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The Benefits of Exercising Before Breakfast - The New York Times

At the end, the nonexercising group was, to no one’s surprise, super-sized, having packed on an average of more than six pounds. They had also developed insulin resistance — their muscles were no longer responding well to insulin and weren’t pulling sugar (or, more technically, glucose) out of the bloodstream efficiently — and they had begun storing extra fat within and between their muscle cells. Both insulin resistance and fat-marbled muscles are metabolically unhealthy conditions that can be precursors of diabetes. The men who ate breakfast before exercising gained weight, too, although only about half as much as the control group. Like those sedentary big eaters, however, they had become more insulin-resistant and were storing a greater amount of fat in their muscles. Only the group that exercised before breakfast gained almost no weight and showed no signs of insulin resistance. They also burned the fat they were taking in more efficiently. “Our current data,” the study’s authors wrote, “indicate that exercise training in the fasted state is more effective than exercise in the carbohydrate-fed state to stimulate glucose tolerance despite a hypercaloric high-fat diet.”

The Best Thing to Eat Before a Workout? Maybe Nothing at All - The New York Times

Most obviously, the men displayed lower blood sugar levels at the start of their workouts when they had skipped breakfast than when they had eaten. As a result, they burned more fat during walks on an empty stomach than when they had eaten first. On the other hand, they burned slightly more calories, on average, during the workout after breakfast than after fasting. But it was the impacts deep within the fat cells that may have been the most consequential, the researchers found. Multiple genes behaved differently, depending on whether someone had eaten or not before walking. Many of these genes produce proteins that can improve blood sugar regulation and insulin levels throughout the body and so are associated with improved metabolic health. These genes were much more active when the men had fasted before exercise than when they had breakfasted.

Run on empty

Gene expression in the adipose tissue differed significantly in the two trials. The expression of two genes, PDK4 and HSL, increased when the men fasted and exercised and decreased when they ate before exercising. The rise in PDK4 likely indicates that stored fat was used to fuel metabolism during exercise instead of carbohydrates from the recent meal. HSL typically increases when adipose tissue uses stored energy to support increased activity, such as during exercise, explained Dylan Thompson, corresponding author of the study. These results reinforce the view that "adipose tissue often faces competing challenges," Thompson wrote. After eating, adipose tissue "is busy responding to the meal and a bout of exercise at this time will not stimulate the same [beneficial] changes in adipose tissue. This means that exercise in a fasted state might provoke more favorable changes in adipose tissue, and this could be beneficial for health in the long term," he noted.

Exercise boosts tryptophan, a mild hypnotic and serotonin precursor

The largest body of work in humans looking at the effect of exercise on tryptophan availability to the brain is concerned with the hypothesis that fatigue during exercise is associated with elevated brain tryptophan and serotonin synthesis. A large body of evidence supports the idea that exercise, including exercise to fatigue, is associated with an increase in plasma tryptophan and a decrease in the plasma level of the branched chain amino acids (BCAAs) leucine, isoleucine and valine (see64,65 for reviews). The BCAAs inhibit tryptophan transport into the brain.66 Because of the increase in plasma tryptophan and decrease in BCAA, there is a substantial increase in tryptophan availability to the brain. Tryptophan is an effective mild hypnotic,67 a fact that stimulated the hypothesis that it may be involved in fatigue. A full discussion of this topic is not within the scope of this editorial; however, it is notable that several clinical trials of BCAA investigated whether it was possible to counter fatigue by lowering brain tryptophan, with results that provided little support for the hypothesis. Further, exercise results in an increase in the plasma ratio of tryptophan to the BCAAs before the onset of fatigue.64,65

Overview of exercise and serotonin

A third strategy that may raise brain serotonin is exercise. A comprehensive review of the relation between exercise and mood concluded that antidepressant and anxiolytic effects have been clearly demonstrated.53 In the United Kingdom the National Institute for Health and Clinical Excellence, which works on behalf of the National Health Service and makes recommendations on treatments according to the best available evidence, has published a guide on the treatment of depression.54 The guide recommends treating mild clinical depression with various strategies, including exercise rather than antidepressants, because the risk–benefit ratio is poor for antidepressant use in patients with mild depression. Exercise improves mood in subclinical populations as well as in patients. The most consistent effect is seen when regular exercisers undertake aerobic exercise at a level with which they are familiar.53 However, some skepticism remains about the antidepressant effect of exercise, and the National Institute of Mental Health in the United States is currently funding a clinical trial of the antidepressant effect of exercise that is designed to overcome sources of potential bias and threats to internal and external validity that have limited previous research.55

