ActiveHealthUNC

Today the NYT published an interesting piece about the importance of being fit or BECOMING FIT in middle age based on a new study published last week in Archives of Internal Medicine.

The good news—even if you haven’t previously bothered with exercise, becoming fit appears to reshape the landscape of aging. Bottom line– exercising during midlife can starve off chronic disease and significantly improve quality of life and the chances of living well.

http://well.blogs.nytimes.com/2012/09/05/the-benefits-of-middle-age-fitness/

A recent presentation at the American Heart Association scientific meeting by Dr Huffman reported that if Americans stay on the current path 83% of men and 72% of women will be obese or overweight by 2020.

Read about this at http://www.npr.org/blogs/health/2011/11/16/142414818/americans-are-fat-and-expected-to-get-much-fatter?sc=17&f=1128.

What should we do?  Get moving.  Even a few minutes a day can start a healthy habit.  Lets do our part to change this trajectory!

David Berkoff, MD

A new book called “Exercise for Mood and Anxiety” by Dr. Michael Otto, PhD, provides readers with step-by-step guidance on how to start and maintain an exercise program geared towards improving mood. http://exercise4mood.com

People who exercise regularly often report that both mood and memory/concentration are improved after exercise.   Today, the New York Times Health section discusses a new study which showed increased levels of a protein known as brain-derived neurotrophic factor, or BDNF after exercise.  http://well.blogs.nytimes.com/2011/11/30/how-exercise-benefits-the-brain/?ref=health. 

For some time, scientists have thought that BDNF promotes the health of nerve cells.  However, it wasn’t clear until recently that exercise can actually induce increased levels of BDNF that may play a role in improving memory and recall.   It is also known that BDNF is associated with mood.

This new study provides another clue as to why exercise makes us feel better.  Exercise causes many different biological changes to occur in the brain and scientists are starting to figure out exactly what types of brain chemicals are involved. You can now add BDNF to the list of brain chemicals that have positive effects on “cognitive health”. 

Or, you can just remember that if you exercise regularly you’ll feel better. 

You’ll be surprised at how quickly you can feel better.

For example, one of my patients reluctantly joined a gym after much encouragement.   She began to exercise regularly after work and was delighted by how much better she began to feel.  She recently said, “I didn’t see how I could find the time to exercise and still meet the demands of work and family. But, now that I’ve started to take the time out of my day to exercise, I’m feeling like I actually have more time in each day because I’m thinking better, more efficiently, and have more energy overall”.

Samantha Meltzer-Brody, MD

The relationship between exercise and mood has been carefully studied and the results are clear. People who exercise regularly report improved mood and well being.  Regular exercisers also report feeling less anxious, having greater ability to cope with stressful situations, and reduced pain perception.   And, the good news is that you don’t need to be an endurance athlete to obtain the so-called “runner’s high”!

Exercise has also been shown to be an effective treatment for major depression, performing at levels similar to antidepressant medications (Blumenthal et al, 2007). http://www.ncbi.nlm.nih.gov/pubmed/17846259  For those who struggle with depression or anxiety, adding regular exercise (a minimum of 5 times per week for at least 30 minutes in duration per the Center for Disease Control), can provide significant relief and improvement of symptoms. http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html

So, why does exercise improve mood?  Initial studies in athletes documented changes in circulating blood levels of natural opioids (endorphins)–including up to a 5-fold increase in blood endorphin levels after physical exercise.   However, until recently, studies were not able to measure opioid levels in the brain.  Now, new neuroimaging technology has demonstrated that there are specific brain regions that show opioid activation with physical exercise.  (http://cercor.oxfordjournals.org/content/18/11/2523.full.pdf+html). In particular, these brain regions are known to be key players in mood states.

Therefore, the bottom line message is as follows…. regular exercise will improve your mood.  Exercise has a powerful impact across the whole body—heart, lungs and brain.  If you want to feel better, sleep better and have an improved sense of well-being, then strongly consider adding regular exercise to your life.

Samantha Meltzer-Brody, MD

WIth more than 2 billion people flying worldwide annually, travel health is an important issue.  Travellers often have excessive stress regarding scheduling, connections and flying. Sleep and comfort are big issues and are closely related to jet lag and post travel illness. There are also more serious conditions like DVT that we should be aware of and knowing some simple tricks to prevent illness while enjoying holiday travel will make the process more enjoyable.

See Tips for healthy flying in Medical News Today for a great overview of how to stay healthy during your holiday travel.
Dave Berkoff, MD

I wanted to mention an article in the NY Times titled “Sports Medicine Said to Overuse MRI’s“.  It is interesting because the physicians quoted are some of the most prominent in our specialty.  They are the thought leaders in sports medicine and the article outlines how doctors often are now using pictures instead of clinical facts to drive decision making.

I frequently explain to my patients that the more we look the more we find.  Not everything we detect is relevant nor does it need to be addressed.  However, once we find abnormalities, they become hard to ignore.

As patients you must understand that as technology continues to improve, we will be able to see more than we have ever previously seen.  With this enhanced diagnostic ability, we must now learn what to do with this additional information.

As patients I caution you to be educated consumers.  Understand the risks and benefits of testing before you do it and do not be shy about asking your doctor what s/he is looking for when they order another study.

David Berkoff, MD.