Exercise and Your Brain with Chris Young and Tim Parke

Disclaimer: Unedited AI Transcript

Announcer (00:06):

You are connected and you are listening to specifically for seniors, the podcast for those in the Remember When Generation. Today's podcast is available everywhere you listen to podcasts and with video at specifically for seniors YouTube channel. Now, here's your host, Dr. Larry Barsh.

Larry (00:37):

The number of Americans over the age of 65 is projected to increase from 55.8 million in 2020 to 88.5 million in 2050. As many of us know from personal experience, we start to have problems remembering names or where our car keys are, or whether we took our morning pills specifically for seniors, in conjunction with a program instituted by Hebrew Senior Life and the residence of Orchard Cove, a senior living facility near Boston has embarked on a series of podcasts about maintaining cognitive health. Today we're gonna discuss the benefits of exercise on your body and on your brain from the perspective of those who work on a day-to-day basis with older adults. Our guests today are Chris Young. Chris has a Bachelor of Science degree in Exercise physiology and is a senior fitness instructor and Tim Park, a board certified clinical specialist in geriatric physical therapy, both work at Orchard Cove. Welcome to specifically for seniors. Gentlemen, it's great to have you here.

Chris Young (02:01):

Thank you, Larry. Thank you. Thank you. Thank you, Larry. It's good to be here.

Larry (02:04):

Chris, let's start with you. Let's review the benefits of exercise on the body

Chris Young (02:11):

<Laugh>. Okay. We could probably spend all day talking about the benefits of exercise on the body. One of my favorite quotes is from a gentleman. His name was Robert Butler, and he was the founding director of the National Institute on Aging. And if I can get his quote correctly, by memory, it was, if exercise could be packaged in a pill, it would be the single most widely prescribed and beneficial medicine in the nation. And I think that statement really says a lot. When I think about the benefits of exercise, I put exercise in the same category as a medication. Exercise is medicine. You know, as far as the benefits, you know, all you have to do is look through the years and years of research and data, and you'll find compelling evidence on the benefits of physical activity and exercise. Specifically, you know, there's a dose response.

Chris Young (03:12):

In other words, the more exercise you do, the more benefit there is. And what we see is that also an inverse relationship. So in other words, the more exercise you do you know, as as physical activity and exercise increases, risk of disease goes down. So risk of cardiovascular disease risk of stroke, osteoporosis type two diabetes, obesity, certain types of cancer. When we look at mental and cognitive health decreased risk of depression, you know for older adults, decreased risks of falls. You know, so, you know, there's a whole host of benefits. And you know, I think when you get into the specifics the types of training that you do specifically when we talk about aerobic conditioning, strength training, flexibility training, there's sort of unique benefits to each of those. And so when we look at a complete and balanced exercise program, we wanna incorporate multiple components to get the whole gamut of benefit.

Larry (04:26):

Sure. When we exercise, our hearts beat stronger and faster to circulate more oxygenated blood through our muscles and brain. Chris described the benefits of exercise on our bodies, but what happens to our brains?

Tim Parke (04:41):

There, there's been this idea that the body and the brain are totally separate, and nothing could be further from the truth. Really, we're all one organism. And when Decart said, I think therefore I am he was right in some sense. But it goes the other way too. And whatever happens to our body, happens to our brain as well. So as you exercise it creates a stress just like Chris was mentioning. And that stress causes a response. And the responses are, are manifold. There are cytokines that get released from muscles called mykines. There are other molecules that get released to tissues nearby and far in terms of targets that are called exer kines in response to exercise. And one of the major ones that affects the brain is lactate. So when you exercise and your muscles burn, you're starting to feel that that point where the muscles aren't quite getting enough oxygen and they're producing lactate.

Tim Parke (05:52):

That lactate crosses the into the brain and stimulates the production of bdnf. And BDNF is brain-derived neurotrophic factor, and it's like miracle growth for neurons. It improves the connectivity between synopsis and it also causes neurogenesis. So it causes new neurons to, to develop and form. The other way that exercise affects the brain in a major way is that as you pump the blood around, that stress of the blood pumping allows the brain tissue to make changes and actually develop new blood vessels. So angiogenesis, so you get a better perfusion of your brain, which is without that you have nothing.

