nicabm - itineris coaching · so, john, i’m grateful that you are part of this call. i thank you...

nicabm www.nicabm.com

Exercise and the Neuroplasticity Revolution

A Teleseminar Session withJohn Ratey, MD

and Ruth Buczynski, PhD

The National Institute for the Clinical Application of Behavioral Medicine

http://www.nicabm.com

The National Institute for the Clinical Application of Behavioral Medicinewww.nicabm.com

Exercise and the Neuroplasticity Revolution 2

A complete transcript of a Teleseminar Session featuring John Ratey, MD and conducted by Dr. Ruth Buczynski, PhD of NICABM


Contents

How and Why Exercise Can Change the Brain. . . . . . . . . . . . . . . . . . . . . . . . . 3

Neuroplasticity, Exercise, and the Brain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

The Role of Exercise in the Prevention of Cognitive Decline . . . . . . . . . . . . . . . 5

Building Your Patients’ Brains . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

The Impact of Exercise on Children’s Learning . . . . . . . . . . . . . . . . . . . . . . . . 8

Is Exercise an Option for Everyone?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

BDNF – "The Miracle Gro" For the Brain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

The Role of IGF as a Growth Factor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Exercise as an Alternative to Drugs in the Treatment of Depression . . . . . . . . 12

Movement Improves Scores in Children and the Elderly . . . . . . . . . . . . . . . . . 13

High Intensity Interval Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Exercise and the Fight Against Addiction . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Do School Gym Classes Help or Hinder Neuroplasticity? . . . . . . . . . . . . . . . . . 17

Planning an Optimal Exercise Program For Our Patients . . . . . . . . . . . . . . . . . 18



Dr. Buczynski: Hello everyone! Welcome back. I’m so glad you are here with us tonight again for The New Brain Science.

I am Dr. Ruth Buczynski. I am a licensed psychologist and President of the National Institute for the Clinical Application of Behavioral Medicine. We are hosts for this series.

I want to welcome people from all over the world. I know that practitioners have been calling in each week from all kinds of time zones. And no matter what time it is, we appreciate you taking the time to be part of this call. We are a big family of multidisciplinary practitioners. We are physicians, nurses, psychologists, social workers, counselors, marriage and family counselors. We are physician assistants, dieticians, occupational therapists, chiropractors, clergy, stress management consultants, and coaches. If you are a layperson and you don’t fit into any of those categories, I want you to know we’re glad you’re here!

My guest today is Dr. John Ratey. I am very excited about this call. He is the author of one of my favorite books; it is called Spark: The Revolutionary New Science of Exercise and the Brain. And I will tell you, when I am having trouble motivating myself, I just think about the things that I read in this book and it gets me going and exercising, even when I don’t always feel like doing it.

So, John, I’m grateful that you are part of this call. I thank you for your work. People may know of you from your work with Driven to Distraction and the many other books that you have written, but tonight we are going to spend time talking about exercise and where exercise fits into the brain. So, welcome John!

Dr. Ratey: Great to be with you. It sounds like you have an exciting program and an exciting audience.

How and Why Exercise Can Change the Brain

Dr. Buczynski: Well thanks! So, you have said that exercise is the single most powerful tool you can have to optimize your brain. Can you tell us why you say that?

Dr. Ratey: Well, I think that what we know today, in this growing field of knowledge and science, is that exercise really helps regulate our emotional brain. It helps us manage our moods, both up and down, it helps us with motivation, as you alluded to, it helps us with anxiety and stress management, and it helps keep our attention system and our ability to withhold actions from cravings. In other words, it improves the impulse control issues that we may have. Also there is nothing that we know of that is better than physical aerobic and anaerobic exercise to optimize our brain to function cognitively - that is to learn, to remember, and to think, even think creatively.


with John Ratey, MD and Ruth Buczynski, PhD

"...there is nothing that we know of that is better than physical aerobic and anaerobic exercise to optimize our brain to function cognitively..."



Dr. Buczynski: Okay. So, let’s go into more detail, like why does exercise help us to learn, and think creatively. What happens when we’re exercising?

Dr. Ratey: Well, the “why” is important because it gives people a framework. I think we need to remember who we are, like the Greeks and “know thyself.” I think we are still hunter gatherers, all of us. It has only been ten thousand years since we have come off the plains and savannahs and farming has become a part of things.

And we aren’t moving like we used to when our genes were developed over a half a million years ago. Then we were moving approximately ten to fourteen miles a day, lifting, balancing, and all those physical attributes that were part of our lives. And that is not so long ago. Our genes have not changed that drastically.

So why movement is so crucial is because it is really part of the brain. Our thinking brain and the emotional control part of our brain really developed from our moving brain. Because we became better movers is the way I like to think of it. We became able to think, to imagine, to abstract and have all the wonderful human functions that we have - in part to help us be better movers and be the evolutionary victors that we were.

Also “how?” is what is coming to the fore front now. We know that exercise, activity, and play help us because it causes our brain cells to really work a lot. And this causes a release of neurotransmitters. Those in mental health certainly will recognize dopamine, norepinephrine and serotonin, all of which get immediately increased in concentration when we begin exercise and stay up for a period of time.

