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Exercise improves brain function, possibly reducing dementia risk

Exercise is potentially able to improve the brain’s capacity to respond to insulin for neuronal function.

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A study led by scientists at Rutgers University-New Brunswick has shown that specialized cells involved in how the body responds to insulin are activated in the brain after exercise, suggesting that physical activity may directly improve brain function.

The study, published in Aging Cell, a journal focused on the biology of aging, indicates that therapies targeting this insulin action may be developed to offset or even prevent dementia progression.

“We believe this work is important because it suggests exercise may work to improve cognition and memory by improving the abilities of insulin to act on the brain,” said Steven Malin, an associate professor in the Department of Kinesiology and Health in the Rutgers School of Arts and Sciences and lead author of the study.

Conducted in collaboration with the National Institutes of Health’s National Institute on Aging, the researchers focused on the role of neuronal extracellular vesicles, specialized cells released by the brain.

Extracellular vesicles, once dismissed by researchers as “cell dust,” have in the past 15 years grown exponentially in recognition as important players in the microscopic world of the human body, facilitating transport of key molecules such as proteins between cells. For this study, the scientists targeted vesicles produced in the brain that ferry several proteins involved in insulin sensitivity – one of which is called Akt.

Insulin sensitivity is a measure of how well the body responds to insulin, a hormone that controls blood sugar levels. People with high insulin sensitivity can use blood glucose more effectively in the body, such as in its muscles, which reduces blood sugar. People with diabetes, with its key symptom of low insulin sensitivity or insulin resistance, have brain cells that are less responsive to insulin. This can have negative impacts on cognition.

Researchers were able to study the vesicles by isolating them in the blood of participants in an experimental study. The trial, conducted over two weeks, included a group of 21 volunteers who had an average age of 60 and had prediabetes. Over the course of the study, they engaged in 12 individual, supervised, 60-minute exercise sessions of moderate to high intensity. The participants ingested a glucose drink before and after training. Researchers then collected blood samples before and during the drink from the participants at the start and end of exercise training.

The blood samples showed that the number of neuronal vesicles carrying proteins involved in insulin sensitivity increased after each training, with Akt being most notable.

“We showed for the first time that exercise impacts insulin signaling from neuronal extracellular vesicles in relation to clinical improvements in blood sugar,” Malin said. “And we use these neuronal extracellular vesicles as an indicator of brain insulin sensitivity.” 

Exercise, therefore, is potentially able to improve the brain’s capacity to respond to insulin for neuronal function, he said.

Insulin is a hormone increasingly recognized to regulate cognition, the mental process of acquiring knowledge through thought, experience and the senses. Prediabetes is a serious health condition that occurs when blood sugar levels are higher than normal but not high enough to be diagnosed as Type 2 diabetes. Those with prediabetes run the risk of having insufficient levels of insulin in their bodies, particularly the brain, which increases the chances of developing diseases of dementia such as Alzheimer’s, Malin said. 

Insulin also plays a crucial role in memory formation, recall, processing speed and the functioning of synapses, structures that allow brain cells to communicate with one another. 

“If insulin is insufficient in the brain, that means not only will brain cells become potentially dysfunctional, but also they may fail to interact with each other properly,” Malin said. “It’s like playing the game telephone with a friend. At some point the message gets lost when the brain becomes insulin resistant.”

Exercise has long been believed to improve cognition, but the mechanisms involved have been unclear. Past studies have uncovered evidence that high blood sugar contributes to a decrease in the brain’s ability to recall information and learn new information.

Malin said that insulin, which is produced by the pancreas and travels to the brain to perform its functions, plays a central role in promoting brain blood flow and neuronal functioning for cognition.

“Our work suggests that therapies that target brain insulin action may be able to ward off dementia,” Malin said.

In a new study, Malin and his colleagues are examining whether a single bout of exercise can enhance the ability of intranasal insulin to support cognitive health in aging adults with obesity by measuring brain blood flow and neuronal extracellular vesicles. Their future plans are to conduct a long-term exercise training study that assesses brain insulin sensitivity improvements in relation to cognition in older adults. 

Other Rutgers scientists on the study included Michal Beeri, director of the Herbert and Jacqueline Krieger Klein Alzheimer’s Research Center at Rutgers Robert Wood Johnson Medical School; and Daniel Battillo, a doctoral candidate in the kinesiology and applied physiology graduate program. Scientists from the National Institute of Health’s National Institute on Aging involved in the study included Dimitrios Kapogiannis, Maja Mustapic and Francheska Delgado-Peraza.

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Wellness

Men’s health expert issues warning to fans copying Mark Wahlberg’s early starts

Getting up at 3 a.m. might look like a head start in a social media morning routine. But for men tempted to copy it, there is an important question to answer before setting the alarm: what time will you actually be asleep?

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A men’s health expert explains why copying an early alarm without changing your bedtime could leave you tired, unfocused and less productive

Getting up at 3 a.m. might look like a head start in a social media morning routine. But for men tempted to copy it, there is an important question to answer before setting the alarm: what time will you actually be asleep?

