Category Archives: Medical

Exercise and dementia

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Dementia is a medical condition that hits close to home for more and more people.  According to the World Health Organization, around 50 million people have dementia, and there are nearly 10 million new cases every year.  Chances are, it is affecting your life through those you know and care about.

In 1999 a group of scientists discovered that running caused new brain cells to form in mice (3).  Before this, it was believed we had a set number of brain cells at birth and it was not changeable.  This and other studies on exercise and the brain shifted our thinking about exercise beyond just the health of the body.    This started a cascade of studies that are providing more and more information about how exercise helps the brain in humans. The brain is now is know to respond to exercise much like a muscle -getting weaker with less exercise and stronger with regular exercise.

It has been shown through research that 35 percent of risk factors for developing dementia can be attributed to modifiable lifestyle choices, with exercise being a large portion of what we can control in our chances of getting dementia (4).

Although maintaining a healthy weight is part of that healthy lifestyle that helps prevent dementia, how you lose weight matters. In one study between three sets of people—individuals who lost weight through restrictive eating, people who lost weight through exercise, and a group that used a combination of the two—only the groups who had exercise as part of their weight loss regimen noted an improvement in brain function (2).

How exercise makes the difference in your brain is still not fully understood but it seems to improve brain function by:

  • Increasing the size of the hippocampus (the part of your brain responsible for memory and learning)
  • Increased BDNF (brain-derived neurotrophic factor), called fertilizer for the brain by John Ratey, MD because it is an important brain chemical in boosting memory and learning
  • Increased blood flow to the brain

However, one factor that cannot be ignored when we talk about these brain benefits of exercise; the role stress plays in helping or limiting these brain benefits. Prolonged and unpredictable stress can interfere with brain cell growth, whereas mild stress (what we might call a “good challenge”), improves brain cell growth (3).  We need to then carefully plan exercise so it is not stress producing, but rather to be a good challenge for the body and brain. 

That means that the type, level and frequency of your exercise plan needs to be something you look forward to, not something that is boring or that is overwhelming. The place you choose to exercise in needs to help you feel confident, not self-conscious  Exercise needs to fit into your life rather than make your life fit around your exercise plan.  Finding that sweet spot takes careful planning, mindful awareness, and a good understanding about how much is enough exercise to get what you want from it.    This balance is not only possible, it is essential if you are going to use exercise to help your brain function at its best for your whole life. 

Keep Moving, Be Well,



1. Exercise and hippocampal neurogenesis: a dogma re-examined and lessons learned.  Patrick Z. Liu, BA and Robin Nusslock.  2018

2. Why Exercise Is Good for Your Brain. Mylea Charvat, Ph.D. January 2019

3. Adult neurogenesis and physical activity. José R. Alonso. January 2018

4. .Dementia prevention, intervention, and care. Commission in Lancet. July 2017



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by | August 13, 2019 · 7:46 pm

Exercise and asthma


Asthma is a medical condition where parts of your airway tightens making it difficult to breathe.  There are many triggers and exercise can be one of them.  For this reason, many people with asthma avoid exercise. This is unfortunate because exercise, when done right, can actually help give you more days free of asthma symptoms.

Along with all the other benefits,

regular exercise has been shown to improve asthma control

What makes exercise a trigger for asthma?

  • Exercise induced asthma seems to be caused by dehydration of the airways.  When you breathe heavier, the airways are more likely to dry leading to a series of events that causes asthma symptoms
  • When water loss is prevented, by breathing warm humid air, exercise does not provoke an attack of asthma

What are the benefits of exercise for people with asthma?

  • More symptom free days
  • Reduces risks of asthma exacerbation
  • Improved exercise capacity
  • Improved quality of life
  • Improved pulmonary function

How can I prevent an asthma episode with exercise?

  • Exercise regularly
  • Do a pre-exercise warm up
  • Cover your mouth with a scarf or mask while exercising in cold temps
  • Avoid exercising in
    • High pollution areas
    • Periods of high allergen levels
    • Extreme temperatures
  • Avoid exercising when asthma is exacerbated or during a respiratory tract infection
  • Ask your doctor about using a fast acting asthma medication 10-15 minutes before exercise can help you avoid or minimize an asthma episode during exercise.
  • Use all of your asthma medications as directed
  • Treat other medical conditions that can worsen asthma symptoms, such as gastric reflux


Keep Moving, Be Well,


Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.


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by | June 26, 2019 · 6:50 pm

Exercise and fibromyalgia


If you or someone you care about has fibromyalgia, you know it can be one of the most frustrating illnesses around.  The symptoms of widespread pain and tenderness (sensitivity to touch) that tends to come and go and move about the body mean you never know what will hurt next.   The fatigue is compounded by sleep problems, which compounds other problems.  The wide range of symptoms effect every aspect of life and can leave you feeling like your body is the enemy.

