Exercise for Enhancing Neuroplasticity and Alzheimer’s Risk Reduction

Sarah C. McEwen, PhD, NSCA-CPT

Thank you, and I’m sorry about that long introduction.

Heather Sandison, N.D.

I love it. I like I more or less, the more I learn about you and your passion and commitment, and just like excitement around learning how we can prevent and reverse Alzheimer’s is so clear from all of the work you’ve done and just the quick chat that we’ve already had, so welcome to the summit.

Sarah C. McEwen, PhD, NSCA-CPT

Thank you, thank you, Heather, thank you for having me, thank you for the participants for coming, I really appreciate you inviting me, thank you.

Heather Sandison, N.D.

So one of your big areas of expertise is how exercise impacts the brain. Let’s just start there.

Sarah C. McEwen, PhD, NSCA-CPT

Yeah, I don’t like to use this word loosely, but panacea is how I would describe exercise. There’s really nothing I’ve ever seen, and all of my years of research of looking at how, you know, activities can affect the brain, and disease states and preventative ways. But exercise does seem to be that magic bullet. It does seem to be that one thing that just keeps coming up time and time again, of why, you know, why would it work? Why is it so profound to us? And I mean, you can always think of it from an evolutionary perspective I mean, it is who we are. 

You know, there’s a really really really cool book that came out of quite a few years ago now, but it’s called “Born To Run”. And it’s the book by Christopher McDougall and he talks about this Indian tribe that lives in the copper canyons in Mexico, called the Tarahumara. And it really looks at how the impact of their lifestyle has just incredibly reduced their risk for, you know, major illnesses that we suffer within modern society. So, type two diabetes, cancer, other types of cardiovascular disease, are basically non-existent in this population, this small population of Indians that live in these mountainous terrains, and they have to run every day and they have to be active all day long.

 And it just shows that, you know, even in this modern world we live in, there’s still people that live in such a way that has physical activity and lifestyle as just being their main component of their life, and that’s been preventing them from getting sick. So, you know, taking that as a very, you know, lofty goal to be able to run, you know, 200 miles or something like that, you know, but this idea that, you know, 80% of our population doesn’t even meet the lowest level of recommendations for exercise is just to pointing you know, so I feel like as an advocate and custodian to science, you know, that I wanna be out there and I just wanna be telling people how important exercise is, and it’s not just something that you do to look good or something, you know, but it really actually does have a fundamental level in your brain to be able to change the way that it functions to, you know, preserve it as we age, it increases something called cognitive reserve, which you could think of as like a savings account for your brain. 

o this idea that, you know, the activities that you do throughout your life, can actually preserve your brain, even in the face of injury and insult, even as, you know, amyloid might be building up in the brain, you’re built up this reserve through exercise, to be able to fight it and not let it, you know, consume your cognitive functioning. So there’s many many different layers we can talk about from neurochemical improvements, to, you know, plasticity improvements, actually growing new neurons in the brain. I mean, there’s just so many levels that exercise accept that it’s just like, you know, pick one and you’ll find it, you know.

Heather Sandison, N.D.

Circulation, right. I think one of the things that surprises people is that even as we age, even like people in their eighties and nineties, that neuroplasticity still exists, that you still can form new neurons. So can you talk about a bit of the science around that?

Sarah C. McEwen, PhD, NSCA-CPT

Absolutely. So, I mean, it was really sad, but it was basically until the 1960s I wanna say until a neuroscientist came along and was able to actually show that neuro-plasticity still happens in the adult brain. A lot of people thought that what you were born with was the brain that you were essentially stuck with, you know, and it was genetics that played into it, but actually the reality is there’s something called experience dependent plasticity. And basically what that means is that your brain has this incredible agile ability to reorganize itself, all throughout life, based on the things that you do. 

So, you know, you could think of neuroplasticity as being something that helps you form, you know, new connections in the brain, and it helps the sprouting of new neuronal fibers, and all of this is because of the things that we do in our daily lives, and that we have the ability to do that, because of our brain’s innate ability to do so. And it’s hardwired in such a way though, that it’s very responsive to exercise and the changes that exercise could bring on the brain. So one of the most common ones you’ll hear about though, and this was a lot of the work that was done back in the late nineties at the Salk Institute, by Fred Gage and Henriette van Praag, where they had animals, that they would put in a cage with a running wheel. And what they did was they looked at the difference between the animals that had the wheel in a cage, and they were running in there. 

