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Pumped: How To Build ABetter Brain Through Exerciseand MovementMichael Lara, MDDiplomate, American Board of Psychiatry and...
The Pumped e-book will teach youeverything you need to know to getstarted• The physical and mental health benefitsof inter...
$19.9530 Day Money-Back Guarantee!Download yourcopy atwww.drmikelara.com$9.95Facebook.com/BrainMD MichaelLaraMD
Born To MoveWhy Our Brains Were Designed To Move andHow Our Sedentary Habits are Killing Us
The Human Brain EvolvedThrough MovementThe human brain evolved over 4 million years from 400grams in earliest hominids to ...
Physical activities of our paleolithic ancestors havecorrelates in modern day forms of exerciseTypical Activities of Hunte...
The Primary Motor Cortex
Cerebellum and Movement• Cerebellum (Latin for ―little brain‖) isresponsible for coordination, precisionand accurate timin...
Americans Move Less0 2000 4000 6000 8000 10000 12000AmericansAustraliansSwissJapaneseSteps/day; 1 mile=2,000 stepsBassett ...
Too Much Sitting: An ImportantPredictor of Chronic Disease?• Increased participation in physical activity is a central ten...
Sedentary Physiology• Though conceptualized as the low end of the physicalactivity continuum, sedentary behavior has indep...
TheConsequences ofa SedentaryLifestyle• Type 2diabetes, cardiovasculardiseases, coloncancer, breastcancer, dementia anddep...
Plasma Levels of Interleukin-6 and C-Reactive Protein are Associated withPhysical Inactivity Independent of Obesity• Infla...
Myokines and InflammationPedersen BK. The diseasome of physical inactivity - and the role of myokines in muscle-fat cross ...
Longer Periods of Standing or Walking ImproveInsulin Action More Than Acute Bouts ofModerate to Vigorous ActivityOne hour ...
Benefits of Outdoor Exercise• Exposure to natural settings has restorative health effects• Japanese practice of shinrin-yo...
Exercise Improves Sleep• Exercise improves sleep quality and normalizes circadianrhythms.• Acute and chronic exercise incr...
Exercise increasestime spent in deepsleep
Source: National Sleep Foundation. Exercise and Sleep 2013 .www.sleepfoundation.org
The Molecules of MovementNeurotransmitters, Hormones, and Neurotrophins
Norepinephrine SerotoninDopamineAlertnessConcentrationEnergyObsessionsCompulsionsMemoryPleasureRewardMotivationHigh-Intens...
Exercise IncreasesNeurotransmitters• Exercise has both short and long-term effects on neurotransmittersthat regulate atten...
Catecholamine Response to Exercise
Beta-Endorphin and TheRunner’s High• Exercise, a form of voluntary stress, activates thehypothalamic-pituitary-adrenal axi...
Boecker H, Sprenger T, Spilker ME, et al. The runners high: opioidergic mechanisms in thehuman brain. Cerebral Cortex. 200...
Effects of Chronic EnduranceExercise on Testosterone• Gonadal steroid hormones, testosterone andestrogen, are affected by ...
Effects of Intensive, Long-TermRunning on Reproductive HormonesTestosterone levels were lowerin the group of runners whoex...
Effect of Exercise on Estrogen inPostmenopausal Women• Elevated circulating estrogens and a sedentary lifestyleincrease ri...
Andreasen, Brave New Brain: Conquering Mental Illness in the Era of the Genome, 2001Effects of Cortisol onHippocampus
Cortisol and The Hippocampus• Chronic exposure to elevated levels of cortisol is known toreduce hippocampal volume• Reduct...
Exercise Reverses HippocampalVolume Loss in Late Adulthood• Hippocampus shrinks in late adulthood, leading toimpaired memo...
Aerobic Exercise Training IncreasesBrain Volume In Aging AdultsBlue regions: Gray matter volume was increased for aerobic ...
Cardio or Weights?The Cognitive Benefits of Aerobics, Resistance Training, andOther Forms of Mindful Movement
Pumped will teach you everything youneed to know to get started• The physical and mental health benefitsof intermittent fa...
$19.9530 Day Money-Back Guarantee!Download yourcopy atwww.drmikelara.com$9.95Facebook.com/BrainMD MichaelLaraMD
Exercise and Pharmacotherapy inthe Treatment of Major Depression• Objective: to assess whether patients receiving aerobice...
Exercise v. Sertraline in MDDHamilton Depression Rating Scale (HAM-D) scores after 16 weeks of treatmentusing intention-to...
Exercise v. Clomipramine in PanicDisorderObjective: To compare the therapeutic effect of exercise for patients with panic ...
Benefits of Aerobic Training• The majority of scientific literature supports a generalbenefit of aerobic fitness on childh...
Juggling Increases Gray Matter in theCortex• Learning to juggle can alter graymatter in the occipito-temporalcortex as ear...
Benefits of Resistance- Training• In addition to increasing strength, resistance training (RT)increases growth hormone, im...
Resistance-Training andExecutive Function• Background: We compared the effect of once-weekly and twice-weekly resistance t...
Resistance-Training andExecutive FunctionResults: Both resistance training groups significantly improvedtheir performance ...
The CONSORT (Consolidated Standards of Reporting Trials) flowchart. BAT indicates twice-weekly balance and tone exercisetr...
Ability to Sit and Rise from FloorPredicts Mortality• Background: While cardiorespiratory fitness is stronglyrelated to su...
Ability to Sit and Rise from FloorPredicts Mortality• Results: Median follow up was 6.3 years and there were 159deaths (7....