Meta analysis: exercise promotion is ineffective for social anxiety disorder (see powerpoint slide)

All psychological interventions apart from promotion of exercise and other psychological therapies (supportive therapy, mindfulness, and interpersonal psychotherapy) had greater effects on outcomes than did waitlist (table; figure 3). In decreasing order of effect size, these were individual cognitive–behavioural therapy (CBT; class effect SMD −1·19, 95% CrI −1·56 to −0·81), group CBT (−0·92, −1·33 to −0·51), exposure and social skills (−0·86, −1·42 to −0·29), self-help with support (−0·86, −1·36 to −0·36), self-help without support (−0·75, −1·25 to −0·26), and psychodynamic psychotherapy (−0·62, −0·93 to −0·31).

Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis - The Lancet Psychiatry

Individual CBT compared with psychological placebo (SMD −0·56, 95% CrI −1·00 to −0·11), and SSRIs and SNRIs compared with pill placebo (−0·44, −0·67 to −0·22) were the only classes of interventions that had greater effects on outcomes than appropriate placebo. Individual CBT also had a greater effect than psychodynamic psychotherapy (SMD −0·56, 95% CrI −1·03 to −0·11) and interpersonal psychotherapy, mindfulness, and supportive therapy (−0·82, −1·41 to −0·24). Interpretation Individual CBT (which other studies have shown to have a lower risk of side-effects than pharmacotherapy) is associated with large effect sizes. Thus, it should be regarded as the best intervention for the initial treatment of social anxiety disorder. For individuals who decline psychological intervention, SSRIs show the most consistent evidence of benefit.

Sauna Bathing and Mortality | Lifestyle Behaviors | JAMA Internal Medicine | The JAMA Network

This study provides prospective evidence that sauna bathing is a protective factor against the risk of SCD, fatal CHD, fatal CVD, and all-cause mortality events in the general male population. Our results suggest that sauna bathing is a recommendable health habit, although further studies are needed to confirm our results in different population settings.

Weight-bearing exercises promote bone formation in men: Human hormone, protein linked to bone mass are impacted by 12 months of targeted exercise -- ScienceDaily

"People may be physically active, and many times people know they need to exercise to prevent obesity, heart disease or diabetes," Hinton said. "However, you also really need to do specific exercises to protect your bone health." In the study, men 25- to 60-years-old who had low-bone mass were split into two groups. One group performed resistance training exercises such as lunges and squats using free weights. The other group performed various types of jumps, such as single-leg and double-leg jumps. After 12 months of performing the exercises, Hinton then compared the levels of bone proteins and hormones in the blood. "We saw a decrease in the level of sclerostin in both of these exercise interventions in men," Hinton said. "When sclerostin is expressed at high levels, it has a negative impact on bone formation. In both resistance and jump training, the level of sclerostin in the bone goes down, which triggers bone formation." The other significant change Hinton observed was an increase in the hormone IGF-1. Unlike sclerostin, IGF-1 triggers bone growth. The decrease of harmful sclerostin levels and the increase in beneficial IGF-1 levels confirmed Hinton's prior research that found both resistance training and jump training have beneficial effects on bone growth. To increase bone mass and prevent osteoporosis, Hinton recommends exercising specifically to target bone health. While exercises such as swimming and cycling are beneficial to overall health, these activities do not strengthen the skeleton. Hinton suggests also doing exercise targeted for bone health, such as resistance training and jump training. The study, "Serum sclerostin decreases following 12 months of resistance- or jump-training in men with low bone mass," was published in Bone.

Insulin resistance may lead to faster cognitive decline: Executive function, memory are particularly vulnerable to the effects of insulin resistance, researchers say -- ScienceDaily

nsulin resistance is a condition in which cells fail to respond normally to the hormone insulin. The resistance prevents muscle, fat, and liver cells from easily absorbing glucose. As a result, the body requires higher levels of insulin to usher glucose into its cells. Without sufficient insulin, excess glucose builds up in the bloodstream, leading to prediabetes, diabetes, and other serious health disorders. The scientists followed a group of nearly 500 patients with existing cardiovascular disease for more than two decades. They first assessed the patients' baseline insulin resistance using the homeostasis model assessment (HOMA), calculated using fasting blood glucose and fasting insulin levels. Cognitive functions were assessed with a computerized battery of tests that examined memory, executive function, visual spatial processing, and attention. The follow-up assessments were conducted 15 years after the start of the study, then again five years after that. The study found that individuals who placed in the top quarter of the HOMA index were at an increased risk for poor cognitive performance and accelerated cognitive decline compared to those in the remaining three-quarters of the HOMA index. Adjusting for established cardiovascular risk factors and potentially confounding factors did not diminish these associations.