So unlike humans, where you put a treadmill in the room with us, we can close on it or something, you know, the animals actually liked to run on it. So they had them several weeks running on these wheels, and then they had another group that didn’t have a wheel in there, and then they looked at the brains, specifically the hippocampus in the brain, which is the learning and memory center in the brain. And they looked at little tiny samples within the hippocampus, and they found that in the animals that were exercising, they actually sprouted brand new neurons, adult neurons in the brain, because they were exercising where they didn’t see that same effect in the sedentary animals. 

And this was just a few weeks of doing exercise, but they showed that these new neurons sprouted in the brain, but some of the more interesting research that’s happening right now is showing that even though that neurogenesis is happening in the brain and exercise can grow those new neurons, they actually will quickly die off, in the absence of some sort of a cognitively stimulating environment. So the idea that those new neurons actually need to latch on to something in there and become integrated into the system is really important. So it’s this whole idea of, you know, not only growing the new neurons, but that adding some sort of a cognitive or cognitively stimulating environment or challenge, actually helps those neurons actually link up and survive within the hippocampus in the brain.

Heather Sandison, N.D.

So it sounds like what you were describing on a hamster wheel is cardio. Does it matter if we’re getting cardio or strength training?

Sarah C. McEwen, PhD, NSCA-CPT

Yes, yes, it does, and I just wanna say to both of them are equally important, right? So I think a lot of people prioritize like walking, because it’s really easy to do. Like, you can just go out of the door and do it, you know, but it’s almost just as easy to get some dumbbells as well too or, you know, get a virtual trainer or an app or something like that that can help you do some resistance muscle building exercises, because actually the American college of sports medicine actually recommends four different kinds of exercise. So aerobic, which is like, you know, you’re walking in, you’re running and jogging and you’re swimming, but then also resistance. So strength training exercises. So resistance machines, dumbbells, body weight exercises, things like that. And then something called neuro motor or skill-based exercise. 

So this is one of, kind of one of more of the newer areas of research, where a lot of people are looking at the different types of exercise and how they affect the brain. And they look at things like dance or Tai Chi or Pilates or boxing, things like that, and how those affect the brain. And some of the research I’ve done in Parkinson’s disease I actually looked at this systematically. So we looked at different kinds of aerobic fitness. So people that had really high VO to max, which is basically a readout of how aerobically fit you are, and then also people that had high motor scale fitness. 

So this ability to do different kinds of like gain balance tests, things like that. And we were really interested in looking at how, the different types of fitness affected the brain. And for a robotic exercise what we know is, as I’ve talked about the wheel running, we know that that improves neurogenesis in the brain at that level. So we know that it forms new neurons, and it also does something called angiogenesis, which is the formation of new blood vessels as well. And usually this happens, as I said, in the hippocampus, which is the medial temporal lobe in the brain. So that’s in the middle of the brain, and that exercise has been shown through different brain imaging studies to increase the actual size, the gray matter volume in the medial temporal lobe, and then a little bit in the frontal lobe, some more of those like higher order thinking parts of the brain, and then the sensory motor network too. 

So there’s some really cool research on that. And all of those areas I was just talking about subserve memory. So aerobic exercise is really fundamentally trying to improve memory, for some reason that just keeps coming back again and again, and all of these research studies be it brain imaging studies, or, you know, behavioral cognitive testing studies, it seems that people that have this higher aerobic fitness have better memory skills, larger hippocampus, but then the different kind of fitness is that motor skill fitness. So that’s the things I was saying like the dancing or the boxing, or doing things like that. That actually seems to have a much different impact on the brain. So, whereas you could think of aerobic exercise being kind of bottom up of like kind of low level sensory processing and memory functioning, motor skills actually more top down. So if you think about it, it makes sense because basically a motor skill learning is all about having a goal and doing, you know, movements that are all around trying to reach that goal, with predetermined outcomes, you’ve got a lot of novelty that’s happening to a lot, and it’s just, it’s a very different type of exercise. And with that one, we actually see more synaptic Genesis within the brain. So this is actually the formation of new synapses between the neurons in the brain. 

