Sharp Brains: Brain Fitness and Cognitive Health News

Neuroplasticity, Brain Fitness and Cognitive Health News


Exercising the body is exercising the mind

I apol­o­gize for the long delay in get­ting back to this col­umn but I have a good excuse. We just recently had a baby, and boy, that takes care right there of the phys­i­cal exer­cise need. Between car­ry­ing the baby upstairs and down­stairs, run­ning to get the baby, get­ting out of the bed and pick­ing the baby up and putting the baby down a cou­ple of times a night no you need not worry about get­ting your daily exer­cise dose in…Now, the major­ity of the answers to my post on the brain virtues of phys­i­cal exer­cise sug­gests that most peo­ple think that the brain ben­e­fits of phys­i­cal exer­cise are mostly to be under­stood as com­ple­men­tary effects of a healthy life style.

Is this cor­rect? In my post today I will attempt to answer this question.

First, while gen­er­ally health­ier peo­ple seem to have health­ier brains, the phys­i­cal exer­cise effect on the brain seems to be inde­pen­dent of other things. One of the most impor­tant devel­op­ment in neu­ro­science was when the offi­cial dogma claim­ing that there was no neu­ro­ge­n­e­sis (pro­duc­tion of new brain cells) in the adult brain was top­pled. Now we know that the brain is “plas­tic” mean­ing that, under the right cir­cum­stances, the brain can change in terms of both pro­duc­ing new cells and get­ting more cells con­nected to each other.

One of the places where neu­ro­ge­n­e­sis has been shown to occur in the adult brain is the den­tate gyrus, a strip of grey mat­ter placed deep down in the brain. The den­tate gyrus is a part of the hip­pocam­pus, the main mem­ory struc­ture, and has been shown to play a role in the form­ing of new mem­o­ries. What can the den­tate gyrus teach us with regards to phys­i­cal exercise?

Fol­low­ing a series of extremely thought pro­vok­ing exper­i­ments researchers from the Gage lab­o­ra­tory at UCSD con­cluded that exer­cise leads to the pro­duc­tion of new brain cells in the den­tate. First the researchers found that mice housed in an enriched envi­ron­ment (a larger cage with toys, tun­nels, and more oppor­tu­nity for phys­i­cal activ­ity, learn­ing, and social inter­ac­tion than in stan­dard bare cage) have an increased num­ber of new neu­rons in the den­tate gyrus.

The enriched envi­ron­ment is a mice equiv­a­lent of not only healthy but good liv­ing: leisurely enjoy­ing life, get­ting both phys­i­cal and intel­lec­tual stim­u­la­tion, social­iz­ing with friends. Now, the fact that new neu­rons were pro­duced was a big enough news in itself but the Gage group did not stop there. Their next goal was to fig­ure out if neu­ro­ge­n­e­sis was the result of a sum of fac­tors act­ing together (i.e. the enriched envi­ron­ment) ver­sus a spe­cific effect of indi­vid­ual fac­tor. So, they first dis­sected the enriched envi­ron­ment in a num­ber of “sub” envi­ron­ments. In their next exper­i­ment they placed the mice in a “learn­ing envi­ron­ment” where they had access to a maze, a “phys­i­cal exer­cise envi­ron­ment” where mice had unlim­ited access to a run­ning wheel, in addi­tion to enriched and stan­dard (empty cage) envi­ron­ments. Then they com­pared the groups in terms of behav­ioral per­for­mance and even­tu­ally looked at their brains.

Their con­clu­sion was any­thing but expected: while both enrich­ment and wheel run­ning led to improved spa­tial mem­ory func­tion only phys­i­cal exer­cise in a run­ning wheel also pro­moted neu­ro­ge­n­e­sis and enhanced the sur­vival of new­born neu­rons in the den­tate gyrus.

Bot­tom line: exer­cis­ing seems to lit­er­ally mean “exer­cis­ing the brain”.

So, in lieu of con­clu­sion, till next I wish you all happy trails (and I don’t mean it as just trails on the paper in a paper and pen­cil mem­ory task)!