Yoga as Health Intervention for ChronicDiseaseInnes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin...
Effects of Yoga Versus Walking onMood, Anxiety, and Brain GABA Levels• Objectives: Yoga and exercise have beneficial effec...
Effects of Yoga Versus Walking onMood, Anxiety, and Brain GABA Levels• Results: The yoga subjects (n = 19) reportedgreater...
Streeter CC, Whitfield TH, Owen L, et al. Effects of Yoga Versus Walking on Mood, Anxiety, andBrain GABA Levels: A Randomi...
Tai Chi Improves Balance, SleepQuality and Cognitive Performance• Objective: To evaluate the effects of Tai chi exercise o...
Tai Chi Improves Balance, SleepQuality and Cognitive Performance• Outcome measures: The Falls Efficacy Scale(FES), Pittsbu...
Tai Chi Improves Balance, SleepQuality and Cognitive PerformanceNguyen MH, Kruse A. A randomized controlled trial of Tai c...
Dance as Therapy for Individuals withParkinson DiseaseA comparison oftango, waltz/foxtrot, Tai Chi, and nointervention sug...
Establishing the ExerciseHabitHow to Form Healthy Habits and Avoid Unhealthy Habits
Habits DefinedHabits (mannerisms, customs, rituals) are largely learned; theyare acquired via experience-dependent plastic...
Habit Formation and the BasalGangliaYin HH, Knowlton BJ. The role of the basal ganglia in habit formation. Nat Rev Neurosc...
Neurobiology of Addiction
Tools to Start and MaintainHealthy Habits• StickK.com: uses a ―commitment contracts‖ to publiclydeclare stated goal. Progr...
Tracking Tools• Fitbit is an accelerometer that tracks movements andsleep patterns. Data is sent wirelessly to fitbit.com,...
Just Do It!An Overview of Exercise Types and Program Design
How Intense? In aerobic studies examined, participants exercised at60%-70% of maximum heart rate. This is equivalent to a...
How Often? In aerobic studies examined, participants exercised anaverage of 3 days/week. Exercise sessions lasted 45 mino...
Exercise Programs for a Better BrainPrograms that include cross-training outdoors―constantly varied, high-intensity functi...
77Lift Heavy ThingsMove Frequently at aSlow Pace―The Primal Blueprint‖ by Mark SissonPrimal FitnessSprintWalk, hike or jog...
78Leisurely walks in nature at least five times/weekMove Frequently at a Slow PaceExercise in green environmentsreduces st...
79Pushing, pulling, squatting, and throwingLift Heavy Things‣ Heavy resistance trainingincreases growth hormone (GH)and te...
Body-Weight Resistance TrainingThe Big 5 of Body Weight Resistance TrainingUpper Body Push-ups, pull-ups, chin-ups, rowsLo...
81Nutritional strategy that alternates brief periods of fasting with non-fastingIntermittent Fasting• Fasting raises catec...
82Alternate periods of fasting with non-fasting for 1-3 non-consecutive days/weekHow to Succeed with IntermittentFasting6:...
May’s StoryDecember 2010 March 2012To Watch the Free 1-hour Webinar:www. Brain Webinar. com
84
Running at maximal intensity for no more than 30secondsSprint Training• Exercise intensity correlates withrise of catechol...
88HIIT involves ―all out‖ efforts with fixed work:rest ratiosHigh-Intensity Interval Training30:30Total time: 10 min30 sec...
Power Program for a Better BrainA comprehensive program for exercising to improve mood andcognitionLeisurely Walks in Natu...
Pumped will teach you everything youneed to know to get started• The physical and mental health benefitsof intermittent fa...
$19.9530 Day Money-Back Guarantee!Download yourcopy atwww.drmikelara.com$9.95Facebook.com/BrainMD MichaelLaraMD
Get Pumped!
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
Pumped: How to Build A Better Brain Through Exercise and Movement
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Pumped: How to Build A Better Brain Through Exercise and Movement

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Exercise is one of the most effective, non-pharmacologic methods to elevate mood, improve memory and enhance overall wellbeing. Learn how to develop a personalized program and maintain the exercise habit in this 6-hour seminar by Dr. Michael Lara, a board-certified psychiatrist and fitness enthusiast.
Learn how sedentary behaviors contribute to mood disorders and cognitive decline.
Learn how key neurotransmitters such as serotonin, norepinephrine and brain opiates are influenced by exercise.
Learn how exercise induces anatomical changes in the brain through brain-derived neurtrophic factor, vascular endothelial growth factor, and other chemical messengers.
Learn how different forms of exercise such as cardiovascular training and resistance training affect mood and cognition.

