112- How Exercise Improves Our Cognitive Abilities with Dr. Jenny Etnier

Bryan: [00:00:15] Often we participate in exercise programs to improve our overall movement quality. Whether that be to improve our strength and coordination or to recover from injuries we have had.

But what if exercise also plays a role in our brain health, especially when it comes down to Alzheimer's disease. What's up everyone. I'm Bryan Carroll and I'm here to help people move more, eat well, and be adventurous. And today I have Dr Jenny Etnier and I are on the show to discuss different research that has been done to test how exercise impacts our brain.

We'll also be looking at how exercise becomes beneficial across different age groups from children to the elderly. So let's dive into my conversation with Jenny at night. Dr Jennife  is a distinguished professor of kinesiology at the university of North Carolina at Greensboro. Her research focuses on the cognitive benefits of physical activity.

Jenny is highly acclaimed as a fellow of the American college of sports medicine and the national Academy of kinesiology, former president of the North American society for the psychology of sport and physical activity. And a member of multiple editorial boards for peer reviewed journals. She is also the principal investigator of the physical activity and Alzheimer's disease to study, which is focused on understanding the potential protective effects of physical activity for people are relative to their risk.

Where Alzheimer's disease. In addition to her research, Jenny has how was two books focused on improving the youth sport experience, which are called bring your a game and coaching for the love of the game. Thank you for coming onto the show, dr Jenny. 

Jenny Etnier: [00:01:59] Oh, thanks Bryan. And thanks for that wonderful introduction.

Bryan: [00:02:01] Of course, and it sounds like you are just a part of a lot of different things, so I would love to learn a little bit more about your background and what brought you to where you are today. 

Jenny Etnier: [00:02:11] Yeah, sure. So I have a PhD in kinesiology, which is, the area of study that's focused on human movement. And I was trained as an exercise psychologist.

I'm a professor at the university of North Carolina at Greensboro. And in my teaching, I usually get to focus on courses that look at, either using psychological techniques to promote physical activity and to help people be physically active. and I also get to focus on the mental health benefits of physical activity.

I'm also, as you mentioned, I'm really interested in passionate about youth sports and, I'm trying to do some work to improve the sport experience. 

Bryan: [00:02:46] So when you mentioned. I'm trying to work on the psychology around movement. What have you discovered with that? Like how can we get someone that absolutely hates exercise to start enjoying it?

Jenny Etnier: [00:02:58] Yeah, that's a great question. I mean, I think one of the, one of the real keys is to sort of flip it around and do the other side first, which is, let's think about the benefits that you receive in response to being physically active and, brand. I know you're physically active, so you can, you can relate to this firsthand, but when you are physically active and used to being physically active.

You get a feel good response, you get, these benefits that have to do with mood and affect, that can then carry through with you for the rest of the day. we also know, of course, that we get physical health benefits, that are more chronic in nature and chronic health benefits that are more chronic in nature.

Like, it helps with stress management, helps our cognition, helps reduce depression. so all of these benefits, I think can be used as a way to motivate people to become physically active, especially if you can help, identify those outcomes that are of most relevance to you. So right now we're all dealing with this covert pandemic.

We're dealing with a lot of stress and anxiety. This is a great time to get outside and be physically active because that physical activity can help give you the mechanisms you need to be able to cope with what you're experiencing. 

Bryan: [00:04:01] Yeah, and that is a nice part is a lot of us still have that freedom to be able to go out for walks and get some exercise and get moving.

I remember a few years ago I had, a mold issue, a mycotoxin issue where, I was so fatigued I couldn't move. So going from that very active lifestyle to being completely sedentary and basically bedridden, it definitely does, a toll on the psychological factor of. You as a person. 

Jenny Etnier: [00:04:26] Yeah, absolutely.

Absolutely. I mean, we know that in this country a lot of people are very sedentary, and I used walking outside as an example because that, that always feels great to me. I love to be in the out of doors. but you know, you don't have to be outside. there are a lot of opportunities to do kind of acute, quick types of exercise within your own home, sort of bootcamp style activities or seven minute workouts.

anything that you can do to get up and move and can really make a big difference. 

Bryan: [00:04:51] Of course. And, one of the things that you've been putting a lot of, research into is movement, quality of people, what it does to their brains over the lifespan of a human. So can you, kind of talk. Talk to us about what you have discovered with this, because kids tend to move a lot more, right?