Larry (06:51):

So the size of the brain actually increases.

Tim Parke (06:57):

Yeah, yeah. The, the sizes of different parts of your brain increases with exercise. For instance, the hippocampus in general decreases in size as we get older by about 1.4% a year. But if you exercise it can then increase to 2%. So you can sort of offset that completely.

Larry (07:25):

And I understand that the prefrontal cortex increases in size as well.

Tim Parke (07:33):

That's correct. That's correct. And both the hippocampus and prefrontal cortex among other parts of the brain are really important in terms of how we function and dementia, because the hippocampus is sort of the, the memory center of the brain.

Larry (07:53):

Chris, we started to discuss previously the different forms of exercise. You mentioned aerobic exercise and strength training. Are they both important?

Chris Young (08:08):

Yes, absolutely. I think the best program is one that takes a balanced approach, meaning that you touch upon each component of fitness. So when we think about aerobic exercise, you know, that is typically exercise that uses large muscle groups usually done at a rhythmic pace over time. So it elevates the heart rate, respiratory rate increases, you burn calories. When we talk about strength training, we are pushing and pulling through a resistance exerting force through a resistance to condition, our muscles, our bones, our joints obviously to maintain or improve a joint range of motion, we want to incorporate some flexibility training, some stretching. And I would also put in neuromotor training. So thinking about balance, gait coordination. So maybe for example, trying to stand on one leg and balance. And so again, we wanna touch upon each of those components when we, you know, go into the specifics.

Chris Young (09:11):

There are guidelines that, you know, they're important to strive for. I do try to tell people that, you know, where you are in your training program is, is exactly where you're supposed to be, and that fitness is really a journey and that it takes time. You know, for some people the guidelines, they're recommended maybe over training for some. So you, everybody has to kind of, you know, look at themselves, tune into their body, see where they're at, and then progress gradually. But in general when we talk about aerobic exercise, we wanna think about moderate intensity done at least five days a week. And I always use time as the goal, so it's 150 minutes per week, and that's accumulated time. So that might be 30 minutes, five days a week with a couple days off for rest and recovery.

Chris Young (10:05):

And I would recommend using different modalities, so maybe not always on the treadmill, but maybe ride in the stationary bike too, or swimming or walking or elliptical training. When we look at resistance training, we wanna think about conditioning the full body, so not just the upper body or the midsection or the lower body, but incorporating a little bit of everything. And I would say two to three days per week. Two to day, two to three days per week of full body resistance training. In terms of stretching flexibility, the guidelines would tell you two to three days per week, but really stretching every day is probably most effective. And then as far as neuromotor training, so that's your balance and your coordination, your gait agility training, you know, you could say 20 to 30 minutes per week of neuromotor exercises. So that just might be a few minutes each day working on your balance and tying all of that together and thinking about your exercise program in a seven day block of time and deciding, you know, sort of planning what you're going to do on each day, I think that's effective as well.

Larry (11:13):

And Tim, there's another form of exercise, mind body exercises.

Tim Parke (11:21):

Yeah. there's a whole realm of exercise that sort of crosses between just physical aspects and mental or meditative aspects. And those include things like tai chi yoga or just being mindful as you exercise. It turns out that the physiological effect of, of mindfulness and doing things like paying attention to your breath as it's, as it's, as you're breathing in, as you're breathing out, has a very calming effect on the nervous system. It decreases the blood pressure and it allows you to focus, focus on just how your body is feeling as you're exercising, or if you're not exercising, it also allows you to tune in during those times too. Back in the seventies, it was thought that meditation was just sort of a mystical art. It wasn't taken seriously by the medical world. And Dr. Herbert Benson at Harvard Medical School started to do research with people who had meditated for many years, these Tibetan monks. And he measured the physiological responses and found a decrease in blood pressure less anxiety even changes in the brain itself. And he, he sort of brought that into popularity with his book, the relaxation response. And so a lot of people learned that. And it's very simple just to be able to take some breaths in and breaths out, and within two minutes you can affect your physiology in a really positive way.