Published in: Health & Medicine

Pumped: How to Build A Better Brain Through Exercise and Movement

  1. 1. Pumped: How To Build ABetter Brain Through Exerciseand MovementMichael Lara, MDDiplomate, American Board of Psychiatry and NeurologySan Francisco, CAwww.drmikelara.com
  2. 2. The Pumped e-book will teach youeverything you need to know to getstarted• The physical and mental health benefitsof intermittent fasting• How to begin an intermittent fast• Best timing schedules forfasting/nonfasting• What type of results to expect• What supplements to use to maximizegains• An overview of exercise strategies• The single best interval strategy formaximal fat loss
  3. 3. $19.9530 Day Money-Back Guarantee!Download yourcopy atwww.drmikelara.com$9.95Facebook.com/BrainMD MichaelLaraMD
  4. 4. Born To MoveWhy Our Brains Were Designed To Move andHow Our Sedentary Habits are Killing Us
  5. 5. The Human Brain EvolvedThrough MovementThe human brain evolved over 4 million years from 400grams in earliest hominids to 1.4 kilograms (3 lbs).Complex movement sequences such as long-distancerunning and throwing projectiles were essential todevelopment of neocortical structures and pathwaysThe brain exists, according to some neuroscientists, forone reason and one reason only: not to think or feel, butto produce adaptable and complex movements.Wolpert, D. The Real Reasons for Brains. TedTalks.http://www.ted.com/talks/daniel_wolpert_the_real_reason_for_brains.html. Accessed March 18, 2013
  6. 6. Physical activities of our paleolithic ancestors havecorrelates in modern day forms of exerciseTypical Activities of Hunter-Gatherer• Slow Cardio: 5-10 miles/day of low intensity walking• Hunter gatherers cover 5-15 miles per days. Persistence hunterscover in excess of 30 miles/day.• Resistance Training: Lifting, Throwing, and Carrying Objects• Encompass functional movements such as pushing, pulling, sprinting,and jumping• Interval Training: Periodic bursts of high-intensity activity• Brief bouts of sprinting alternating with walking or jogging in pursuit ofpreyOKeefe JH, Vogel R, Lavie CJ, Cordain L. Achieving Hunter-gatherer Fitness in the 21st Century:Back to the Future. AJM. 2012:1–5.
  7. 7. The Primary Motor Cortex
  8. 8. Cerebellum and Movement• Cerebellum (Latin for ―little brain‖) isresponsible for coordination, precisionand accurate timing of movement• Contains 50-80% of total neurons inbrain• Cerebellum is dysfunctional inmovements of attention (ADHD) andmovement (Parkinson Disease)• Moving to rhythm or cadence is anestablished treatment for both ADHDand PDBledsoe J, Semrud-Clikeman M, Pliszka SR. A magnetic resonance imaging study of the cerebellarvermis in chronically treated and treatment-naive children with attention-deficit/hyperactivity disordercombined type. Biol. Psychiatry. 2009;65(7):620–624.
  9. 9. Americans Move Less0 2000 4000 6000 8000 10000 12000AmericansAustraliansSwissJapaneseSteps/day; 1 mile=2,000 stepsBassett DR JR.,Wyatt HR, Thompson H, Peters JC, Hill JO. Pedometer-measured physical activity andhealth behaviors in United States adults. Med Sci Sports Exerc. 2010;42(10):1819.
  10. 10. Too Much Sitting: An ImportantPredictor of Chronic Disease?• Increased participation in physical activity is a central tenet ofstrategies for preventing major chronic diseases (type 2diabetes, cardiovascular disease, breast and colon cancer).• Recent findings also suggest that physical activity, in the context ofotherwise sedentary lifestyles, is unlikely to be sufficient to preventincreasing rates of chronic disease.• We spend an average of 9.3 hours/day sitting--even more timethan we spend sleeping (7.7 hours)Owen N, Bauman A, Brown W. Too much sitting: a novel and important predictor of chronic diseaserisk? British Journal of Sports Medicine. 2009;43 (2):81–83.
  11. 11. Sedentary Physiology• Though conceptualized as the low end of the physicalactivity continuum, sedentary behavior has independentand qualitatively different effects on humanmetabolism, physical function and brain function.• Individuals can achieve high levels of moderate tovigorous physical activity and still exhibit high levelsof sedentary behavior — one behavior does notnecessarily displace the otherTremblay MSTM, Colley RCCR, Saunders TJST, Healy GNHG, Owen NON. Physiological and healthimplications of a sedentary lifestyle. Applied Physiology, Nutrition, and Metabolism. 2010;35(6):725–
  12. 12. TheConsequences ofa SedentaryLifestyle• Type 2diabetes, cardiovasculardiseases, coloncancer, breastcancer, dementia anddepression constitute acluster of diseases, whichare mediated byinflammation.• Chronic inflammation isinvolved in thepathogenesis of insulinresistance, atherosclerosis,neurodegeneration andtumor growth.• Evidence suggests that theprotective effect of exercisemay due to the anti-inflammatory effect ofregular exercisePedersen BK. The diseasome of physical inactivity - and the role of myokines in muscle-fat cross talk.Journal of Physiology. 2009;587(23):5559–5568.
  13. 13. Plasma Levels of Interleukin-6 and C-Reactive Protein are Associated withPhysical Inactivity Independent of Obesity• Inflammatory cytokines are released in response to acuteexercise, but trained subjects have a markedly lowerlevels of C-reactive protein (CRP) and interleukin-6 (IL.)• CRP and IL-6 reflect the degree of regular physical activitywhen compared with other markers of inflammation.• Obesity is associated with elevated insulin, C-peptide, triglycerides, low-density lipoprotein, IL-6, CRP, and adiponectin.• Physical inactivity was associated with elevated C-peptide, IL-6, and CRP independent ofobesity, age, gender, and smoking.Fischer CP, Berntsen A, Perstrup LB, Eskildsen P, Pedersen BK. Plasma levels of interleukin-6 and C-reactive protein are associated with physical inactivity independent of obesity. Scand J Med Sci Sports.2006.
  14. 14. Myokines and InflammationPedersen BK. The diseasome of physical inactivity - and the role of myokines in muscle-fat cross talk.The Journal of Physiology. 2009;587(23):5559–5568. doi:10.1113/jphysiol.2009.179515.