And then as you start aging and you're going through the school system and you get less recess, you have more time sitting in the classrooms, you're not moving as much. Now people, you know, I spend a lot of times on video games, and then that continues as you age because then as adults, you get, for the most part, that's jobs or office jobs.

And you become, like you said, more sedentary. So what have you found. With this lack of movement as we age. 

Jenny Etnier: [00:05:34] Yeah. And that's a, that's a great preface to that. I mean, the, the increase, well I guess that's a backwards way of saying it. The increase in sedentary time, right. Or the, or the decrease in physical, physically active time, is having an impact on people's physical and mental health.

And the work that we've done is really looking at how even a single session of exercise can benefit your ability to think clearly, to remember things. during the day. And so what I get really excited about is that we've done this with children in school settings. We've done it with college dates, adults.

and then we've also done it with middle aged and older adults. And in all of those age groups, if we ask somebody to exercise for, say, 20 to 30 minutes, just at a moderate intensity, we can see cognitive benefits immediately following that exercise. 

Bryan: [00:06:20] That's amazing. 

Jenny Etnier: [00:06:21] So, so I think what's cool about that, you know, when you think about the implications, so.

During the school day, as you rightfully pointed out, Bryan, most kids are sitting right, and they might get recess and they might get some free time and they might get to move around at lunch and hopefully they have physical education. But all of those free time and movement periods are being decreased in the schools because they're trying to make time more time for academics.

Well, the irony of that is, is that the movement time actually helps children to perform better academically. It helps them to remember things better. It helps them to attend better in the classroom. And so a school day would be ideally designed where there were multiple opportunities during the day for children to get up and to be active and to move around.

Because it would impact their ability to perform well in that school setting. And the same is true for working adults, right? So if, if we got up and moved around more regularly during the Workday, it would allow us to perform more effectively at our jobs. 

Bryan: [00:07:18] So in a school type setting, would it be better, to a sprinkle in 20 minute moment sessions throughout the day, or is it better to do like one 60 minute movement session right in the middle of the school day?

Jenny Etnier: [00:07:33] Yeah. You know, that's a great question. And I don't know if scientifically we actually know the answer to that question. So, you know, right now I'll take the cop out answer and say, give me either one of those and I'll take them. Right? So if you would give me the opportunity for kids to be active for 60 minutes during the school day every day, I would say that would be a win for the children and the win for public health.

If they could be active every two hours for 20 minutes, that would still accumulate to 60 minutes. And I would say that would be a win. we do have some evidence that leads us to believe that if they exercise in the morning, that makes more sense in terms of cognitive benefits. But that makes more sense, right?

Because if they exercise in the morning, then they've got the whole day just following it, and that's when they'll see their benefits. So if they exercise at the end of the day, like afterschool sports, they might, that might benefit their ability to do their homework and their ability to study at night, but those effects are pretty transient.

The likely wear off by the next morning. 

Bryan: [00:08:25] Hmm. Interesting. so one thing that we definitely see as kids start to age, especially once they get to like middle school, they tend to, or you get different groups, right? You get the people that, or the kids that are more active. And then you get the people that are scared to move in certain ways because either their friends, they want to impress our friends or they just don't want to be made fun of.

and w. I mean, this happens a lot where, you know, when they, when schools schedule like the one mile run and you see the kids opting out of that because their friends are opting out of it, right? There's a lot of peer pressure type stuff going on there. What can we do? Two, motivate those kids to focus less on what their friends are thinking and focus more on what they can be doing to improve their own health.

Jenny Etnier: [00:09:16] Yeah, I mean, I think that's, you know, that, that, that, that's one way of answering that. Let me, let me try to tackle that first and then I'll, hopefully I'll remember to add something else on. But I think one of the things that's really important in our society is to help people to really think about personal improvement and sort of the process of becoming a better, you.

And so if, if people are, convinced, if you will, about the benefits that they'll achieve in response to physical activity, then I think it can help them to be more self referenced. So I don't care how fast you can run the mile, Bryan, but what I do care about is that you're willing to. Cover the distance of a mile, right?

So when we make it outcome based and we care about speed and time and strength and performance, then of course people self select not to be involved. But if we can shift our focus to make it more about participation, right? Or just simply being physically active and let's not put any metrics on it, right?

