and vitamin D are also potentially protective. In fact, the preventive value of leafy greens, whole grains, beans and nuts may lie in their high magnesium content. In a well-designed clinical trial of 32 overweight people with insulin resistance, the prelude to diabetes, blood glucose levels and insulin sensitivity improved in those who took a daily magnesium supplement for six months. Don’t go overboard: More than 350 milligrams of magnesium daily can cause diarrhea. 

Vitamin D, long known to be crucial to healthy bones, may also be helpful. In one study of 92 overweight or obese adults with prediabetes, those who took a supplement of 2,000 international units of vitamin D daily had better function of the pancreatic cells that produce insulin..

Of course, how much you weigh and what you eat are not the only concerns. Regular, preferably daily, physical exercise is a vital component of any prevention and treatment program for Type 2 diabetes, or most any chronic ailment. Weight loss can reduce diabetes risk by about 50 percent, but adding exercise to that can lower the odds by 70 percent, compared with people who remain overweight and inactive, according to a study that followed nearly 85,000 female nurses for 16 years. Women who were active for seven or more hours weekly had half the risk of developing diabetes as did women who exercised only a half-hour a week.