Adrian PredaAdrian Preda, M.D. is an Asso­ciate Pro­fes­sor of Psy­chi­a­try and Human Behav­ior in the UC Irvine School of Medicine’s Depart­ment of Psy­chi­a­try and Human Behav­ior. His exper­tise in human behav­ior, psy­chol­ogy and spir­i­tu­al­ity is based on years of expe­ri­ence work­ing as a psy­chi­a­trist, psy­chother­a­pist, teacher and researcher in a vari­ety of aca­d­e­mic clin­i­cal and non-clinical set­tings. He also teaches the UC Irvine Exten­sion class The Mind that Changes the Brain: Well­ness in the Sec­ond Mil­len­nium.

van Praag H, Christie BR, Sejnowski TJ, Gage FH (1999) Run­ning enhances neu­ro­ge­n­e­sis, learn­ing, and long-term poten­ti­a­tion in mice. Proc Natl Acad Sci USA 96: 13427–13431

van Praag H, Kem­per­mann G, Gage FH (1999) Run­ning increases cell pro­lif­er­a­tion and neu­ro­ge­n­e­sis in the adult mouse den­tate gyrus. Nat Neu­rosci 2: 266–270.

Farmer J, Zhao X, van Praag H, Wodtke K, Gage FH, Christie BR (2004) Effects of vol­un­tary exer­cise on synap­tic plas­tic­ity and gene expres­sion in the den­tate gyrus of adult male Sprague-Dawley rats in vivo. Neu­ro­science 124: 71–79

Related read­ing:

- Phys­i­cal Exer­cise and Brain Health

- Art Kramer on Why we Need Walk­ing Book Clubs

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14 Responses

  1. Mark Waldman says:

    Dr. Andrew New­berg and I, at the Uni­ver­sity of Pennsylvania’s Cen­ter for Spir­i­tu­al­ity and the Mind, heartily con­cur with Dr. Preda. In fact, in our forth­com­ing book (How God Changes Your Brain) we cite con­sid­er­able evi­dence that aer­o­bic exer­cise is one of the three best ways to exer­cise your brain (meditation-which is our field of research-only came in fourth). Brain scans show that vig­or­ous exer­cise strength­ens every part of the brain, and if you’re between the ages of 18 and 90, exer­cise is going to lengthen your life by about 10%.

    Exer­cise can even be viewed as a form of med­i­ta­tion because it involves sus­tained con­cen­tra­tion and a delib­er­ate reg­u­la­tion of body move­ments and breath­ing.
    Vig­or­ous stretch­ing, such as yoga, also does won­ders for your brain. In a recent meta-analysis of 813 med­i­ta­tion stud­ies, the researchers stated that yoga was as ben­e­fi­cial as exer­cise. It can even pre­vent the onslaught of migraine headaches.
    In a study con­ducted in 2007, researchers at the Boston Uni­ver­sity School of Med­i­cine found that lev­els of the neu­ro­trans­mit­ter GABA increase after a sin­gle 60-minute yoga ses­sion. Since peo­ple who suf­fer from depres­sion and anx­i­ety dis­or­ders have low lev­els GABA, yoga exer­cise, as well as other forms of aer­o­bic exer­cise, is a valid modal­ity for improv­ing psy­cho­log­i­cal and men­tal health. It even has been found to reduce the symp­toms of schizophrenia.

    Exer­cise enhances a wide range of cog­ni­tive skills in chil­dren and adults.
    All forms of exer­cise enhance neural plas­tic­ity and rebuild dam­aged cir­cuits caused by brain lesions and strokes. Exer­cise improves cog­ni­tion and aca­d­e­mic per­for­mance. It repairs and pro­tects you from the neu­ro­log­i­cal dam­age caused by stress. It enhances brain plas­tic­ity. It boosts immune func­tion. It reduces anx­i­ety. It can be used to treat clin­i­cal depres­sion and it is just as effec­tive as anti­de­pres­sants. In fact, for older patients, exer­cise is equiv­a­lent to twelve ses­sions of psy­cho­dy­namic psy­chother­apy. It slows down the loss of brain tis­sue as you age, pro­tects you from Alzheimer’s dis­ease, and reduces your vul­ner­a­bil­ity to chronic ill­ness. Need I say any­thing more to con­vince you of the impor­tance of exer­cise? But don’t take my word for it; check the ref­er­ences I cite below that sup­port the claims made above.

    Mark Wald­man
    Asso­ciate Fel­low
    Cen­ter for Spir­i­tu­al­ity and the Mind
    Uni­ver­sity of Pennsylvania

    Yates LB, Djoussé L, Kurth T, Bur­ing JE, Gaziano JM. Excep­tional longevity in men: mod­i­fi­able fac­tors asso­ci­ated with sur­vival and func­tion to age 90 years. Arch Intern Med. 2008 Feb 11;168(3):284–90.

