We know that spending hour after hour sitting down isn’t good for us, but just how much exercise is needed to counteract the negative health impact of a day at a desk? A 2020 study suggests about 30-40 minutes per day of building up a sweat should do it.
Up to 40 minutes of “moderate to vigorous intensity physical activity” every day is about the right amount to balance out 10 hours of sitting still, the research says – although any amount of exercise or even just standing up helps to some extent.
That’s based on a meta-analysis across nine previous studies, involving a total of 44,370 people in four different countries who were wearing some form of fitness tracker.
The analysis found the risk of death among those with a more sedentary lifestyle went up as time spent engaging in moderate-to-vigorous intensity physical activity went down.
“In active individuals doing about 30-40 minutes of moderate to vigorous intensity physical activity, the association between high sedentary time and risk of death is not significantly different from those with low amounts of sedentary time,” the researchers wrote in the British Journal of Sports Medicine (BJSM) in 2020.
In other words, putting in some reasonably intensive activities – cycling, brisk walking, gardening – can lower your risk of an earlier death right back down to what it would be if you weren’t doing all that sitting around, to the extent that this link can be seen in the amassed data of many thousands of people.
While meta-analyses like this one always require some elaborate dot-joining across separate studies with different volunteers, timescales, and conditions, the benefit of this particular piece of research is that it relied on relatively objective data from wearables – not data self-reported by the participants.
“These guidelines are very timely, given that we are in the middle of a global pandemic, which has confined people indoors for long periods and encouraged an increase in sedentary behavior,” said physical activity and population health researcher Emmanuel Stamatakis from the University of Sydney in Australia.
“People can still protect their health and offset the harmful effects of physical inactivity,” says Stamatakis, who wasn’t involved in the meta-analysis but is the co-editor of the BJSM. “As these guidelines emphasize, all physical activity counts and any amount of it is better than none.”
The research based on fitness trackers is broadly in line with the new WHO guidelines, which recommend 150-300 mins of moderate intensity or 75-150 mins of vigorous-intensity physical activity every week to counter sedentary behavior.
Walking up the stairs instead of taking the lift, playing with children and pets, taking part in yoga or dancing, doing household chores, walking, and cycling are all put forward as ways in which people can be more active – and if you can’t manage the 30-40 minutes right away, the researchers say, start off small.
Making recommendations across all ages and body types is tricky, though the 40 minute time frame for activity fits in with previous research. As more data are published, we should learn more about how to stay healthy even if we have to spend extended periods of time at a desk.
“Although the new guidelines reflect the best available science, there are still some gaps in our knowledge,” said Stamatakis.
“We are still not clear, for example, where exactly the bar for ‘too much sitting’ is. But this is a fast-paced field of research, and we will hopefully have answers in a few years’ time.”
The research was published here, and the WHO guidelines here, in the British Journal of Sports Medicine.
Athletes have a very complicated relationship with pain. For endurance athletes in particular, pain is an absolutely non-negotiable element of their competitive experience. You fear it, but you also embrace it. And then you try to understand it.
But pain isn’t like heart rate or lactate levels—things you can measure and meaningfully compare from one session to the next. Every painful experience is different, and the factors that contribute to those differences seem to be endless. A recent study in the Journal of Sports Sciences, from researchers in Iraq, Australia, and Britain, adds a new one to the list: viewing images of athletes in pain right before a cycling test led to higher pain ratings and worse performance than viewing images of athletes enjoying themselves.
That finding is reminiscent of a result I wrote about last year, in which subjects who were told that exercise increases pain perception experienced greater pain, while those told that exercise decreases pain perception experienced less pain. In that case, the researchers were studying pain perception after exercise rather than during it, trying to understand a phenomenon called exercise-induced hypoalgesia (which just means that you experience less pain after exercise).
This phenomenon has been studied for more than 40 years: one of the first attempts to unravel it was published in 1979 under the title “The Painlessness of the Long Distance Runner,” in which an Australian researcher named Garry Egger did a series of 15 runs over six months after being injected with either an opioid blocker called naloxone or a placebo. Running did indeed increase his pain threshold, but naloxone didn’t seem to make any difference, suggesting that endorphins—the body’s own opioids—weren’t responsible for the effect. (Subsequent research has been plentiful but not very conclusive, and it’s currently thought that both opioid and other mechanisms are responsible.)