Also, we know the effect of exercise on a variety of different hormones like endorphins and the new class of hormones called endocannabinoids - or our body’s own marijuana. The endorphins are our body’s own morphine. When I lecture to student audiences, I always tell them, “If you really want to get high on morphine and marijuana, just go out for a long run, lift weights, play tennis, play basketball, soccer, or whatever you have available. Or just jump rope!”

But also we know that in the past ten years we’ve seen a whole new group of targets that exercise really propels and they are what we call the growth factors, in both the body and the brain. Specifically, in the brain there is one that has become a big favorite, called brain-derived neurotrophic factor or BDNF, which I call “Miracle Gro" for the brain because it is brain fertilizer.

Dr. Buczynski: I was going to say, I would like to get into that but before we do, I would like to just lay out some of

"Because we became better movers...We became able to think, to imagine, to abstract and have all the wonderful human functions that we have..."

"When I lecture to student audiences, I always tell them, 'If you really want to get high on morphine and marijuana, just go out for a long run...'''

"...in the brain there is one that has become a big favorite, called brain-derived neurotrophic factor or BDNF, which I call ‘miracle growth for the brain’ because it is brain fertilizer."



the work that buttresses this whole idea. Can we talk some about Scott Small’s work? He is a neurologist that you wrote about in your book.

Neuroplasticity, Exercise and the Brain

Dr. Ratey: Yes. Well, basically that is the sexy part of what we call neuroplasticity. Exercise improves the brain’s ability to be plastic. That means all of the hundred billion nerve cells that we have are much more apt to grow and change, which is necessary if we are to learn and remember.

Scott Small’s specific contribution comes from showing, really for the first time, “in vivo” that is in a live person that exercise improves our brain’s ability to make new nerve cells from the stem cells that we have in our brain. And this is a process called neurogenesis, a process that we really only began looking into about ten years ago in humans.

And Scott showed that, even a group of previously sedentary thirty-three-year-olds, who began an exercise program for, I believe, only three months, four times a week, for forty minutes, getting their heart rates up eventually, could show a pretty dramatic improvement in their pre and post test scores.

And most importantly they showed a dramatic increase in the volume of the area in the brain where we know we are growing new brain cells every day. An area called the hippocampus, which is what I call the “Grand Central Station for memory.” This is the area that gets the new brain cells that we make from our supply of stem cells in our brains. And we didn’t know this really until 1999. Small’s work began, I think in 2007 and really showed the change in the volume of this area by using the fancy scans that were developing then. This led everyone to conclude that in fact it really does happen in humans.

Dr. Buczynski: Okay. And let’s also talk about Carl Cottman’s work. He is the Director of the Institute for Brain Aging and Dementia at UC Irvine.

Dr. Ratey: Yes. And he is one of the three people I dedicated my book to.

The Role of Exercise in the Prevention of Cognitive Decline

Dr. Ratey: Yes, because he started the whole process going. In the late eighties or early nineties there was the big MacArthur Study, an international study, looking at which activities prevented the onset of cognitive decline and Alzheimer’s disease. And from that study, it was quite large, they showed three activities.

One was reduce caloric intake or not getting overweight. Actually being a little underweight which no one likes to hear

"...even a group of previously sedentary thirty-three-year-olds, who began an exercise program...four times a week...could show a pretty dramatic improvement in their pre and post test scores."

"...the three activities [that prevent the onset of cognitive decline] reduce caloric intake...continuous learning...and exercise."



but it’s the truth! The second was continuous learning. So doing Sudoku or crossword puzzles or whatever people are doing these days and keeping your brain active all the time. And the third activity was exercise. It was really quite profound.

And Carl Cottman was a co-author of this study and decided to look at this. He began a study back in his lab in Irvine and published it in 1995. That study really turned the world around in terms of exercise and neuroscience.

He got a group of mice and taught them how to run in a running wheel, he had their brothers and sisters in other cages where they weren’t able to run. He pre and post tested both groups and found that the running rats improved their test scores about twenty percent over the controls and over their previous tests. And then he sacrificed them and looked at their brains.

Their brains were thicker. The cortex seemed like they were much more connected. They had an area of the brain, the hippocampus, which was much bigger than it had been and very much bigger than the match controls.

He also measured the substance, BDNF, which we had only known about for about ten years and found that it had increased quite significantly. And this really opened the door to what I think is a virtual tsunami of neuroscience on the issue of exercise and the brain.

So there is a connection between increased BDNF, I am pretty sure of that now, and an increase in actual cell proliferation or new growth or neurogenesis, which means new brain cells growing.

Dr. Buczynski: Okay. Has anybody done this work with aging adults?

Dr. Ratey: Oh yes, after Carl Cottman’s work, for the past ten years or fifteen years, most of the work has been done with the aging generation. Arthur Kramer and his group out at the University of Illinois, Urbana, has sort of led the way in this area. But there are people from all over the world, in many countries that are looking at how to delay the onset of cognitive decline and Alzheimer’s disease and also how exercise specifically is working on the brain.

Kramer is sort of the leading light because he has a lot of scans and information about cell growth in the elderly, but basically the conclusion of all the studies is that if you are sedentary and you begin to exercise in your middle-age years, you can prevent the onset of cognitive decline by as much as ten to fifteen years.

And some of our Alzheimer’s researchers have found that if you begin to exercise and continue at it, you

"Carl Cottman's...study really turned the world around in terms of exercise and neuroscience."

"So there is a connection between increased BDNF...and an increase in actual cell proliferation or...neurogenesis..."

