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Newsletter - October 2009

There's More to Exercise Than Meets the Eye!

Welcome to our second newsletter. It's early Fall and most folks say with football, fall foliage, pumpkins and the cool fall weather that they love this time of the year. It is indeed my favorite! I am hopeful that the information in this newsletter spurs you to exercise. I know for some of you it is very difficult for many reasons. One of the main reasons is getting motivated. I have found that information motivates me. Once I understand why something is important...really important...I become motivated.

As my title says..."there's more to exercise than meets the eye!" Exercise is vital to our brains in ways that most of us never realized. We know for sure that exercise is good for our cardiovascular health and health in general. Exercise is also excellent for depression and anxiety. The newest research is showing that exercise helps us learn better and with neuroplasticity actually increases our brain power. With aging and the changes therein, exercise is the best antiaging medicine out there. Interestingly it is an excellent adjunct to treatment for ADD in children and adults. Included in this newsletter is information from the new book Spark by Dr. John J. Ratey and Eric Hagerman.

I started exercising many years ago after gaining weight from being ill with Epstein Barr. I was never active in any kind of sport in high school. I was spurred on by Kenneth Cooper's book just out (1968) on Aerobics. I started jogging and finally was able to jog two miles. I remember it being so hard and said to myself if I can run 2 miles. there's nothing I can't do. It indeed made a difference. I not only lost the weight I gained, but recovered much quicker.

I have continued over the years to exercise as much as I can and have recommended exercise to my patients for a variety of reasons. After looking at the research in this book, I am more convinced than ever that exercise is essential to a life well lived.

Exercise is vital!

The real reason exercise makes us feel so good is that it gets blood pumping and thereby makes the brain function at its best. Building muscles and conditioning the heart and lungs are essentially the side effects.

The reason moving the body is so important has to do with our history. We are born movers...animals, in fact--because we've engineered movement right out of our lives. As we have adapted to an ever-changing environment over the past half million years, our thinking brain evolved from the need to hone motor skills. We envision our hunter-gatherer ancestors as brutes who relied primarily on physical prowess, but to survive over the long haul they had to use their smarts to find and store food. The relationship between food, physical activity, and learning is hardwired into the brain's circuity.

But we no longer hunt and gather, and that's a problem.The sedentary character of modern life is a disruption of our nature and it poses one of the biggest threats to our continued survival. Evidence of this is everywhere: 65% of our nation's adults are overweight or obese, and 10% of the population has Type 2 diabetes, a preventable and ruinous disease that stems from inactivity and poor nutrition. Once an affliction almost exclusively of the middle aged, it's now becoming an epidemic among children. We're literally killing ourselves, and it's a problem throughout the developed world, not merely a province of the supersize lifestyle of the US. What's even more disturbing, and what virtually no one recognizes is that inactivity is killing our brains too--physically shriveling them.

It was already known that exercise increases levels of serotonin, norepinephrine, and dopamine--important neurotransmitters that traffic in thoughts and emotions. Serotonin is associated with depression. Important to know here also is that toxic levels of stress erode the connections between the billions of nerve cells in the brain or that chronic depression shrinks certain areas of the brain.

Conversely, exercise unleashes a cascade of neurochemicals and growth factors that can reverse this process, physically bolstering the brain's infrastructure. In fact, the brain responds like muscles do, growing with use, withering with inactivity. The neurons in the brain connect to one another through "leaves" on treelike branches, and exercise causes those branches to grow and bloom with new buds, thus enhancing brain function at a fundamental level.

Researchers have now shown in the roots of our biology signs of the body's influence on the mind. It turns out that moving our muscles produces proteins that travel through the bloodstream and into the brain, where they play pivotal roles in the mechanisms of our highest thought processes. It's only in the past few years that neuroscientists have begun to describe these factors and how they work, and each new discovery adds awe-inspiring depth to the picture.

Exercise sets the stage, when you sit down to learn something new. In many ways it is vital.

Interestingly forcing yourself to exercise doesn't work. Experiments with lab rats suggest that forced exercise doesn't do the trick quite like voluntary exercise. If you can get to the point where you're consistently saying to yourself exercise is something you want to do, then you're charting a course to a different future--one that's less about surviving and more about thriving.

In October of 2000 researchers from Duke University made the New York Times with a study showing that exercise is better than Zoloft at treating depression. If exercise came in pill form, it would be hailed as the blockbuster drug of the century.