  15. 15. Longer Periods of Standing or Walking ImproveInsulin Action More Than Acute Bouts ofModerate to Vigorous ActivityOne hour of daily physical exercise cannot compensate the negative effects of inactivity on insulinlevel and plasma lipids if the rest of the day is spent sitting.Duvivier BMFM, Schaper NC, Bremers MA, et al. Minimal intensity physical activity (standing andwalking) of longer duration improves insulin action and plasma lipids more than shorter periods ofmoderate to vigorous exercise (cycling) in sedentary subjects when energy expenditure is comparable.PLoS ONE. 2013;8(2):e55542.
  16. 16. Benefits of Outdoor Exercise• Exposure to natural settings has restorative health effects• Japanese practice of shinrin-yoku, or forest bathing• Exercising in natural environments associated with greaterfeelings of revitalization and positiveengagement, decreases in tension, confusion, anger, anddepression, and increased energy.• Exercising outdoor increases body levels of vitamin Dlevels.• Persons aged >60 yrs who participated in daily outdooractivities had vitamin D concentrations similar to that ofpersons aged 20-39 yrs.Coon JT, Boddy K, Stein K, Whear R, Barton J, Depledge MH. Does participating in physical activity inoutdoor natural environments have a greater effect on physical and mental wellbeing than physicalactivity indoors? A systematic review. Environ. Sci. Technol. 2011;45(5):1761–1772.
  17. 17. Exercise Improves Sleep• Exercise improves sleep quality and normalizes circadianrhythms.• Acute and chronic exercise increases slow wave sleep andtotal rest time. Exercise also decreases the amount of time tofall asleep and decreases the amount of time spent in non-restorative REM sleep.• Lack of restorative sleep increases inflammatory cytokinesand is associated with chronic disease• A single night of sleep deprivation results in higher levels ofinterleukin-6 and tumor necrosis factorUchida S, Shioda K, Morita Y, Kubota C, Ganeko M, Takeda N. Exercise Effects on SleepPhysiology. Frontiers in Neurology. 2012;3.
  18. 18. Exercise increasestime spent in deepsleep
  19. 19. Source: National Sleep Foundation. Exercise and Sleep 2013 .www.sleepfoundation.org
  20. 20. The Molecules of MovementNeurotransmitters, Hormones, and Neurotrophins
  21. 21. Norepinephrine SerotoninDopamineAlertnessConcentrationEnergyObsessionsCompulsionsMemoryPleasureRewardMotivationHigh-Intensity Interval TrainingSprint TrainingWalkingSwimmingJoggingYogaTai ChiDancing
  22. 22. Exercise IncreasesNeurotransmitters• Exercise has both short and long-term effects on neurotransmittersthat regulate attention, mood, and movement• Norepinephrine (NE) increases abruptly at exercise intensities thatexceed 50% of VO2 max• NE turnover is increased in the frontal cortex and is helpful in alleviatedsymptoms of ADHD• Serotonin (5-HT) is modulated by exercise in specific brain regionsand is also affected by intensity and duration of exercise.• High-intensity interval training increases 5-HT synthesis in thehippocampus via interaction with brain derived neurotrophic factor(BDNF).• Dopamine (DA) is also increased in pathways involved in regulationand control of movement• Higher levels of moderate to vigorous activities are associated with alower risk of developing Parkinson diseaseMattson MP, Maudsley S, Martin B. BDNF and 5-HT: a dynamic duo in age-related neuronalplasticity and neurodegenerative disorders. Trends in Neurosciences. 2004;27(10):589–594.
  23. 23. Catecholamine Response to Exercise
  24. 24. Beta-Endorphin and TheRunner’s High• Exercise, a form of voluntary stress, activates thehypothalamic-pituitary-adrenal axis• Beta-endorphin is released from anterior pituitary• Subjective feelings of euphoria are mediated by risinglevels of beta-endorphin• Naloxone, an opioid antagonist, attenuates the subjectivefeelings of joy and euphoria associated with running• Beta-endorphin increases in prefrontal and limbic regions ofthe brain after 2 hours of endurance running and levelscorrelate with euphoria ratings.Janal MN, Colt EWD, Clark WC, Glusman M. Pain sensitivity, mood and plasma endocrinelevels in man following long-distance running: Effects of naloxone. Pain. 1984;19(1):13–25.
  25. 25. Boecker H, Sprenger T, Spilker ME, et al. The runners high: opioidergic mechanisms in thehuman brain. Cerebral Cortex. 2008;18(11):2523–2531.ACC: Errordetection, modulationof emotional responsesOFC: signals expectedreward/punishment ofan actionINS: interoceptiveawareness of bodystate
  26. 26. Effects of Chronic EnduranceExercise on Testosterone• Gonadal steroid hormones, testosterone andestrogen, are affected by exercise mode and intensity.• In general, chronic endurance training depressesreproductive hormone responses in both men and women• Endurance-trained men have lower levels of testosteronecompared with sedentary controls.• Decreases in testosterone, sperm motility and correlatewith exercise intensity.Wheeler GD. Reduced Serum Testosterone and Prolactin Levels in Male Distance Runners.JAMA. 1984;252(4):514.
  27. 27. Effects of Intensive, Long-TermRunning on Reproductive HormonesTestosterone levels were lowerin the group of runners whoexercised more intensely andwere restored after 36 weeks ofrecoveryTotal sperm count, spermmotility, and sperm morphologywere all lower in the high-intensity exercise group v. themedium-intensity exercise groupSafarinejad MR, Azma K, Kolahi AA. The effects of intensive, long-term treadmill running on reproductive hormones, hypothalamus-pituitary-testis axis, and semen quality: a randomized controlledstudy. Journal of Endocrinology. 2008;200(3):259–271.