That seems to be what’s happening in this more skill-based exercise. And then at a structural level, you see parts of the brain increasing in the prefrontal cortex. So that higher order thinking part of the brain, but really hitting that hard, because think about it when you’re learning a new skill, you really have to think, like, not just like, you know, when you’re running, it’s kind of an automatic movement, but when you have to do a new skill learning that that’s a lot of the frontal cortex, anterior cingulate kind of problem solving online processing those sorts of things. So it actually increases the size of those parts of the brain. And it also helps at the behavioral level, we see changes in cognitive functioning for more executive functioning, more reasoning types of exercises, things like that. So that’s really been kind of the landscape, if you will, for the different kinds of exercises and how they differentially affect the brain, pretty, pretty profoundly.

Heather Sandison, N.D.

That really inspiring to get out there and like learn a new skill. And also not to rely on like, oh, I was good at volleyball when I was in high school, and so that’s gonna serve me forever, but like, okay, I need to pick up some other type of activity and always be sort of challenging your brain to do that so that you continue to develop those areas.

Sarah C. McEwen, PhD, NSCA-CPT

Exactly, exactly. But I mean, I can tell, I can say this for certainty, I probably get the questionnaire every day, like, well, what’s the best kind of exercise for my brain there? You know. And it’s like, well, I mean, I always started the place of saying like, well, clearly, like you have to do what you enjoy. Like I’m not gonna tell you to go do something that you aren’t gonna find enjoyable, you know. In addition to being a research scientist, I also did a fitness leadership program at UCLA. So I’m also a certified personal trainer. 

So one of the things you learn as a personal trainer is yeah, you have to meet people where they’re at, it’s the same as like a health coach or, you know, a brain-based coach. It’s somebody that, you know, is able to understand where you’re coming from and what you’re interested in. So maybe it’s, you know, volleyball that was your thing back then but, you know, how can we think about integrating that into your life now? Like what other kinds of activities? Maybe it’s you know, maybe it’s gonna be something different, you know, maybe it’s a smaller scale, maybe it’s the competition piece of it you like, or, you know, maybe it’s an individual sport that you’re more than two. So you really have to think about that in terms of prescribing exercise to people because you, I mean, there’s a million things under the sun you could be doing, but including in addition, so the recommendations that I usually have for exercise are really doing aerobic exercise five days a week, at least 30 minutes, at least a moderate intensity. 

I don’t wanna be able to talk to you when you’re exercising with me, aerobic lately. That’s a key right there. That intensity seems to, you have to really dial that in. You can’t just be walking the dog, that’s not gonna be intense enough, it’s got to be a little bit more. And then having two days of the muscle building, because we know as we age, you know, we get, you know, sarcopenia, we get osteoporosis, and we need to make sure that we’re doing muscle building exercises at least twice a week, and doing at least like six to eight different muscle groups for that. But then for these like neuro motor and skills sorts of things like the dance or the Tai Chi, I would also say two days a week to have at least 20 minute sessions. 

So really this idea of doing like multi-component exercise training too, and then to just kind of layer it on a little bit more, you know, what about the idea that you can make? I don’t want to call it like an artificial environment, but somehow that you could be adding some sort of another cognitive challenge to it, you know. So obviously like with a sport or, you know, with dancing or you’re learning a new skill like that, clearly that’s all novelty and that’s doing something different, but it’s interesting because you don’t actually get any feedback about it. 

So there’s been a lot of research that’s done on, have you heard of like neurocognitive, like computerized training before, that people do like posit science, Michael Merzenich, Dr. Michael work at UCS staff? So his idea that, you know, you know, training neurons that fire together wire together, so explicitly training, different kind of lower level cognitive networks. So the idea of training, like memory networks or attention networks, and playing computer games that are known to like activate those sort of neuronal systems, seems to be really effective. But the problem with those, you know, city data computer playing video games thing, is they don’t really transfer very well to like everyday life, you know. It doesn’t mean you’re gonna forget where you parked your cars, you know, it doesn’t mean that you’re gonna remember, you know, your daughter’s friend’s name or something like that, you know. So doing more specifically targeted neuro-cognitive drills is really important, and some of the work I’m doing now, which is really cool is the idea that we’re like explicitly training compensatory cognitive skills, because sometimes what happens is we age, like it’s just natural that we’re losing, you know, parts of the brain as we age. 