"...basically the conclusion of all the studies is that if you are sedentary and you begin to exercise in your middle-age years, you can prevent the onset of cognitive decline by as much as ten to fifteen years."



can cut the incidence of Alzheimer’s, your chance of developing Alzheimer’s disease almost in half, which is really quite remarkable.

Dr. Buczynski: Cutting your chance of Alzheimer’s almost in half that is pretty attention-getting. Tell us some of the studies that show that.

Dr. Ratey: Yes. The names escape me right now - my own cognitive decline! No, there’s a whole host of them that are listed in my book, and I refer people to that. And, boy, if you just Google “Exercise Alzheimer’s disease” you’ll get a lot of the more recent studies.

Dr. Buczynski: Is anyone doing it with people that have an early diagnosis or who have been recently diagnosed?

Dr. Ratey: Yes - but again I can’t give you their names, there are too many.

Dr. Buczynski: Sure!

Dr. Ratey: But there are many, many people that have looked at this and they find that exercise is one way to delay the progression of Alzheimer’s disease and cognitive decline and that it lets you really make a dent in the speed at which people deteriorate. If people are diagnosed or if there is a hint of that, then you really want to get exercising.

Dr. Buczynski: Right. Let’s talk about learning. What do we think is happening in the brain when we are learning?

Building Your Patients’ Brains

Dr. Ratey: Well, when we learn anything, at the basic cellular level what has to happen is your cells have to grow. And that is because of our wonderful neuroplastic brain, that is our brain is able to grow and change. And the only way we can learn anything is if that happens, if the brain does grow.

So we know what exercise does. One, it helps this learning process by providing the right “soup,” the right constituents, to help our brains grow and change. And second, as I mentioned earlier, it helps make new brain cells, which adds to the potential for our brains to learn and remember just in our memory banks, if you will.

But the third area, which is most important to me, is that exercise really makes for an optimal learner because exercise helps our attention system to work better. It helps us stay focused and fixed on whatever subject we are wanting to learn about, it provides motivation for us so we don’t get as bored, it decreases our impulsivity in general, so it makes us less fidgety and more able to sit in our seats or stay with whatever it is we are trying to master.

It reduces stress, the toxic stress that is anti-learning and blocks our ability to learn if we are under too much stress and anxiety. And in general, exercise puts us in a very positive place to take the world in.

"...exercise is one way to delay the progression of Alzheimer’s disease and cognitive decline...'"

"...it helps make new brain cells, which adds to the potential for our brains to learn and remember..."



I think this is really one of the reasons why I have spent so much time lecturing and pushing the schools to get exercise and play back on their dockets. All over the world, less and less time is being spent with our kids exercising, as they spend less and less time moving outside of school. So it is a very huge problem.

Dr. Buczynski: Yes. And are there studies going on that are looking at the impact of exercise on kids’ ability to learn?

The Impact of Exercise on Children’s Learning

Dr. Ratey: Oh, absolutely. Again, this is all over the world now. There are some very good studies. There are scientifically rigorous studies and empirical studies, as well. The first chapter in my book is on a school in Naperville, Illinois. It stimulated me to write the book and shows that exercise played a big role in helping this school to be one of the best in Illinois. All the kids are in a fitness-based PE program every day and they scored at the top of the heap of all the schools in Illinois.

So for me the “sacrificing of seat time” as it is called did not negatively affect their scores.

Dr. Buczynski: Has anyone figured out how long the effect of exercise lasts after one has exercised?

Dr. Ratey: No, I don’t think so. First of all, exercise is cumulative. If you are a chronic exerciser, which is the more fit you are as a person the better learner you are going to be. And that has been well documented over years, both in the United States and across the world, the more fit you are, the better learner you are going to be.

One recent study out of Illinois looked at ten-year-olds. They divided the children into two groups, those that were fit on a running test and those that they deemed unfit. They did tests and found that the fit kids did a little better, fifteen percent better I believe. But then they also imaged their brains to look at their hippocampuses - or hippocampi as they are called - and found that those that were in the “fit” category versus the “unfit” had bigger hippocampi - which is very nicely in concert with what we know in adults and in the elderly. So it is the first study to sort of break that news and I think it is really quite remarkable.

Dr. Buczynski: Has anyone looked at a previously sedentary population to try to determine how long it takes before an effect starts to kick in?

"And in general, exercise puts us in a very positive place to take the world in."

"...exercise played a big role in helping this school to be one of the best in Illinois. All the kids are in a fitness-based PE program every day and they scored at the top of all the schools in Illinois."

"One recent study out of Illinois looked at ten-year-olds...those that were fit on a running test and those that they deemed unfit...they imaged their brains to look at their...hippocampi...and found that those that were in the ‘fit’ category versus the

‘unfit’ had bigger hippocampi - which is very nicely in concert with what we know in adults and in the elderly."



Is Exercise an Option for Everyone?

Dr. Ratey: Oh, I think you can see an effect on anyone. I mean, if you are talking about that day’s effect, you can see an effect on almost any population, whether they are sedentary movement-based, or are in a

“fit” category. Their brains will be much more open to information from the environment, which is really what learning and memory is all about.

There are plenty of people looking at a variety of different exercises, such as, strength training, tai chi, and a variety of different modes of movement that improve test scores.