  28. 28. Effect of Exercise on Estrogen inPostmenopausal Women• Elevated circulating estrogens and a sedentary lifestyleincrease risk for breast cancer.• Objective: examine effects of 12-month moderate-intensityexercise intervention on serum estrogens.• Method: 173 sedentary, overweight women, ages 50-75, assigned to exercise (45 min, 5days/week) and controlgroup.• Results: After 3 months, exercisers experienced declinesin estrone, estradiol, and free estradiol versus no changeor increased concentrations in controls. After12, months, the direction of effect remained the same. Theeffect was limited to women who lost body fat.McTiernan A, Tworoger SS, Ulrich CM, et al. Effect of Exercise on Serum Estrogens inPostmenopausal Women A 12-Month Randomized Clinical Trial. Cancer Research. 2004;64(8):2923–
  29. 29. Andreasen, Brave New Brain: Conquering Mental Illness in the Era of the Genome, 2001Effects of Cortisol onHippocampus
  30. 30. Cortisol and The Hippocampus• Chronic exposure to elevated levels of cortisol is known toreduce hippocampal volume• Reductions in hippocampal volume are seen across manyneurocognitive and neurodegenerative diseases includingmajor depressive disorder, dementia, and schizophrenia• Exercise-trained individuals tend to display attenuatedHPA axis responses to exercise and mental stress.Hippocampal volumes are larger in high fit adults.Videbech P, Ravnkilde B. Hippocampal Volume and Depression: A Meta-Analysis of MRI Studies. AmJ Psychiatry. 2004;161(11):1957–1966.
  31. 31. Exercise Reverses HippocampalVolume Loss in Late Adulthood• Hippocampus shrinks in late adulthood, leading toimpaired memory and risk for dementia• Randomized controlled trial with 120 older adultsdemonstrated an increased size of anteriorhippocampus, leading to improvements in spatial memory.• Exercise training increased hippocampal volume by2%, effectively reversing age-related loss in volume by 1to 2 years.• Hippocampal volume declined in the control groupErickson KI, Voss MW, Prakash RS, et al. Exercise training increases size of hippocampus andimproves memory. PNAS. 2011;108(7):3017–3022.
  32. 32. Aerobic Exercise Training IncreasesBrain Volume In Aging AdultsBlue regions: Gray matter volume was increased for aerobic exercisersYellow regions: White matter was increased for aerobic exercisersColcombe SJ, Erickson KI, Scalf PE, et al. Aerobic exercise training increases brain volume in aginghumans. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences.2006;61(11):1166–1170.
  33. 33. Cardio or Weights?The Cognitive Benefits of Aerobics, Resistance Training, andOther Forms of Mindful Movement
  34. 34. Pumped will teach you everything youneed to know to get started• The physical and mental health benefitsof intermittent fasting• How to begin an intermittent fast• Best timing schedules forfasting/nonfasting• What type of results to expect• What supplements to use to maximizegains• An overview of exercise strategies• The single best interval strategy formaximal fat loss
  35. 35. $19.9530 Day Money-Back Guarantee!Download yourcopy atwww.drmikelara.com$9.95Facebook.com/BrainMD MichaelLaraMD
  36. 36. Exercise and Pharmacotherapy inthe Treatment of Major Depression• Objective: to assess whether patients receiving aerobicexercise achieve reductions in depression compared tostandard antidepressant medication.• Methods: RCT of 202 adults diagnosed with MDDassigned to one of four conditions: supervisedexercise, home-based exercise, antidepressantmedication, or placebo for 16 weeks.• Results: after 4 months of treatment, exercising groupshad response rates comparable to group takingmedication.Blumenthal JA, Babyak MA, Doraiswamy PM, et al. Exercise and Pharmacotherapy in theTreatment of Major Depressive Disorder. Psychosomatic Medicine. 2007;69(7):587–596.
  37. 37. Exercise v. Sertraline in MDDHamilton Depression Rating Scale (HAM-D) scores after 16 weeks of treatmentusing intention-to-treat analysisPatients in the Home andSupervisedexercise groups had comparableresults to group taking medication
  38. 38. Exercise v. Clomipramine in PanicDisorderObjective: To compare the therapeutic effect of exercise for patients with panic disorderto a drug treatment..Method: 46 outpatients suffering from panic disorder were randomly assigned to a 10-week treatment protocol of regular aerobic exercise, clomipramine, or placebo pills.Results: Both exercise and clomipramine led to a significant decrease in symptoms.Clomipramine treatment improved anxiety symptoms significantly earlier and moreeffectively.Conclusions: Regular aerobic exercise alone is associated with significant clinicalimprovement, but it is less effective than treatment with clomipramine.Broocks A, Bandelow B, Pekrun G, et al. Comparison of Aerobic Exercise, Clomipramine, and Placebo in the Treatment ofPanic Disorder. Am J Psychiatry. 1998;155(5):603–609.
  39. 39. Benefits of Aerobic Training• The majority of scientific literature supports a generalbenefit of aerobic fitness on childhood cognitiveperformance.• Interventional studies in adults suggest that previouslysedentary older adults improve in executivefunctioning, attention, and memory after as little as 5-6months of regular aerobic exercise.• Aerobic training associated with increases in brain-derivedneurotrophic factor (BDNF) and vascular endothelialgrowth factor (VEGF).Voss MW, Nagamatsu LS, Liu-Ambrose T, Kramer AF. Exercise, brain, and cognition acrossthe life span. Journal of Applied Physiology. 2011;111(5):1505–1513.