    Bar­clay L. Exer­cise May Have Neu­ro­pro­tec­tive Effect. Med­scape Med­ical News (

    Knobf MT, Musanti R, Dor­ward J. Exer­cise and qual­ity of life out­comes in patients with can­cer. Semin Oncol Nurs. 2007 Nov;23(4):285–96.

    John PJ, Sharma N, Sharma CM, Kankane A. Effec­tive­ness of yoga ther­apy in the treat­ment of migraine with­out aura: a ran­dom­ized con­trolled trial. Headache. 2007 May;47(5):654–61.

    Streeter CC, Jensen JE, Perl­mut­ter RM, Cabral HJ, Tian H, Ter­hune DB, Ciraulo DA, Ren­shaw PF. Yoga Asana Ses­sions Increase Brain GABA Lev­els: A Pilot Study. J Altern Com­ple­ment Med. 2007 May;13(4):419–26. See also: Har­i­nath K, Mal­ho­tra AS, Pal K, Prasad R, Kumar R, Kain TC, Rai L, Sawh­ney RC. Effects of Hatha yoga and Omkar med­i­ta­tion on car­diores­pi­ra­tory per­for­mance, psy­cho­logic pro­file, and mela­tonin secre­tion. J Altern Com­ple­ment Med. 2004 Apr;10(2):261–8.

    Duraiswamy G, Thirthalli J, Nagen­dra HR, Gan­gad­har BN. Yoga ther­apy as an add-on treat­ment in the man­age­ment of patients with schiz­o­phre­nia — a ran­dom­ized con­trolled trial. Acta Psy­chi­atr Scand. 2007 Sep;116(3):226–32.

    Telles S, Praghu­raj P, Ghosh A, Nagen­dra HR. Effect of a one-month yoga train­ing pro­gram on per­for­mance in a mirror-tracing task. Indian J Phys­iol Phar­ma­col. 2006 Apr-Jun;50(2):187–90.

    Telles S, Hanu­man­tha­iah BH, Nagarathna R, Nagen­dra HR. Plas­tic­ity of motor con­trol sys­tems demon­strated by yoga train­ing. Indian J Phys­iol Phar­ma­col. 1994 Apr;38(2):143–4.

    Man­ju­nath NK, Telles S. Improved per­for­mance in the Tower of Lon­don test fol­low­ing yoga. Indian J Phys­iol Phar­ma­col. 2001 Jul;45(3):351–4.

    Telles S, Hanu­man­tha­iah B, Nagarathna R, Nagen­dra HR. Improve­ment in sta­tic motor per­for­mance fol­low­ing yogic train­ing of school chil­dren. Per­cept Mot Skills. 1993 Jun;76(3 Pt 2):1264–6.

    White LJ, Castel­lano V. Exer­cise and brain health — impli­ca­tions for mul­ti­ple scle­ro­sis : part 1 — neu­ronal growth fac­tors. Sports Med. 2008;38(2):91–100.

    Vayn­man, S. and F. Gomez‐Pinilla (2005). License to run: Exer­cise impacts func­tional plas­tic­ity in the intact and injured cen­tral ner­vous sys­tem by using neu­rotrophins. Neu­rore­ha­bil­i­ta­tion and Neural Repair 19(4): 283–295.

    McMor­ris T, Col­lard K, Cor­bett J, Dicks M, Swain JP. A test of the cat­e­cholamines hypoth­e­sis for an acute exercise-cognition inter­ac­tion. Phar­ma­col Biochem Behav. 2008 Mar;89(1):106–15.

    Hill­man CH, Erick­son KI, Kramer AF. Be smart, exer­cise your heart: exer­cise effects on brain and cog­ni­tion. Nat Rev Neu­rosci. 2008 Jan;9(1):58–65.

    Tom­porowski, P. D. (2003). Effects of acute bouts of exer­cise on cog­ni­tion. Acta Psy­cho­log­ica 112(3): 297–324.

    Radak Z, Kuma­gai S, Tay­lor AW, Naito H, Goto S. Effects of exer­cise on brain func­tion: role of free rad­i­cals. Appl Phys­iol Nutr Metab. 2007 Oct;32(5):942–6.

