Exercise and Anxiety, Part 2: A Healthy Relationship

Exercise and Anxiety, Part 2: A Healthy Relationship

Exercise and anxiety have a bit in common. They both cause increased heart rate and breathing. They both make you sweaty. And you can’t seem to think of much else at the time!

A little on anxiety…

Anxiety is something we all feel, at some point, in some way or another. It may look and feel slightly different for everyone! It’s a natural reaction to a ‘threat’ that happens at a certain point in our bodies stress response. When the sympathetic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis shift into high gear (you may remember I touched on this in my last blog!).

When you’re preparing for a speech, this is great – because it sharpens your attention so you can rise to the challenge. Completely normal. But if you worry when there’s no real threat, to the point where you can’t function normally, that’s an anxiety disorder.

18% of the population suffers from a clinical anxiety disorder.

Introducing exercise…

A study done in 2004 looked at 54 sedentary college students with generalized anxiety disorder. Split into two groups, one group ran on treadmills at 60-90% of their maximum heart rate. The second group walked. Whilst both groups showed reduced anxiety levels, the rigorous exercise worked more quickly and effectively. Furthermore, students in this group reported less fear of the physical symptoms of anxiety.

So here’s the theory:

When we raise our heart rate and our breathing in the context of exercise, we learn that these physical signs don’t necessarily lead to an anxiety attack. We become more comfortable with our body being aroused, and we don’t automatically assume that the arousal is noxious.

We use exercise to combat the symptoms of anxiety, and thus treat the state. While your level of fitness improves, you chip away at the anxiety trait. Over time, you teach the brain that the symptoms don’t always spell doom and that you can survive. You’re reprogramming the cognitive misinterpretation.

A match made in physiological heaven

How does exercise do this?

As we start using our muscles, the body breaks down fat molecules in the blood stream to fuel them. These free fatty acids compete with tryptophan to catch a ride on our transport proteins, elevating its concentration in the blood stream.

To equalize its levels, tryptophan pushes through the blood brain barrier, and is used as a building block for our old friend serotonin (feel good hormone).

BDNF, which is also released with exercise, also increases levels of serotonin, which enhances our sense of safety.

Moving the body also triggers the release of GABA, which is the brain’s major inhibitory neurotransmitter (and the primary target for most anti-anxiety medications), which interrupts the obsessive feedback loop within the brain.

When our heart starts beating hard, its muscle cells produce a molecule called atrial natriuretic peptide. That puts the brakes on our hyper-aroused state.

Clearly there is a connection between how much you exercise, and how anxious you feel.

Scientists have shown that exercise helps the average person reduce normal feelings of anxiousness – next time you’re feeling stressed, overwhelmed, or anxious, try squeezing in 15-20 minutes of huff and puff exercise and see how you feel after. You be the judge!

References:

 Broman-Fulks, Berman & Webster (2004), ‘Effects of aerobic exercise of anxiety sensitivity‘, Journal or Behaviour Research and Therapy, vol. 42, no. 2, pp. 125-136

Ratey, John J.,Hagerman, Eric. (2008) Spark :the revolutionary new science of exercise and the brain New York : Little, Brown,

 

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Physical Activity For The Gold

Physical Activity For The Gold

With the Gold Coast Commonwealth Games starting this blog is a timely reminder to endorse the benefits of physical activity.

As the Australian public cheer on their favorite athletes from the comfort of her/his living room an oxymoron of sorts is this:

People are likely to be sitting on their glutes all day rather than getting out and using them! So while the Commonwealth Games is displaying the epitome of fitness, we are more likely to be sedentary and less physically active while we watch the athletes.

 

An evidence to practice gap in physical activity

A recent perspective paper in the Medical Journal of Australia discusses an “evidence-practice gap” of physicians. This means that while the evidence is strong in regards to the benefits of physical activity, there is an inadequacy in discussing and prescribing it to patients.

NOW, in no way am I slanting a bias towards exercise physiologist/scientists. However, physicians are typically the first line of contact for patient care, and thus, with physical inactivity being the fourth leading cause of morbidity/mortality worldwide (1) my premise is thus justified right?

The authors found that physicians who were themselves physically active, were more adept at discussing exercise over physicians who are physically inactive (3).

The benefits of physical activity are very well known (2). I am an evidence based analytical thinker, so when the evidence is very strong and robust – the likelihood for adherence is highly likely. Of course, there are “health professionals” and unfortunate reality television shows; that promote unhealthy physical activity.