We all unfortunately know that, but we can do something called compensatory training. So there’s an idea that, you know, you can still train the different neural circuits that are still stable within the brain. So you can use different strategies and tools to try to help you remember things. So with my colleagues at UCLA and the Pacific Brain Health Center, we’ve developed a compensatory memory program that people do while they’re on a bike on a stationary bike. So it’s this idea that people can be in an aerobic state, but then they have a tablet, and they’re actually doing compensatory memory training drills, where we created like virtual environments, where people are, you know, at a barbecue and they’re remembering people’s names and we give them strategies to remember their names and things like that. So that’s been a lot of fun and that research was funded by the NIH. And we should hopefully have those results sometime by the end of the year. So I can share that with you and your viewers.

Heather Sandison, N.D.

That’s so exciting. And I think about kind of layering things on top, because I think part of the goal, like you said, compensatory mechanisms, we know that there’s gonna be some decline as we age, and if we have that great cognitive reserve, it’ll be less than if we don’t. But if we can, if the goal is executive function and independence, right, how do we keep you in your home for as long as possible, as independent as possible? How do we keep your driver’s license for as long safely, for as long as possible? How do we keep you cooking for yourself for as long as possible? 

When you have that autonomy and independence, there’s usually a lot more, you know, freedom of course, but also mood is better. There’s less depression and anxiety. And when I was listening to you talk about, you know, that higher order brain, the prefrontal cortex, that’s where a lot of that executive function is happening. And the more we can do to preserve, protect and enhance that function, the better off people are typically gonna be as they age.

Sarah C. McEwen, PhD, NSCA-CPT

Exactly, and I think that’s just, it speaks volumes about, you know, really the impact of exercise on the brain, because it really does seem to preferentially have the ability to improve the gray matter and the function and the structure within the prefrontal cortex and the hippocampus. And I mean, this has been research that has been replicated for the last 30 years, you know. So it seems like there’s something that’s really sticking there, you know. That it’s those two parts of the brain that speak really well together in terms of the areas we know that actually decline with age, but actually are highly plastic as well, too. So it really just emphasizes the fact that it’s like, hey, if you take what we’re saying to heart, you know, you can actually do something to improve the fate of your brain. And it doesn’t have to go in this like linear downward trajectory, but you can actually try to course correct that with these different sorts of lifestyle behaviors.

Heather Sandison, N.D.

And is it different for women than it is for men? We know that more women end up with Alzheimer’s than men. Is there something going on there that may be a structural in the brain or biochemical?

Sarah C. McEwen, PhD, NSCA-CPT

Yeah, I mean there’s a lot of, you know, theories around, you know, what might be happening in women’s brains, and this is a huge area of research and there’s a wonderful researcher that’s at Cornell, actually, that’s looking at this and she’s doing a lot of research in pet imaging and looking at different kinds of metabolism within the brain. Because the interesting thing about women’s brains is that, yeah, we are wired a little bit differently than men’s brains, and unfortunately Alzheimer’s actually hits yeah, two thirds more women than it does men, you know. So it’s something that we need to be very, very careful about. 

And women in their sixties are just as likely to develop Alzheimer’s diseases as they are breast cancer, you know, throughout rest of their lives. There’s some studies that are pointing to the role of estrogen, you know, and maybe what’s going on there in terms of, you know, the onset of Alzheimer’s and why that happens around menopause. So actively the research that’s happening right now is looking at exactly that. So it’s looking at perimenopausal women, looking at through them, you know, through menopause and then after, and looking at transition rates, but that’s obviously still a work in progress, which is, you know, being looked at right now. But the cool part is though that again, you know, the beauty of exercise really is that it specifically seems to have a beneficial effect for women. They’ve done some studies, I can think of a study that was done with resistance training and they have middle-aged females, and they were actually showing that they had greater improvements in executive functioning after doing this resistance training intervention than men. 

So that was something that was really interesting. And then also Esther dial as well to the dendrite explained density in the hippocampus neurons seem to respond better to higher estradiol levels in females but not males, showing that that’s another kind of sensitive area in the brain for the hippocampus. And then also the BDNF gene as well, too, that also has some estrogen, you know, specificity for estrogen receptors on it as well, too, showing that, you know, it could be pointing to, you know, BDNF as being a central mechanism for the improved fitness in females as well, too. And also the fact that the hippocampus actually do the more exercise females do, it seems to have this, what they call like a dose response. So the more exercise women do seems to increase the hippocampus volume more, but you don’t see that dose response in men, which is kind of curious.

Heather Sandison, N.D.

You sure you can’t put that in a pill for me so I can just swallow it?

