cardiovascular system and the brain - · pdf filedefinition of cardiovascular activity...
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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
CARDIOVASCULAR SYSTEM AND
THE BRAIN
Definition of Cardiovascular activity
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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.
CARDIOVASCULAR SYSTEM AND
THE BRAIN
Decreased fatigue in everyday activities
Improved immune function
Improved glucose tolerance and insulin
sensitivity
Improved body composition
Just a few Benefits…
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
THE BRAIN
Sports and hobbies like gardening count
Short bouts of 10min can be accumulated
Arthritis- water classes, swimming, cycling,
UBE
Aerobic Assessment
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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
]
CARDIOVASCULAR SYSTEM AND
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
HIIT (High Intensity
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
]
HIIT (High Intensity
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
HIIT (High Intensity
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!
HIIT (High Intensity
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
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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
]
CARDIOVASCULAR SYSTEM AND
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.
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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.
CARDIOVASCULAR SYSTEM AND
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]
CARDIOVASCULAR SYSTEM AND
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
]
CARDIOVASCULAR SYSTEM AND
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:
CARDIOVASCULAR SYSTEM AND
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]
CARDIOVASCULAR SYSTEM AND
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:
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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]
CARDIOVASCULAR SYSTEM AND
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
CARDIOVASCULAR SYSTEM AND
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–
381.
[13
]
Colberg SR, Sigal RJ, Fernhall B, et
al. Exercise and type 2 diabetes: the American
College of Sports Medicine and the American
Diabetes Association joint position
statement. Diabetes Care 2010;33:e147–e167
[14
]
Rognmo Ø, Moholdt T, Bakken H, et
al. Cardiovascular risk of high- versus
moderate-intensity aerobic exercise in
coronary heart disease
patients. Circulation 2012;126:1436–1440
[15
]
REFERENCES
[17
]
Little JP, Gillen JB, Percival ME, Safdar A,
Tarnopolsky MA, Punthakee Z, Jung ME, Gibala MJ
J Appl Physiol (1985). 2011 Dec; 111(6):1554-60.
[16
]
Mitranun W, Deerochanawong C, Tanaka H,
Suksom D
Scand J Med Sci Sports. 2014 Apr; 24(2):e69-
76.
Cotman CW, Berchtold NC (2002) Exercise: A behavioral
intervention to enhance brain health and plasticity. Trends
Neurosci 25:295–301.
[18
]
Vaynman S, Ying Z, Gomez-Pinilla F (2004) Hippocampal BDNF
mediates the efficacy of exercise on synaptic plasticity and
cognition. Eur J Neurosci 20:2580–2590.
[19
]
Neeper SA, Gómez-Pinilla F,
Choi J, Cotman C (1995) Exercise and brain
neurotrophins. Nature373:109.
[20
]
Erickson KI, et al. (2010) Brain-derived neurotrophic factor is
associated with age-related decline in hippocampal volume. J
Neurosci 30:5368–5375.
[21
]
REFERENCES
[23
]
Raji CA, Lopez OL, Kuller LH, Carmichael OT, Beck
er JT (2009) Age, Alzheimer disease, and brain
structure. Neurology 73:1899–1905.
[22
]
Hackert VH, et al. (2002) Hippocampal head size
associated with verbal memory performance in
nondemented elderly. Neuroimage 17:1365–1372.
Raz N, et al. (2005) Regional brain changes in aging healthy
adults: General trends, individual differences and
modifiers. Cereb Cortex 15:1676–1689.
[24
]
Jack CR Jr.., et al., Alzheimer's Disease Neuroimaging
Initiative (2010) Brain beta-amyloid measures and magnetic
resonance imaging atrophy both predict time-to-progression
from mild cognitive impairment to Alzheimer's
disease. Brain 133:3336–3348
[25
]
Arthur F. Kramer., et al. (2011) Exercise training increases size of
hippocampus and improves memory. Proc Natl Acad Sci USA. 2011
Feb 15; 108(7): 3017–3022., Published online 2011 Jan 31. doi:
10.1073/pnas.1015950108
[26
]
Lee R, Kermani P, Teng KK, Hempstead BL (2001) Regulation of
cell survival by secreted proneurotrophins. Science 294:1945–
1948.
[27
]
REFERENCES
[29
]
Pencea V, Bingaman KD, Wiegand SJ, Luskin MB (2001) Infusion of
brain-derived neurotrophic factor into the lateral ventricle of the
adult rat leads to new neurons in the parenchyma of the striatum,
septum, thalamus, and hypothalamus. J Neurosci 21:6706–6717
[28
]
The NY Times., OCT. 30, 1998 ADULT BRAIN CELLS SAID
TO REPRODUCE., by Holcomb B. Noble
Stanley J. Colcombe., Kirk I. Erickson., Paige E. Scalf., Jenny S. Kim., Ruchika
Prakash.,Edward McAuley Steriani Elavsky., David X. Marquez., Liang Hu.,
Arthur F. Kramer..,Aerobic Exercise Training Increases Brain Volume in
Aging Humans., J Gerontol A Biol Sci Med Sci (2006) 61 (11): 1166-1170. DOI:
https://doi.org/10.1093/gerona/61.11.1166
[30
]
[31
]
Ge Y, Grossman RI, Babb JS, Rabin ML, Mannon LJ, Kolson DL. Age-
related total gray matter and white matter changes in normal
adult brain. Part II: quantitative magnetization transfer ratio
histogram analysis. AJNR Am J Neuroradiol. 2002; 23: 1334–41.
Taki Y, Kinomura S, Sato K, Goto R, Kawashima R, Fukuda H. A
longitudinal study of gray matter volume decline with age and
modifying factors. Neurobiol Aging. 2011; 32: 907–15.
[33
]
REFERENCES
[35
]
Pereira AC, et al. (2007) An in vivo correlate of exercise-induced
neurogenesis in the adult dentate gyrus. Proc Natl Acad Sci
USA 104:5638–5643.
[34
]
Burdette JH, et al. (2010) Using network science to
evaluate exercise-associated brain changes in older
adults. Front Aging Neurosci 2:23.
Redila VA, Christie BR (2006) Exercise-induced changes in dendritic
structure and complexity in the adult hippocampal dentate
gyrus. Neuroscience 137:1299–1307
[36
]