Leisure-time physical activity is related to cartilage health and quality health in knee osteoarthritis -- ScienceDaily

"The effects of intermittent impact and compressive loading during gait to knee cartilage may evoke favorable effects in cartilage such as improved fluid flow and nutrient diffusion. Maintaining cartilage health requires daily physical activity, and when performed regularly, walking and Nordic walking together with other activities of daily living can maintain or even improve the quality of knee articular cartilage," says Doctoral student, physiotherapist Matti Munukka.

Wired to Run—and Think 2012

"While early hominins were undergoing intense skeletal and metabolic changes, major changes also occurred in their brains," Spedding and Noakes wrote in a recent commentary in Nature. "We propose that these changes have rendered us dependent on mental and physical exercise to maintain brain health. Exercise doesn’t just help muscles—it activates our brains." It is widely believed that bigger brains resulted from a shift in the hominin diet to include more meat, which requires less digestion than vegetables, freeing up energy to feed the brain instead. Anthropologist Richard Wrangham famously proposed that cooking our food made meals even easier to digest, increasing the potential for bigger brains. But recently, studies into a protein called brain derived neurotrophic factor (BDNF) have uncovered a more basic link between running after prey and growing bigger brains—exercise stimulates BDNF production. This led Spedding and Noakes to propose BDNF as a central factor in both the mental and physical advances as humans evolved to run. Carl Cotman first discovered this link between BDNF and exercise in the early 90s when he was studying aging, and realized that more active elderly people experienced slower mental decline. Thinking that increased blood flow to the brain was not sufficient to explain the phenomenon, he began to look for a more fundamental relationship. He discovered a few studies that described BDNF's essential role in neuronal growth and health, and started experimenting with mice. Sure enough, by exercising the animals in wheels, Cotman found that BDNF levels increased in the brain, particularly in the hippocampus. Further study has revealed just how fundamental BDNF is to maintaining brain health. "It controls things from synaptic plasticity to new synapse growth, promotes neurogenesis in the hippocampus, and plays in part in mediating vascularization," said Cotman. "It's basically like brain fertilizer." Spedding and Noakes believe that it's this relationship that drove human brains to develop as our ancestors started to run away from the trees and towards meat on the open plains. Indeed, BDNF appears to play crucial roles in building brain areas associated with the task of tracking prey in organized social groups. "As humans needed more brain power to track prey, increases in BDNF may have helped to build up the hippocampus and prefrontal cortex—key brain areas that are involved in spatial mapping, decision-making and control of context, fear and emotions, including violence," Spedding and Noakes wrote in their commentary. BDNF comes in several forms, created via alternative splicing patterns of the transcribed gene, and although it is found across the animal kingdom, more varieties are found in humans than any other species. Compared to rodents, regulation of the different BDNF forms is more complex and sophisticated in humans, providing more control over a greater number of BDNF varieties. While the majority of these proteins are found in the brain, they are also in muscle and other tissues, where they can increase protein synthesis and fat metabolism. Restricting BDNF in mice induces obesity and type II diabetes, ailments readily coupled with lack of exercise, but diminishing BDNF is also associated with stress and psychiatric disorders. Conversely, exercise has been linked to many cognitive benefits, including helping to treat mild depression, Alzheimer's disease, and schizophrenia. "Putting it all together, we think that exercise increases BDNF in key areas of the brain, which, in turn, has physiological effects that help to protect humans from psychiatric problems," Spedding and Noakes wrote. But while BDNF levels rise in the bloodstream of people as they exercise, the direct influence on brain function isn't clear. While there is mounting evidence from human studies to support the hypothesis that BDNF was crucial to the developing brain, Noakes said, but this has yet to be shown more definitively. Ongoing work by Cotman and others, such as investigations into the effects of exercise on Alzheimer's, could be the nail in the coffin Spedding and Noakes, both competitive athletes themselves, have been waiting for. But even with details left to be worked out, Spedding and Noakes are pushing the idea of exercise as a way to brain health, as well as bodily health. Cotman agrees. "I think it's an important principle that there is something you are physically doing to your brain that we know is good for it," he said. "I know sometimes when I'm working out I think, 'Oh boy, my BDNF levels are getting a boost!'"