Other than maybe time, right? Try to be physically active for 60 minutes a day. Well then maybe we could get everybody to be engaged. And then the other piece I want to add to that is, is that we've got to make sure that the options that are available are attractive to the kids, right? Whoever that may be.

So we know that, boys and girls can have different interests in the types of physical activities they want to participate in. While are we offering physical activities that are attractive to both. genders. there are even differences in terms of people who are more competitive and less competitive, whether they're boy or girl.

So people who are more competitive might enjoy sports settings and might be really attracted to that form of movement, but people who are less competitive might really prefer to walk or to jog or to do group exercise or to take a dance class. or to ride a bike. And so we need to make sure in the school settings that we're offering opportunities across those continuums.

Bryan: [00:11:01] And so we've been talking about duration. and going back to the, the one mile example, some kids might finish the one mile in seven minutes where others might walk it and it takes 20. Are they getting the same benefits from the distance or. It is a benefit changing based off of duration. 

Jenny Etnier: [00:11:20] Wow. That's such a high level question, Ryan.

Nobody really knows the answer to that. You'd be surprised. That's more tricky than you think to try to sort of tease that apart with our cognitive outcomes. What we know is that about 20 minutes of exercise seems to be the best free cognitive benefit, but if you start to add in intensity, so if I, if I'm the kid who can run a seven minute mile and I run for 20 minutes.

Then I've covered what, two and a half miles approximately. Right? But that 20 minutes is going to be at a fairly high intensity. And so the nature of the benefits that I get might be different than somebody who exercises for the same length of time. It doesn't cover as much distance, but they're at a moderate intensity of exercise.

And so we think duration's important. We probably think intensity is more important. but if you only do a minute of high intensity exercise, you're probably not going to get enough of a stimulus to the system to see any very long lasting benefits. Yeah. It probably makes no sense because it's, it's like a combination.

If you think of it as like total work, you know, total work accomplished is sort of a combination of intensity and duration. Well then we want it, we want to get that up to some level where we think that the body's going to have a physiological response. that will then benefit the brain and how we perform cognitively.

Bryan: [00:12:36] So the other question with that is, intensity wise, is there a certain thresholds of intensity where you're getting different biological, effects that aren't necessarily cognitive, but. It's less cognitive based and more physical based, whereas a lower intensity might be more cognitive based and less physical.

Jenny Etnier: [00:12:56] Again, great questions, Bryan. I'm glad I'm doing this with you because you got me. He got me thinking he got my wheels turning. You know what we know, so let me, let me just tell you what we know. So for instance, if we're looking at memory, okay, if I asked you if I told you a list of 15 words and asked you Bryan to recall back to me, as many as you could remember, okay?

That's a measure of memory. And. If I do that with you after you've done light intensity exercise, pretty low intensity, say walk it, then your memory will be improved, but only for a little short period of time. But if you do high intensity exercise, then we might see those memory effects being more long lasting.

But right after, so right after he finished running at maximum intensity, say you just ran that seven minute mile and you're exhausted. Then I asked you to remember the words back to me. You can't remember, you're, you're exhausted and that's what you're dealing with, right? But if I wait five minutes, if I wait 10 minutes, if I wait 24 hours, then I might see bigger benefits than if you had done that light intensity exercise.

So there's a question too about the timing, and you can think about it for, you know, some people ask about exercise while you're doing cognitive tasks, if you're exercising as hard as you possibly can. You're not going to perform great cognitively because you are focused on something else. You're trying to maintain this homeostasis while you're exercising at a really high intensity, but if you lower that intensity and I asked you to do something cognitively, you will perform better on that cognitive test than if you were just sitting there quietly.

So you know, again, it's just a con. It's a complicated question, but it, I think it makes good practical sense. If you're at really high intensity, then in that moment and immediately after that moment, you're not going to see great benefits. But if you wait, then when the body's kind of returning to homeostasis, then you're going to get those benefits and they're going to appear.

But if it's light intensity exercise or moderate intensity exercise, you can get benefits during exercise and even in the window of time after the exercise. But they probably won't last as long. 

Bryan: [00:14:52] Right? Yeah. It makes sense. If you break it down into, you know, you're sprinting away from a tiger because the tiger is trying to get you, you're not gonna remember anything that you saw in the process.

You're just trying to get out of there. But if you're on a walk with your friend and you're talking about things, you're going to remember. Exactly what you talked about. 