But the very nature of pain—the fact that seeing an image of pain or being told that something will be painful can alter the pain you feel—makes it extremely tricky to study. If you put someone through a painful experiment twice, their experience the first time will inevitably color their perceptions the second time.
As a result, according to the authors of another new study, the only results you can really trust are from randomized trials in which the effects of exercise on pain are compared to the results of the same sequence of tests with no exercise—a standard that excludes much of the existing research.
The new study, published in the Journal of Pain by Michael Wewege and Matthew Jones of the University of New South Wales, is a meta-analysis that sets out to determine whether exercise-induced hypoalgesia is a real thing, and if so, what sorts of exercise induce it, and in whom. While there have been several previous meta-analyses on this topic, this one was restricted to randomized controlled trials, which meant that just 13 studies from the initial pool of 350 were included.
The good news is that, in healthy subjects, aerobic exercise did indeed seem to cause a large increase in pain threshold. Here’s a forest plot, in which dots to the left of the line indicate that an individual study saw increased pain tolerance after aerobic exercise, while dots to the right indicate that pain tolerance worsened.
The big diamond at the bottom is the overall combination of the data from those studies. It’s interesting to look at a few of the individual studies. The first dot at the top, for example, saw basically no change from a six-minute walk. The second and third dots, with the most positive results, involved 30 minutes of cycling and 40 minutes of treadmill running, respectively. The dosage probably matters, but there’s not enough data to draw definitive conclusions.
After that, things get a little tricker. Dynamic resistance exercise (standard weight-room stuff, for the most part) seems to have a small positive effect, but that’s based on just two studies. Isometric exercises (i.e. pushing or pulling without moving, or holding a static position), based on three studies, have no clear effect.
There are also three studies that look at subjects with chronic pain. This is where researchers are really hoping to see effects, because it’s very challenging to find ways of managing ongoing pain, especially now that the downsides of long-term opioid use are better understood. In this case, the subjects had knee osteoarthritis, plantar fasciitis, or tennis elbow, and neither dynamic nor isometric exercises seemed to help. There were no studies—or at least none that met the criteria for this analysis—that tried aerobic exercise for patients with chronic pain.
The main takeaway, for me, is how little we really know for sure about the relationship between exercise and pain perception. It seems likely that the feeling of dulled pain that follows a good run is real (and thus that you shouldn’t conclude that your minor injury has really been healed just because it feels okay when you finish).
Exercise-associated muscle cramps (EAMC) are defined as cramping (painful muscle spasms) during or immediately following exercise. Muscle cramps during exercise are very common, even in elite athletes. EAMC are a common condition that occurs during or after exercise, often during endurance events such as a triathlon or marathon.
Although EAMC are extremely common among athletes, the cause is still not fully understood because muscle cramping can occur as a result of many underlying conditions. Elite athletes experience cramping due to paces at higher intensities.The cause of exercise-associated muscle cramps is hypothesized to be due to altered neuromuscular control, dehydration, or electrolyte depletion.
It is widely believed that excessive sweating due to strenuous exercise can lead to muscle cramps. Deficiency of sodium and other electrolytes may lead to contracted interstitial fluid compartments, which may exacerbate the muscle cramping. According to this theory, the increased blood plasma osmolality from sweating sodium losses causes a fluid shift from the interstitial space to the intervascular space, which causes the interstitial fluid compartment to deform and contributes to muscle hyperexcitability and risk of spontaneous muscle activity.
The second hypothesis is altered neuromuscular control. In this hypothesis, it is suggested that cramping is due to altered neuromuscular activity. The proposed underlying cause of the altered neuromuscular control is due to fatigue. There are several disturbances, at various levels of the central and peripheral nervous system, and the skeletal muscle that contribute to cramping.
These disturbances can be described by a series of several key events. First and foremost, repetitive muscle exercise can lead to the development of fatigue due to one or more of the following: inadequate conditioning, hot and or humid environments, increased intensity, increased duration, and decreased supply of energy. Muscle fatigue itself causes increased excitatory afferent activity within the muscle spindles and decreased inhibitory afferent activity within the Golgi tendon.