  40. 40. Juggling Increases Gray Matter in theCortex• Learning to juggle can alter graymatter in the occipito-temporalcortex as early as after 7 days oftraining.• Learning a new task is more criticalfor the brain to change thancontinued training of an already-learned task.Driemeyer J, Boyke J, Gaser C, Büchel C, May A. Changes in Gray Matter Induced by Learning—Revisited.PLoS ONE. 2008;3(7):e2669
  41. 41. Benefits of Resistance- Training• In addition to increasing strength, resistance training (RT)increases growth hormone, improves glycemiccontrol, and increases lean body mass (LBM).• RT increases LBM by approx. 2.2 lbs in older adults. Thisis in contrast to the 0.4 lb annual decline that occursthrough sedentary lifestyle after age 50.• RT reverses aging in skeletal muscle. Gene expressionchanges associated with aging are reversed to youthfullevels after only 6 months of resistance training.Melov S, Tarnopolsky MA, Beckman K, Felkey K, Hubbard A. Resistance Exercise ReversesAging in Human Skeletal Muscle. PLoS ONE. 2007;2(5):e465.
  42. 42. Resistance-Training andExecutive Function• Background: We compared the effect of once-weekly and twice-weekly resistance training with that of twice-weekly balance andtone exercise training on the performance of executive cognitivefunctions in senior women.• Methods: Single-blinded randomized trial, 155 women aged 65to 75 years were randomly allocated to once-weekly (n = 54) ortwice-weekly (n = 52) resistance training or twice-weeklybalance and tone training (control group) (n = 49). The primaryoutcome measure was performance on the Stroop test, anexecutive cognitive test of selective attention and conflictresolution. Gait speed, muscular function, and whole-brainvolume were also secondary outcome measures.Liu-Ambrose T, Nagamatsu LS, Graf P, Beattie BL, Ashe MC, Handy TC. Resistance Training andExecutive Functions: A 12-Month Randomized Controlled Trial. Arch Intern Med. 2010;170(2):170–178.
  43. 43. Resistance-Training andExecutive FunctionResults: Both resistance training groups significantly improvedtheir performance on the Stroop test compared with those in thebalance and tone group (P ≤ .03). Enhanced selective attentionand conflict resolution was significantly associated withincreased gait speed. Both resistance training groupsdemonstrated reductions in whole-brain volume compared withthe balance and tone group at the end of the study (P ≤ .03).Conclusion: Twelve months of once-weekly or twice-weeklyresistance training benefited the executive cognitive function ofselective attention and conflict resolution among senior women.Liu-Ambrose T, Nagamatsu LS, Graf P, Beattie BL, Ashe MC, Handy TC. Resistance Training andExecutive Functions: A 12-Month Randomized Controlled Trial. Arch Intern Med. 2010;170(2):170–178.
  44. 44. The CONSORT (Consolidated Standards of Reporting Trials) flowchart. BAT indicates twice-weekly balance and tone exercisetraining; 1× RT, once-weekly resistance training; and 2× RT, twice-weekly RT.Figure Legend:Resistance Training Improves Executive FunctionLiu-Ambrose T, Nagamatsu LS, Graf P, Beattie BL, Ashe MC, Handy TC. Resistance Training andExecutive Functions: A 12-Month Randomized Controlled Trial. Arch Intern Med. 2010;170(2):170–178.
  45. 45. Ability to Sit and Rise from FloorPredicts Mortality• Background: While cardiorespiratory fitness is stronglyrelated to survival, there are limited data regardingmusculoskeletal fitness indicators. Our aim was toevaluate the association between the ability to sit and risefrom the floor and all-cause mortality.• Methods: 2002 adults aged 51–80 years (68% men)performed a sitting-rising test (SRT) to and from thefloor, which was scored from 0 to 5, with one point beingsubtracted from 5 for each support used (hand/knee).Final SRT score, varying from 0 to 10, was obtained byadding sitting and rising scores and stratified in fourcategories for analysis: 0–3; 3.5–5.5, 6–7.5, and 8–10.de Brito LBB, Ricardo DR, de Araújo DSMS, Ramos PS, Myers J, de Araújo CGS. Ability tosit and rise from the floor as a predictor of all-cause mortality. Eur J Prev Cardiol. 2012.
  46. 46. Ability to Sit and Rise from FloorPredicts Mortality• Results: Median follow up was 6.3 years and there were 159deaths (7.9%). Lower SRT scores were associated with highermortality. Each unit increase in SRT score conferred a 21%improvement in survival.• Conclusions: Musculoskeletal fitness, as assessed by SRT, wasa significant predictor of mortality in 51–80-year-old subjects.de Brito LBB, Ricardo DR, de Araújo DSMS, Ramos PS, Myers J, de Araújo CGS. Ability tosit and rise from the floor as a predictor of all-cause mortality. Eur J Prev Cardiol. 2012.
  47. 47. Yoga as Health Intervention for ChronicDiseaseInnes KE, Bourguignon C, Taylor AG. Risk indices associated with the insulin resistancesyndrome, cardiovascular disease, and possible protection with yoga: a systematic review. The Journal ofthe American Board of Family Practice. 2005;18(6):491–519.
  48. 48. Effects of Yoga Versus Walking onMood, Anxiety, and Brain GABA Levels• Objectives: Yoga and exercise have beneficial effects onmood and anxiety. GABA activity is reduced in mood andanxiety disorders. The practice of yoga postures isassociated with increased brain GABA levels. This studyaddresses the question of whether changes inmood, anxiety, and GABA levels are specific to yoga orrelated to physical activity.• Methods: Healthy subjects with no significantmedical/psychiatric disorders were randomized to yoga ora metabolically matched walking intervention for 60minutes 3 times a week for 12 weeks.Streeter CC, Whitfield TH, Owen L, et al. Effects of Yoga Versus Walking on Mood, Anxiety, andBrain GABA Levels: A Randomized Controlled MRS Study. The Journal of Alternative andComplementary Medicine. 2010;16(11):1145–1152.
