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Wednesday, May 2, 2012




     Your mind is a terrible thing to lose, and the fact is that you don't have to. I am often asked, "What can I do to prevent Alzheimer's disease?," and it turns out there is a nice, simple, effective answer, but it takes a lot of work. The answer is exercise. Chapter One of John Medina's book, Brain Rules, makes this point very nicely.
     Research shows that overall the greatest predictor of successful aging was the presence or absence of a sedentary lifestyle. The primary benefit of exercise is to the heart and vascular system, but it also has a very specific benefit for brain function. "When couch potatoes are enrolled in an aerobic exercise program, all kinds of mental abilities begin to come back online. Positive results were observed after as little as four months of activity."
     "A lifetime of exercise can result in a sometimes astonishing elevation in cognitive performance, compared with those who are sedentary. Exercisers outperform couch potatoes in tests that measure long-term memory, reasoning, attention, problem-solving, even so-called fluid-intelligence tasks (the ability to reason quickly and think abstractly, improvising off previously learned material in order to solve a new problem).
      But how much activity does it take? The encouraging answer is, "Not much." "If all you do is walk several times a week, your brain will benefit. Even couch potatoes who fidget show increased benefit over those who do not fidget." The effect is so significant that your lifetime risk for general dementia is literally cut in half if you participate in leisure-time physical activity. "Aerobic exercise seems to be the key. With Alzheimer's, the effect is even greater: Such exercise lowers the odds of getting the disease by more than 60 percent." "You have to participate in some form of exercise just twice a week to get the benefit. Bump it up to a 20-minute walk each day, and you can cut your risk of having a 57%."
     Exercise is also a powerful treatment for depression as it influences the neurotransmitters serotonin, dopamine, and norepinephrine. "For both depression and anxiety, exercise is beneficial immediately and over the long term. It is equally effective for men and women, and the longer the program is deployed, the greater the effect becomes. It is especially helpful for severe cases and for older people."
     In fact, "the benefits of exercise seem nearly endless because its impact is system-wide, affecting most physiological systems. Exercise makes your muscles and bones stronger, for example, and improves your strength and balance. It helps regulate your appetite, changes your blood lipid profile, reduces your risk for more than a dozen types of cancer, improves the immune system, and buffers against the toxic effects of stress. By enriching your cardiovascular system, exercise decreases your risk for heart disease, stroke, and diabetes. When combined with the intellectual benefits exercise appears to offer, we have in our hands as close to a magic bullet for improving human health as exists in modern medicine."
      How did exercise become so important in the history of the survival of our species. The answer is pretty simple--once upon a time, it was necessary. Our prehistoric ancestors in the homo species (erectus and sapiens) walked about 10 to 20 kilometers a day for men and about half that for women in the pursuit of food. That's 12 miles a day. In addition the species was steadily expanding its range--by about 25 miles per year. Survival required constant motion, quick reflexes, and quick thinking. What's unfortunate is that survival (in good health) still requires that even when it is not obvious.
     If you've drifted away from this healthy habit over the course of your life, don't despair. The Atherosclerosis Risk Factors in Communities Study (ARIC) has shown that even long-term couch potatoes with no healthy habits who convert to not smoking, exercising 20 minutes a day, eating 5 servings of fruits and vegetables a day, and getting their BMI to less than 30, enjoy a 40% reduction in mortality over a period as short as 4 years. It's really amazing that it only takes 4 years of good habits to make up for a lifetime of bad habits. You can do it.
     So, why not take advantage of this simple secret. It's easy to do. Dr. Medina offers two simple suggestions: (1) Wear your gym clothes all day. Eliminate the barrier to exercise that changing clothes imposes. Employers should encourage this. (2) Adapt yourself during your PC time managing email or surfing the web by doing it while on a treadmill. Dr. Medina says it took him only 15 minutes to become fully proficient on the laptop keyboard while walking at a 1.8 mile per hour pace. My additional suggestion is to find a way to capitalize on our preference, nay, need for, regular rituals. Create either four 5-minute ritual walks for your every day routine--walking to the store or post office, exploring a neighborhood park, walking from the parking lot to work or up several flights of stairs, etc., or create two 10-minute rituals. Whatever works for you--it just needs to add up to 20 minutes a day every (or almost every) day. And, either before your walk or right after, consume a fruit or vegetable (a smoothie or a glass of V8 juice), and then relax. Hey, you've got the whole lifestyle challenge beat according to the "Formula for Health", assuming you're not smoking and your weight (read "BMI") is heading down to 30 or below.

     You could even organize a neighborhood outing for 10-15 minutes every day after work. Invite the local kids and their parents to join you for a walk or ride. Making this kind of activity communal is the single best contribution you can make for your community. It will be immensely rewarding.
     And remember, you don't need to get Alzheimer's disease. It is essentially completely preventable.

Medina J. Brain Rules: 12 Principles for Surviving and Thriving at Work, Home, and School. Pear Press. 2008.

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NOTE: I will be in Portola this weekend for the Saturday morning clinic. I hope to see you there!


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