Exercise is part of the standard recommended treatment, yet this can often lead to even more frustration when it only leads to more pain and fatigue.  Let’s look at why exercise with fibromyalgia so you know how to make exercise work for you.

Since the cause of fibromyalgia is unclear, we can only use exercise to treat the symptoms rather than the root cause of the illness.  Exercise has the most impact on preventing the secondary symptoms of fibromyalgia, the ones caused by living with pain and fatigue.  Let me explain.

The first secondary symptom is the loss of strength, stamina and mobility the comes when movement is limited by pain and fatigue.   This leads to the spiral of inactivity where you move less because of pain and fatigue, which causes you to lose function, which causes you to move less, and so on. This downward spiral continues so it looks like the disease is progressing when in reality it is the direct result of moving less.

So first and foremost, having regular routines for exercise that includes strength, cardio and stretching will help you recover from a flare up by reclaiming what is lost when you were resting.  Equally as important is having a ‘flare up’ routine you can switch to so you can keep moving but adjust the way you move to help with healing.   This duel approach to exercise gives you the ability to use exercise to help your body get what it needs in each stage; one is about rebuilding, one is about recharging.

That leads to the next important factor in fibromyalgia – mindfulness. Mindfulness, paying attention to what is happening in the present moment has been shown to be helpful with fibromyalgia pain.  When combined with exercise, mindfulness helps you stay out of the frustration of comparing your body to what you used to do or think you should do.  The focus on noticing when you are judging, and shifting to curiosity helps you move in the way your body needs to move now.  The most important ingredient of mindfulness is kindness.  Remembering that you are exercising to take care of your body, rather than trying to overcome it.  Mindfulness during exercise is the mindset that keeps you exercising in the way that helps fibromylagia.

Another side effect of fibromyalgia is depression.  Exercise, done in a way that helps your body feel better, will also help your brain function better.  Just ten minutes of exercise releases a natural balance of brain chemicals that raises mood and calms nerves.  Since stress is a trigger for fibro flare ups, using regular exercise to reduce stress in some way every day in your brain and body can help to lower the frustration of the changing symptoms of fibro.

For all of us to function well in daily life, we need strength, stamina and mobility.  There is no one type of exercise that gives you all three of these.  When you have fibromylagia, finding the balance between these three types of exercise is even more important. It helps you avoid doing too much of one kind and straining your body rather than helping it regain function.

  • Stretching: Helps your connective tissue regain some elasticity, reducing pain and stiffness, and helps your lymph system reduce inflammation. Stretching is the foundation of exercise for fibromyalgia because it can help directly improve the symptoms both in a flare up and between flare ups.
  • Strength training: Helps your muscles and bones and metabolism stay strong and counteract the effects of prolonged times of resting during a flare up.  Do strength training in a way that teaches your body to be strong for movements of daily life.  Stay clear of the athletic type strength training that tends to push your body to do more faster. Also stay clear of the  aesthetic fitness style strength training that is more about changing the look of your body (which is mostly myth and marketing based anyway) than the function of your body.
  • Cardio:  Helps keep your stamina up so that you have more energy for every day activities.   Find a kind of cardio that feels good on your joints and allows you to modify the intensity depending on how you are feeling that day.  Doing shorter bouts, like 5-10 minutes, often feels better and still improves stamina.  Starting with one a day and then gradually adding more bouts during the day makes it easier on your body to adapt well without increasing pain.

Lastly, one sure way to put yourself in a flare up is doing too much too soon.  The fact is,  the body can adapt to a 10% increase in exercise a week.  That is not much.  When you have a medical concern like fibromyalgia, the rule is 5% increase per week. That means if you are doing a 10 minute walk, increase by 30 seconds! That is much less than your brain thinks you should, but is the amount your body can do. By working with your body in this way, you help avoid flare ups and can better use exercise to help you manage fibro well.

Bottom line: When you have fibromyalgia, it is extra important to be sure your brain and body are working together.  When you work with your body, listening to it as your best guide, giving it the right balance of rest and movement, exercise can be a great part of your fibro management toolbox.

Keep Moving, Be Well,


  1. Fibromyalgia:
  2. Mindfulness and Fibromyalgia:
  3. Mindful Movement and pain management:  https://med.stanford

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by | June 11, 2019 · 7:14 pm

Exercising with Asthma


When doing cardiovascular exercise, there is a line between the level that is a comfortable challenge for your breathing and the level that feels uncomfortable for your breathing.  When you have asthma, the difference between these two levels is a very thin line.  It often does not take much to cause breathing that is not only uncomfortable, but also scary.  The fear of an asthma episode with exercise can really drain motivation to do it at all.