Looking at Anxiety and Exercise

Exercise is excellent in helping reduce anxiety. Here's how:

1. It provides distraction. Quite literally, moving puts your mind on something else. Studies have shown that anxious people respond well to any directed distraction--quietly sitting, meditating. eating lunch with a group, reading a magazine. But the antianxiety effects of exercise last longer and carry the other side benefits listed here.
2. It reduces muscle tension. Exercise serves as a circuit breaker just like beta-blockers, interrupting the negative feedback loop frrom the body to the brain that heightens anxiety. Back in 1982, a researcher named Herbert de Vries conducted a study showing that people with anxiety have overactive electrical patterns in their muscle spindles and that exercise reduced that tension. He called it the "tranquilizing effect of exercise." Reducing muscle tension. he found, reduced the feelings of anxiety.
3. It builds brain resources. Exercise increases serotonin and norepinephrine both in the moment and over the long term. Serotonin works at nearly every junction of the anxiety circuitry, regulating signals at the brain stem, improving the performance of the prefontal cortex to inhibit fear, and calming down an important part of our brain, the amygdala.
4. It teaches a different outcome. Anxiety brings the sympathetic nervous system into play, when you sense your heart rate and breathing picking up. With this awareness an anxiety or panic attack can ensue. But these same symptoms are inherent in physical exercise, aerobic exercise--that's a good thing.
   If you begin to associate the physical symptoms of anxiety with something positive, something that you initiated and can control, the fear memory fades in contrast to the fresh one taking shape.
5. It reroutes your circuits. By activating the sympathetic nervous system through exercise, you break free from the trap of passively waiting and worrying. and prevent the amygdala from running wild and reinforcing the danger-filled view of what life is presenting. Instead, when you respond with action, you send information down a different pathway of the amygdala, paving a safe detour and wearing in a good groove.
6. It improves resilience. You learn that you can be effective in controlling anxiety without letting it turn into panic. The psychological term is self-mastery,
   and developing it is a powerful prophylactic against anxiety sensitivity and against depression. In consciously making the decision to do something for yourself, you begin to realize that you can do something for yourself.
7. It sets you free. Researchers immobilize rts in order to study stress. In people too, if you're locked down--literally or figuratively--you'll feel more anxious. People who are anxious tend to immobilize themselves--balling up in a fetal position or just finding a safe spot to hide from the world. Many resort to heavy medication with antianxiety agents or use of recreational drugs such as marijuana. Agoraphobics feel trapped in their homes, but in a sense any form of anxiety feels like a trap. That opposite of that, and the treatment, is taking action, going out, and exploring moving through the environment. Exercising!

Aging and Exercise

Here's how exercise profoundly affects our ability to keep going!

1. It strengthens the cardiovascular system. A strong heart and lungs reduce resting blood pressure. The result is less strain on the vessels in the body and the brain. Exercise helps expand the vascular network, bringing each area of the brain that much closer to a lifeline and creating redundant circulation routes that protect against future blockages. Second, exercise introduces more nitric oxide, a gas that widens the vessels' passageways to boost blood volume. Third. the increased blood flow during moderate to intense activity reduces hardening of the brain arteries. Finally, exercise can some extent counteract vascular damage. Stroke victims and even Alzheimer's patients who participate in aerobic exercise improve their score on cognitive tests.
   
   Starting when you're young is best, but it's never too late!
2. It regulates fuel. As we age, insulin levels drop and glucose has a harder time getting into the cells to fuel them. Then glucose can skyrocket, which creates waste products in the cells—such as free radicals—and damages blood vessels, putting us at risk for stroke and Alzheimer's. When everything is balanced. insulin works against the buildup of amyloid plaque, but too much encourages the buildup, as well as inflammation, damaging surrounding
   neurons.
3. It reduces obesity. Aside from wrecking havoc on the cardiovascular and metabolic systems, body fat has its own nasty effect on the brain. The CDC estimates that 73% of Americans over 65 are overweight, and, given the potential problem obesity can lead to—from cardiovascular disease to diabetes—the agency is right in declaring it a pandemic. Simply being overweight doubles the changes of developing dementia, and if we factor in high blood pressure and high cholesterol—symptoms often come along with obesity—the risk increases sixfold! When people retire, they figure they deserve a break after working their whole lives, and they start piling on the food. Exercise, naturally, counteracts obesity on two fronts; it burns calories, and it reduces the appetite.
4. It elevates the stress threshold. Exercise combats the corrosive effects of too much cortisol, a product of chronic stress that can bring on depression and dementia. This excess cortisol is what directly causes accumulation of weight around the waist and lower abdomen...belly fat! Exercise makes proteins that fix the damage to the cells and delays the process.
5. It lifts the mood. A number of studies have shown that keeping our mood up reduces our chances of developing dementia. The evidence applies not only to clinical depression but also to general attitude. Staying mobile also allows us to stay involved, keep up with people, and make new friends; social connections are important in elevating and sustaining mood.
6. It boosts the immune system. Stress and age depress the immune system response and exercise strengthens it directly in two important ways.
   