Sarah C. McEwen, PhD, NSCA-CPT

They trying to, there was actually a study that came out last year that, yeah, it was trying to tell like that, that exercise protein or something and put that in a pill. But yeah, I think the reality is it’s like exercise is just so systemic. I mean, it helps with like, you know, you know, blood flow and vascularization and all these other things that you can’t really pin down to just one mechanisms. And now, so unfortunately not.

Heather Sandison, N.D.

Well that it sounds like we know a ton about what’s going on, but there’s always more in research that we wanna know. What are some of the big questions that you think are left unanswered at this point?

Sarah C. McEwen, PhD, NSCA-CPT

Yeah, I think there’s still a lot of work to be done around, you know, the actual dosage of exercise, if you will, and how to prescribe exercise for people, you know, what kind of, you know, genetic or proteomic metabolomics sort of factors are going into it? What sort of pre-positions do we already have, taking on a new exercise routine? How are we gonna respond to it, this whole idea of treatment response responders and non-responders? And who’s gonna have a bigger benefit, like how many patients should we be thinking about, we really need to push for exercising, maybe not so much these other things, and how do we temper that? 

So I think some of the research now, and we’re trying to do some of this stuff right now, too, is some of the exercise studies I’m doing is we’re taking blood samples on patients and seeing their levels of BDNF, and seeing how they change during the course of the intervention. And we’re looking at things like norepinephrine, which we know is a really important neurotransmitter for attention and alertness in the brain, and how that has changed with exercise. So I think that’s a lot of these, talk about like precision, you know, medicine and precision psychiatry, you know, and how we can better design intervention. So this idea that we’re getting more of a holistic picture of the patients and really understanding them, you know what I’m talking about. 

I see you shaking your head, you’re like, yes, I do this every day. But making sure that we’re addressing all of the factors in the individual and this isn’t just about, you know, getting bigger muscles or being able to run a mile, you know, but it’s really about, you know, how can we address all of these systemic concerns at the individual level and prescribe better interventions for them? And there’s even research being done, as I was saying, you know, what’s the best kind of combination of exercises, you know, should we be doing more like high intensity training? ‘Cause that seems to have some sort of a differential effect in terms of glucose metabolism as well. And you can do it in a fraction of the amount of time. 

It would take you to do a 30 minute exercise session. You can do it in four minutes, you know? So there’s those kinds of studies being done too, and then, yeah, how do we include cognitive stimulation as well, too? Like how can we do that? Is there, you know, some sort of an app for that? You know, or some way that you can have people be able to do that at home, you know, because it’s nice that we’re hearing all this cool stuff and research, but what’s something we can do practically, you know, is that, you know, me listening to a podcast on the treadmill, or is it gonna be something that’s probably a little bit more engaging, that gives you feedback as well, too? So I think that’s some of the exciting stuff coming down the pipeline.

Heather Sandison, N.D.

That is, I mean, it’s making me think of my patients, everyone’s got a Peloton this year, not everybody, but the people who can got Peloton this year, and there’s a screen in front of them, and that just seems like the next natural step that you would put something engaging on that. I’m trying to imagine if I were really exerting, and then you started asking me to like, do multiplication tables or something, I would just be like, no, no, I’m out, I’m out. People engage, ’cause that’s quite a bit of effort, right, you’re efforting physically, and then you’re efforting mentally. And so how do you not just give up?

Sarah C. McEwen, PhD, NSCA-CPT

Yeah, no, it’s actually, it’s interesting because there is like a whole area of psychological sides about this, and they look at something called like the dual tasking trade-off, right. So if the intensity of the exercise is too hard, then your cognitive functioning goes down. So you kind of have to find that sweet spot. So some of the stuff I’ve done is creating exercise interventions, where we get people at just a moderate level of intensity. So just enough where you can, you know, carry out a conversation, but it’s enough where you can still be thinking, and then I deploy different cognitive stimulation on top of it. 

But it’s obviously been carefully thought out in terms of the timing, because yeah, you don’t wanna make it too hard, but there’s also something that’s, you know, I call it the neuro-plasticity sweet spot, where you have to be around 80% accurate, which is not too easy and not too hard. So you don’t wanna be doing something where it’s like, you know, Sudoku or crosswords or something because it’s like, well, first of all, you can’t do those when you’re running, you know, kinda evolve. 