The coupling of these events leads to altered neuromuscular control from the spinal cord. A cascade of events follow the altered neuromuscular control; this includes increased alpha-motor neuron activity in the spinal cord, which overloads the lower motor neurons, and increased muscle cell membrane activity. Thus, the resultant of this cascade is a muscle cramp.
Can’t bend over and touch your toes? You might think flexibility is something you’re born with — you either have it or you don’t. While your flexibility level does have ties to genetics (we can’t all be contortionists), you might be surprised to learn that you can build flexibility just as you can build strength, endurance or speed.
Just like anything else, developing flexibility takes practice. It takes just as much consistency as does building muscle or getting in shape for a marathon. It may not be easy, but it’s definitely doable, and you can get started with these simple ways to become more flexible.
Holding static stretches may be the simplest method to improve flexibility. Static stretching includes all flexibility exercises that involve holding a muscle in a stretched position for a substantial amount of time, usually around 30 seconds. This allows you to isolate and deeply stretch a muscle. Starting and ending your day with static stretches — just for 5 to 10 minutes — can make a big difference in how flexible your muscles feel on a daily basis.
Static stretches you might already be familiar with include:
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2. Perform dynamic stretches before and after you exercise
Dynamic stretches, in contrast to static stretches, continuously move your muscles and joints through their full range of motion. This type of stretching feels much more vigorous than static stretching and may even get your heart rate up.
Dynamic stretching doesn’t isolate muscles as much as static stretching; rather, this type of active stretching works multiple muscles at the same time and teaches you how to engage your muscles and joints to support deeper and more fluid motion. Performing dynamic stretches before your workout makes for a good warmup, and engaging in a few after your workout helps return your body to its resting state (rather than just stopping cold after an intense sweat).
You might feel inflexible due to adhesions in your fascia, a type of connective tissue that covers your muscles, bones and joints. What people refer to as “muscle knots” often actually occur in the fascia (though your muscle tissue can develop knotty areas, too).
If you have a lot of these adhesions, which can develop from long periods of sedentary behavior as well as from intense physical activity, try adding self-myofascial release to your routine. Self-myofascial release is essentially self-massage with the goal of “releasing” those tight knots from your body tissues. You can do self-myofascial release with a foam roller, a lacrosse ball, a muscle roller or a massage gun.
Your ability or inability to fully rotate your spine and ball-and-socket joints (hips and shoulders) greatly influences your overall flexibility level. Your spine, hips and shoulders dictate most of the movements you make on a daily basis whether you realize it or not: Every time you step, reach, bend, turn, sit or stand, you’re using your spine along with your hips or shoulders. If you don’t actively practice rotating these joints, you’re missing out on your potential for flexibility.
Try these rotational exercises to improve flexibility:
In addition to your usual exercise, such as lifting weights or walking, try dedicating a few minutes each day to flexibility training. Time constraints may make it hard to prioritize flexibility exercises, but if you really want to get bendy, you’ll have to commit to a regular practice.
Here’s one way to incorporate flexibility training into your workout routine:
Morning: 5 minutes of static stretching, focus on the lower body
Before workout: 10 minutes of full-body dynamic stretching
After workout: 5 minutes of myofascial release on the muscles you worked
Before bed: 5 minutes of static stretching, focus on the upper body
By dedicating just a few minutes at a time, you can achieve nearly half an hour of flexibility training each day you exercise.
You can always slightly cut back on your active exercise time to incorporate flexibility work. For example, if you usually walk for 60 minutes a day, walk for 50 minutes and end your walk with 10 minutes of stretching. In the end, becoming more flexible is all about prioritizing flexibility as a goal.
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
Some fast-paced, high-pressure workplaces take a physical toll on their workers. This is counterproductive to the employers because it decreases worker productivity and increases costs. For the employees, they may be literally working themselves to death. Some of the physical effects of an unhealthy workplace include:
1. Carpal Tunnel Syndrome
According to the Mayo Clinic, carpal tunnel syndrome can be caused by conditions in the workplace that cause repetitive flexing of the wrist, which can damage the median nerve or exacerbate any existing damage. Carpal tunnel syndrome can affect workers who use computers all day, grocery checkers, and assembly line workers, especially if you work in a cold environment.