Treadmill Exercise Induced Functional Recovery after Peripheral Nerve Repair Is Associated with Increased Levels of Neurotrophic Factors

We used a peripheral nerve regeneration model that has a good correlation between functional outcomes and number of motor axons that regenerate to evaluate the impact of treadmill exercise. In this model, the median nerve was transected and repaired while the ulnar nerve was transected and prevented from regeneration. Daily treadmill exercise resulted in faster recovery of the forelimb grip function as evaluated by grip power and inverted holding test. Daily exercise also resulted in better regeneration as evaluated by recovery of compound motor action potentials, higher number of axons in the median nerve and larger myofiber size in target muscles. Furthermore, these observations correlated with higher levels of neurotrophic factors, glial derived neurotrophic factor (GDNF), brain derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1), in serum, nerve and muscle suggesting that increase in muscle derived neurotrophic factors may be responsible for improved regeneration.

Sustained aerobic exercise increases adult neurogenesis in brain -- ScienceDaily

The results indicate that the highest number of new hippocampal neurons was observed in rats that ran long distances and that also had a genetic predisposition to benefit from aerobic exercise: Compared to sedentary animals, HRT rats that ran voluntarily on a running wheel had 2-3 times more new hippocampal neurons at the end of the experiment. Resistance training had no such effect. Also the effects of HIT were minor. To conclude, only sustained aerobic exercise improved hippocampal neurogenesis in adult animals.

5 minute bout of walking boosts mood

This may be partly due to the guideline's inclusion of a 10-minute minimum time-bout requirement for PA. Our findings suggest that a shorter, 5-minute bout of PA is adequate to elicit psychological health benefits. This may be encouraging to individuals who perceive “lack of time” as an exercise barrier. Individuals may also perceive this shorter time requirement to be less physically demanding. Notably, the present study demonstrates that mood-related benefits of a 5-minute exercise bout can occur from a self-selected walking pace. A self-selected pace is generalizable, and encouragingly, this may positively influence an individual's confidence in his or her ability to sustain activity and his or her anticipated enjoyment of the activity. Health care providers should consider the positive benefits of a 5-minute bout of exercise when prescribing treatment for patients suffering from mood-related disorders.

The effects and determinants of exercise participation in first-episode psychosis: a qualitative study | BMC Psychiatry | Full Text

Preliminary research has indicated that increasing physical activity and fitness during the first-episode of psychosis (FEP) can improve physical health and support functional recovery [14, 15, 16]. In a recent feasibility trial (the “iBeep” study) of an exercise intervention delivered through EIP services for patients with FEP, significant improvements were observed in cardio-metabolic health, positive and negative symptoms and cognitive functioning after just 10 weeks [17]. Additionally, adherence and retention rates were substantially higher than in previous exercise trials in schizophrenia [8, 17], perhaps due to the nature of the intervention applied, or certain characteristics of the first-episode sample. We conducted a qualitative study of patients who had participated in the iBeep trial. The aim of this investigation was to explore the perceived benefits of exercise as experienced by people with FEP, and to establish the barriers and facilitating factors for increasing physical activity in this patient group. These findings could inform the development of future studies, and the implementation of exercise interventions within EIP services.

Exercise: a neglected intervention in mental health care? - PubMed - NCBI

exercise is seldom recognized by mainstream mental health services as an effective intervention in the care and treatment of mental health problems.

Lots of studies and hypothes: Exercise for Mental Health

Aerobic exercises, including jogging, swimming, cycling, walking, gardening, and dancing, have been proved to reduce anxiety and depression.3 These improvements in mood are proposed to be caused by exercise-induced increase in blood circulation to the brain and by an influence on the hypothalamic-pituitary-adrenal (HPA) axis and, thus, on the physiologic reactivity to stress.3 This physiologic influence is probably mediated by the communication of the HPA axis with several regions of the brain, including the limbic system, which controls motivation and mood; the amygdala, which generates fear in response to stress; and the hippocampus, which plays an important part in memory formation as well as in mood and motivation. Other hypotheses that have been proposed to explain the beneficial effects of physical activity on mental health include distraction, self-efficacy, and social interaction.4 While structured group programs can be effective for individuals with serious mental illness, lifestyle changes that focus on the accumulation and increase of moderate-intensity activity throughout the day may be the most appropriate for most patients.1 Interestingly, adherence to physical activity interventions in psychiatric patients appears to be comparable to that in the general population.