This recent study found that people with elevated body weight and asthma had fewer episodes of asthma when exercise was part of weight loss when compared to a group losing weight without exercise.  They also had less depressive symptoms, improved sleep quality and improved sleep apnea too!

That sounds great in theory, but when it comes down to it, if you are concerned about your ability to breathe while exercising, this information still does not lead to motivation. The fact is we are motivated, or de-motivated, by what we experience, not what we think.   So exercising with asthma (or any breathing limitation) means you need to make sure your experience with exercise feels safe and comfortable for your breathing.

It is possible when you use your ability to self-monitor your exercise intensity.  Staying mindful while exercising means you can tune into the signals from your body as you start approaching that line, before moving into an uncomfortable challenge level.   The more in tune you are with those warning signals, the sooner you can slow down to bring it back to a comfortable breathing level.  Practicing the art of self-monitoring your breathing level while exercising means you are more likely to reduce your risks of an asthma episode with exercise.  That probably means you will have an easier time getting yourself motivated to do it regularly.

The bonus of regular exercise is your body adapts and with asthma the line between just enough and too much gets a little less fine.  You start building the ability to do more exercise before you reach the uncomfortable breathing level.  That can mean fewer episodes and freedom to do more activities at a comfortable breathing level.

If you have asthma, you know what triggers an asthma episode can change day to day and with different environments, so use this information in the way that is right for you.  But this skill is a key part of using regular cardiovascular exercise as part of the treatment for asthma and many other breathing limitations.

Keep Moving, Be Well,


These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

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by | March 19, 2018 · 5:51 pm

Lower the risks, raise the benefits!


We hear stories of people getting injured or having a heart attack during exercise. You might have even experienced this yourself.    At the same time, we are flooded with all the reasons we “should” exercise.  How do we make sure we are getting the benefits and keeping the risks low.

The risk of having a heart attack or dying as a result of exercise is relatively low.  Only 4% to 17% of heart attacks in men are linked to physical exertion, with much lower rates observed for women.  The risk is greater for people who are unaccustomed to exercise and for those at the lower fitness levels.   Compare that to the fact that regular physical activity cuts the risk of getting heart disease by about 40%.  In fact, regular physical activity has been shown to reduce the risk of dying from any cause by 40%.

Does anything jump out at you with that last set of facts?  The risk goes up if your fitness level is low and you get protection as your fitness level goes up.  Regular physical activity offers amazing protection, and irregular physical activity increases risk.

One of the best ways to protect yourself is be consistent with some physical activity because it provides protection from doing nothing.   Notice also the statistics from the Exercise is Medicine Fact Sheet   are for physical activity – which is a broad term that includes regular movement, not necessarily a rigid exercise program.  Bottom line, move and move often and regularly!

The second big factor that has been shown to increase risk is the intensity.  Vigorous exercise tends to increase risk.  Doing a moderate intensity lowers the risk while keeping benefits.  But what does vigorous or moderate mean?  Often you will hear it described as an absolute level; vigorous is jogging 6mph and moderate is walking 3mph.  But in reality, it all depends on your fitness level!   For some 6mph jog will be moderate and for others a 3mph walk will be vigorous.

Exercise at the level that is a moderate to comfortable challenge for your breathing – above what you would feel when you are resting but not so uncomfortable that you can’t wait to stop.   Avoid vigorous intensity where your breathing is heavy or uncomfortable.

The risks also go up with a sudden burst of intense (vigorous) exercise followed by a sudden stop in activity.  When you do feel like your breathing is uncomfortable (like when climbing stairs or a hill), keep moving slowly until breathing level comes back down to moderate to light before stopping completely.

Finally, if you have concerns with your heart, diabetes or high blood pressure and are not exercising regularly, discuss your plans to start with your doctor. Your best bet is to start with a light intensity activity that you can do on a very regular basis.  As you improve your fitness level, your risks will reduce and the benefits go up.

If you have symptoms such as pain anywhere above your waist that comes on with exertion and goes away with rest, or have more shortness of breath with usual activities, tell your doctor.  If you have pain in joints with activity, adjust what you are doing so it does not cause pain.  (either by doing that activity for less time or lower intensity or do something different until your body is stronger).  Pushing through pain only requires your body to “speak” louder to get your attention to let you know something is not right.

The bottom line is listen to and be kind to your body!  When you move it regularly at the just right challenge level, you can relax about the risks and enjoy the benefits of exercise.

Keep Moving, Be Well,


Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

Leave a comment

by | September 20, 2017 · 6:48 pm