They’re not really hard enough and they’re kind of automatic. So you wanna make sure you’re gonna give somebody stimulation that’s gonna be appropriate for their ability levels. So you wanna make sure that it’s adaptive. So there’s different levels of, you know, easy, medium and hard, kind of based on the individual patient. And then also making sure that it’s actually like training specific neural networks. So I’ve created an app called Genius Gyms, which is where we actually give people combined exercise interventions with different cognitive stimulation, and the whole reason for this was because I’ve been in this research field for years and, you know, talking to patients and people just telling me, what am I supposed to do for my brain? And it’s just been interesting to think about, well, like there’s actually a way that you can contrive this environment. 

Like yes, you can go to dancing and Tai-Chi and boxing and everything else, which is great, but like how does somebody just go out of their front door and do something that can be cognitively stimulating, but like tempered for the individual level, and also knowing that it’s supposed to be activating these networks in the brain. So there’s well-known, you know, attention and memory and executive functioning networks, but yeah, how do you train those things? So the idea was just to make an app, an auditory based app that was gonna make it easy for people to do this kind of an intervention, you know, 20 minutes, that’s all you have to do and you’re banging out your cognitive training and your exercise, and you’re good to go. So that’s been a lot of fun too.

Heather Sandison, N.D.

Sounds efficient. It also makes me want like my kids to do it. It seems like it would be helpful at either end of the spectrum or in the middle, right. With it, you would benefit from something like that. And if it’s only 20 minutes a day, that it’s quite doable, it’s very practical for either a kid or for someone who’s aging and struggling with dementia.

Sarah C. McEwen, PhD, NSCA-CPT

Exactly. Like it kind of cuts across the spectrum, but yeah, you definitely have to meet people where they’re at in terms of the difficulty level. So yes, I have my eight year old before he has a soccer game, I have them using the app, you know, I call it cross training for the brain. So it’s the way of, yeah, just trying to activate those neural circuits before you have to yeah, either go do something important at work or, you know, or even if it’s just yeah, trying to, you know, keep your cognitive skills sharp, you know, there’s obviously different kinds of clinical programs, but then there’s also known as like optimizer programs, so for like stressed out executives, you know, people that are dealing with a lot, you know, it’s teaching them a different way to think, because I think in today’s society, what happens a lot is we do a lot of multitasking, which is really toxic on the brain because it’s basically, you’re just doing micro-tasking all day long. 

Like you’re on your computer, but you’re on your side, you’re on your phone and somebody over here, and you’re constantly being, you know, switched in different directions. But this whole idea of doing pre-program dual tasking, which is basically the idea that you’re doing something , which would be like aerobic exercise, but then combining that with something that was strategically done to be a task based exercise, then it’s not multitasking, then you’re actually consciously just doing things at the same time, but it’s in a way that was intended to be that way, and not supposed to be distracting you in 50 different ways, but like trying to strengthen the ability to be able to do this kind of combined training.

Heather Sandison, N.D.

That’s really fascinating. Now you mentioned that you would have your son do it right before he played a soccer game, or you would have an executive do it right before a stressful meeting. Now that’s interesting because I have expected the opposite, right, like that you would do it maybe a day before or the day, or right after as a way to come down, but it’s actually prepares you.

Sarah C. McEwen, PhD, NSCA-CPT

Yeah, I mean, it kind of perpetuates the brain in such a way, because I like to call it kind of this like neurochemical that happens with exercise, you know, so it’s releasing different chunk big factors and you know, it’s having this different, you know, release a different sort of metabolism and blood flow and things like that that are happening with the exercise. So it’s really optimizing the brain to be in this state for learning and memory, and it’s really priming it if you will. So I like to do this as, you know, like, I don’t know, a brain break or something like that, if you will. You know, like the ability to be able to prime the system or the pump, if you will, before you have to go do something else.

And then you’re kind of in this heightened state of awareness and challenge, you know, that whatever comes next is not gonna be as bad either because you’re more prepared for it. And they even show with just exercise. The benefits of it lasts the most important benefits are within that first hour after you exercise. So if you ever have to give a keynote or something like that, or, you know, have some important meeting to go to, it’s best to do the exercise first and then go do the event. And they’ve done a lot of these studies with learning as well too. So the idea that you do, you know, the exercise and then do the learning task, that seems to be better than doing it after, it seems to help with consolidation later on, because when you sleep your brain consolidates everything, it seems to help with that too. 