Larry (13:14):

It's interesting you mentioned Herb. Benson. Herb was my lab partner. The first year I went to dental school. He was in medical school for the first two years. Our programs were together. And Herb, herb and I shared certain specimens during the first year of school.

Tim Parke (13:39):

That's great. <Laugh>

Larry (13:43):

Tim, those of us with Apple watches get a notice about our VO two max. I've tried to ask cardiologists about that, and they don't come out with a definite answer of what that is.

Tim Parke (14:02):

So VO two max is a measurement and it's the gold standard measurement of cardio respiratory fitness. In research, the way that they determine it is you get on a treadmill or a bike in a lab and you put on a mask that collects everything you breathe in or everything you breathe out and analyzes it to see how much oxygen you're using. As you increase the intensity of your exercise and for everybody, you get to a certain point where your body cannot process any more oxygen. And so at that point, your brain tells you to stop and you just have to stop exercising. So VO two max is a great measure of just general fitness because it, it's a, it, it really tells you how much endurance you have to do things and the, there are all kinds of proxy ways of measuring that kind of fitness. And I think there's a, an algorithm that the Apple Watch must use to determine based on your heart rate when you are walking, cuz it knows when you're walking and your heart rate response to recovery. I think it takes all of those into account and comes up essentially with a proxy measurement of your VO two max.

Larry (15:34):

So it's more an estimate than anything else.

Tim Parke (15:38):

Absolutely. It's not a direct measurement.

Larry (15:40):

Okay. Both of you guys work with old adults. We know that exercise benefits all ages, but what about people who are physically limited on, on what they can do? Is it as important there?

Tim Parke (16:05):

I I, Chris, do you wanna start?

Chris Young (16:06):

Yeah, I would probably say more important. I think that's, that builds more of a case to start. An exercise program, you know, the training goal for everybody is different and, you know, older adults people with limitations. You know, for them maybe the goal is just to more easily get out of a chair maybe picking up a grocery bag, you know. And I think, again, when I work with people, the first thing I do is try to assess where they are at. And I always try to meet people where they are at and, you know, everybody can do something. I work with a woman who has MS as in a wheelchair. She can't use her lower body, so we do upper body strengthening exercises and that helps her in her daily life, in her daily function, you know, so everybody can do something. And I think working with a trainer is super helpful. You know, meet him with an exercise professional who can help you navigate a program and piece together a sound and structured and safe exercise program is beneficial. Absolutely. Yeah.

Larry (17:15):

Tim, do you have anything to add?

Tim Parke (17:18):

Yeah, I would, I, I agree a hundred percent with Chris actually becomes more important as you get older or as you have a variety of, of things that get in the way of being able to do as much, it becomes more important to exercise. If you're 20 years old and you lift weights, it's not really a make or break situation, but for someone who can just barely stand up, if they can strengthen their quads and their glutes even just a little bit, it starts to mean that they can get up safely and consistently and basically go through their day doing the things that they really enjoy doing. So it becomes more important as you get older. And as far as folks as, as Chris mentioned, who might have something going on that makes it harder to do the traditional stuff, there's always ways to move your body for almost every person.

Tim Parke (18:16):

There are ways to figure out and be creative and try to get your breath going. Try to feel some of that burning sensation in the muscles. You don't want pain, but burning is good. That's a good indicator of the stress. And for, for folks who can't stand up and down, they can do other things. If they can't walk there are other ideas that can be creatively implemented. And working with a personal trainer is a great idea. Working if it really gets complicated and you're not sure how much to do or exactly how to do it, you can work with a physical therapist too.

