Exercise improves cognitive function in adults over 50. Break a sweat and build your brain.

Over the past few years we have all heard of one study or another that says exercise is good for your brain function.  Well now there is a new meta-analysis that adds to the evidence that exercise improves cognitive function for adults older than 50.  So whether you are training older adults, are over 50 yourself, worried about getting older or just looking for material to email to your parents to harass them into exercising now you have the evidence to guilt them or yourself into getting off the sofa and breaking a sweat.

For those of you who aren’t research geeks like me, a quick primer on what a meta-analysis is.  It is a type of study that takes the results for a number of different studies and combines their results to form a single conclusion that has more statistical power then the individual studies.  An individual study might only look at a few particular variables regarding the issue at hand.  It may have a limited population of subjects and be prone to certain types of errors or biases.  Often different studies on the same topic will come up with different results and conclusions creating a situation where you don’t know which studies are correct and should be followed.  A meta-analysis tries to overcome these limitations by compiling multiple studies, often with differing results, and analyses them in a way that balances out these differences resulting in a final conclusion that accounts for all of the evidence available.  It is still limited by the information in the studies it complies but for the primary question at hand, it generally offers a more complete conclusion.

In this particular study the authors looked at the effects of different forms of exercise including aerobic, resistance, a combination of both, tai chi and yoga on cognitive function.  They also addressed the affect of different training variables including duration, frequency, intensity and length of the exercise session.  Ultimately they were interested in determining the impact of all of these different factors on global cognition as well as the specific areas of attention (sustained alertness, the ability to process information rapidly), executive function (cognitive processes responsible for the initiation and monitoring of goal-oriented behaviors), memory (storage and retrieval of information) and working memory (short –term manipulations of encountered information).

The analysis was limited to studies where the exercise programs were actually supervised and lasted at least 4 weeks.  This allows for some measure of assurance that the subjects actually did the prescribed exercise as intended and for a long enough period of time for the exercise to have a measurable effect.  Studies with subjects of differing cognitive abilities were included though samples with subjects who had other neurological conditions such as strokes or mental illness such as depression were not included.  Ultimately 36 studies were included in the final quantitative analysis.

As for the good news, aerobic exercise, resistance training, a combination of the two and tai chi all were found to have a positive effect and improved cognitive function in adults over 50.  The effect was seen regardless of the cognitive status of the participants.  A particularly pronounced effect from resistance training was seen for executive function, memory and working memory.  The results for Tai chi were very promising but the number of studies that focused on that intervention were small so further research in the area is needed but the initial suggestion is that it could be a very powerful intervention, especially useful for those individuals who cannot perform more traditional aerobic and resistance training due to physical limitations.

When it comes to time, moderate length exercise sessions of 45-60 minutes were far and away the most beneficial.  This doesn’t mean shorter or longer sessions are not good for your brain, just that the results of this study show the most improvements overall working in that moderate range.

Both moderate and vigorous intensity were found to have similar positive impacts while low intensity exercise did not have a statistically significant impact.  This tends to go along with the results we have been seeing in much of the HIIT research we have been talking about recently.  When individuals have the capacity to go harder, the results seem to be greater though when looking at overall populations, the impact of moderate intensity appears to have overall similar effects.  Considering the psychology of most people, being able to achieve such positive benefits with moderate effort means we can reach that huge segment of people in the middle who are willing to exercise but not push themselves to that vigorous level.  While the low intensity work did not reach a level of statistical significance, the trend was still positive and it is far too early to say that exercise at a low intensity doesn’t have a cognitive effect.

All weekly frequencies of exercise as well as the overall length of time of the intervention showed significant impacts.

There you have it, aerobic and resistance training done for 45-60 minutes on as many days of the week as possible at a moderate to vigorous level of intensity improves your brain function.  Now you just need to remember to get up and do it and have the drive and commitment to focusing on your goal and following through with it.  If only there was something you could do that would improve your memory and executive function.

Works cited:

Northey, J., Cherbuin, N., Pumpa, K., Smee, J. and Rattray, B. (2017) Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis.  Br J Sports Med. April 24

How HIIT impacts untrained men, overweight women and elite endurance athletes.

A few weeks ago I wrote about a study that highlighted a number of significant changes on the cellular level produced by high intensity interval training.  If you take that study on its own, HIIT sounds like the best thing to hit the exercise world since the invention of sneakers.  Of course we know that any given study can only look at a few very specific parameters and you have to take the results in context with a much larger body of study.

The results were so intriguing from the first study I reviewed that I couldn’t help but start to ask an assortment of questions about HIIT training.  What is the best combination of work and rest intervals and what differences exists when using different interval/rest times?  What differences then exists between different types of intervals: running, biking, rowing, weight lifting, body weight exercises and so on?  How do different populations (men vs. women, young vs. old, sedentary vs. active, endurance athletes vs. strength athletes) react to different types of interval training? What are the differences between interval training and other forms of training (traditional strength training, endurance training, etc.)?  How does interval training impact individuals with various medical conditions such as diabetes and obesity and how are those impacts different then other forms of exercise?