  49. 49. Effects of Yoga Versus Walking onMood, Anxiety, and Brain GABA Levels• Results: The yoga subjects (n = 19) reportedgreater improvement in mood and greaterdecreases in anxiety than the walking group(n = 15). There were positive correlations betweenimproved mood and decreased anxiety andthalamic GABA levels.• Conclusions: The 12-week yoga intervention wasassociated with greater improvements in mood andanxiety than a metabolically matched walking exercise.This is the first study to demonstrate that increasedthalamic GABA levels are associated with improved moodand decreased anxiety.Streeter CC, Whitfield TH, Owen L, et al. Effects of Yoga Versus Walking on Mood, Anxiety, andBrain GABA Levels: A Randomized Controlled MRS Study. The Journal of Alternative andComplementary Medicine. 2010;16(11):1145–1152.
  50. 50. Streeter CC, Whitfield TH, Owen L, et al. Effects of Yoga Versus Walking on Mood, Anxiety, andBrain GABA Levels: A Randomized Controlled MRS Study. The Journal of Alternative andComplementary Medicine. 2010;16(11):1145–1152.
  51. 51. Tai Chi Improves Balance, SleepQuality and Cognitive Performance• Objective: To evaluate the effects of Tai chi exercise onbalance, sleep quality, and cognitive performance.• Design: A randomized controlled trial.• Participants: One hundred two subjects were recruited.• Intervention: Subjects were divided randomly into twogroups. The Tai chi group was assigned 6 months’ Tai chitraining. The control group was instructed to maintain theirroutine daily activities.Nguyen MH, Kruse A. A randomized controlled trial of Tai chi for balance, sleep quality andcognitive performance in elderly Vietnamese. Clin Interv Aging. 2012:185.
  52. 52. Tai Chi Improves Balance, SleepQuality and Cognitive Performance• Outcome measures: The Falls Efficacy Scale(FES), Pittsburgh Sleep Quality Index (PSQI), and TrailMaking Test (TMT) were used as primary outcomemeasures.• Results: Participants in the Tai chi group reportedsignificant improvement in TMT in comparison with thecontrol group. Tai chi participants also reported betterscores in PSQI and FES than the control group.• Conclusion: Tai chi is beneficial to improve balance, sleepquality, and cognitive performance of the elderly.Nguyen MH, Kruse A. A randomized controlled trial of Tai chi for balance, sleep quality andcognitive performance in elderly Vietnamese. Clin Interv Aging. 2012:185.
  53. 53. Tai Chi Improves Balance, SleepQuality and Cognitive PerformanceNguyen MH, Kruse A. A randomized controlled trial of Tai chi for balance, sleep quality andcognitive performance in elderly Vietnamese. Clin Interv Aging. 2012:185.
  54. 54. Dance as Therapy for Individuals withParkinson DiseaseA comparison oftango, waltz/foxtrot, Tai Chi, and nointervention suggests that all threeinterventions were superior to noexercise.With both forms of dance and Tai Chithere were significant improvements onthe Berg Balance Scale.All three interventions also resulted insignificant improvements of 40 metersor more in six minute walk distanceEarhart GM. Dance as therapy for individuals with Parkinson disease. European journal ofphysical and rehabilitation medicine. 2009;45(2):231.
  55. 55. Establishing the ExerciseHabitHow to Form Healthy Habits and Avoid Unhealthy Habits
  56. 56. Habits DefinedHabits (mannerisms, customs, rituals) are largely learned; theyare acquired via experience-dependent plasticity.Habitual behaviors occur repeatedly over the course of days oryears, and they can become remarkably fixed.Habits are performed almost automatically, virtually non-consciously, allowing attention to be focused elsewhere.Habits tend to involve an ordered, structured action sequencethat is prone to being elicited by a particular context or stimulus.Habits can comprise cognitive expressions of routine (habits ofthought) as well as motor expressions of routine.Graybiel AM. Habits, rituals, and the evaluative brain. Annu. Rev. Neurosci. 2008;31:359–387.
  57. 57. Habit Formation and the BasalGangliaYin HH, Knowlton BJ. The role of the basal ganglia in habit formation. Nat Rev Neurosci.2006;7(6):464–476.
  58. 58. Neurobiology of Addiction
  59. 59. Tools to Start and MaintainHealthy Habits• StickK.com: uses a ―commitment contracts‖ to publiclydeclare stated goal. Progress is monitored via referee.• Place a financial wager on yourself. If you accomplish yourgoal, you get your money back; if not, your money goes tocharity.• HabitForge.com: identify one simple goal and receivedaily emails for tracking progress. Goals can be public orprivate.• Dietbet.com: Uses commitment contracts and wagers withfocus on weight loss. Bet against others or yourself.• 21Habit.com: Identify one goal and deposit $21. Each dayyou succeed you get $1; each day you fail, you lose $1.
  60. 60. Tracking Tools• Fitbit is an accelerometer that tracks movements andsleep patterns. Data is sent wirelessly to fitbit.com, wheredata is parsed and visualized according to variables youspecify.• Withings WiFi body scale tracks weight, BMI, and LBM.Data is sent wirelessly to your mobile devices, where it isanalyzed. Reminders to weight in are sent via email andtext messages.• RunKeeper and Digifit are websites and mobile apps thatintegrate with fitbit and the Withings WiFi scale. Both takedata from multiple sources and represent it in graphicformat.