Larry (18:55):

What do you do about the person who says, I'm 89 years old, I'm 90 years old, I've never exercised, it's too late for me to start

Chris Young (19:05):

<Laugh>. Definitely,

Tim Parke (19:08):

Yeah. Well, <laugh> well, it's never too late. And I guess I'd say two different things. One is that you don't have to be an exerciser to have some physical activity injected into your life. It doesn't necessarily have to be exercise in, in that strict sense of doing something repetitive and planned for a specific fitness outcome that you're looking for. It can also be just walking and being busy and gardening and and doing something that you enjoy, like dancing a little bit. Anything like that. And then the other point is that even folks who are in their nineties, even more, even people who are over a hundred, can gain strength when they exercise and when they move their bodies. So that's encouraging cuz it wasn't always the case that people believed that. They thought, ah, well I'm 70, I'm 80, I'm 90, that's it, I'm getting weaker. It's, it's inevitable. But you can gain strength and you can gain endurance even in the oldest of old.

Chris Young (20:19):

Yeah, I would, I would just add to that too, you know, if people with conditions that might otherwise disable them or exacerbate physical or mental issues may actually see their strength and stamina improve through exercise with a reduction in symptoms related to issues. And it's a wide range of issues. Everything from bone density loss, arthritis, Alzheimer's disease, depression, anxiety. So, you know, living with a chronic condition, to me is just a stronger case for adopting an exercise program.

Larry (20:54):

Let's talk a little bit on the other side of this and talk about reducing the amount of time you spend sitting watching tv, playing cards, computer games, all of which are important. But there's a limit to how much time you can do things sitting down for your health, correct?

Tim Parke (21:19):

Oh, absolutely. Yeah. Our bodies evolved, you know, thousands of years ago as folks who would have to do quite a bit of physical activity just to get through the day. You know, we had to climb trees and get honey and we had to chase down animals over long distances and, and generally just stay busy. And through the miracle of sort of modernity, we don't need to do those things. We end up sitting far, far more than our ancestors ever did. And our body is really tuned to be assisted by having that stress of movement happen more often than we've been giving it in general. So just getting up every 20 or 30 minutes to move, even if it's not to move a great deal, is very helpful. It sort of teaches the body what it needs to do it when you're just sitting for eight hours at a time. There's a physiology of inactivity that sets in that's very different than the physiology of your body when you're moving.

Chris Young (22:28):

Yeah, I think all movement is good for the body. Any movement, as long as you're not sedentary, like as Tim was saying, all movement is good for the body. So if it's not going to the gym, if it's not doing a structured workout, going out and taking a walk, you know, absolutely all movement. Super important.

Larry (22:47):

Or climbing a tree to get honey

Chris Young (22:50):

<Laugh>. Absolutely, yes. <Laugh>.

Larry (22:52):

Yeah. I I I like that one. <Laugh>. 

Tim Parke (22:56):

Well, they, yeah, there's a, there's a great book by an evolutionary anthropologist, Daniel Lieberman. And in that he studies the Hadza people, and apparently that's what they do if they're out for a hunt and they're looking to, you know, to get meat. If they happen upon a beehive, they, they forget about the meat, they say no, and they make a fire and they, and they smoke the bees out and they eat the honey right there. <Laugh>

Larry (23:24):

I, I remember in the, I guess seventies people with heart disease were told to take it easy, slow down don't stress yourself, relax,

Chris Young (23:40):

<Laugh>.

Larry (23:42):

I, I know there's a problem with safety and exercise in some people with, with medical problems, but what about that?

Tim Parke (23:53):

Yeah, absolutely. Here, just like someone who's getting older and the question of whether should I exercise? Is it important for me, someone who's had a heart attack or has other heart conditions almost always benefits from some amount of activity. You're right. They used to recommend that people stay in bed after open heart surgery, and then they realized over time that that was one of the worst things they could be doing. That being said, you have to stress yourself gradually and see how you're responding to it. So a lot of people who have had open heart surgery or heart attack can go to cardiac rehab, and there it's a monitored setting where they can gradually increase the intensity, the duration of their exercise program in a more monitored way. And they also work on stress reduction, which is an important component. So the stress of activity actually is really important, but the sort of chronic inflammatory, increasing stress that we get from just being anxious and worried is deleterious to the heart. So that piece you can address with things like mindfulness, meditation.