Dr. Buczynski: The reason I ask is, when practitioners are thinking about their patients, there are some obvious patients that you would suggest exercise for and then there are some that perhaps are significantly overweight and are attached to a sedentary lifestyle. They shouldn’t rule out the possibility of there being some help for that person even if they are sedentary.

Dr. Ratey: Oh, I think you are asking the right question but I think those are the people that are helped the most, so that it is just the opposite of what one might think. I mean, they don’t have to go out and run a marathon! You know, for somebody who is really overweight you want to start them off slowly, in something that they can see progress in.

At our Department of Obesity and Nutrition here at Harvard, the head guy who has been in it for many years says the first exercise people who are really obese should begin with is actually weight training because probably they don’t have the energy to go much distance-wise and aerobically.

And with weight training they can see that they are getting stronger day-by-day. They need that sort of reinforcement. That they can go from 5 lbs to 8 lbs in whatever exercise they are doing. That reinforcement is so important because exercise is so off-the-radar for so many people.

Dr. Buczynski: Okay. That’s interesting. Let’s go into BDNF - that is brain-derived neurotrophic factor. When did people start figuring out that BDNF was so important?

BDNF – The "Miracle Gro" For the Brain

Dr. Ratey: I think it really was in the late eighties and early nineties when we learned what BDNF was. It has really increased its power with Cottman’s 1995 study on mice. So people began to really know that it had a significant fertilizer power to improve cell life, longevity of the cells, and the ability of the cells to do what they are supposed to do.

"...people looking at a variety of different exercises, such as, strength training, tai chi, and a variety of...modes of movement that improve test scores."

"The Department of Obesity and Nutrition at Harvard...says the first exercise people who are really obese should begin with is...weight training...with weight training they can see that they are getting stronger day-by-day...That reinforcement is so important..."



And since then we have learned it has many partners. Neuro growth factor itself and factors that come up from the body when you are moving that help with the learning process, and also with the neuroplasticity process, which usually goes along with keeping your cognition for a longer period of time than you might had you not been moving.

Dr. Buczynski: Right. Now, as you mentioned, you coined the term that BDNF is the “Miracle Gro" for the brain. What is BDNF doing that seems to be so positive for the brain?

Dr. Ratey: Well, what it does, it turns on a lot of genes that have to do with all kinds of very good things. And it turns on the growth factors. In our genes it is a growth factor, but it also helps each individual brain cell be that much more vigorous.

It also helps with brain cell repair, it promotes what I think of as the “janitorial service” inside each and every brain cell to get tougher, to have “more employees” if you will, to clean up the waste products and to decrease the potential for cell death. BDNF does all those things and does it at the synapse level where the growth occurs as well as intracellularly. So it really has quite a remarkable effect.

It is also an antidepressant. It helps manage our moods and an anti-anxiety, anti-panic agent or one can think of it in those terms. So it helps to do the regulating of those problems.

Dr. Buczynski: And there is a study out of Kandel’s Lab in Columbia where they worked with BDNF with mice - is that correct?

Dr. Ratey: Well, I think they do a lot of studies at Eric Kandel’s lab, he has won a Nobel Laureate. But his work had been done mainly with squid neurons. But, yes, BDNF is a factor there. He might be doing some mice studies that I am unaware of now. But I wouldn’t doubt it because they are looking into how to make more of this BDNF, or the biotech companies have been. I think he was involved with a number of the studies, to promote the cell learning at a very, very basic level.

Dr. Buczynski: And I think I read in your book that there are German researchers who found that people with a gene that robs them of BDNF are more likely to have learning deficiencies?

Dr. Ratey: Yes, yes. That is now supported by other studies. There are certain families that have rampant mental retardation and their BDNF is very, very low. So it goes along with the whole idea that BDNF is a very powerful enhancement for our brain and what it supposed to.

Dr. Buczynski: Okay. So let’s tackle some of the other growth factors. There is IGF, insulin-like growth factor.

"BDNF...turns on the growth factors. In our genes...but it also helps each individual brain cell be that much more vigorous. It also helps with brain cell repair."

"There are certain families that have rampant mental retardation and their BDNF is very low. So it goes along with the whole idea that BDNF is a very powerful enhancement for our brain..."



The Role of IGF as a Growth Factor

Dr. Ratey: Right. It is made both in the body and in the brain. And in the body it helps us grow more insulin receptors, which is all to the good, to help us use our over-supply of glucose, in the developed world, anyway. Also it works in partnership with BDNF and other factors in the brain to promote cell growth. And that is the real link in the lynchpin, that it helps BDNF when the supply comes from the body when we exercise.

And it is very useful paradigm. When we exercise, our muscles get over-stressed and when that happens, in both our heart and our muscles, it sets up a call for more of this IGF-1 to help, “Bring in more glucose!”. That is really what it translates to, more insulin receptors so you can bind more insulin so it can do its job. That is to bring glucose into the cell, which feeds the cell. Because when you are overtaxing it, you want more of it available.

So it releases this IGF-1 plus a bunch of other different factors that we now know also have an important function in the brain, although not the same as I just described. But they promote other growth-enhancing factors and mechanisms in the brain.

Dr. Buczynski: And there is also vascular endothelial growth factor?

Dr. Ratey: Boy, you really read the book! This is great, I love it! VEGF is vascular endothelial growth factor - right. And it is the same story, when you overtax a muscle you are causing this alarm to go off saying, “We need more help! We need more blood supply!” And so this is one of the important factors. It stimulates more blood vessel growth, small capillaries.