    Cot­man CW, Berch­told NC, Christie LA. Exer­cise builds brain health: key roles of growth fac­tor cas­cades and inflam­ma­tion. Trends Neu­rosci. 2007 Sep;30(9):464–72.

    Dish­man RK, Berthoud HR, Booth FW, Cot­man CW, Edger­ton VR, Flesh­ner MR, Gan­de­via SC, Gomez-Pinilla F, Green­wood BN, Hill­man CH, Kramer AF, Levin BE, Moran TH, Russo-Neustadt AA, Sala­m­one JD, Van Hoomis­sen JD, Wade CE, York DA, Zig­mond MJ. Neu­ro­bi­ol­ogy of exer­cise. Obe­sity (Sil­ver Spring). 2006 Mar;14(3):345–56.

    Camp­isi J, Leem TH, Green­wood BN, Hansen MK, Moraska A, Hig­gins K, Smith TP, Flesh­ner M. Habit­ual phys­i­cal activ­ity facil­i­tates stress-induced HSP72 induc­tion in brain, periph­eral, and immune tis­sues. Am J Phys­iol Regul Integr Comp Phys­iol. 2003 Feb;284(2):R520-30.

    Trejo JL, Llorens-Martín MV, Torres-Alemán I. The effects of exer­cise on spa­tial learn­ing and anxiety-like behav­ior are medi­ated by an IGF-I-dependent mech­a­nism related to hip­pocam­pal neu­ro­ge­n­e­sis. Mol Cell Neu­rosci. 2008 Feb;37(2):402–11.

    Guszkowska M. Effects of exer­cise on anx­i­ety, depres­sion and mood. Psy­chi­atr Pol. 2004 Jul-Aug;38(4):611–20.

    Scully D, Kre­mer J, Meade MM, Gra­ham R, Dud­geon K. Phys­i­cal exer­cise and psy­cho­log­i­cal well being: a crit­i­cal review. Br J Sports Med. 1998 Jun;32(2):111–20.

    Byrne A, Byrne DG. The effect of exer­cise on depres­sion, anx­i­ety and other mood states: a review. J Psy­cho­som Res. 1993 Sep;37(6):565–74.

    Petruzzello SJ, Lan­ders DM, Hat­field BD, Kub­itz KA, Salazar W. A meta-analysis on the anxiety-reducing effects of acute and chronic exer­cise. Out­comes and mech­a­nisms. Sports Med. 1991 Mar;11(3):143–82.

    Broocks A, Ahrendt U, Som­mer M. Phys­i­cal train­ing in the treat­ment of depres­sive dis­or­ders. Psy­chi­atr Prax. 2007 Sep;34 Suppl 3:S300-4.

    Meeusen R. Exer­cise and the brain: insight in new ther­a­peu­tic modal­i­ties. Ann Trans­plant. 2005;10(4):49–51.

    Blu­men­thal JA, Babyak MA, Doraiswamy PM, Watkins L, Hoff­man BM, Bar­bour KA, Her­man S, Craig­head WE, Brosse AL, Waugh R, Hin­der­liter A, Sher­wood A. Exer­cise and phar­ma­cother­apy in the treat­ment of major depres­sive dis­or­der. Psy­cho­som Med. 2007 Sep-Oct;69(7):587–96.

    Col­combe SJ, Erick­son KI, Raz N, Webb AG, Cohen NJ, McAuley E, Kramer AF. Aer­o­bic fit­ness reduces brain tis­sue loss in aging humans. J Geron­tol A Biol Sci Med Sci. 2003 Feb;58(2):176–80.

    Adlard PA, Per­reau VM, Pop V, Cot­man CW. Vol­un­tary exer­cise decreases amy­loid load in a trans­genic model of Alzheimer’s dis­ease. J Neu­rosci. 2005 Apr 27;25(17):4217–21.

  2. merri ellen says:

    When I suf­fered from depres­sion and got no help from anti depres­sants, I searched the med­ical jour­nals to dis­cover that exer­cise is actu­ally more effec­tive than any antidepressant.

    It is the most under­rated cure for depres­sion because it is so often scoffed at and need­less to say, dif­fi­cult to be moti­vated to do.
    But, it has by far the bet­ter side effects! :)

    When I begin to feel blue, I lift weights or go for a walk or bike ride.

    I am now depres­sion free for 6 years thanks to imple­ment­ing a reg­u­lar exer­cise rou­tine as the first part of my recov­ery plan and now lifestyle.