And that’s something that I’ve looked at in my research as well, this idea of doing them separately or doing them together, and there seems to be very different things that happen when you do them separately, versus having done them simultaneously. So when you do them separately, it seems to actually, when you do the exercise, then the cognitive training, it seems to help more with a different kind of reasoning skill. But then the simultaneous helps with memory, it helps with attention, it helps with a different kind of problem solving ability. So it seems to have more benefits than doing them separately, and it’s time-saving, which I think we all know in this day and age is the benefit too.

Heather Sandison, N.D.

Wow! I’m so glad I’m talking to you today, because I’ve been doing it all wrong. I’ve been exercising after the stressful event rather than before.

Sarah C. McEwen, PhD, NSCA-CPT

I mean, you could use exercise in many different ways. I mean, it’s multipurpose, but for this specific kind that I’m talking about, because definitely like, I definitely do different kinds of restorative exercise. So after, yeah, maybe a really stressful week, I’ll do like a slum jog, you know, on the beach or something. Whereas, you know, maybe on a Monday morning, I would do more of the junior students kind of combined workout, you know, as something that’s a little bit more intensive, you know. So you have to temper it as well too, ’cause you never really want to overwhelm the system, and you have to really kind of tap into where you’re feeling and what you’re open to and receptive to at the time. But as long as you start slow and you just start integrating these tiny habits into your lifestyle, wherever they fit best, that’s the best advice I would have.

Heather Sandison, N.D.

And then you mentioned you’re developing the app. So is it available for people right now?

Sarah C. McEwen, PhD, NSCA-CPT

Yes, it will be in the app store in June. So it will be ready to go. So I’ve been working on this for a number of years, and finally gotten to a place where yeah, it’s gonna be ready for the public. So it’ll be in the Apple app store, and then also in the Google play store as well too. And it’s called Genius Gyms, and you can find there.

Heather Sandison, N.D.

That’s so exciting. And then where else can people learn more about your research and I’ll say, do you see people, are you a clinician? Do you have a book? Yes, tell me more about how people can learn more and just get the benefit of all of this really really important information.

Sarah C. McEwen, PhD, NSCA-CPT

Yeah, and I can definitely share with you some papers as well, too, for your listeners and your learners. But if you go to the Pacificbrainhealth.org, so Pacificbrainhealth.org, that’s the website. So I’m a clinical research scientist there, and that’s where I’m working as, I’ve created a research department there, where we carry out clinical trials, and we’re looking at different multi-modal lifestyle interventions, we’re looking at this compensatory memory training and exercise study, but there’s also a neurology practice there as well too. So they’re seeing MCI patients, Alzheimer’s patients, Parkinson’s patients every day that come through there. So really the research that I’m doing is in hopes of one day being able to be moved into the clinic, and have, you know, lots of patients benefit from the kind of, you know, innovation we’re doing on the research side.

Heather Sandison, N.D.

And I’m sure the research that you’re doing is already informing to some degree what they’re doing there.

Sarah C. McEwen, PhD, NSCA-CPT

Absolutely, yeah. So yeah, we have a paper that’s coming out in Alzheimer’s and dementia as well, too, where we talk about our multi-modal lifestyle intervention. So obviously exercise is a huge piece of it, but it’s not the only piece of course, you know, so making sure that we’re paying attention to our diet, and our stress levels and, you know, there’s different supplements and there’s all kinds of different routines and things you can do to address multiple factors in your life. Exercise, you know, obviously being just one, but a very important one. So there’s some research out there about that program as well, too.

Heather Sandison, N.D.

That’s so exciting. Thank you so, so much for sharing your time and your passion. This is just really exciting and interesting work that you’re doing. And so so important for people to know, as I mentioned, I’m so glad I talked to you today because I’m learning about how I can optimize the exercise I’m doing to make sure I’m protecting my brain personally, and of course that will hopefully impact my patients starting tomorrow.

Sarah C. McEwen, PhD, NSCA-CPT

I’m really happy to hear that. See, when you say, you know, if I’m a clinician, I’m like, well, I’m not a clinician, but I love to just be able to just profoundly impact patient’s care and patient’s lives. So that’s something that means a lot to me. So thank you for saying, and it’s been an honor to be here today and talk with you. So thank you.

Heather Sandison, N.D.

So inspiring, thank you so much.

Sarah C. McEwen, PhD, NSCA-CPT

You’re welcome.