2. Back Injuries
The main causes of back injuries in the workplace include inadequate training, improper lifting technique, rushing, and a skewed perception of the risks involved with lifting. Once you injure your back, you are significantly more likely to experience another back injury in the future. Employers need to make sure employees who lift have safety gear and are well-trained.
3. Illnesses From Exposure to Toxins
Exposure to toxic substances on the job can cause respiratory, renal, cardiovascular, and reproductive harm. The Occupational Safety and Health Administration (OSHA) requires employees to have protocols in place to reduce workers’ exposure to chemical hazards and toxic substances. Any violation of these standards should be reported to OSHA.
Working long hours can increase your risk of developing high blood pressure, which is also known as hypertension. This condition can have serious effects on your health including aneurysm, strokes, heart damage, kidney failure, and even damage to your vision. If you’re working overtime, you may need to cut back your hours to protect your health.
According to OSHA, fatigue can have serious health effects. Aside from reducing your alertness and impairing your ability to make decisions, it can affect your memory and your ability to concentrate. It can also cause you to be irritable and unmotivated. Workplace fatigue can be deadly if you are a driver or you work with machinery, and it can also cause heart problems.
6. Digestive Issues
Workplace fatigue can also cause digestive problems that have symptoms similar to those experienced with irritable bowel syndrome. These can include diarrhea, nausea, constipation, and bloating. These symptoms can also be caused by stress in the workplace. Work stress can also cause you to produce excess stomach acid, leading to indigestion and heartburn.
Depression, stress, and anxiety at work can lead to the development of type 2 diabetes, and there is no cure for this condition. When you’re under stress, your body may not release its insulin. This will eventually cause an excess of glucose in your blood. The longer you’re under stress for, the higher your glucose levels will become.
8. Injuries From Accidents or Explosions
Millions of Americans are injured in non-fatal workplace accidents each year, and approximately 5,000 workers are killed on the job annually. Slip, trip, and fall accidents, fires, explosions, and violence cause many disabilities. They also cost employers millions of dollars. Most of these are preventable injuries that wouldn’t have happened with better training and equipment.
Any of these physical effects of toxic workplaces can lead to lost wages, missed work, and in the most serious cases the permanent inability to work. If you’re experiencing any of these health conditions due to your job, you’re in an unhealthy work environment.
As a psychotherapist, I spend a fair amount of time completing paperwork that convinces insurance companies to pay for someone’s mental health treatment.
In order to help people get their services covered, I have to help patients answer questions like, “How do you hope your life will be different in 90 days?”
Asking people with a mental health problem to look that far ahead can feel like torture. People struggling with depression often can’t see 10 minutes into the future, let alone 3 months down the road.
And individuals experiencing anxiety are often consumed with the future–and they’re usually making catastrophic predictions. They might imagine themselves losing their jobs, becoming homeless, or contracting a rare disease all within the next three months.
But even if you aren’t experiencing a mental health issue, pinpointing how your life will be different 90 days in advance is tough.
Establishing a 30-day challenge can be a more effective way to create positive change. In fact, 30-day challenges (or sometimes 30-day experiments) are how I stay motivated to reach my goals–especially my fitness goals.
Most recently, I set out to see if I could get six-pack abs in 30 days. I hired Robert Brace, a fitness trainer who is known for getting people in shape fast, to help me reach my goal.
And just as he promised, over the course of one month, I saw my formerly flabby stomach morph into a muscular set of abdominal muscles. Almost every day, I could see progress, and it helped me stay on track to reach my goal.
Had I set out to do the same challenge in 90 days, I’m certain it wouldn’t have worked. Having more time would have led to fewer results. Not only do I know this from personal experience and anecdotal evidence from my therapy clients, but science also backs up this notion.
Your Brain Is Designed for 30-Day Challenges
Studies show our brains view time according to either “now deadlines” or “someday deadlines.” And “now deadlines” often fall within this calendar month.
For example, if you have a project due at the end of the month, studies show that you’re likely to start working on it earlier in the month, because your brain tells you that your deadline is looming. You’ll prioritize the project as something that is due “now.”
If however, that same project is due at the beginning of the next month, your brain will categorize it as a “later project”–even if the calendar is set to roll over to the next month within a few days
You’re more likely to procrastinate when it comes to working on the goals you categorize as “later.”