  3. Tim says:

    Dr. Preda,

    Con­grat­u­la­tions on your new baby!

    I just read your pre­vi­ous post and the com­ments. While I think any one of the twelve items you men­tioned at the end would be inter­est­ing, I think the most inter­est­ing would be any clar­i­fi­ca­tion on the “dosage” of exer­cise that you allude to and seems to be a main inter­est of yours already. Specif­i­cally, what types of exer­cise are most effec­tive? High inte­sity aer­o­bic (i.e. run­ning), low inten­sity aer­o­bic (i.e. walk­ing), strength, stretch­ing, or per­haps a sport with more var­ied require­ments? What is the min­i­mum required to see a ben­e­fit? Is there a plateau? Is there a point when exer­cise becomes detri­men­tal? While I’m sure you could add to the forum in any num­ber of ways, plenty of peo­ple are talk­ing about the many brain ben­e­fits of exer­cise. Far fewer, it seems to me, are talk­ing about the para­me­ters of the exer­cise itself, and how to best real­ize those benefits.

  4. Mark, thank you for that excel­lent context.

    Merri, great to hear you are feel­ing so well now!

    Tim: I will let Adrian answer your superb ques­tions, but you prob­a­bly saw in the Com­ments to the pre­vi­ous post that the main mes­sage here is DON’T BE SEDENTARY, do at least 2–3 weekly ses­sions of car­dio exer­cise (any intensity).

  5. Encefalus says:

    Thnx for the arti­cle. I feel bet­ter about my weightlift­ing train­ing now :)

  6. Susan Smirnoff says:

    Is there research spe­cific to the role of phys­i­cal exer­cise on the abil­ity to be a more effec­tive communicator?

  7. Ilan Kerman says:

    While the evi­dence you cite for neu­ro­ge­n­e­sis and its asso­ci­a­tion with exer­cise is cer­tainly inter­est­ing and poten­tially impor­tant, it is impor­tant to keep in mind that it is not clear whether neu­ro­ge­n­e­sis is indeed the mech­a­nism that under­lies improved brain func­tion. I cer­tainly would like neu­ro­ge­n­e­sis to do all of these won­der­ful things, how­ever, what about the fol­low­ing observations:

    1) mice that have inborn pre­dis­po­si­tion to increased wheel run­ning actu­ally have lower (or no dif­fer­ent) lev­els of neu­ro­ge­n­e­sis than their less active coun­ter­parts exposed to run­ning wheels

    2) I am aware of only one study that reported dif­fer­ences in neu­ro­ge­n­e­sis in depressed patients. These data were recently pre­sented by the group of Dr. Vic­to­ria Arango and Dr. John Mann of Colum­bia Uni­ver­sity at the recent Soci­ety for Neu­ro­science meet­ing. These inves­ti­ga­tors found lare increases in neu­ro­ge­n­e­sis in depressed indi­vid­u­als treated with anti­de­pres­sants vs. non-treated depres­sives and non-depressed con­trols. Yet, patients in both depressed groups (those on anti-depressants and those not treated) were equiv­a­lently depressed.

    Clearly these exam­ples indi­cate that our knowl­edge about the role of neu­ro­ge­n­e­sis is imper­fect. What about alter­na­tive mech­a­nisms? Such as changes in sero­ton­er­gic, nora­dren­er­gic, and/or dopamin­er­gic neu­ro­trans­mis­sion? All of these trans­mit­ter sys­tems are impacted by exer­cise, and all are known to affect mood, affect, and over­all brain function.

  8. Adrian Preda says:

    I agree – exactly how neu­ro­ge­n­e­sis cor­re­lates with brain per­for­mance is still to be deter­mined. That being said, there is plenty of empir­i­cal data com­ing from the ani­mal litt. show­ing that increased neu­ro­ge­n­e­sis cor­re­lates with improved per­for­mance. Also, there is accu­mu­lat­ing evi­dence that a lack of neu­ro­ge­n­e­sis is bad for the brain. For exam­ple, patients with depres­sive dis­or­ders or post-traumatic stress dis­or­der have reduced hip­pocam­pal vol­ume. Now, while the jury is still out in terms of deter­min­ing if this is a cause or an effect, the fact is that the hip­pocam­pus is the neu­ro­ge­n­e­sis star when it comes to the adult brain. So, while there is no direct evi­dence link­ing neu­ro­ge­n­e­sis and per­for­mance in humans, the cir­cum­stan­tial evi­dence is pretty compelling.