Self-reported impact of exercise on psychosis: good quotes

Participants generally felt that exercise was capable of providing acute relief for psychiatric symptoms. These effects varied across participants. Some reported relief from positive symptoms (i.e. auditory hallucinations and paranoia) and others for negative symptoms (amotivation and anhedonia). This seemed to depend on which aspects of psychosis characterised the individual’s current condition.

Towards a study of exercise impact on schizophrenia

We aim to conduct a trial where these methodological considerations are addressed by comparing a 12-week aerobic high-intensity interval training (HIIT) program to skills training of the same duration, with regard to: 1) aspects of cognitive function, especially memory, attention and executive function, and 2) psychiatric symptom load (negative and positive symptoms) and wellbeing. Post-treatment improvement in cognition and psychotic symptoms are anticipated. We hypothesize that the individuals in the Exercise Group (EG) will perform better than individuals in the Computer Skills Group (CSG) on aspects of cognitive function, especially memory, attention and executive function. In addition, we expect ameliorated positive and negative symptoms in the EG.

The effects and determinants of exercise participation in first-episode psychosis: a qualitative study | BMC Psychiatry | Full Text

Exercise offers a possible adjunctive intervention which may improve both physical and mental health outcomes in schizophrenia. A recent systematic review and meta-analysis found that 90 min of moderate-to-vigorous activity per week can increase fitness, reduce positive and negative symptoms and improve cognition [5]. The qualitative literature has also shed light on how exercise may have these effects. Two separate reviews, each including between 11 and 13 qualitative studies, found that vigorous exercise can draw attention away from auditory hallucinations and/or adverse beliefs that people with long-term schizophrenia may have, and help them to ‘reconnect with reality’ by focusing on physical exertion [6, 7]. Furthermore, exercise may improve negative symptoms and real-world functioning through providing a valued, sociable activity with achievable and rewarding goals [6, 7].

Exercise mediates against psychotic symptoms

Exercise offers a possible adjunctive intervention which may improve both physical and mental health outcomes in schizophrenia. A recent systematic review and meta-analysis found that 90 min of moderate-to-vigorous activity per week can increase fitness, reduce positive and negative symptoms and improve cognition [5]. The qualitative literature has also shed light on how exercise may have these effects. Two separate reviews, each including between 11 and 13 qualitative studies, found that vigorous exercise can draw attention away from auditory hallucinations and/or adverse beliefs that people with long-term schizophrenia may have, and help them to ‘reconnect with reality’ by focusing on physical exertion [6, 7]. Furthermore, exercise may improve negative symptoms and real-world functioning through providing a valued, sociable activity with achievable and rewarding goals [6, 7].

Physical Exercise and Psychological Well-Being: A Population Study in Finland - ScienceDirect

The results of this cross-sectional study suggest that individuals who exercised at least two to three times a week experienced significantly less depression, anger, cynical distrust, and stress than those exercising less frequently or not at all. Furthermore, regular exercisers perceived their health and fitness to be better than less frequent exercisers did. Finally, those who exercised at least twice a week reported higher levels of sense of coherence and a stronger feeling of social integration than their less frequently exercising counterparts.

Effects of a Sedentary Behavior-Inducing Randomized Controlled Intervention on Depression and Mood Profile in Active Young Adults. - PubMed - NCBI

A 1-week sedentary behavior-inducing intervention has deleterious effects on depression and mood. To prevent mental health decline in active individuals, consistent regular physical activity may be necessary.

Why Exercise May Be the Best Fix for Depression - Scientific American

Despite the mounting evidence that exercise can remedy some forms of depression, skepticism persists in academia and health care, Trivedi notes. “There is this general bias that exercise is not a bona fide treatment—it's just something you should do in addition to treatment, like trying to sleep and eat well,” he says. “Even though recognition of exercise as a treatment is increasing,” only some health insurance companies pay for gym time, he explains, and when they do, they often offer small temporary discounts. “I can prescribe a drug that costs $200 and insurance will pay, but they won't give $40 to open a gym membership.”

Exercise switches off genes for depression?

intriguing 2015 study, physician Helmuth Haslacher and his colleagues at the Medical University of Vienna in Austria compared the mental health and genomes of 55 elderly marathon runners and endurance bicyclists with those of 58 nonathletes. Among the nonathletes, they found a statistically significant correlation between the number of depressive symptoms these individuals experienced and a particular gene variant that interferes with normal BDNF production. Among the athletes, however, there was no such correlation. The researchers concluded that by stimulating BDNF production, long-term, vigorous aerobic exercise might actually counteract a genetic susceptibility to depression.