Brain metabolism in health, aging, and neurodegeneration

  • Brain cells normally respond adaptively to bioenergetic challenges resulting from ongoing activity in neuronal circuits, and from environmental energetic stressors such as food deprivation and physical exertion.
  • At the cellular level, such adaptive responses include the “strengthening” of existing synapses, the formation of new synapses, and the production of new neurons from stem cells.
  • At the molecular level, bioenergetic challenges result in the activation of transcription factors that induce the expression of proteins that bolster the resistance of neurons to the kinds of metabolic, oxidative, excitotoxic, and proteotoxic stresses involved in the pathogenesis of brain disorders including stroke, and Alzheimer’s and Parkinson’s diseases.

  • Emerging findings suggest that lifestyles that include intermittent bioenergetic challenges, most notably exercise and dietary energy restriction, can increase the likelihood that the brain will function optimally and in the absence of disease throughout life.

Here, we provide an overview of cellular and molecular mechanisms that regulate brain energy metabolism, how such mechanisms are altered during aging and in neurodegenerative disorders, and the potential applications to brain health and disease of interventions that engage pathways involved in neuronal adaptations to metabolic stress.

By Simonetta Camandola and Mark P Mattson

Yoga and behavioral memory interventions for the aging brain

Yoga and behavioral memory interventions to prevent age-related cognitive decline

A study examined changes in brain metabolites and structure among individuals undergoing memory training and yogic meditation. We demonstrated that memory training over 3 months is associated with decreased choline levels in bilateral hippocampus and increased gray-matter volume in dACC, suggesting that behavioral interventions like MET may ameliorate markers of brain aging. These effects are somewhat modest, and would benefit from independent validation in larger samples and perhaps over longer-duration interventions. However, these findings suggest that engaging in cognitive activities and mind-body practices may affect the brain in positive ways, and may be combined as part of a multi-faceted approach to encourage healthy aging.

Behavioral memory training is also popular, based on the notion that cognition is plastic in older age (Acevedo and Loewenstein, 2007; Eyre et al., 2016). For example, traditional memory training interventions that teach mnemonic techniques involving verbal association and visual imagery and practical strategies have been shown to boost cognitive performance, memory, and quality of life in healthy older adults (Verhaeghen et al., 1992; Jean et al., 2010). Given the growing popularity of online “Brain Training” programs, clearer understanding of behavioral memory training programs already demonstrated to be effective in the clinic is needed.

In recent years, mind-body therapies have also been studied as potential preventive measures for MCI (Grossman et al., 2004). By simultaneously targeting multiple physiological and cognitive processes, as well as their dynamic integration, meditation may offer a more efficient alternative to other behavioral interventions. Indeed, some studies indicate that senior meditators have better memory, perceptual speed, attention and executive functioning compared with non-meditators (Prakash et al., 2012), though results are mixed (Chiesa et al., 2011; Goyal et al., 2014). A combination of Kirtan Kriya (KK) meditation and Kundalini Yoga (KY), as used as an intervention in the current study, is specifically shown to affect physical and mental health outcomes (Shannahoff-Khalsa, 2004; Krisanaprakornkit et al., 2006), including older adults with memory complaints (Moss et al., 2012). Like other forms of mind-body practice, KY and KK have been demonstrated to benefit cognitive function, depressed mood and anxiety, sleep and coping (Black et al., 2013; Lavretsky et al., 2013), including older adults with cognitive impairments (Newberg et al., 2010).

Role of Anterior Cingulate Cortex in Cognitive Aging

In our study, we provide novel evidence that a behavioral memory intervention (MET) can modestly increase cortical gray matter in dACC, a region of the brain linked to multiple key cognitive functions, such as error detection (Gehring et al., 1993), and executive processing (Carter et al., 2000). Gray-matter volume has been demonstrated to decrease with age in the ACC in both cross-sectional (Sowell et al., 2003) and longitudinal studies (Resnick et al., 2003). Correspondingly, age is negatively correlated with blood flow in dorsal and rostral ACC regions (Vaidya et al., 2007). Seniors who engage more in cognitive games and puzzles in their daily lives also tend to have greater ACC gray matter volume (Schultz et al., 2015), which is consistent with our results and raises the possibility that engaging in cognitive-behavioral games or training could prevent age-related structural atrophy in this region. Indeed, a recent study indicated a trend towards increased rostral ACC thickness in seniors after MET; however, this effect did not survive a stringent validation analysis (Engvig et al., 2010). Although our effects are modest, they do indicate that participating in effective behavioral interventions may help to ameliorate age-related brain changes associated with poor memory and cognitive performance.