Which is why I challenge the reader to ask her/his medical/health professional about the recommended physical activity guidelines. Do you know yourself? What the minimum physical activity guidelines are? What if your job entails eight hours of sitting a day… how much physical activity should one be achieving, based on evidence?

So many interrogatives!

 

So in summary, here’s some tips to help you increase your physical activity:

  • Query your medical and allied health team about the physical activity guidelines.
  • Ask your medical and allied health team – “am I safe to move”? 
  • Lastly, trust your source of information, including mine – by doing further research, while being mindful for confirmation biases.

 

Enjoy the games, and cheers to moving more!

James 👨🏼‍⚕️🏅

 

References:

  1. Lee IM, Shiroma EJ, Lobelo F, et al. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012; 380: 219-229.
  2. Pedersen BK, Saltin B. Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports2015; 25: 1-72.

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Exercise and gut health: The benefits may be greater than we think!

Exercise and gut health: The benefits may be greater than we think!

What do exercise and a diet high in fibre have in common? We’ve known for some time now that both of these are good for our gut health and decrease our risk of colon cancer. However, it seems as though there may something extra that fibre and exercise have in common, and it comes as a fatty acid called butyrate. This link between exercise, fibre and gut health will be explored, and you’ll see that the effects travel as far as the brain.

What actually is butyrate and what does it do?

Butyrate is a short chain fatty acid produced by our gut bacteria as they break down foods that are high in fibre. Resistant starches are a type of fibre, that are some of the best fuels for these butyrate producing bacteria (Bourassa 2016). These starches come in foods such as legumes, oats and starches that are cooked and cooled like potato and rice salads.

Now butyrate is an important fuel for the cells of our colon. In fact it supplies up to 70% of their energy (Bourassa 2016). Keeping your colon cells healthy is thought to be one of the reasons why higher butyrate levels decrease your risk of colon cancer by 50% (Matsumoto et al, 2008).

However, the benefits of butyrate go well beyond reducing our risk of colon cancer. This is because healthier gut membranes improve their integrity (how closely they bond together) allowing them to act as a better barrier, which has flow on effects to improving our immunity and reducing inflammation (Ji Wang et al, 2018).

What’s the evidence on exercise and gut health?

Most of the interest on the effect of exercise on butyrate levels started back in 2008. Matsumoto and colleagues showed that butyrate levels, and the bacteria that produce butyrate, were higher in rats that exercised versus a sedentary control.

In 2014 a group of Irish researchers found that professional rugby players had a greater diversity of gut microbiota than a group of sedentary controls (Clarke et al, 2014). However a signifiant limitation in this study was that professional athletes eat very differently than the general population. And these results could possibly be related to their diet and not their activity.

We had to wait until late last year when a group from the University of Illinois designed a study that looked at the impact of aerobic exercise on butyrate. Previously sedentary individuals were asked to exercise three times a week for a 6 week period (Allen et al 2017). What they found was that there is a link between butyrate, exercise, and gut health in humans.

Much like the rodent study back in 2008 they found that aerobic exercise increases the levels of butyrate along with the colonies of bacteria that produce butyrate. Interestingly this effect was most pronounced in lean subjects. The overweight group did still increase the colonies of the butyrate producing bacteria (not to the extent of the lean group) but they didn’t see an increase in butyrate levels in their stools.

Exercise and gut health can also improve your brain!

Now here is where it really gets interesting. The term “your gut is your second brain” has been well used over the last decade. This has been used to explain that the enteric nervous system of the gut is not only quite complex, but it also  has the capacity to signal the brain via many neurotransmitters.

We know that butyrate can cross the blood brain barrier and it is well known to suppress HDAC (Histone deacetylase; Bourassa 2016). Now HDAC inhibitors will increase the expression of BDNF (Brain-derived neurotrophic factor) in the brain. This is important for memory and learning as BDNF is like fertiliser for the brain. It helps your brain cells grow in number and connections!

So where’s the research at?

An interesting experiment, albeit in mice, was published back in 2013 where mice were given an object recognition memory task that is usually not enough to form in either their short or long term memory (Intlekofer et al, 2013). They had a sedentary group and a group that was exercising 3 weeks before the task. They also had a sedentary and exercising group that was injected with butyrate.

The non-butyrate injected sedentary mice could not successfully remember the task 24 hours post initial exposure However, both the sedentary/butyrate injected group and the exercise group could. And when it came to remembering the task 7 days after the initial exposure, it was only the butyrate group that could.