  61. 61. Just Do It!An Overview of Exercise Types and Program Design
  62. 62. How Intense? In aerobic studies examined, participants exercised at60%-70% of maximum heart rate. This is equivalent to aleisurely walk for a sedentary individual.Karvonen Formula:220 – age = Maximum HR (MHR)Max HR – Resting HR = Heart Rate Reserve (HRR)HRR x Training Intensity % + Resting HR = Training HR Studies on resistance training began with weight that was50% of 1 repetition max (1 RM) and increased 3-5%/weekuntil 80% 1RM weight was used.Estimated 1RM :Weight x Reps x .0333 + Weight
  63. 63. How Often? In aerobic studies examined, participants exercised anaverage of 3 days/week. Exercise sessions lasted 45 minor less. Participants in resistance training programs exercised 3days/week. Exercise sessions lasted 30 min or less. The average drop-out rates for the aerobic and exercisegroups was less than 10%.
  64. 64. Exercise Programs for a Better BrainPrograms that include cross-training outdoors―constantly varied, high-intensity functionalmovements with goal of increasing workcapacity across broad time and modaldomains‖ crossfit.comFit byNatureOutdoor fitness program incorporatingcross-training and body weight exercisesacross different terrains. Adventx.comPrimalFitnessMoving frequently at a slow pace, lift heavythings, and sprint. marksdailyapple.comCrossfit
  65. 65. 77Lift Heavy ThingsMove Frequently at aSlow Pace―The Primal Blueprint‖ by Mark SissonPrimal FitnessSprintWalk, hike or jog at 55-75% maximum heartrate for 2-5 hours/weekBrief, intense sessions of full-body functional movements forup to 30 minutes 1-3x/week―All Out‖ efforts once every 7-10days, for <10 minutes
  66. 66. 78Leisurely walks in nature at least five times/weekMove Frequently at a Slow PaceExercise in green environmentsreduces stress and improves focusLeisurely walks improve fatmetabolism and insulin sensitivityEngages passive attention
  67. 67. 79Pushing, pulling, squatting, and throwingLift Heavy Things‣ Heavy resistance trainingincreases growth hormone (GH)and testosterone‣ Low levels of GH/IGF-1associated with cognitive decline‣ Testosterone may improvesome domains of cognitivefunction‣ Activates myokines, muscle-derived cytokines that protectagainst inflammation
  68. 68. Body-Weight Resistance TrainingThe Big 5 of Body Weight Resistance TrainingUpper Body Push-ups, pull-ups, chin-ups, rowsLower Body Squats, lunges, jumpsCore Sit-ups, hanging leg-raises, planksBack Good Mornings, bridgingTotal Body Squats, dead lifts, bear crawls, burpees12345
  69. 69. 81Nutritional strategy that alternates brief periods of fasting with non-fastingIntermittent Fasting• Fasting raises catecholamine levels• Norepinephrine and dopamine levels rise in the first 8 hours of fasting• Fasting reduces markers of chronic inflammation• Reductions of inflammatory markers (IL-1, IL-6) observed in the first12 hours of fasting• Fasting increases BDNF levels• Intermittent fasting increases brain-derived neurotrophic factor
  70. 70. 82Alternate periods of fasting with non-fasting for 1-3 non-consecutive days/weekHow to Succeed with IntermittentFasting6:00 PM 10:00 AMModified Fast: 16 hours Feed: 8 hours6:00 PMOptional Nutrients•Green tea•Omega-3 fatty acids (fish oil)•Medium chain triglycerides (coconutoil)Recommended Diets•Mediterranean Diet•Zone Diet•Paleo DietLeisurely walk SprintLiftFor more information: www.drmikelara.com
  71. 71. May’s StoryDecember 2010 March 2012To Watch the Free 1-hour Webinar:www. Brain Webinar. com
  72. 72. 84
  73. 73. Running at maximal intensity for no more than 30secondsSprint Training• Exercise intensity correlates withrise of catecholamines and brain-derived neurotrophic factor (BDNF)• High-intensity interval training (HIIT)increases glycogen storage inastrocytes cells• Carb loading for the brain
  74. 74. 88HIIT involves ―all out‖ efforts with fixed work:rest ratiosHigh-Intensity Interval Training30:30Total time: 10 min30 seconds of work 30 seconds of rest15:45Total time: 10 min15 seconds ofwork45 seconds of restTabata20:10Total time: 4 min20 seconds ofwork10secondsof rest
  75. 75. Power Program for a Better BrainA comprehensive program for exercising to improve mood andcognitionLeisurely Walks in Nature5 hours/week in outdooractivitiesOmega-3 Fatty Acids 4 grams of EPA+DHA dailyIntermittentFasting 3x/week: fast for 12-18 hoursSprint 1x/week ; ―all out‖ efforts for less than 10 minLift Heavy 2x/week: body weight resistance training
  76. 76. Pumped will teach you everything youneed to know to get started• The physical and mental health benefitsof intermittent fasting• How to begin an intermittent fast• Best timing schedules forfasting/nonfasting• What type of results to expect• What supplements to use to maximizegains• An overview of exercise strategies• The single best interval strategy formaximal fat loss
  77. 77. $19.9530 Day Money-Back Guarantee!Download yourcopy atwww.drmikelara.com$9.95Facebook.com/BrainMD MichaelLaraMD
  78. 78. Get Pumped!

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