CARDIOVASCULAR SYSTEM AND THE BRAIN · 30s x 2 Impact of some medications 150-300 min week Moderate...

CARDIOVASCULAR SYSTEM

AND THE BRAIN

CARDIOVASCULAR SYSTEM AND

THE BRAIN

Consists of a pump and more than __???___

miles of blood vessels

60,000

miles

Fun Fact: Circumference of the Earth is

__????__ miles

25,000

miles

Shuttles oxygenated and deoxygenated

blood Removes waste by-products for reuse or

elimination

Distributes nutrients to the cells

Maintains body temperature

Regulates pH to control acidosis and

alkalosis

Transports enzymes and hormones to

regulate function


THE BRAIN

Definition of Cardiovascular activity


THE BRAIN

Activities that cause an increase in

distribution and uptake of oxygen by

skeletal muscles.

Performed repeatedly over time provides

numerous health benefits

One of the Major determinates in

tolerance to all exercise and activity

with aging is cardiovascular function


THE BRAIN

More we improve function the easier life

feels and becomes

Exercise over time results in better

conditioned heart. Does more with each heartbeat

(nutrients, oxygen)

Car example


THE BRAIN

Walking at DisneyWorld with grandkids

40% vs 90% maximal effort

Those who are aerobically fit have less

incidence of chronic illnesses – High BP,

Stroke, Heart Disease, Diabetes and

some Cancers.

[5,6,7,8,9,10]

Exercise for Health vs Fitness


THE BRAIN

Activity that would only yield small

fitness improvement had significant health

benefits.

[1]

Benefits are dose related, the more

volume of activity the greater the

benefits.


THE BRAIN

Decreased fatigue in everyday activities

Improved immune function

Improved glucose tolerance and insulin

sensitivity

Improved body composition

Just a few Benefits…


THE BRAIN

Improved Cardiorespiratory Function Reduced Risk of the following

Increased maximal oxygen uptake Mortality from ALL causes

Increased maximal cardiac output and

stroke volume

Coronary artery disease

Increased capillary density in skeletal

muscle

Cancer (colon, and possibly breast and

prostate)

Increased mitochondrial density Hypertension

Increased lactate threshold Non-insulin dependent diabetes

Lower heart rate and blood pressure

at submaximal rate

Osteoporosis

Lower heart oxygen demand at

submaximal rate

Anxiety and Depression

Ok just a few

more..

[6]

Gains at any age


THE BRAIN

Older adult group 38% increase in VO2,

Younger group 29%

12 week study of untrained men 60-70yrs vs 20-

30yrs vigorous cycling ergometer

Magnitude of gains similar, even greater than

younger adults

[4]

Other studies have demonstrated same ability

of older adults

Beauty of Aerobic Exercise is all the choices


THE BRAIN

Sports and hobbies like gardening count

Short bouts of 10min can be accumulated

Arthritis- water classes, swimming, cycling,

UBE

Aerobic Assessment


THE BRAIN

Senior Fitness Test: 2 min Step or 6 min walk

test

Maximal Treadmill Stress test

Submaximal tests: Treadmill, Cycle

Ergometer, Step

How to determine exercise intensity needed


THE BRAIN

Old method still ok for younger adults: 220-

age

More accurate especially for older adults:

208 – (age x .7)

220 – 85 =

135

220 – 42 =

178

208 – (85 x .7) =

149

208 – (42 x .7) =

179


THE BRAIN

Guideli

nes

65-90% max HR

55-64% max HR for beginners is

acceptable

Quick way to take pulse: radial or carotid

10s x

6

15s x

4

20s x

3

30s x

2

Impact of some medications

150-300 min week Moderate or 75-150 week

Vigorous

[11]

Don’t have to overcomplicate it


THE BRAIN

If you don’t have heart rate monitor use RPE

or Talk Test

Rating of Perceived Exertion. Modified Borg

Scale of Exertion

Talk

test. Light- You can carry on a conversation

Moderate- You can say a few sentences at a

time

Very Heavy- Can answer “yes” or “no” not much

beyond on that

Vigorous- You can talk but you don’t feel like it

0-10 scale. Moderate is 5-6, Vigorous is 7-8

(85% max HR)

[13

]


THE BRAIN

Guideli

nes

Moderate intensity: 30min most days of week

can be accumulated in 10min bouts

Vigorous intensity: 20min continuous most

days of week

Warm up and Cool down 5-15min each

HIIT (High Intensity

Interval Training)

Intensity pick up relative to the individual

Short bouts of more intense activity ≥ 70%

max HR

A foundation of basic conditioning before

implementing

Followed by recovery period 40-55% of max HR

Examples: 3min faster walking pace then

3min slower recovery 30 second “sprints or pick ups” followed by 3-

4min recovery

repeated 3-5 times


Interval Training)

Just two weeks of training 30min each week (vs

75min guidelines)

Physiological benefits with less exercise time

HIIT was effective in reducing 24hr mean

blood glucose levels

Average age 65yrs, obese with Type 2 diabetes

(free of complications)