So here we go with the first of what will probably be many follow up articles about various aspects of high intensity interval training.

Steady-state and moderate intensity intervals can be just as good as HIIT in untrained individuals

Let’s begin by going way back to 2015 and a study by Foster et al. (2015) in the Journal of Sports Science and Medicine.  Relatively inactive young adults were put into either a steady-state training group, a very high intensity-brief interval protocol (Tabata) or a moderate intensity –moderate time interval (Meyer).  The steady state group cycled for 20 minutes at a moderate to vigorous intensity.  The Tabata group cycled for 20 seconds of intense work then 10 seconds of unloaded cycling for 8 sets, equaling a total of 4 minutes.  The Meyer interval group did 20 minutes of cycling consisting of 13 sets of 30 second work intervals followed by 60 seconds of active recovery.  Each group performed three workouts per week for 8 weeks, totaling 24 exercise sessions.

All three groups showed significant improvement in measures of aerobic and anerobic capacity however, there were no significant differences between the groups, suggesting that in relatively inactive young adults it doesn’t really matter which approach is used.  All three groups did increase the intensity at which they worked out over the course of the study and even the steady-state group was cycling at a fair degree of difficulty but overall, this study does not support the increased value of high intensity work for this population.

Usually most research studies are more concerned with the physiological impact of whatever they are testing but in this study the authors did start to take into account a factor that really comes into play in the real world, the psychological motivation of exercisers. How much they really enjoy a particular form of exercise and how likely they are to actually do it.  We can come up with the world’s greatest form of exercise but if it is so miserable to do only a tiny number of people will actually perform it and for the majority of people who need to exercise, the approach is worthless because they won’t do it.

In this study, subjects’ enjoyment of all three forms of exercise went down over time but significantly more so for the Tabata group.  While many people may find a moderate intensity interval approach more interesting than a steady state approach, the very high intensity intervals may just be too much for many members of the general public, especially those who have been more sedentary.  Yes high performing individuals may need the stimulus of very high intensity intervals to elicit improvements but for the majority of people it is probably not that crucial.  And ultimately we need people to want to continue to participate in exercise over time to truly gain the benefits and if their level of enjoyment is so low due to the discomfort of very high intensity intervals they are much more likely to stop exercising and not enjoy any of the benefits.

This also carries over to the time benefits of HIIT.  While a HITT workout can be completed in a reduced period of time, if by the time participants feel recovered enough to go on with their day they have needed as long as participants who engaged in longer duration more moderate to vigorous exercise sessions then there is no net benefit to the shorter duration period of exercise.  In this study the Tabata group needed so long to recover they didn’t see any time saving benefit as compared to the other two groups.  Keep in mind the Tabata subjects were exercising at a very high intensity.

So there you go, if you are working with or are someone newer to exercise you do have to put some real effort into what you are doing but you don’t have to go all out with extremely high intensity intervals to elicit many of the same benefits.  At least until you read HITT Reverses Aging At a Cellular Level.  I’ve got a nagging feeling that despite the important observations about participant behavior in this study, we are going to find a lot of data in future articles that continues to support higher intensity intervals.

HIIT improves body composition, strength, aerobic capacity and quality of life in overweight women

Now that we’ve taken a peak at young sedentary subjects let’s see what impacts HIIT has on a population of women with a little more to love.  Sperlich et al. (2017) studied women ages 18-35 who had body mass indexes (BMI) of 25 or higher, categorizing them as overweight, who had not been exercising for the previous six months or longer.  What is most interesting about this study is that instead of building intervals around traditional cardiovascular exercises, the authors developed interval circuits consisting of body weight exercises such as burpees, push-ups, lunges, squats and sprints.  The intervals used look far more like the type of HIIT circuits that are being used by personal trainers and group exercise instructors in classes at gyms and training facilities.

The subjects were broken down into two groups.  One group (HITT) performed three interval workouts per week for 9 weeks while the other group (Combined) performed the same workout twice a week and one low-intensity higher-volume cardiovascular workout consisting of jogging and walking.  The authors theorized the participants in the Combined group would experience some different cardio-respiratory and metabolic changes along with higher perceptions of quality of life.

Subjects in both groups saw similar decreases in weight, BMI, waist-to-hip ratio and fat mass while also seeing similar increases in fat-free mass (=muscle).  Ratings of perceived exertion for both groups went down over time in a similar manner.  Cardio-respiratory measures were all similar with the exception of peak oxygen uptake which was improved to a greater extent I the HIIT group.