So whether you’re trying to quit smoking, or you want to lose weight, your brain will categorize a 90-day goal as something you can work on later. And if you don’t start out filled with motivation and momentum right from the beginning, you aren’t likely to pick up steam as time passes.
Why 30-Day Challenges Work So Well
Whether your goal is to pay down debt, or you want to start going to the gym, design your own 30-day challenge. In addition to your brain viewing it as a “now” goal, you’re more likely to succeed because:
You won’t have time for excuses. When you have a short-term goal, there isn’t time to take days off because you feel tired. And you don’t have time to make up missed work later. You have be all in if you want to reach your goals.
Fast progress builds momentum. Your hard work will begin to pay off fast. And when you begin to see results, it’s easier to stay motivated. Building momentum early can help you stay on course and finish your month-long challenge strong.
Short-term pain feels tolerable. Working hard to reach a new goal means you’ll have to give something up.It’s easier to give up time with your family or your daily latte when you know there’s an end in sight.
Create Your Own 30-Day Challenge
There are many 30-day challenges that can improve your physical health, mental health, social life, or spiritual life.
And as we approach the beginning of a new year–where many people will be setting gigantic annual goals that they never reach–it’s a great time to launch a 30-day challenge. You might find that a short-term objective is a much more effective way to create big changes in your life.
As things like whatever you’re reading this on have made us more sedentary, researchers have found that even low intensity physical activity has measurable health benefits, including the biggest benefit of all: a longer life.
A recently published study by an international team found that doing more physical activity – even something as simple as cooking, washing dishes or walking slowly – is linked with a lower risk of early death in middle-aged and older folks.
You may have heard or just assumed that you need to break a sweat or get your heart rate up to the point that you’re panting for exercise to really be of any benefit.
People with busy modern schedules may have a hard time fitting in all that sweating, especially when you add the time it takes to get ready and then clean yourself up afterward.
“It has previously been widely assumed that more is better in terms of physical activity for health,” said Tom Yates, a professor at the University of Leicester and a co-author of the paper, which was published in the journal BMJ. “However, this study suggests health may be optimized with just 24 minutes per day of brisk walking or other forms of moderate-intensity physical activity.”
“Another important finding was that spending 9.5 hours or more each day sedentary – which essentially means sitting – was associated with a statistically significant increased risk of death, with each hour more above this threshold increasing the risk of death further.”
Co-author Charlotte Edwardson, also from Leicester, said the study reinforces the idea that ‘doing something is better than doing nothing,’ even if it just means standing up for a bit at work.
“A large risk reduction was seen between the least and the second least active group suggesting that incorporating some time doing physical activity, light or moderate intensity, in daily life is associated with a big health benefit.”
Living a longer life could be as simple as standing up while you read things like this, so long as you’re not crossing the street.
Gadgets and their ever increasing speed have become firehoses of information. Our nervous systems are awash in bits and bytes by the trillions around the clock whether we’re online or not, awake or sleeping. In this talk, Pack will describe vital behavioral strategies we can re-learn and re-purpose to leverage and focus upon to create virtuous feedback circles.
Pack Matthews is known in Columbia, Missouri primarily as a local musician, yoga instructor and piano tuner, and has recently added the moniker “inventor” to his credentials. His passions are numerous and leave him making hard choices to avoid becoming a jack of all trades. So far he’s keeping them focused on Jazz piano and bass while devoting most of his time to his start- up, mysoulseat.com. He particularly enjoys unearthing the depth of talented people here in Columbia.
TEDxCoMo, held April 6, 2013 at the historic Missouri Theatre in Columbia, Missouri, was produced by Keith Politte and Cale Sears. Event website: TEDxCoMo.org
We learn at school that warming up before training or playing sport is vital, but cooling down is every bit as important. We are taught from childhood that warming up is a must in preparation for any exercise. It allows us to gear our muscles up for the strain we are about to place on them and prevent injury. More importantly, it steadily increases the heart rate and circulation, which loosens joints and increases blood flow to the muscles. These all help towards an effective workout.
But cooling down is as important as warming up. It prevents dizziness, helps return the heart rate back to normal and prevents chronic venous insufficiency (CVI). Also known as “blood pooling”, CVI occurs when the blood in blood vessels expands during prolonged exercise, making it difficult for it to return to the heart from the legs.