And in the brain, however, it is very important. Scott Small showed that there is actually an improvement in changing our stem cells into new nerve cells. Well, VEGF is very involved in that process, to help stimulate our stem cells to change or divide and grow into a new nerve cell. It is also important in keeping that nerve cell alive as it is young and it needs to be integrated. The VEGF, IGF-1, and BDNF all are crucial in that whole process.

Dr. Buczynski: And there was one more I read in the book - FGF2.

Dr. Ratey: Yes, Fibroblast Growth Factor. Again, the same sequence, of having the muscle needing to build more muscle, FGF2 also goes up to the brain to turn on the division process of the stem cells and to make brand new nerve cells. So they are all important and it is a veritable symphony of action. These growth factors together help, one, build muscles and, two, build brain.

Dr. Buczynski: Now, we have a lot of mental health people on the call and, in the US anyway, many times if a patient presents with depression they will be treated with antidepressants. But in Europe they might be treated with an exercise regimen first?

"When we exercise, our muscles get over-stressed and when that happens...it sets up a call for more of this IGF-1...to bring glucose...which feeds the cell."

"VEGF is vascular endothelial growth factor...It stimulates more blood vessel growth...It is also important in keeping that nerve cell alive..."



Exercise as an Alternative to Drugs in the Treatment of Depression

Dr. Ratey: Right, and very well, by the way. But, of course they do have antidepressants there too. I think one of the reasons I became interested and stayed interested over the years in the exercise role in mental health is just that target - depression and mood regulation.

And I think many centers have been looking at how exercise is doing it, what are the crucial components, how much, how fast, and how intense, all those questions are being looked at as we speak, and have been looked at. Duke University leads most prominently in this area. They picked up on it early in the eighties and began to notice that people exercising for cardiac reasons decreased their hostility, decreased their anxiety, decreased their depression, and improved their mood and sense of wellbeing.

They began to look at this pretty seriously. And ten years ago a fairly large study came out of Duke. It took place over a number of years. They looked at about a hundred people who came in looking to be treated at Duke for depression and divided them into three categories. One group receiving increasing doses of Zoloft, one of our antidepressants. A second group was started on an exercise program four times a week and a third group got both the exercise and the medication.

They met with these people weekly, they did scales and at the end of two weeks all groups were starting to drop in terms of their depressive scores. At the end of four weeks, all of them had achieved a dramatic, statistically significant drop in their depressive scores. And at the end of four months this remained true.

So it showed that exercise is at least as good as our antidepressants. And there is some hint that maybe the activity, the resilience, and the feeling that you did it on your own kind of thing might have a more lasting impact on mood.

Dr. Buczynski: Yes. Too bad they didn’t use talking treatment as part of that research design.

Dr. Ratey: Right. I think there are studies looking at that now, but at that point there wasn’t. It is hard to find funding for exercise studies – at least in this country!

Dr. Buczynski: Yes. If there is nothing you can sell, if it is not going to increase sales of any pharmaceutical. But, still, it would have been nice to know the effect and where a talking treatment fell in that process.

Let’s spend some time looking at the various intensities - low, medium and high level intensities of exercise and

"I think one of the reasons I became interested and stayed interested over the years in the exercise role in mental health is just that target - depression and mood regulation."

"Duke University...began to notice that people exercising for cardiac reasons decreased their hostility, decreased their anxiety, decreased their depression, and improved their mood and sense of wellbeing."

"...it showed that exercise is at least as good as our antidepressants...maybe the activity, the resilience, and the feeling that you did it on your own...might have a more lasting impact on mood."



what is going on in the brain at each of those levels. Let’s start with low-intensity exercise, which is probably where, if one of the practitioners on the call has a patient who has been sedentary, is they are going to start. What is happening in the brain with low-intensity exercise?

Movement Improves Scores in Children and the Elderly

Dr. Ratey: Well, I think what is happening with movement in general and with low-intensity exercise in particular, you are activating all of your nerve cells. So there is much more activity going on that will cause an increase in neurotransmitters.

And I think that is the real action there. So it is like taking, a little bit of Prozac and a little bit of Ritalin. Because it improves the serotonin levels, it improves our dopamine and norepinephrine levels, it helps us be a little less stressed, a little more positive, and improves our focusing quite a bit.

A recent study, since my book came out, showed that in children, even walking at sixty percent of their maximum heart rate, which is really walking, being able to talk, and not sweating, but just walking for twenty minutes, improved their test scores by fifteen percent, from pre to post. So it is not as though you are not getting anything, you know, with walking.

Dr. Buczynski: Okay. So I just want to make sure I got that down. Children's test scores improved by how much?

Dr. Ratey: By fifteen percent.

Dr. Buczynski: Wow!

Dr. Ratey: Yes. And with the elderly, there are walking studies showing an improvement over a three to six month period. Different studies showing that just walking sixty to sixty-five percent, before they start to get out of breath, has a very positive effect on mood, cognition, and anxiety in general. It also tends to make you more social. And it certainly has a big impact on your physical health.

Dr. Buczynski: Right. We have known that for years; it seems to me with Ken Cooper’s work out of Texas. We have known that aerobic exercise was healthy for cardiac purposes and helpful in reducing hypertension and certainly we have known that it is helpful in managing weight. But the whole idea that it is helpful with learning and with the brain that seems to be more recent research.