Study of 1min vigorous (90% Max HR) for 10

bouts with 1 min rest periods

[16

]


Interval Training)

Compared to 30min of continuous exercise at

65% max HR Both protocols improve body fat mass, cardio

fitness, fasting blood glucose and

endothelial function (lining of arteries)

HIIT protocol of 6 x 1min bouts of 85% max HR

with 4min recovery

On blood glucose lowering medication but

not on insulin

Study of 12 weeks with 43 type 2 diabetics ages 50-

70yrs

[17

]

HIIT Training -> greater improvements & only

one to impact A1C

But


Interval Training)

Had Coronary Heart Disease, Heart Failure,

Hypertension, Metabolic Syndrome and

Obesity HIIT Training significantly increased

Cardiorespiratory Fitness (VO2 max)

compared to Moderate Intensity Continuous

Training

Meta Analysis of 10 studies of 273 patients

[12

]

HIIT Almost Doubled improvement compared to

Moderate Continuous!


Interval Training) HIIT Safety

ADA recommends 12 lead ECG test for those

with Type 2 Diabetes before engaging in

vigorous activity

[14

]

One nonfatal heart attack per 23,182 hours of HIIT

training

[15

]

Seven year analysis of over 5,000 patients of

supervised cardiac rehabilitation exercise

reported low risk of HIIT

[15

]

Physician clearance for Diabetic and Heart

conditions


THE BRAIN

Massive benefits to the body, highly

modifiable, can be accumulated

While massive benefit to the body even more

exciting it’s impact on the Brain!

Mountains of research, easier for rodents to

do cardio

Exercise and the

Brain

Exercise and the

Brain Where did all this attention between

exercise and the brain come from?

BDNF (Brain-Derived Neurotrophic

Factor) Nourishes neurons, helps build and main the

cells infrastructure Improves signal strength between synapse

Improves function and encourages growth of

neurons Also strengthens and protects from natural

cell death Introduced to neurons in petri dish helps survive

and grow dendrites

Exercise and the

Brain

From Older Adults to The “Midnight Mice

Marathon” Study Divided into 4 groups: running for 2, 4 or 7

nights One control group without a mouse

treadmill

Exercise and the

Brain

The “Midnight Mice Marathon” Study

Injected with molecule that binds to

BDNF and scanned The running mice had increased BDNF

levels. The more they ran the higher the

levels.

But

…

Thought changes would occur in motor

sensory areas of the brain dealing with

movement

Exercise and the

Brain

Showed in hippocampus- which is

vulnerable to degenerative disease and

needed for learning and memory

Demonstrated link between movement and

cognitive function

Exercise and the

Brain

Other studies solidified the connection

LTP (Long Term Potentiation)

Method of strengthening the connection

between neurons

Inversely mice without BDNF lose ability to

learn

Found that if LTP was stimulated in mice by

making them learn BDNF levels rose

Finally injecting BDNF directly into brain of

rats encouraged LTP


THE BRAIN

Exercise increases levels of BDNF (Miracle Gro)

in the hippocampus

[18,19,20]

Higher levels of BDNF are associated with

better memory function and larger hippocampal

volumes

[21]

BDNP is a player in neurogenesis and also

contributes to the branch- like dendrites

expanding

[27,28

]


THE BRAIN

Found that people learned vocabulary words

20% faster following exercise than they did

before

2007 German study of humans

Rate of learning directly tied to levels of

BDNF

With Exercise also the RATE of learning

improves.


THE BRAIN

The Brain is adaptable or “plastic” as muscles

are able to be “sculpted”

The Brain is less hardwired and more

constantly being rewired

Exercise directly influences the Brain


THE BRAIN

Showed neurogenesis in hippocampus

Even has the ability in certain sections to

make new neurons

Terminally ill cancer patients injected with

dye

[29

]

Doesn’t happen in all areas

[30

] In 2006 study improved fitness participants

had increase in brain volume in frontal and

temporal lobes


THE BRAIN

Born with blank slate

New Neurons must be put to use or they die

Must integrate and fire its axon survive

Exercise births the neurons but the

environmental enrichment helps them survive.


THE BRAIN

Exercise can help regain in certain areas that

volume

With age our brains degrade and even shrink

[31

]

Gray matter volume decreases by

approximately 15%, from the 20s through the

70s

[33

]

Can occur from new neurons, greater

dendrite branching or complexity, or new

capillaries formed.

[34,35,

36]


THE BRAIN

Group one 60 adults did aerobic exercise

Group two 60 adults just did stretching

MRI done beginning, 6 month point, end of one

year

(no hippocampus difference in groups at

beginning)

One Year Randomized controlled study of 120

older adults without dementia

[26

]


THE BRAIN

Aerobic exercise group increased volume of

left and right hippocampus 2.12% and 1.97%

Stretching control group LOST left and right

volume 1.40% and 1.43%

At end of one year:


THE BRAIN

Aerobic exercise group increased volume of

anterior hippocampus by 2%

Anterior portion shows more age related

decline than tail of hippocampus

[22,23]

Hippocampus volume shrinks 1-2% per year in

older adults without dementia, increasing risk

of impairment

[24,2

5]


THE BRAIN

“These results clearly indicate that

aerobic exercise is

neuroprotective and that starting an

exercise regimen later in

life is not futile for either enhancing

cognition or augmenting

brain volume.”