It is important to know that the exercise group only did so for the 3 weeks leading up to the task, and not during the 7 days after the task. This highlights that to get the improved learning outcome, continual exercise exposure is needed.

This mechanism of increased BDNF release via butyrate is probably why we see that children who are fed a high fibre diet perform better in cognitive tasks than those on a low fibre diet (Bourassa 2016). And it could also be the reason why it shows promise in the treatment of neurodegenerative diseases (Bourassa 2016).

We also know that aerobic exercise has an effect on increasing BDNF levels, and this may be why individuals have a 20% improvement in learning tasks (Winter et al, 2007). So it makes sense to eat a high fibre diet and exercise at the same time right?  

 

Take home points about exercise and gut health:

  • It appears as though aerobic exercise continues to benefit our health in many different ways, and improving our gut health is another reason to be active. Aerobic exercise of around 30 to 60 minutes a few times a week can give you this benefit to your gut.
  • Improve the diversity of your microbiota through eating foods that are high in butyrate producing fibre such as legumes, oats and potato salads.
  • Combine this with regular exercise to improve the butyrate production of your gut as this have effects that travel to your brain.
  • And while there is still much more research to be done, it seems to indicate that by doing this you are improving your capacity to learn and remember things, along with decreasing your risk of developing neurodegenerative conditions such as Alzheimer’s.

 

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Links between Exercise, Mood and Stress – How Moving Your Body, Helps Move Your Mood.

Links between Exercise, Mood and Stress – How Moving Your Body, Helps Move Your Mood.

Everybody feels stressed at some point. But how do we deal with it? 75% of Australians admit that stress adversely effects their physical health and 64% report an impact on their mental health (APA, 2014). For 86% of us, watching TV or movies is our chosen coping strategy for stress and only 55% of us are getting an adequate amount of physical activity (Australian Health Survey 2011-12). So exercise, mood and stress; what’s the link? Here’s the science to support why exercise should be our go-to for those stressful situations.

You know those days where you wake up in the morning, a bunch of crazy happens and then you go to sleep (way too late)… Maybe some of this feels familiar; you’re up to your eye balls in reports at work. The kids have basketball training tonight. You forgot to get dinner out. It’s your mum’s birthday next week. You said you would help the school with their fundraiser this Friday. You promised your friend you would catch up for lunch on the weekend. You still haven’t found time to exercise, like you planned. Feeling stressed? How’s your mood?

A Brief Bio About Stress

Stress comes in many shapes and sizes, acute and chronic; social stress, physical stress, metabolic stress… just to name a few.

There is a psychological state of stress, and a physiological response to stress – it’s important to distinguish these. One is the external stressors of life, such as a looming deadline at work. The other is our internal state of stress, like when we feel we are stressed out of our minds and cannot think straight!

I want to talk about how we can manipulate one by manipulating the other.

The body’s stress response is a built-in gift from evolution, without it we wouldn’t be here today. This complex alarm system (the panic button being the amygdala), is more commonly known as the fight of flight response.

I’m going to try and explain how this process actually works in our brain using cute pictures, it gets a bit nerdy, but stick with me.

 

The Neurophysiology of Stress (the simple version)

Basically, the short version is: our amygdala signals the adrenal gland to release a few different hormones, such as adrenaline, which causes increases in blood pressure, heart rate, and breathing. These hormones also act on the pituitary gland which triggers the release of cortisol into our immune system. The amygdala then signals the hippocampus to start recording memories (so we remember to avoid this in future), and the prefrontal cortex assesses whether this is an actual threat requiring action.

Humans are unique in the fact that danger doesn’t have to be clear and present to illicit a stress response, we can create it ourselves.  The mind is so powerful we can actually set off our stress response just by imagining we’re in a stressful situation. You see how this can start to get unhealthy…

But just as we can get ourselves into a stressful state, we can get ourselves out.

The purpose of the fight-or-flight response is to mobilise us to act, so physical activity is the natural way to prevent the negative consequences of stress. When we exercise in response to stress, we’re doing what human beings have evolved to do over the past several million years.

Your Prescription for exercise, mood and stress

If I prescribe you 1 x exercise session per day, you should see a reduction in stress symptoms and an improvement in mood immediately…

Why is that?

Now that you’re all over the neurophysiological mechanisms that are behind the stress we feel, how exactly does exercise improve our mood and reduce our stress?

  • Exercise triggers the production of more insulin receptors, thus lowering blood glucose levels
  • Exercise produces FGF-2 and VEGF which build new capillaries and expand the vascular system in the brain
  • Exercise increases BDNF production, which is responsible for neurogenesis: the creation of new neurons
  • Exercise increases serotonin, norepinephrine and dopamine (feel good hormones!)