Dr. Ratey: Absolutely. And it is, around the edges, most people know about it and have written about it but now we know, once you get into the mechanisms what is actually happening. Then it becomes something that people can latch onto, can understand. And I think that it goes along with the rise of what

"...it is like taking, a little bit of Prozac and a little bit of Ritalin...it improves the serotonin levels...improves our dopamine...levels, it helps us be a little less stressed, a little more positive..."

"A recent study...showed that in children, even walking at sixty percent of their maximum heart rate...improved their test scores by fifteen percent, from pre to post."



we know about what is going on in the brain and with neuroscience in general. That has given people more information to see how this might all play together.

Dr. Buczynski: So, let’s move on to medium-intensity activity. You describe low-intensity as an activity where you could still have a conversation and wouldn’t necessarily break a sweat. And that seemed to have a fifteen percent improvement in test scores. First, what would be some markers for medium-intensity excercise?

Dr. Ratey: Well, it is hard to go low, medium and maximal, other than by using heart rate, because that is something most people can understand. When we talk about “sixty percent maximum heart rate,” what is

“maximum heart rate?” Well, every person’s maximum heart rate is roughly figured by taking 220 minus your age. And whatever that is, that is a hundred percent, or supposedly what your maximum heart rate is or should be. And if you take sixty percent of that, then that is what the heart rate would be.

So medium or moderate, it depends on the author of the study, is anywhere from seventy, to eighty-five percent of your maximum. And there you are going to see much more of a change in the neurochemistry, much more of taxing the nerve cells. And you are likely to see development of more neurotransmitter receptors, as well as improvement in the amount of neurotransmitter that you might have available. You are going to see higher levels of BDNF and all the other factors that we mentioned, the VEGF, the FGF2 and IGF-1, just because you are taxing the body more and you are getting more input into the brain.

The markers are a better improvement in mood, certainly more reduction of anxiety and stress. One begins to develop resilience, which is doing something that is a little more taxing, and staying with it - that whole practice of committing to something and then making it, you know, doing it, - three-four times a week or every day, that takes practice. And that is a skill that has been lost in the sedentary world that we are living in.

It is a very big issue with our kids, all over the world now. I just returned from India and I have been working in Taiwan and it is not just in the US that we are have a problem with our children who are mesmerized, as we all are, by our wonderful cyber toys, including TV and all the wonders of the computer. We pay a price for that, like sitting in our chairs and not moving. And our kids are really not moving and that is a big problem.

Dr. Buczynski: Yes. So, with medium-intensity activity, the body starts burning glucose?

"And with the elderly, there are...walking studies showing...that just walking...before they start to get out of breath, has a very positive effect on mood, cognition, and anxiety..."

"...that practice of committing to something...that is a skill that has been lost in the sedentary world we are living in."

"...it is not just in the US that we are have a problem with our children who are mesmerized...by our wonderful cyber toys, including TV and all the wonders of the computer...our kids are really not moving and that is a big problem."



Dr. Ratey: Well, it is burning glucose even in moderate and low activity. But then you start really churning it up and start taxing the muscles even more, so you are going to cause a lot more of these recovery factors to be generated and that is going to lead to more growth of the muscles and the heart and better circulation overall.

Certainly better circulation to the muscles of the heart and especially to the brain. And you are probably going to have jump in neurotransmitters and growth factors even more than you would have with low-intensity exercise.

Dr. Buczynski: And I think you wrote that higher exercise activity triggers the release of metabolic cleanup crews?

High Intensity Interval Training

Dr. Ratey: Yes! You’re so good! Yes, it is really quite extraordinary. I think one of the areas that I got into in doing research for this book is what is called high-intensity interval training. Some questions that everybody asks, from all audiences that I have ever spoken to are, “How little can I do?”, “How little time can I devote?” and “How little pain can I make?”

Well, I say it is not about that - it is about intensity duration. So, if you spend just a small amount of time but in a very intense way, you get a very powerful effect on the brain and you cause a release of other factors.

At the very high-intensity intervals and we are talking here “beyond the beyond” sprinting for thirty seconds as fast as you can go, uphill or lifting weights continuously for thirty seconds and not taking any breaks. This really causes a release not only

of all the factors we have talked about, but of a hormone called the human growth hormone, HGH. HGH is popular among all the athletes and the Hollywood stars because it keeps you young. It is the anti-aging hormone.

There are anti-aging centers around all over the world that have synthetic HGH and give it to people to use. What it does is keep the body young, like an adolescent. One of the properties of HGH is that it burns fat and makes muscle. People like that because one of the best measures of how healthy we are is out body fat content. We want to want low fat content and this hormone really helps with that.

Secondarily, in the real peak exercise experience that I am trying to describe, you make more of the substance called nitrous oxide, which we make all the time. But you make more of it as you go up the scale. Then all of a sudden, at the higher stressors, the high-intensity exercise points, you are making more of this substance.

And this is really magical because it functions in our small vessels in our brain, in our body, and in our hearts, as what I think of as a “Roto Rooter effect”. It has been described as such, to clean up all the

"...if you spend just a small amount of time but in a very intense way, you get a very powerful effect on the brain..."

"HGH is popular among all the athletes and the Hollywood stars because it keeps you young. It is the anti-aging hormone."



plaque and cells that adhere to the small little arteries that lead to trouble later on in terms of stroke and heart attacks and just general loss of function. It also expands these arterials, these small arteries.

