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Fitness and White Matter: Another Reason to Add Exercise to Your Doctor Bag

It’s not news to anyone that physical fitness has a positive effect on the health of pretty much every system in the body. But there are so many variables at play, it’s difficult to define the exact mechanism and magnitude of its effect on brain health. Are the brain benefits from fitness due to its effect on other issues such as blood pressure, blood glucose, or some other factor? Or does fitness have its own direct effects on the brain? And how fit is fit enough to yield benefits?

A recent study examined these types of limitations in the existing data and attempted to fill in some blanks. The study, published in Nature, looked at the link between a variety of cognitive functions, brain structure, and fitness, and it did so while accounting for the confounding variables so prevalent in previous research.

Researchers used the Human Connectome Project to gather their data. This project includes brain MRIs from over 1200 young adults. Participants underwent further testing including a walking test for physical fitness and cognitive tests in areas such as memory and reasoning.

Researchers were able to demonstrate that results of the cognitive tests correlated with those on the walking test. Or more simply, the more fit a person was, the better their cognitive functioning. Researchers controlled for age, education level, sex, BMI, and blood pressure among other factors. Only education level blunted the effect of fitness, while none of the other factors influenced the impact of fitness on cognition.

MRI revealed that improved structural integrity of white matter also accompanied higher fitness levels.

Some questions obviously still need to be asked. Since this was a cross-sectional study, more data is needed on the changes in fitness over time, and how they affect cognitive ability. We also need more research into the impact of fitness on elderly and less healthy individuals and their brain function.

Even though gaps remain in the data, this research, along with everything we already know, points to the same general conclusion—level of fitness appears to be a modifiable risk factor for poor cognitive and brain health.

The question then, is how neurologists should act on this information. The research in this and other studies gives little concrete information about what physical activities yield the best results. Ditto for nutrition, an important aspect of physical fitness. But doing nothing doesn’t seem to be an appropriate option.

There are several ways to encourage fitness for your patients, even if they have already experienced physical or cognitive decline. There are fitness resources you can offer your patients to help them get started. And helping them with accountability is much easier with the increased use of fitness trackers, even in the setting of chronic disease.

Even the simple act of incorporating fitness counseling into your patient visits can help patients get on the right track.

If you want to take it to the next level, adding a health coach to your practice can have remarkable benefits in the health of your patients by helping them keep their healthy living goals in focus.

Improved fitness won’t cure all woes, but it certainly can help with the cognitive function of patients. We are sure to learn more as researchers dig deeper, but in the meantime, it will benefit your patients if you help them become fitter. It’s a low-cost, low-effort way to make their lives a bit better.



from Neurology Insights https://ift.tt/2ns0apF

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