Anneliese Cadena, a board-certified nurse practitioner and clinical consultant at Feel30, is encouraging men to protect their sleep when adopting an earlier routine. Moving the alarm forward without bringing bedtime forward can reduce the rest needed to function well during the day.

“If you normally wake up at 7 a.m., suddenly setting your alarm for 3 a.m. while keeping the same bedtime cuts four hours from your opportunity to sleep. That can leave you feeling worse during the day, even if you manage to get out of bed.”

The consequences can undermine the very reason for getting up early. According to the National Heart, Lung, and Blood Institute, insufficient sleep can affect concentration, decision-making and reaction times, leaving people taking longer to finish tasks and making more mistakes.

For someone who needs eight hours of sleep, a 3 a.m. alarm means being asleep by 7 p.m. the previous evening. That also requires time beforehand to wind down and fall asleep.

Start with a smaller change

For men who want an earlier start, a more manageable approach is to adjust the evening routine gradually.

Cleveland Clinic recommends moving bedtime earlier by 15 or 20 minutes for a few days, then making another small adjustment. Its guidance advises seven to nine hours of sleep each night.

Someone who usually wakes at 7 a.m. could start by working toward 6:45 a.m., alongside an earlier bedtime. Further changes should leave enough time for sleep. Moving the alarm forward by a full hour every day can quickly eat into rest if bedtime does not keep pace.

If falling asleep earlier proves difficult, or daytime sleepiness increases, pause further changes and reconsider whether the target wake-up time fits your needs.

Anneliese adds: 

“Choose a wake-up time that fits your responsibilities and still gives you enough sleep. Getting up at 6 a.m. and feeling rested may serve you much better than forcing a 3 a.m. start that leaves you struggling through the afternoon.”

An earlier morning starts the evening before

Changing the alarm may also mean reconsidering an afternoon coffee or a late evening spent scrolling.

The NHLBI recommends keeping a consistent sleep schedule and using the hour before bed for quiet time, while avoiding bright artificial light. It also notes that caffeine’s effects can last up to eight hours, which matters when bedtime moves earlier.

Morning daylight can help support an earlier sleep schedule. Spending time outside once it is light is one practical step, although people differ in when they naturally feel sleepy and alert.

What does sleep loss mean for testosterone?

Testosterone is one area researchers have investigated, although the findings do not justify claiming that a 3 a.m. alarm causes low testosterone.

A small University of Chicago study published in 2011, involving 10 healthy young men, found daytime testosterone levels were approximately 10% to 15% lower after about a week of sleep restricted to five hours a night, compared with a longer sleep condition.

However, two randomized studies published together in 2019 did not find an adverse effect on testosterone under the sleep-restriction conditions they tested. The studies used different schedules and measurements, and neither paper tested the social media trend itself.

The evidence supports taking sleep seriously without assuming that tiredness automatically signals a hormone problem.

Wyoming, Alaska and Montana lead searches for testosterone therapy

Separately, Feel30’s analysis of 312 testosterone replacement therapy (TRT) search terms recorded a combined estimated U.S. search volume of 3.37 million between September 2025 and August 2026.

Wyoming had the highest estimated search rate relative to population, followed by Alaska and Montana.

RankStateEstimated annual searches per 100,000 residents
1Wyoming3,093.0
2Alaska2,575.7
3Montana2,336.9
4North Dakota2,298.1
5Hawaii2,174.0
6South Dakota2,091.8
7Delaware2,056.7
8New Hampshire2,041.2
9Vermont2,029.0
10Rhode Island2,011.6

Rates use total state populations. Figures estimate searches, not individual searchers, patients or diagnoses.

Wyoming’s rate was almost three times California’s 1,045.7 searches per 100,000 residents. California recorded the largest total estimated volume, at 411,520, but ranked 41st once population was taken into account.

The rankings show geographic differences in search activity. They do not identify the states with the lowest testosterone, and the analysis did not measure sleep habits or establish any connection with early waking.

When tiredness needs checking

Persistent tiredness deserves a medical assessment, especially alongside loud snoring, gasping during sleep or breathing that stops and starts. These can be signs of sleep apnea.

Tiredness alone cannot diagnose low testosterone. The Endocrine Society recommends diagnosis only when compatible symptoms and signs are accompanied by consistently low testosterone levels, confirmed through repeat morning fasting blood tests. Treatment decisions require an appropriate clinical assessment.

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Wellness

Structured exercise linked to longer cancer survival and time free of disease

Those who exercised as part of their care were 23% less likely to die and 17% less likely to have a recurrence before death than those who didn’t exercise. Separate analyses showed that they were also 18% less likely to die from any cause, and 26% less likely to die from their cancer.

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Structured exercise may help people with cancer live longer and have more time free of disease, finds a synthesis of the available evidence, published in the British Journal of Sports Medicine.

The survival and recurrence risk benefits were strongest in early stage disease, in those who did aerobic exercise or aerobic exercise plus strength training, and in those who managed to keep up their exercise routines, the findings indicate.

Their analysis prompts the researchers to conclude that incorporating the therapeutic potential of exercise into cancer care merits consideration.

Cancer comes back in between 20%–40% of patients, even after standard curative surgery and chemotherapy, point out the researchers.