Jenny Etnier: [00:15:09] Yeah, that's right. You got it. That's a perfect analogy. Good. 

Bryan: [00:15:12] Yup. Perfect. So when you are measuring, cognition improvement, what different type of markers are you looking at to see, you know, what changes are happening in the body when you're, adding in exercise?

Jenny Etnier: [00:15:24] so when you're, when you asked me that question, Bryan, are you thinking like, what, what are the cognitive measures or what do we see physiologically. Both. Both. Okay. okay, so let me start with the behavioral first. So most of the research that's been done in this area is looking at lab based type tasks.

As you can imagine, we're trying to tightly control the exercise. And so the best way to do that is to bring it into a lab. but the types of measures that we take, we think have implications for real world types of decision making and problem solving and, and thinking. so we use things like speed of performance.

How quickly can you respond to a green light on the, on the screen. Then we make it more complicated. Okay. There's a green light and a red light. When you see the green light go, if you see the red light don't go right. So we, we try to make it more natural and we try to also look at sort of questions of complexity.

And then we also try to look at, different cognitive domains. And so when we talk about cognitive domains. you may have heard of, executive functions there. They're in the news a lot, and so executive functions are kind of higher order cognitive processes that allow us to plan things too. Inhibit inappropriate responses.

To take things into our mind and manipulate them and then give back another answer. So those types of executive measures we think obviously have big implications for what you might do in a school, in a classroom, or in your place of business. and so those are the types of measures we use when we measure, mechanisms or the underlying biological variables that we think might explain cognitive benefits.

We're looking into some different places. So one of the things that we've looked at, in my lab is something called brain derived neurotrophic factor, which is BDNF for short. And BDNF has been euphemistically referred to as sort of miracle grow for the brain. The more BDNF you have, you know, it's like a fertilizer.

It's going to help with synaptogenesis neurogenesis in the brain. And so that's one of the things that we look at. We measure that from the blood. but what's tricky about that is of course, I don't really care what's happening to BDNF in the general body. I really care what's happening in the central nervous system.

Well, I can't measure it there. So I'm limited in human studies, right? I could only look at it peripherally and I'm trying to understand what that means centrally. in animal studies, they have looked at BDNF and showed that BDNF is an important potential mechanism, possibly explaining why exercise benefits cognition.

we're also starting to do some work using functional MRI, magnetic resonance imaging, which is, excuse me. You've probably seen this. People use it in the medical field, but we're also using it in research where we're looking at, essentially oxygenation patterns in the brain and using to infer from that what is happening functionally in the brain.

And we're, we're in my lab, we're just starting to do some of this relative to acute exercise to use it as a way of understanding, how exercise might benefit cognition. People have been doing it for quite some time with chronic exercise. So if I start exercising exercise for a year, if I do a structural MRI, a brain scan, I will see that over the course of that year, I'm likely to see that I will get benefits to my hippocampus.

My hippocampus will grow in size, I'll look more healthy. And those changes to hippocampus may explain why I also perform better in terms of memory and explain why I might be a list risk for Alzheimer's disease. So blood-based markers, neuroimaging measures are some of the places people are really looking.

We're also looking a little bit at heart rate variability, because that tells us a little bit about sort of the, the relative activation of the, two different sides of the nervous system, the side that sort of arousing you in the side that's bringing you back to homeostasis. And so heart rate variability gives us an indication of, is exercise working through that, through that mechanism.

So we're, we're kind of looking at all over. That's, that's quite the, quite the spread of mechanisms, but we're, we're, it's probably not a simple answer is we probably need all of those, right. To understand what in the world is going on in response to this really huge stimulus to the body of exercise.

Bryan: [00:19:23] Right, and that's where, you know, research comes into play too, right? Because you're trying to think through all the different variables that could be impacted by looking at. Blank, right? So you're trying to think, what should we be setting and monitoring to see what is changing? And then after you come to conclusions, now you have data that you can look back on and say, okay, if we want to really study this and study deeper, we know these variables were important, but we also discovered we should have.

Then following these variables as well. 

Jenny Etnier: [00:19:56] Yeah. Yeah. Well, and that's so well stated, Bryan. That's great. So, so that is absolutely true, what you just said, and also it might help us to think about things like dosing. So we started this conversation about intensity and duration. Well, if I don't know what the mechanisms are, how can I answer the question about intensity and duration?