According to many health and fitness instructors, the total cool-down period should last three to 10 minutes, or until you are ready to stop. Areas to target depend on which part of the body you trained. For example, if you have been working your legs, you will need to do lower body stretches or a slow walk. There are many helpful tutorials online.
The best way to measure whether you have cooled down effectively is purely based on common sense – if you feel your heart rate has reduced, that’s enough. If you wear a heart rate monitor, that will also tell you once your heart rate has returned to normal. There is no research to prove stretching after a session will help reduce soreness, but if you feel it helps, there is no harm in it, do so – it is down to personal preference.
Cooling down methods, including foam rollers, a sports massage or dry needling are worth investigating. If you experience any pain when stretching, stop, and consult your doctor or a physio if the pain is there the next day, and, more importantly, warm up more thoroughly next time.
By: Callum Nicholls
Callum Nicholls is a trainer at Third Space and Barry’s Bootcamp. Interview by Joti Birdi
No information is to be taken as medical or other health advice pertaining to any individual specific health or medical condition. You agree that use of this information is at your own risk and hold Fitness Blender harmless from any and all losses, liabilities, injuries or damages resulting from any and all claims.
In the world of health research, exercise is one of the few things that pretty much everyone agrees on.
Regular physical activity improves heart health, reduces your risk of cancer, keeps your bones healthy, improves mental health, and the list goes on.
But does it matter where you do your exercise? Will a gym work-out have the same health benefits as a bootcamp in a local park?
The bottom line is any exercise is better than no exercise, doctor and researcher Sandro Demaio tells ABC Life. So if exercising indoors works for you, stick with it.
“But there is some interesting evidence that running on a treadmill does not give the same mental health benefits as running outside, and it may not give you the same happy hormone boost as running outside,” Dr Demaio says.
“That makes sense because you’re not just running to improve your heart health and get the blood moving around the body and improve your fitness. You’re also outside seeing things, smelling things and getting fresh air. All those things will have an effect.”
Time in nature can boost mental health
It turns out, simply ‘being’ in a beautiful, natural environment really can benefit your mental health.
Levi Wade is a University of Newcastle PhD student studying the effects of outdoor exercise on mental health and cognition in teenagers.
“There’s a big evidence base on its effect on concentration and stress reduction. Those are the two big effects you’ll find,” Mr Wade says.
Broadly speaking, we can exert two different types of focus: hard and soft. Doing homework, checking over a spreadsheet, or crafting a pithy email all require hard focus.
Being immersed in a beautiful natural environment, on the other hand, can stimulate our soft focus. You might acknowledge the rustling of the leaves, or pay attention to the bird life.
Switching to soft focus allows your hard focus to recover: this is referred to as the restorative effect.
“If you’re walking in a forested environment or just somewhere that’s fascinating and beautiful, then a lot of the mechanism behind that effect on stress and mood is due to that environment taking your mind away from your own problems and whatever stress you are experiencing,” Mr Wade says.
“It’s just relaxing your mind because you’re not focusing on those thoughts.”
Much of the research around these benefits of outdoor exercise has been conducted on walking — specifically, walking in forested environments in Japan. It’s a popular activity there (not surprising given that 65 per cent of the country is covered in forest) and it’s termed shinrin-yoku, or “forest-bathing”.
One of the world’s leading shinrin-yoku researchers is Professor Yoshifumi Miyazaki, who has been conducting research on the physiological relaxation effects of nature since the early 1990s.
“The most important thing is to make use of nature that you like,” he says.
“During our research, we found that even small elements of nature that you personally like, like plant aromas, flower arrangements, potted plants, or bonsai can have a physiological relaxation effect.”
Of course, sitting next to a potted plant for halfa won’t have the same effect on your health (physical or mental) as a 5k run. But if you’re feeling overworked, then taking some time away from the city is likely to make you feel better.
Then there’s vitamin D boost
Exercising outdoors is also a great way to get your vitamin D, which you need for healthy bones, muscles and other vital body functions.
If you have fair skin you need roughly around 5–15 minutes of sun exposure a day, but this can vary depending on the time of year, and where in Australia you are.
More and more studies are showing how regular exercise benefits the brain, and in particular, the aging brain. What’s less clear is how exactly exercise counters the cognitive decline that comes with aging and diseases like Alzheimer’s.