So it makes for a cleaner, bigger transport mechanism for our blood flow to get through so we can feed our organs with more glucose and oxygen.

But it really takes you getting to this maximal stress and it is not something that I would recommend for anybody that is not already in pretty good shape but this really has a very powerful effect.

People are using it to train. Even endurance athletes are training with much more time spent on sprinting and going “beyond the beyond,” and worrying less about the endurance because they will improve with this real challenge to the body.

Dr. Buczynski: So that is with interval training.

Dr. Ratey: Right.

Dr. Buczynski: You know, I was at a conference once and I did not have time to do a whole half-hour of running. And I went outside and found a back set of stadium steps and I went up them as fast and I could and came down, and back up again. I did that four or five times and I was amazed at the impact that had on me pretty much the whole day!

Dr. Ratey: Oh, it’s incredible when you do it. I mean, you couldn’t ask for a better description or a better example. It was probably maximal or above the maximum for you, when you are running up stairs. That is a really good challenge.

Dr. Buczynski: Yes. Now, I want to go in an entirely different direction and talk about some of your thoughts about using exercise to fight addictions.

Exercise and the Fight Against Addiction

Dr. Ratey: Okay. Well, there are many reasons why exercise is very useful in treating addictions. One reason is that exercise reduces craving because all of our addictive substances and activities really come down to jazzing-up or improving the concentration of dopamine in our brains.

It seems that not only is it involved with the attention system but it is also a key player in the addiction issue and the “getting the buzz” off of whatever it is, from cigarettes to heroin, from gambling to porn, to intensity, to extreme sports. All of those give you “the dopamine rush” and exercise does as well.

So one gets a craving, at least at a neurochemical level, partially sated by this neurotransmitter and you increase endorphins and endocannabinoids, which are very important for feeling of satiation and feelings of wellbeing and wellness. So in that score it really helps with reducing the craving.

“...there are many reasons why exercise is very useful in treating addictions. One reason is that exercise reduces craving...”

"...addiction...from cigarettes to heroin...give you

'the dopamine rush.' And exercise does as well."



And I think it gives people an activity. One of the big pluses of AA is that it is an activity that is not part of the addiction issue. It is not related to anything that is surrounding the addiction problem. So that is why they push “90 meetings in 90 days” because it is something to supply an activity.

Well, exercise is a pretty good activity. And also it brings about a better physical health, reduces panic and stresses, and influences mood improvement - all that factors in to, I think, being something that is really crucial for helping people who are struggling with addictions.

Do School Gym Classes Help or Hinder Neuroplasticity?

Dr. Buczynski: Thank you. Now, you have some thoughts about kids’ gym classes and why they don’t always help with neuroplasticity. Can we get into that just a little bit?

Dr. Ratey: Sure. I think the focus in many gym classes is on just athletics what is called the “Three R’s” where the gym teacher

“Rolls a ball out, Relaxes, and Reads the paper!” and lets happen whatever is going to happen. That is an extremely bad example but I think the over-focus on athletics and athletic skills is really taking away from getting everybody involved all the time.

It is one of the beauties of the programs that are very successful in schools now, that everybody is involved and everybody is participating, whether it is an athletic event or a fitness, aerobic, calisthenics, or even weight training program. But all kids are expected to be involved, are involved, and are not identified as

being terrible at it, using shame and humiliation. Unfortunately that had been used too frequently by many of our PE teachers in the past.

But to spend the precious time that we have with kids in a very thoughtful, planned kind of way where everybody is moving about as much as they can, certainly with breaks and everything, but really keeping them going, and hopefully showing them how much fun it can be because that is such an important part of the puzzle.

Dr. Buczynski: Now, we don’t have a lot of time left so I would like to sort of pick your brain about what would be an optimal regimen when we are thinking about our patients? Where would we be hoping to get to in terms of number of times a week, and types of exercise, and length of exercise, structure and so forth?

"...exercise...brings about a better physical health, reduces panic and stresses, and influences mood improvement...that is really crucial for helping people who are struggling with addictions."

"...I think in many gym classes...the over-focus on athletics and athletic skills is really taking away from getting everybody involved all the time."

"...all kids are expected to be involved...and are not identified as being terrible at it..."



Planning an Optimal Exercise Program For Our Patients

Dr. Ratey: Right. Our US Health and Human Services has come out with the following recommendations and I think I am describing it accurately. The recommendation is that exercise should be an hour a day for five days a week and on the “off days” doing some kind of fun activity that involves movement. It is almost really an everyday program!

Now, how I would break it down is at least four times a week to really put in at least forty good minutes of aerobic exercise, whether that is at first walking, then jogging, walking uphill, or walking to the point where you are in a moderate stage. The stage where your heart rate is being taxed and you are not just lollygagging along.

And then add in strength training, whether it be calisthenics, lifting weights, just doing knee bends, and push-ups, and sit-ups. One can get a lot of exercise from just doing those, a lot of very good exercise. And one doesn’t need a whole gymnasium to do get that, in fact some of the better groups these days that are providing really good exercises really don’t use much in the way of gym equipment.

Just keep yourself moving, use your own body weight but really work on building your muscles. And especially as we age because our muscles tend to fly away much quicker. They tend to erode very quickly. The more you age, the harder it is to keep the muscles on. So you have to really school yourself to do whether it is weight training or calisthenics on an either three or four times a week basis.