While structured exercise is widely recommended to ease fatigue and improve physical functioning and quality of life, its potential to prolong survival and stave off disease recurrence remains a subject of debate, they add.

In a bid to strengthen the evidence base, the researchers scoured research databases for randomised controlled clinical trials published up to the end of 2025 and reporting on survival and disease recurrence in adults with confirmed cancer who were given structured exercise programmes as part of their care.

From an initial haul of 123 studies, 21 clinical trials from North America, Europe, Australia, and Asia, involving a total of 8449 participants (88% women), met the eligibility criteria.

The average age of participants was 54 (range 47–76), and the average monitoring period was 64 months (range 2–99 months). The most common type of cancer studied was that of the breast followed by those of the bowel and pancreas.

Pooled data analysis of the results showed that structured exercise was associated with significant improvements in overall survival.

Those who exercised as part of their care were 23% less likely to die and 17% less likely to have a recurrence before death than those who didn’t exercise. Separate analyses showed that they were also 18% less likely to die from any cause, and 26% less likely to die from their cancer.

But there was no clear evidence that structured exercise prolonged the time before patients’ cancer worsened or increased the likelihood that no invasive cancer remained after standard treatment.

An exploratory analysis showed that the associations were stronger among participants who completed at least 70% of their exercise programme.

Overall survival estimates favoured aerobic exercise alone and programmes combining aerobic exercise and strength training. No clear association was found for strength training alone, but this finding was based only on one trial, involving 129 participants, note the researchers

“Aerobic exercise drives systemic cardiovascular conditioning, immune cell mobilisation, and normalisation of tumour perfusion, mechanisms directly relevant to systemic tumour control,” explain the researchers.

There are plausible biological explanations for the beneficial effects of exercise on cancer survival and risk of recurrence, they suggest.

Exercise may boost the body’s immune system response to cancer and improve blood flow within tumours, potentially helping treatment to work better. It may also lower circulating levels of sex specific hormones and increase glucose uptake by muscles, leaving less available to fuel cancer cells, they highlight. And it may help cells repair DNA damage, potentially limiting changes that can make tumours more aggressive, they add.

The researchers acknowledge various limitations to their findings, including the migration of participants in comparison groups to healthier behaviours; considerable variations in the type, duration, and intensity of the included exercise interventions; and a predominance of evidence from breast cancer trials, with relatively little evidence on advanced stage disease.

Nevertheless, they conclude: “Our meta-analysis provides direct, quantified evidence suggesting that the benefits of structured exercise may extend beyond supportive care to outcomes traditionally associated with therapeutic interventions, while underscoring that observed effects are context dependent and sensitive to trial design, conduct, and feasibility.”

They add: “On the strength of this evidence, clinicians can reasonably recommend structured exercise as part of oncological care, while recognising that important questions remain and that ongoing trials will continue to refine its optimal application.”

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Workout or nap? Either can help your sleepless brain, study finds

People who either completed 20 minutes of moderate-to-vigorous exercise or took a 90-minute nap performed about 22 per cent better on memory tests after 30 hours without sleep than those who did neither.

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A short workout or a nap can help protect memory after a sleepless night, a McGill University-led study has found.

Researchers found people who either completed 20 minutes of moderate-to-vigorous exercise or took a 90-minute nap performed about 22 per cent better on memory tests after 30 hours without sleep than those who did neither. The findings, published in Proceedings of the National Academy of Sciences (PNAS), point to practical ways to counter the effects of sleep deprivation.

“Sleep loss affects nearly every aspect of how we think and function, but many people can’t simply stop what they’re doing and get more sleep,” said senior author Marc Roig, Professor in McGill’s School of Physical and Occupational Therapy. “Our findings show that even a brief bout of exercise may help preserve one of our most important cognitive abilities.”

The study involved 54 healthy young adults who stayed awake for 30 consecutive hours under lab supervision. Participants were then assigned to one of three groups: a 20-minute cycling session, a 90-minute nap or a control condition. Three days later, researchers tested their memory for images they had viewed immediately after the intervention. Those who exercised or napped remembered significantly more images than participants who did neither.

Same result, different pathways

While the memory benefits were nearly identical, brain recordings revealed that exercise and napping helped in different ways.

Napping appeared to help the brain recharge, making it easier to take in and remember new information. Exercise, by contrast, helped the brain use its remaining resources more efficiently, without making participants feel more tired.

The findings could eventually inform fatigue-management strategies in workplaces where sleep loss is common and mistakes can have serious consequences, such as health care, transportation and emergency response.

“A nap isn’t always possible in the middle of a shift,” said first author Madhura Lotlikar, a doctoral candidate in McGill’s Department of Neurology and Neurosurgery. “Exercise is accessible, inexpensive and easy to implement. That makes it a promising tool to help people stay cognitively sharp when sleep is limited.”

The researchers emphasize that exercise cannot replace sleep, but it may help people function better when getting enough rest isn’t possible.

About the study

“Protecting episodic memory after sleep loss: Similar benefits of exercise and naps via distinct neural contributions” by Madhura Lotlikar and Marc Roig et al., was published in Proceedings of the National Academy of Sciences of the United States of America.

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