To find out, for nearly a decade, Ozioma Okonkwo, assistant professor of medicine at the University of Wisconsin School of Medicine and Public Health and his colleagues have studied a unique group of middle-aged people at higher risk of developing Alzheimer’s. Through a series of studies, the team has been building knowledge about which biological processes seem to change with exercise.
Okonkwo’s latest findings show that improvements in aerobic fitness mitigated one of the physiological brain changes associated with Alzheimer’s: the slowing down of how neurons breakdown glucose. The research, which has not been published yet, was presented at the annual meeting of the American Psychological Association on Aug. 9.
Okonkwo works with the 1,500 people on the Wisconsin Registry for Alzheimer’s Prevention (WRAP)—all of whom are cognitively normal, but have genes that put them at higher risk of developing Alzheimer’s, or have one or two parents who have been diagnosed with the disease, or both. In the latest study, Okonkwo recruited 23 people from the WRAP population who were not physically active. Eleven were asked to participate in an exercise regimen to improve their aerobic fitness for six months, and 12 served as the control.
All had their brains scanned to track Alzheimer’s-related brain changes including differences in how neurons metabolized glucose, since in people with Alzheimer’s glucose breakdown slows. At the end of the study period, the group that exercised more showed higher levels of glucose metabolism and performed better on cognitive-function tests compared to the controls.
“We are carrying our research full circle and beginning to demonstrate some causality,” says Okonkwo about the significance of his findings.
In their previous work, he and his team identified a series of Alzheimer’s-related biological changes that seemed to be affected by exercise by comparing, retrospectively, people who were more physically active to those who were not.
In this study, they showed that intervening with an exercise regimen could actually affect these processes. Taken together, his body of research is establishing exactly how physical activity contributes to significant changes in the biological processes that drive Alzheimer’s, and may even reduce the effect of strong risk factors such as age and genes linked to higher risk of neurodegenerative disease.
For example, in their earlier work his group confirmed that as people age, the presence of Alzheimer’s-related brain changes increases—including the buildup of amyloid, slower breakdown of glucose by brain cells, shrinking of the volume of the hippocampus (central to memory), and declines in cognitive function measured in standard recall and recognition tests.
But they found that in people who reported exercising at moderate intensity at least 150 minutes a week, as public health experts recommend, brain scans showed that these changes were significantly reduced and in some cases non-existent compared to people who were not active. “The association between age and Alzheimer’s brain changes was blunted,” says Okonkwo, “Even if [Alzheimer’s] got worse, it didn’t get worse at the same speed or rate among those who are physically active as in those who are inactive.”
In another previous study, they found the benefits of exercise in controlling Alzheimer’s processes even among those with genetic predisposition for the disease. When they divided the participants by fitness levels, based on a treadmill test and their ability to efficiently take in oxygen, they found that being fit nearly negated the effect of the deleterious gene ApoE4. “It’s a remarkable finding because it’s not something that was predicted,” says Okonkwo.
In yet another previous study, Okonkwo and his team also found that people with higher aerobic fitness showed lower amounts of white matter hyperintensities, brain changes that are signs of neuron degeneration and show up as brighter spots on MRI images (hence the name). White matter hyperintensities tend to increase in the brain with age, and are more common in people with dementia or cognitive impairment.
They form as neurons degrade and the myelin that surrounds their long-reaching arms—which helps nerves communicate with each other effectively—starts to deteriorate. In people with dementia, that process happens faster than normal, leading to an increase in white matter hyperintensities. Okonwko found that people who were more aerobically fit showed lower amounts of these hyperintensities than people who were less fit.
Given the encouraging results from his latest study of 23 people that showed intervening with exercise can change some of the Alzheimer’s-related brain changes of the disease, he plans to expand his small study to confirm the positive effect that exercise and better fitness can have in slowing the signs of Alzheimer’s. Already, his work has inspired a study launched earlier this year and funded by the National Institutes of Health that includes brain scans to track how physical activity affects biological factors like amyloid and glucose in people at higher risk of developing Alzheimer’s.
The cumulative results show that “there may be certain things we are born with, and certain things that we can’t change ]when it comes to Alzheimer’s risk], but a behavior like physical exercise might help us to modify that,” says Heather Snyder, vice president of medical and scientific relations at the Alzheimer’s Association.