And then I like to throw in some time to improve your balance because it is an important part of the whole package for the brain and the body. And for that you can look at yoga, one of the tai chi, or actual balance training in the gym. And it is really quite important. Especially as we age, we know that goes away, that balance tends to leave us and we need to constantly work on it.

Dr. Buczynski: Okay. The aerobic part we had said forty minutes each time. About how long would we be thinking the strength part would be?

Dr. Ratey: Well, it depends. I think you would want to alternate it but I think at least twenty minutes three times a week to really do a good circuit. I mean, in this country women have the Curves kind of thing which is a circuit training. That is very good because generally their heart rates are up most of the time and they are doing weights, as well.

So I like that program or other programs in gymnasiums where you have to go from one machine to another. Or just do you own boot camp with jumping-jacks, push-ups, and sit-ups, and knee bends.

Dr. Buczynski: Right. And how about balance?

Dr. Ratey: Balance you could do, I would say as often as you can tolerate it! If you are into yoga, that’s perfect but you can do that

"Our US Health and Human Services has come out with the following recommendations...that exercise should be an hour a day for five days a week..."

"...as we age...balance tends to leave us and we need to constantly work on it."

"...to improve your balance...you can look at yoga, tai chi, or actual balance training in the gym."



with jump rope or doing balance challenges on your own. Now the Exergaming, the Wii Fit and other PlayStation kinds of games that your kids have, most of them will have an exercise game on it if you can get it and there they have some very good both aerobic and training programs as well as balance programs.

Dr. Buczynski: And jumping rope will improve balance?

Dr. Ratey: Oh yes! Oh yes, sure it does! Because you have to sort of get everything in order, you know? Your swing, your movement, where you are landing and everything, absolutely. As well as, it is probably the best aerobic exercise you can do, if you really get going.

Dr. Buczynski: You know, we have run out of time again. And I am so sorry because we have just scratched the surface here. But, everyone, I am going to be sending you an email and in that email

there will be a couple of links. One will be to our Comment Board and I would like you to do that first. Go to the Comment Board and talk about how you are going to use what you have heard tonight.

And when you do, please put in your first and last name, your city and state or country, and your profession and talk about how you are going to use what you heard tonight. This is our community board and it will continue the dialogue you can see what other people are doing - that in and of itself will be interesting to you. So take some time to do that right away.

And the other thing I am going to send you is a link to John’s book. The book is called Spark: The Revolutionary New Science of Exercise and the Brain. I am going to send you the link to an Amazon link and you can check it out there and take a look at the reviews. If you want to buy it that will probably be one of the least expensive places to buy it or you could print out the review and maybe get your library to buy it. But do have a look at that.

Well, first let me say, John, thank you so much for being part of this call, and for all of your work. You are a prolific thinker and you get involved in so many things and I just want to thank you for your work and for sharing some time with us today, to help us learn more about this issue.

Dr. Ratey: Right. Can I put a pitch in for my newest website of my nonprofit called www.sparkinglife.org, it is all one word, where there is a lot of information that I went over today.

Dr. Buczynski: Okay, great!

Dr. Ratey: And people can get on that and learn, and refresh as well as expand on what I have talked about here today.

Dr. Buczynski: Okay, great! And, everyone, I know many of you went through some trouble to be part of this call - and I’m sure you are glad that you did! And some of you were up very early in the morning, or very, very late at night, or in the middle of the night; and some of the folks in California had to take a very late lunch in order to block off the hour in order to be part of this call and I just want to say thank you to everyone for taking the time to be part of our community.

So with that, I will say thank you and goodnight to everyone.

"...jumping rope is probably the best aerobic exercise you can do, if you really get going."



About The Speaker:

John J Ratey, MD, is an Associate Clinical Professor of Psychiatry at Harvard Medical School, Research Synthesizer, Speaker, and Author, as well a Clinical Psychiatrist maintaining a private practice in Cambridge, Massachusetts. He has lectured and published 60 peer reviewed articles on the topics of Aggression, Autism, ADHD, and other issues in neuropsychiatry.

Most recently, Dr Ratey has penned, Spark: The Revolutionary New Science of Exercise and the Brain published by Little Brown. In Spark, Dr. Ratey guides the reader to an understanding of neurobiology and inspires the reader to reach for their potential, and embrace exercise that is crucial for the brain and body to operate at peak performance.

Find out more about this and related programs at: www.nicabm.com

Delivered from Distraction - Getting the Most Out of Life with

Attention Deficit Disorder

Spark: The Revolutionary New Science of Exercise

and the Brain

A User's Guide to the Brain: Perception, Attention, and the

Four Theaters of the Brain

Books by Featured Speaker: John Ratey, MD

Click HERE to Purchase Now!



http://www.nicabm.com/?loc=deccon09a/presenters/&menu=presenters&bot=1&top=30&speaker=Bill_O%27Hanlon,_LMFT

http://www.nicabm.com

http://www.amazon.com/gp/product/0345442318/ref=as_li_ss_tl?ie=UTF8&tag=natiinstforth-20&linkCode=as2&camp=217145&creative=399349&creativeASIN=0345442318



nicabm - itineris coaching · so, john, i’m grateful that you are part of this call. i thank you...

Documents