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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

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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Wellness

Walking and weight training alone are not enough for strong bones – football and handball may be more effective

Bone formation was stimulated most effectively by activities involving explosive movements, rapid changes of direction, and turning. The findings could help improve exercise programs designed to maintain bone health and prevent osteoporosis. 

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When it comes to maintaining healthy bones, how intensely we exercise may matter more than how much we exercise, according to researchers at Semmelweis University.

Their study, published in Sports Medicine – Open, found that bone formation was stimulated most effectively by activities involving explosive movements, rapid changes of direction, and turning. The findings could help improve exercise programs designed to maintain bone health and prevent osteoporosis. 

Researchers at Semmelweis University analyzed the results of 24 clinical studies involving a total of 1,238 healthy adult participants. Rather than tracking changes in bone mineral density, the studies measured substances in the blood that indicate whether the body is actively building new bone tissue. These so-called biomarkers can reflect the effects of exercise within just a few weeks, providing feedback much earlier than bone density measurements.  

“What makes our study unique is that we examined not only the type of exercise – whether endurance, resistance, or combined training – but also exercise intensity, frequency, and duration. Our goal was to determine which forms of exercise stimulate bone metabolism most effectively and which appear to be less beneficial from this perspective,” said dr. Péter Ferdinandy, Vice-Rector for Science and Innovations at Semmelweis University and senior author of the study. 

The most effective activities were high-intensity sports involving frequent explosive movements, rapid changes of direction, and turning. Recreational football and handball, for example, were associated with increases of up to 45–46 percent in the levels of substances linked to bone formation. In contrast, walking, step aerobics, and traditional gym-based resistance exercises were generally less effective.  

What should you keep in mind?
It is important not to start a high-intensity exercise program suddenly or without proper preparation. This is particularly true for people with cardiovascular, musculoskeletal, or metabolic diseases, as well as those living with osteoporosis. Before beginning a new type of exercise or a more demanding training program, they should consult their treating physician, general practitioner, or a sports medicine specialist to ensure that the activity and its intensity are appropriate for their individual health status.

“The most surprising finding was that resistance training did not produce a significant effect on markers of bone metabolism, even though several professional guidelines recommend this type of exercise for maintaining bone health. Likewise, low- or moderate-intensity endurance exercise, such as walking or jogging, showed no meaningful long-term effect,” explained Viktória Barna, PhD student at Semmelweis University and first author of the study.

This, of course, does not mean that walking or lower-intensity physical activity is without health benefits. However, if the goal is to keep bones strong and healthy for as long as possible, they appear to require a greater mechanical stimulus. 

“According to the World Health Organization, regular physical activity offers numerous health benefits. However, our findings suggest that low-intensity exercise alone is not sufficient to stimulate bone metabolism. High-intensity exercise may trigger early beneficial changes in bone formation, potentially helping to slow bone loss and support healthy ageing,” summarized dr. Nóra Sydó, clinical specialist and co-author of the study. 

According to the researchers, these findings could contribute to the development of evidence-based exercise programs aimed at maintaining bone health and preventing osteoporosis. 

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