Strength and related performance measures which consisted of push-ups, burpees, one-legged squats, timed skipping and counter-movement jump height all improved for both groups with no differences between groups.  The HIIT group did see a higher increase in the number of leg levers they could perform.

For all quality of life measurements both groups showed similar results with the exception of the HIIT group reporting higher perceptions of pain while the Combined group reported enhanced perceptions of general health.

So, if you are more concerned with getting the most possible improvement in VO2max in this population you should do 3 HIIT workouts but if you are more concerned with participants’ perceptions of general health and less discomfort you might want to lean towards a combined approach that replaces one HITT workout with some jogging and walking.  Either way, both approaches appear to be very beneficial for overweight women (at least under 35) and it’s safe to say this study supports body weight resistance exercise based high intensity intervals.

Polarized training vs HIIT vs threshold vs high volume training in elite endurance athletes

Up to now we have mostly looked at the effect of HIIT on less experienced or untrained individuals.  While the results there are positive with HIIT there are arguments for other forms of training.  When it comes to very experienced individuals and elite athletes all previous claims are off.  Their bodies are already highly adapted to training and under a tremendous amount of stress.  How they respond to certain stimulus can be totally different then untrained individuals.

Stoggl and Sperlich (2014) attempted to answer some of the questions regarding different training approaches for elite endurance athletes.  They began with the concept that endurance athletes use some combination of four training approaches.  The first and most common is the more traditional high-volume training (HVT) done at a lower intensity that is usually less than 80% of max heart rate, 65-75% of peak oxygen uptake (VO2peak) and at lower blood lactate levels.  The second approach is training at or near the blood lactate threshold (THR).  The third approach is HIIT training and the fourth is polarized training (POL) that uses some combination of the other three approaches.

Utilizing international level competitors in cycling, triathlon, running and cross country skiing the authors had the subjects train for 9 weeks under one of the four conditions.  They attempted to design workout protocols that resembled what these athletes would actually do for their normal training.  Five key performance variables were measures: VO2peak, velocity/power output at the lactate threshold (V/Plt), work economy, peak running velocity or power output (V/Ppeak) and time to exhaustion (TTE).

Their first interesting finding was that the only training approach that resulted in subjects losing a significant amount of weight was HIIT.  This is despite the HIIT group having less volume in their training then the other three groups.  While elite endurance athletes often are trying not to lose any additional body mass when they are in need of manipulating their body composition we can see that HIIT may be a useful training approach.

When it came to VO2peak the polarized group far and away had the greatest gain at 11.7% followed by HITT at 4.8%.  Work economy improved the most following HIIT while work economy expressed as a percentage of VO2peak improved only following polarized training.

The greatest improvement in time to exhaustion was found in the polarized group, almost double the next best approach, HIIT.  Peak velocity and power improved the most with polarized training followed closely by HIIT.  Both significantly better than the other two approaches.  Velocity/power output at lactate threshold also showed the greatest gains with polarized training again followed by HIIT.

Clearly in this population of highly trained athletes a combined training approach that includes HIIT showed the greatest improvements in performance variables that generally equate to success in ones sport.  So while we might argue for a higher percentage of HIIT in the less trained individual and someone who’s primary objective is weight loss, for more elite athletes we can see HIIT is important for performance improvement but needs to be integrated with other training techniques.  There seems to be a multiplying effect in results when HIIT is integrated with other techniques.

So there you go.  Three distinctly different groups, inexperienced younger adult males, overweight adult females and elite endurance athletes.  All three can benefit in some meaningful way from HIIT but we need to balance the unique demands and psychology of each group.  While elite athletes can handle the high intensity aspect of HIIT, for other groups it may be wise to utilize some work done at more moderate intensities to make the exercise more enjoyable and increase the likelihood of someone sticking around long enough to make significant changes.  We also saw that with our non-endurance athlete groups that interval circuits made up of body weight exercises seem to produce meaningful results.

Works Cited:

Foster, C., Farland, C., Guidotti, F., Harbin, M., Robers, B., Schuette, J., Tuuri, A., Doberstein, S. and Porcari, J.  (2015) The Effects of High Intensity Interval Training vs Steady State Training on Aerobic and Anaerobic Capacity.  Journal of Sports Science and Medicine. 14: 747-755.

Sperlich, B., Wallmann-Sperlich, B., Zinner, C., Von Stauffenberg, V., Losert, H., Holmberg, H. (2017) Functional High-Intensity Circuit Training Improves Body Composition, Peak Oxygen Uptake, Strength, and Alters Certain Dimensions of Quality of Life in Overweight Women.  Frontiers in Physiology. Apr 3;8:172

Stoggl, T. and Sperlich, B. (2014) Polarized training has greater impact on key endurance variables than threshold, high intensity or high volume training.  Frontiers in Physiology. Feb 4;5:33