  9. Adrian Preda says:

    Answer to #1:
    Can you please indi­cate the ref­er­ence? I can only spec­u­late here (please under­stand that I am really going on a limb with­out know­ing the details of the exper­i­ment). Here is a pos­si­ble inter­pre­ta­tion: we might need to reach out­side and pick activ­i­ties that nor­mally lie out­side our com­fort zone (“inborn predisposition”) if we are to get max­i­mum brain points. I.e., a run­ner might get greater brain ben­e­fits from spend­ing time in a library, while a library rat might be well served by get­ting some tread­mill time under his belt.
    Answer to #2:
    What was the time frame of this exper­i­ment? How was neu­ro­ge­n­e­sis quan­ti­fied? It is a known that clin­i­cal response lags way behind “objective“ brain changes when it comes to depres­sion. While most anti­de­pres­sants (ADs) increase the level of neu­ro­trans­mit­ters in the synapse days after they are admin­is­tered, the full clin­i­cal response is not seen until 6–8 weeks after treat­ment initiation.

  10. Adrian Preda says:

    Hi Susan,

    Here are a few of my non-systematic obser­va­tions. Great com­mu­ni­ca­tors can be fit or fat. Also, some very fit peo­ple tend to be more com­fort­able at the gym rather than in a social setting.

  11. Ilan Kerman says:


    Re. #1, check out some of the work by Rhodes JS and col­leagues. For instance, INTEGR. COMP. BIOL., 45:438–455 (2005). One of the find­ings they men­tion in this review is that mice w. high inborn activ­ity lev­els increase neu­ro­ge­n­e­sis w. vol­un­tary wheel run­ning, but show impaired learn­ing. I also heard this inves­ti­ga­tor speak a few years ago at the Exper­i­men­tal Biololgy Meet­ing where her pre­sented data show­ing lack of increased neu­ro­ge­n­e­sis in mice w. increased vol­un­tary exer­cise. Though I have not been able to find these data in print. Maybe no one wants to believe these find­ings, and they keep get­ting shot down by review­ers (or maybe they are flawed)? In the paper cited above, the authors raise an intrigu­ing pos­si­bil­ity that exer­cise may actu­ally con­tribute to neu­ronal death in hip­pocam­pus via increased CORT secre­tion. Increased neu­ro­ge­n­e­sis then may be a com­pen­satory response.

    Re. #2, I don’t remem­ber whether the time fram issue was pre­sented. I pre­sume that the sub­jects were treated w. ADs for a long time. Usu­ally in such stud­ies brains are col­lected from patients who have had a long his­tory of men­tal ill­ness and treat­ment. I’m sure that these inves­ti­ga­tors are aware of the lag between treat­ment ini­ti­a­tion and clin­i­cal response and would have designed their study accord­ingly. Re. their method­ol­ogy, it was sound. They didn’t mea­sure BrdU incor­po­ra­tion, but used Ki-67 and dou­blecortin immuno­cy­to­chem­istry together with neu­ronal and glial markers.

    In any case, I think that neu­ro­ge­n­e­sis is a very inter­est­ing phe­nom­e­non in it of itself. It’s very excit­ing in that it shat­ters the age-old dogma that the adult brain is not capa­ble of gen­er­at­ing new neu­rons. But whether it is respon­si­ble for all of the won­der­ful effects of exer­cise, envi­ron­men­tal enrich­ment, anti-depressant med­ica­tions, improved diet, etc. is not clear (at least not to me). What the field clearly needs is a way to cleanly dis­rupt neu­ro­ge­n­e­sis (and cell death, and dif­fer­en­ti­a­tion of glial prog­en­i­tors into neu­rons, and their inser­tion into exist­ing cir­cuits, etc.) to see whether such manip­u­la­tions affect learn­ing, cog­ni­tion, depres­sive– and anx­i­ety– like behav­iors, etc.

  12. A lot of this is about self image. If peo­ple look good and feel good they are less likely to be depressed.

  13. alan farfort says:

    I have been doing aer­o­bic exer­cise and walk­ing since com­ming off tranx­ene after 30 years depen­dency I feel that exer­cise has given me back my life both men­tally and phys­i­cally. my age is 71

  14. Hello Alan — thank you for shar­ing, and congrats

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