   First, even moderate activity levels rally the immune system's antibodies and lymphocytes, which you probably know as T-cells. Antibodies attack bacterial and viral infections, and having more T-cells makes the body more alert to the development of conditions such as cancer. Population studies bear this out: The most consistent risk factor for cancer is lack of activity. Those who are physically active, for instance, have a 50% lower chance of developing colon cancer. Second, part of the immune system's job is to activate cells that fix damaged tissue. When it's out o whack, these damaged spots fester and you're left with chronic inflammation. A blood test for this is the C-Reactive Protein test. Exercise brings the immune system back into equilibrium so it can stop inflammation and combat disease.
7. It fortifies the bones. Osteoporosis afflicts twenty million women and two million men in the country. More women die every year from hip fractures—vulnerability of osteoporosis—than from breast cancer. Women reach peak bone mass at around 30, and after that they lose about 1% a year until menopause when the pace doubles! The result is that by age 60, about 30% of a woman's bone mass has disappeared. Unless, that is, she takes calcium and vitamin D and does some form of exercise or strength training to stress the bones. Walking doesn't quite do the job—save that for later of life. Weight training definitely helps. Even women in their 90's can improve their strength and prevent this heartbreaking disease.
8. it boosts motivation. Exercise can continually improve our motivation as we push ourselves. Exercise counteracts the natural decline of dopamine, the key neurotransmitter in the motivation and motor systems. When you move, you're inherently boosting motivation by strengthening the connections between dopamine neurons, while at the same time guarding against Parkinson's. This really underscores the idea that if you're not busy living, your body will be busy dying.
9. It fosters neuroplasticity. The best way to guard against neurodegenerative diseases is to build a strong brain. Aerobic exercise accomplishes this by strenthening connections between your brain cells, creating more synapses to expand the web of connections and spurring newly born stem cells to divide and become functional neurons in the hippocampus. Moving the body keeps the brain growing by elevating the supply of neurotrophic factors necessary for neuroplasticity and neurogenesis, which would otherwise diminish with age. The structural changes that occur with exercise improve the brain's ability to learn and remember, execute higher thought processes, and mange your emotions. The more robust the connections, the better prepared your brain will be to handle any damage it might experience.

Getting Started

According to Dr. John Ratey coauthor of Spark, his best advice when exercising for the brain, is to get fit and then continue to challenge yourself. The prescription for how to do that will vary from person to person, but the research consistently shows that the more fit you are, the more resilient your brain becomes and the better it functions both cognitively and psychologically. If you get your body into shape, your brain will follow. Many of the most convincing studies use walking as the mode of exercise.

In our modern lives, there is no need to forage for food or to hunt to survive. Yet our genes are coded for this activity, and our brains are meant to direct it. Take the activity away, and you're disrupting a delicate balance that has bee fine-tuned over half a million years. Quite simply. we need to engage our endurance metabolism to keep our bodies and brains in optimal condition. The ancient rhythms of activity ingrained in our DNA translate roughly to the varied intensity of walking, jogging, running, and sprinting. Walk or jog every day. Before you engage in more strenuous exercise, make sure to check with your doctor.

To get the best effect, it is recommended to also run a couple of times a week, then go for the kill every now and then by sprinting. In talking about walking or low-intensity exercise, Dr. Ratey refers to exercising at 55-65% of your maximum heart rate. By his definition, moderate intensity falls in the range of 65 to 75%, while high intensity is 75-90%. The upper end of high-intensity exercise is sometimes painful but always powerful territory that has gained a lot of scientific interest recently.

To calculate your intensity level: take the number 220 minus your age.

In summary, the most important thing is to do something. And to start. This seems obvious. but with sedentary people it presents quite a challenge...especially if inactivity is due to depression. Taking that first step may seem impossible. For some people it's a Catch-22: they can't start because they're don't have the energy, and they don't have the energy because they're not exercising. The key is to attack the business of starting as a challenge in itself. Working out with a friend helps. Getting a trainer is also a good idea. Write exercise into your schedule just like any other appointment. After a while, your brain will absorb it into your routine just like brushing your teeth.

If you haven't been active. begin by walking. Take the stairs, instead of the elevator, park at the back of the lot, and go for a stroll around the block at lunchtime. Get a pedometer and calculate how many steps you take a day. Based on an average stride of 2.5 feet, ten thousand steps is close to five miles. it is a clever way to begin to get in shape without even setting aside much extra time. And it works. Counting your steps, like weighing yourself or using a heart monitor to guide your efforts, helps keep you focused and motivated, especially if you understand what your body and brain are doing at various intensity levels.

NEXT ISSUE: "Fear"  and how to deal effectively with it.