But if I understand better what the mechanisms are, then maybe I can, you know, seek out my physiology friends to say, Hey, what have you learned about how. Intensity and duration impacts BDNF or how intensity and duration impacts regional measures of cerebral blood flow. Because then, you know, then then we're sort of honing in on the answers that we're all interested in and how much do I need to do at what intensity?

How frequently, and for how long? For a day, for weeks, for months, for years, what do I need to do? 

Bryan: [00:20:42] Right? So, since we are talking about, you know, the lifespan of a human, let's say someone grew up, they were pretty sedentary as kids. They weren't very active. They're in adulthood. Then, you know, from their twenties to thirties, they weren't very active as well.

And now they're in their forties or fifties and they decided to start becoming more active. Are they going to see. Any massive changes in their brain and their body by making those changes at that point, or should they have started way earlier? 

Jenny Etnier: [00:21:13] I'm so glad you asked this question, Bryan, because I think the message is really important.

You can start anytime, right? You can start any time. And if you start being physically active, yes. Over an extended period of time, studies, I would say, you know, most consistently, after about six months. We would start to say that, yes, we could. We could. We could tell a difference between your brain at six months in your brain at zero months, if in between that time you were exercising regularly three times a week, she didn't for maybe 150 minutes a week.

You know, just trying to make sure that you're meeting the, the recommended recommended guidelines. we would see a difference in your brain. Now, this question about when you should start, will it be better if you started when you were young and if you kept it up your whole lifetime? Right? Because what happens is during childhood, the brain is developing so quickly, and if you're physically active, what we believe is that you might be, Creating, if you will, generating a more healthy brain to start with. So as the development is, that rate of development for the brain starts to slow, you may be, can't add as much to it and strengthen it as much, but you can maintain it. You can absolutely maintain it. And we know it's plastic, so you can add to it, just maybe not at the same rate as when you're a child.

So, And a long winded answer, but I think the answer is yes. Start now. Stick with it as long as you can, and you will still get benefits. but if you're 20 don't go well, she said, I could wait until I'm 60. That's not what I said. Start now. No matter what your age is now, start now and start exercising and it will have benefits for you in terms of cognition 

Bryan: [00:22:43] and then looking at athletes.

Let's think about athletes that have a lesser risk of TBIs. And they tend to train pretty heavily and that they could possibly be over-training, their bodies. Is there a point where you can be, I mean, there's always going to be, Physical deterioration of joins and whatnot within the body that can break down from over-training.

But what about that impact on your brain? 

Jenny Etnier: [00:23:08] That's, you know, that's a great question. I don't, I honestly don't know if anybody's looked into that too much. usually when we talk about, overtrading and burnout, just like you suggested, we're looking at sort of dropout behaviors from sport, risk of injury, physical injury and the sport and things like that.

But yeah. What I would think, just based on my thinking about sort of stress and how these things are linked together, is that if you're overtrading and experiencing burnout, then you are having a high level stress response. And that stress response means you're triggering HPA axis. You're releasing cortisol, which is the body stress hormone into the body.

And we know that cortisol, This will be too simple. But if I said BDNF was miracle grow, imagine that this is like some sort of a of a killer, right? A killer of positive things. So the cortisol floating around in your body is not doing your brain any good and your brain health any good. And so, Yeah. So at that point, the, the exercise, because it's at too high a level, may itself per se be causing some negative consequences in the brain. But I don't know that empirically. So I'm going way out on a limb to even say that. it would just be a bit conjecture. So I think if somebody was, if you're talking about a high level athlete who is experiencing over-training, the recommendation that sport psychologists would give is that they need to stop, right?

They need to stop and they need to take a good long break. Once they take that good long break, then they can come back and they're ready again. And hopefully they can control their exercise behavior so that it's still considered, you know, moderate. Now I'm talking about moderate, not just about intensity, but moderate about sort of workload over a period of time.

If it starts to be too much, you're right. You have all these physiological responses that are negative and those are, likely to be reflected in brain health as well. 

Bryan: [00:24:49] Perfect. And then, So what there is more and more people that are adding like, Walking desks or treadmill type desks or walking treadmills at their desks and whatever they're called.

You know, so that they can be moving while they're working. And you also have people that say it on like exercise balls, so that at least their bodies, they able to move a little bit more while they're working. Are there benefits that you have seen by adding these different components into a workspace?