Authors stated:


THE BRAIN

Aerobic activity specifics for study:

Weeks 1-7 did 50-60% max HR, After that 60-

75% remainder Week 1 started with walking 10min

Each week added 5min until at 40min by

week 7. Stayed at 40min for remainder

Walked 3 days per week


THE BRAIN

Importance of Socializing and Play

Rats Sensory and Social Stimuli learned

better than those in isolation

Study led to development of Federal Head

Start Program for preschool

Also their brains weighed more

Berkley Study Environmental Enrichment


THE BRAIN

Importance of Socializing and Play

Rush Alzheimer's Disease Center

Those who reported feeling lonely were 2

x likely to develop Alzheimer's

How about a human study


THE BRAIN

Wrapping up.

Research indicates age-related cognitive

decline due more to secondary effects of

lifestyle specifically health and fitness than

primary aging.

[3]

Programs that incorporate cognitive

challenges with aerobic exercise lead to

larger improvements

[2]


THE BRAIN

Exercise also…

Balances neurotransmitters like dopamine,

serotonin and norepinephrine

Reduces risk of obesity. Being overweight

doubles chance of dementia

With high blood pressure and cholesterol

it’s 6 x risk


THE BRAIN

For Brain Health…

Do Aerobic activity most days of the week

but at least aim for 4 days. 30min – 1hr

Aim for 60-65% Max HR, two days bump up to

70-75% Try to do outside and with a friend.

(environment, social and cognitive)

Seek Novel experiences, break the rut

REFERENCES

[2]

Blair SN, Kohl H, Barlow CE, et al. Changes

in physical fitness and all cause-mortality: A

prospective study of healthy and unhealthy

men. JAMA 273:1093, 1995.

[1]

Bengston, V.L.S., Merrill; Putney, Norella M;

Gans, D, Handbook of Theories of Aging. 2 ed.

2009, New York: Springer Publishing

Company.

Tanaka H and Seals DR. Endurance exercise

performance in Masters athletes: age-

associated changes and underlying

physiological mechanisms, 2008. Jan

1;586(1):55-63.

[3]

Makrides, L., Heigenhauser, G.J., and Jones,

N.L. 1990. High-intensity endurance training

in 20- to 30- and 60- to 70-yr-old healthy men.

J. Appl. Physiol. 69: 1792–1798.

PMID:2272973.

[4]

Pate RR, Prat M, Blair SN, et al. Physical

activity and public health: A recommendation

from the Centers for Disease Control and

Prevention and the American College of

Sports Medicine. JAMA 273:402, 1995.

[5]

REFERENCES

[7]

American College of Sports Medicine. ACSM

Guidelines for Exercise Testing and

Prescription. Philadelphia: Lippincott

Williams and Wilkins, 2000.

[6]

Fletcher GF, Balady G, Blair SN, et al.

Statement on exercise: Benefits and

recommendations for physical activity

programs for all Americans. Circulation

94:857, 1996 NIH Consensus Development Panel. Physical

Activity and Cardiovascular health. JAMA

276:241, 1996.

[8]

U.S. Surgeon General. Physical activity and

health: A report of the Surgeon General.

Washington: U.S. Government Printing

Office, 1996

[9]

Bouchard C, Shepard RJ, Stephens T, eds.

Physical Activity, Fitness, and Health.

Champaign, IL: Human Kinetics, 1994

[10

]

REFERENCES

[12

]

Medicine & Science in Sports & Exercise.

41(7):1510-1530, July 2009. doi:

10.1249/MSS.0b013e3181a0c95c

[11]

Weston, KS., Wisloff, U., Coombes, JS., High-

intensity interval training in patients with

lifestyle-induced cardiometabolic disease: a

systematic review and meta-analysis., BR J

Sports Med., 2014 Aug;48(16):1227-34. doi:

10.1136/bjsports-2013-092576. Epub 2013

Oct 21.

Borg GA.: Psychophysical basis of perceived

exertion. Med Sci Sports Exerc 1982;14:377–

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[13

]

Colberg SR, Sigal RJ, Fernhall B, et

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[14

]

Rognmo Ø, Moholdt T, Bakken H, et

al. Cardiovascular risk of high- versus

moderate-intensity aerobic exercise in

coronary heart disease

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[15

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]

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Tarnopolsky MA, Punthakee Z, Jung ME, Gibala MJ

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[18

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CARDIOVASCULAR SYSTEM AND THE BRAIN · 30s x 2 Impact of some medications 150-300 min week Moderate...

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Transcript of CARDIOVASCULAR SYSTEM AND THE BRAIN · 30s x 2 Impact of some medications 150-300 min week Moderate...