Larry (25:13):

What about other diseases that people have that they have to be concerned about? Safety of exercise

Tim Parke (25:24):

In general? Exercise is very safe. The benefits outweigh the risks for almost everyone. I'd say at, if you do have a complicated medical history, it's a good idea to talk to your doctor about exercise before jumping into something brand new. And also to, to kind of go slowly and really listen to your body, listen to what hurts, listen to if you're feeling too, too tired, you want to feel essentially better after you exercise. Not worse.

Chris Young (26:01):

Yeah, and I would just add I would stress again the importance of probably meeting with an exercise professional, ideally someone who has a college background in exercise science, exercise physiology, strength, and conditioning. Because you know, when you meet with someone, when I meet with someone new, the first thing we do is fill out a medical history and we go through it item by item because I, I need them to paint a picture and inform me of everything that's going on so that I can guide them to the right exercise that's going to help and not obviously make anything worse. So meeting with a, you know, especially for someone who's brand new, who may be new to the gym who has, as Tim said, a complex medical history meeting with a trainer, filling out a medical history together, having a conversation and then you can plan your exercise program more safely and more effectively. For sure. Yeah.

Larry (26:54):

For people who are not in a facility like Orchard Cove, how do you determine the qualifications of an exercise coach?

Chris Young (27:06):

Yeah, I mean, I, yeah, I, I would say with personal training, there is a lot, I mean, hundreds of certifications, a lot of them, a lot of them which are online. And you know, there's a lot of great trainers out there who, you know, are just a certified personal trainer. But I think if you're somebody again, who may be an older adult, higher risk, more complicated medical history, it serves that person more. If they find someone who, like I said, has a college background, has a college degree in an exercise science field in terms of certifications, really the gold standards would be the American College of Sports Medicine. They are the ones that provide the guidelines for exercise professionals to prescribe exercise as well as the National Strength and Conditioning Association. So those are two certifications that somebody could look for in determining who might be the best fit as, as they're looking for a personal trainer to get them started.

Larry (28:10):

Tim, do you have anything you want to add to that?

Tim Parke (28:13):

Well, that all of that is really great information. I think finding, finding someone who is careful to look for red flags of, of feeling too, too much pain or too out of breath or too tired with the exercise is important. If someone tries to push you beyond what you're comfortable with, that's not a great sign. The reality is, is that when people embark on an exercise program, most people, it's a start and stop and more often a stop. And one of the things that gets in the way of that is if you, if you work too hard, too fast. So having someone there who can guide you to work hard enough, you need that stress. That's what creates the change. But also to, to tell you to back off a little bit when that makes sense cuz that's just as important, the recovery and the insight into what happens in between or how intense you do the exercise is very important.

Chris Young (29:22):

I was just gonna say in recognizing that pain is not normal, you know, pain is your body telling, you know, telling you to pull back a little bit. So the idea of no pain, no gain, you know, we've heard that expression and in, in some ways that can be true, but really pain is not a normal response to exercise and shouldn't be. And, and people, as Tim said, should tune into their, to their body and, and listen to that.

Larry (29:48):

Okay. Is there anything we missed? Anything you'd like to bring up?

Tim Parke (29:54):

Oh, yeah, we did cover quite a bit. Well, I'd like to to bring up that the idea of exercise snacking. And I think this is helpful that you can dose yourself with some exercise periodically and really get some benefits without necessarily having to always do it in a continuous fashion. You know, you could stand up and down a few times in a row. You could take a walk and, and, and walk quickly, even for a minute. These little exercise snacks are a great way to stimulate the body and get those kinds flowing

Larry (30:35):

Or climb a tree to get some honey. Absolutely. Yeah. I, I really like that one.

Tim Parke (30:43):

<Laugh>.

Larry (30:44):

Hey guys, thank you so much. This has been, this has been great. It's been informative. I think listeners are gonna get a lot out of it. Thanks again. Great.

Chris Young (30:54):

Thank you. Thank

Tim Parke (30:55):

You. Thank you so much.

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