Jenny Etnier: [00:25:16] Yeah, that's a great question. There hasn't been very much research that's been done on this a little bit. It's taken place in the schools and, The limited evidence that we have says yes, it's helpful in school settings. So, you know, having stand up desks, having extra balls that they're sitting on, having, the pedals underneath the desk that they can sort of keep their legs moving.

those things help. Now the question is, you know, so you remember I was talking about sort of intensity and duration. Sitting on an extra size ball is probably not having cognitive benefits for similar reasons that walking would. So walking is a, you know, as giving the body this again, this sort of large stimulus that it has to respond to and the response is going to be positive for, for thinking abilities.

Sitting on an exercise ball is almost more like a dual task paradigm. So now I'm being asked to do something physically that requires concentration, but it's actually. We believe kind of honing me in so that I can also attend to the teacher on the lesson better. I'm not distracted. If I get distracted, I'm going to fall off the ball.

Right. So, so it's a little bit, you know, it was probably not exactly the same mechanisms, With kids in schools. Now, if you talk about somebody who's at work, and I haven't seen these in schools, so that's why I switched it to work. If they're at a treadmill desk where they're actually moving the treadmill, and so they're walking while they're working, they are likely to be having the same.

The same benefits and the same reason for the benefits as what I described earlier, like going for a walk. I've been trying to do a lot of walking meetings with my students, back when I was on campus and we, and we could do that, you know, and the weather was nice. I love those meetings because I feel like, I think so much more clearly and, it's just so nice to get a break from the office, but.

I can't perceive it. But what is also happening is that physiologically I'm getting a response that is truly helping me to flake better because what it's doing for my brain health. 

Bryan: [00:27:04] So that brings up another question. so like with walking, your entire body is involved. So it was creating an, a response because the entire body has to move.

Whereas you'll mention like the pedals under the desk where your feet are moving and your lower half is moving, but not necessarily your upper half. Are you getting those same benefits from 

Jenny Etnier: [00:27:24] that? that's a great question, Bryan. there, there people have sort of toyed with these ideas, like, you know, you think about like one of those Nordic trackers or people who walk with the walking poles, and so they're using their arms quite a bit and their legs.

Is there something different about that compared to just walking? Like, if I hold my arms kind of still. Or just peddling a bicycle, right? Where I'm, where I'm not using my upper body as much. We don't, we don't, we honestly, we don't know that much about that. I think, I personally think it probably comes back to short of the stimulus to the body, which is probably cardiovascularly linked.

and so as long as I'm sort of getting a good work rate. Regardless, it's, they probably have similar benefits, but that's, that's a bit of a nuance. I mean, it's interesting you would think that these questions would be simple to answer, but they're, they're just not, because we still don't understand enough about the underlying physiological mechanisms.

And the other thing I should say is that although these affects are incredibly robust, they are pretty small. Right? So when I'm talking about saying performance improvements, okay, so you performed, you know, 80 milliseconds faster than the person in the control group. Well, that's not probably important for your performance in school or at work.

It might be important if you're a, you know, if you're flying jet airplanes, it might be important, but it's not really important day to day. So, so the effects are small and what we want to do, I guess, is we want to try to, if I was telling somebody what to do to try to benefit their cognition, I would say do as much as you feel comfortable doing.

Right? So use upper body and lower body if you like, that kind of exercise. But if you really prefer to bike or just to walk and not to use the poles, then by all means just walk, right? Because it's the, it's the movement itself that's going to give you the benefit. And if you repeat it over time, then those small effects are going to somewhat cumulate.

because of the positive effect that it has on brain 

Bryan: [00:29:13] health. And then I think my final question that just popped into my head, since this is a podcast, if you are doing light moment, like walking and you're listening to podcasts or something, audio, some type of learning through headphones. Would that input directly into, here's just some wild walking, are you going to retain that information more, or what do you think about that?

Jenny Etnier: [00:29:40] I think absolutely. I think a hundred percent for sure. But what you got me excited about is one of the things I'm really interested in is this notion of sort of doing, cognitively engaging physical activity. So is there a difference between walking on a treadmill, not listening to anything, looking at a blank wall or walking outside and listening to a podcast.

or let me take that back one. What about walking outside? But I'm listening to music on the radio now. I'm walking us out. I'm listening to a podcast where two people like you and I are talking back and forth, and so the person listening to this has to keep up with our conversation, has to keep track of who's who.