And on a physiological level, exercise can improve the stress we feel in our bodies by:

  • Relaxing the resting tension of muscle spindles, breaking the stress-feedback loop to the brain
  • Increasing the efficiency of the cardiovascular system, lowering blood pressure

Exercise does a whole range of juicy things to our body and our mind, and it’s virtually impossible to impact one without impacting the other – now you see why!

Just keep in mind that the more stress you have, the more your body needs to move to keep your brain running smoothly.

If you’re interested in reading more about this, pick up a copy of Psychiatrist, John Ratey’s book: SPARK; the revolutionary new science of exercise and the brain. This blog is based on the concepts discussed in Chapter 3; Stress. It’s full of stories and fascinating information about the connections between exercise and your brain, in an easily digestible format.

 

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Exercise in or around water makes you healthier and happier in body and mind!

Exercise in or around water makes you healthier and happier in body and mind!

Blue Mind: A mildly meditative state characterized by calm, peace, unity, and a sense of general happiness and satisfaction with life in the moment. 

We can all agree that modern life is tough. We experience chronic stress, struggle with constant monkey mind and are probably all too familiar with directed attention fatigue.  We live a lifestyle where we are “always on”, and this can eventually result in burn out, memory problems, poor judgement, anxiety, and depression. Physically, chronic stress damages the cardiovascular, immune, digestive, nervous and musculoskeletal systems. It does this by lowering levels of serotonin and dopamine (our neurotransmitters responsible for making us happy) and leaves us feeling exhausted and down.  And yet, the knowledge that our lifestyles have some room for improvement is just another source of stress!  “Red Mind” is a term coined by neuroscientist Catherine Franssen, and is described as an “edgy high, characterized by stress, anxiety, fear and maybe even a little bit of anger and despair”. Whilst Red Mind can have its perks and be healthy at times, like everything, it should be experienced in moderation. This blog will show you how exercise in water can provide a much needed balance to “red mind” for your mental health!

Why water?

Our brains are wired to constantly scan for danger, which makes sense historically. But now we’re faced with busy streets and email alerts, not lions.

Our brains like being around water because there is a high degree of predictability. This allows the amygdala (an emotions centre of the brain) to relax. However, small disturbances such as waves breaking or birds flying past give enough sense of surprise that we receive a pleasurable hit of dopamine. Because of this simultaneous sameness and change, we get a soothing familiarity and stimulating novelty when we look over the water. It’s the perfect recipe for triggering a state of involuntary attention in which the brain’s default network, essential to creativity and problem solving, is activated.

Studies have even shown that being at the beach, where there is an abundance of negatively charged ions in the atmosphere, lowers blood lactate levels and elevates mood.

Blue looks good on you

‘So how do I access my Blue Mind?’ I hear you ask. There is a very fitting quote from poet Sylvia Plath; “There must be quite a few things that a hot bath won’t cure, but I don’t know many of them”.

It seems way too simple, but by simply being around, in, on or under water – we trigger our Blue Mind.

There are now studies that show being immersed in water reduces stress, partly by balancing the flux between the sympathetic and parasympathetic nervous systems. Or that taking a spa bath can significantly lower your salivary cortisol levels. Feeling anxious? Taking a hot 5-minute shower can measurably lower anxiety levels.

So… I can just drink mimosas next to the pool?

Technically yes. But! There’s an extra level of Zen that water can offer you. And the answer has something to do with Exercise.

We’re well aware of the wonderful things exercise does to our brain on a neuro-chemical level, like release endorphins and endocannabinoids (the brain’s natural cannabis-like substances), which reduce the brain’s response to stress and anxiety.

The feel-good effects of swimming have actually been assimilated to the “relaxation response” triggered by yoga. When we swim, our muscles are constantly stretching and relaxing, and this movement is accompanied by deep, rhythmic breathing. All of which put us in a quasi-meditative state. On top of this we have to use a level of cognitive effort to learn and coordinate swimming strokes. This cognitive and aerobic combination can provide the brain with the satisfying stress-reducing feeling of “flow”.

Meet the power couple – Exercise in water for mental health

So when you feel yourself getting stressed, tense and a bit tightly wound why not utilise the powerful effects of exercise AND water?

So why not go for a run along the beach each week? Or go for a swim at your local pool? You could even learn to surf with the kids next weekend? Or how about simply going fishing? Perhaps paddle-boarding is more your style?

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