Or what if I was language learning? What if I was listening to, I'm trying to learn Spanish myself. What if I was listening to my Spanish tapes while I was tapes that dated me, my, my Spanish, whatever, right? While I was walking and so I was cognitively engaged, but while I was moving, well, there is some evidence to suggest that that is going to have a bigger benefit for brain health and I, and I think it makes sense, right?

Because you're interacting at the same time that you're being physically engaged. So I think, you know, I think that's, that's a great question at least is something that a lot of people are really interested in. Like, what about walking compared to playing sports, right? In sports, I have to be interactive and I have to look for moving stimuli and I have to watch other players and I have to watch my teammates.

I have to know, you know, have really good sense of my body and space. that type of activity may be more beneficial then walking on a treadmill, looking at a blank wall. Right. Because of the interaction required. So fascinating. That's a great question. That's a really great question. 

Bryan: [00:31:13] Hmm. Yeah, I love it.

There's, there's so many potentials with it, and I love that you're just diving headfirst and all this and trying to figure this stuff out. That's great. And do you have any. final thoughts around all of this, and, is there any type of tie-ins that you want to pull in with Alzheimer's and the research that you've done with that as well?

Jenny Etnier: [00:31:33] Let me definitely talk about that a little bit because the work that I'm doing right now is that we're, we're doing a large funded grant that's funded by the national Institute of aging. That's looking at the possibility that physical activity might be a protective behavior against Alzheimer's. And so what we're doing is we're looking at people who are, middle-aged, so 40 to 65 year olds, If they have a family history of Alzheimer's, and if they carry a certain gene, then their risk of Alzheimer's is pretty high. But what we think is that a one year physical activity program might give them some protection against Alzheimer's. And there's past evidence with older adults like 60 and older, 65 and older, that shows that it is protective, but we're pulling it back and looking at a slightly younger age group because those people who have a genetic risk for Alzheimer's, their brain, and one of those images I was talking about already looks different at the age of 30 from people who don't have the genetic risk of Alzheimer's.

So we're super interested in trying to get at people at a younger age so that we can maybe have a bigger benefit in terms of brain health as measured using neuro imaging, but also in terms of measuring with the cognitive measures that I've been talking to you about. And if we find that it would be incredibly important, because as you probably know, there's no pharmacological treatment for Alzheimer's disease.

and it's such a devastating disease that these findings could be really, really important to help to help everybody, but maybe particularly so for people who have a familial and a genetic risk for Alzheimer's disease. 

Bryan: [00:33:06] That would be amazing. 

Jenny Etnier: [00:33:07] Yeah. It's so neat. I mean, it's so exciting. it's called the physical activity in Alzheimer's disease to study or pad to pad with two A's.

and we're, we're working in North Carolina, so if anybody listening to your podcast is in North Carolina and interested, which you'd love to hear from 

Bryan: [00:33:21] them. Perfect. And speaking on that, where people, where can people find out more about pad too and more about what you're doing? 

Jenny Etnier: [00:33:28] Yeah. That's great. our pet two website is called go dot U N C G.

Dot EDU slash pad to pad with two A's. and then the number two. P a D two. if anybody was interested in learning about the, work that I've done with you sport, which is really focused on trying to improve the youth sport experience for kids. those couple of books that I wrote were, published by UNC press.

And so if you went to the UNC press, and just looked up my last name, E. T. N. I. E. R. you would find those two books. 

Bryan: [00:34:00] Perfect, and we'll have that all linked in the show [email protected] slash one, one, two. that way it's easy for people to find. thank you Denny so much for coming on.

This was a very stimulating episodes. I'm really glad to have you on and dive into some of these questions and see what we can come up 

Jenny Etnier: [00:34:18] with. This is great fun for me, Bryan. Thank you so much. And your, your questions make me think you need to come join us in our graduate program over here at UNC G cause you've got some great, great, interesting ideas.

Bryan: [00:34:29] There'd be a lot of fun. Yeah. Jenny is doing some great research on these topics and if you want to see some of the research she has done or is working on and go to our show [email protected] slash one 12 for the next couple of days until June 10th our nutrition coaching program is open for enrollment.

If you are ready to make nutrition changes and habit changes so you never have to go on a diet again. And make sure to join me in nutrition coaching. You can sign up at summitforwellness.com/nutrition next week I have Dr. Rachel Keith on the show to share with us some research being done on different environments and how it impacts health.

So let's go learn a little more about Rachel. I am here with Dr. Rachel Keith. Hey Rachel. What is one unique thing about you that most people don't know. 

Rachel Keith: [00:35:19] One unique thing about me that most people don't know, I would say is that I have chickens. I raise chickens. 

Bryan: [00:35:32] Oh, me too. How many do you have? 

Rachel Keith: [00:35:33] I have 10.

We have a broody hen right now, so we're hoping to have some more chicks soon. but we'll, we'll see. We do. We have one rooster named Bobby. 

Bryan: [00:35:45] Yep. Yeah. Most of our chickens we raised, or we hatched. So it's a super fun process. It's really cute seeing all those baby checks running around. 

Rachel Keith: [00:35:54] We have never hatched before.

So this is our first attempt. We had a broody hen and we decided we'd let her, let her beans 

see what happened, 

Bryan: [00:36:03] let her do her thing. So what will we be learning about in our interview together? 

Rachel Keith: [00:36:09] In our interview together, I think we'll be, learning more about the research process, and what it takes to put on good studies and how involved 

research is in general.

it will be tied back to projects that we're doing that are involved, greenness and the environment. 

Bryan: [00:36:27] And, what are your favorite foods or nutrients that you think everyone should get more of in their diet? My 

Rachel Keith: [00:36:33] favorite foods. I really like. cauliflower and lentils. We are doing a lot of plant based diet at home right now.

and that is our favorite food that we're eating right now. We do a lot of lentil and cauliflower. Curry. Different types of curried issues, dishes. 

Bryan: [00:36:52] And what are your top three health tips for anyone who wants to improve their overall wellness? 

Rachel Keith: [00:36:58] So I practiced cardiology, so I'm going back to my clinical roots for this.

You gotta give up the cigarettes most people have, but those who haven't disowned it out, their three cigarettes can, do dammit to your heart, three cigarettes a day. So even if you've cut back, quit. consistent exercise. You don't have to be a marathon runner. You don't have to be, you know, a CrossFit 

person.

but five to 10 minutes of exercise every day can actually have heart related benefits. And I think for a lot of people, they think if I don't go for a three mile run, it's not worth it. So five to 10 minutes of elevating your heart rate a day, fantastic and doable. And then my last health tip, I think in particular, take care of yourself, you know, consider mental health and physical health, aspect as well.

Because without, without taking care of yourself, you're, your body's never gonna function at its fullest either. 

Bryan: [00:38:01] so going back to cigarettes. A lot of people have switched to vape. What have you seen so far? What's the difference between cigarettes and vape? 

Rachel Keith: [00:38:10] So I am actually part of the American heart association, tobacco research and addiction center.

So I actually do research on banking and we are seeing, Some interesting things come out with that and it is a hot topic as well, but we are seeing that people are being exposed to high levels of nicotine, which is not benign in and of itself. We are seeing that there are some early indication of health changes and we are seeing the, in young, healthy adults.

That's all we're working with in our tobacco populations. So people who are vaping have some of these, early vascular system changes, compared to our control groups. so w w we're seeing health, we're seeing, you know, health effects that are concerning for us. again, this unfortunately is an early field.

we only have about five. Do you have somewhere between five and 10 years of research on this? And I know a lot of people would think you have answers by then, but that 

the infancy of research 

in 

general. 

Bryan: [00:39:15] So what you're telling me is all the teenagers that tell me that vaping isn't bad for you might be wrong.

Rachel Keith: [00:39:21] I would, I would not. I would not want, if I had a teenager, I would not want them to vape. and I would not do it myself. You know, there are healthy ways to get off of tobacco, you know, and I think it kind of gets back to why are teenagers vaping? And, you know, what are they looking for from that?

And maybe there's, 

there's other, other healthier ways to get guests what they're looking 

for 

Bryan: [00:39:49] that episode. We also walked through the scientific process and the steps and variables that go into creating a well-made study. Which I think is important right now because of all the research being thrown around and all the upcoming research.

I've said it before, and I will keep saying it. By educating ourselves on how these processes work, we can have a better understanding of the results we see posted all around us. So until then, keep climbing to the peak of your health.