Yoga and the Aging Brain

Structural plasticity in the dACC and hippocampus has also been associated with yoga practice in previous studies; however, we did not find evidence of gray-matter volume changes in dACC or hippocampus after our 12-week yoga intervention. Yoga has been linked to anatomical changes in frontal cortex (Baijal and Srinivasan, 2010; Froeliger et al., 2012; Villemure et al., 2014; Desai et al., 2015), anterior cingulate cortex (ACC) and insula (Nakata et al., 2014; Villemure et al., 2014, 2015), and the hippocampus (Froeliger et al., 2012; Villemure et al., 2015). However, many of these studies compare the brains of practiced yogis with several months or years of experience to yoga-naive controls (Froeliger et al., 2012); perhaps the relatively shorter length of training in the current study (12 weeks) was less conducive to detecting structural plasticity associated with our yoga intervention. In this same cohort, we have already demonstrated that memory improvements after yoga and MET may induce functional plasticity in similar brain regions (Eyre et al., 2016).

Brain Metabolism Predicts Fluid Intelligence in Young Adults

A healthy brain is critical to a person’s cognitive abilities, but measuring brain health can be a complicated endeavor. A new study by University of Illinois researchers reports that healthy brain metabolism corresponds with fluid intelligence – a measure of one’s ability to solve unusual or complex problems – in young adults.

The results are reported in the journal Cerebral Cortex.

“Fluid intelligence is one of the most useful cognitive measures available,” said U. of I. Ph.D. candidate Aki Nikolaidis, who led the research with Ryan Larsen, a research scientist at the Beckman Institute for Advanced Science and Technology, and Beckman Institute director Arthur Kramer.

“This domain relates to an individual’s job satisfaction and salary level, among other real-world outcomes,” he said.

The researchers measured concentrations of the molecule N-acetyl aspartate, a known marker of metabolic activity in the brain, using magnetic resonance spectroscopy. Nikolaidis then looked at the relationship between NAA concentrations in different regions of the brain and fluid intelligence.

“MR spectroscopy allows us to go beyond simply imaging the structures of the brain. It allows us to image the capacity of the brain to produce energy,” Larsen said.

Previous research relating MR spectroscopy data to cognition has been inconsistent. One explanation may be that researchers fail to account for all relevant factors that relate to cognition, including brain size, in their analyses, Nikolaidis said. One goal of the current study was to address these previous contradictions.

“We wanted to do a more definitive study with a large sample size and with a higher quality methodological approach of acquiring the data,” Nikolaidis said. The researchers were able to create a more detailed map of NAA concentration in the brain than previous studies had, he said.

Image shows a girl reading a book.

The team found that NAA concentration in an area of the brain linked to motor abilities in the frontal and parietal cortices was specifically linked to fluid intelligence but not to other closely related cognitive abilities. The brain’s motor regions have a role in planning and visualizing movements as well as carrying them out, Nikolaidis said. Mental visualization is a key element of fluid intelligence, he said.

The researchers concluded that fluid intelligence depends on brain metabolism and health. While overall brain size is genetically determined and not readily changed, NAA levels and brain metabolism may respond to health interventions including diet, exercise or cognitive training, Nikolaidis said.


Funding: This research was funded by the Office of Naval Research; Abbott Nutrition through the Center for Nutrition, Learning, and Memory at the U. of I.; and the National Science Foundation.

Source: Sarah Banducci – University of Illinois at Urbana Champaign
Image Source: The image is in the public domain.
Original Research: Abstract for “Multivariate Associations of Fluid Intelligence and NAA” by Aki Nikolaidis, Pauline L. Baniqued, Michael B. Kranz, Claire J. Scavuzzo, Aron K. Barbey, Arthur F. Kramer, and Ryan J. Larsen in Cerebral Cortex. Published online March 22 2016 doi:10.1093/cercor/bhw070

Multivariate Associations of Fluid Intelligence and NAA

Understanding the neural and metabolic correlates of fluid intelligence not only aids scientists in characterizing cognitive processes involved in intelligence, but it also offers insight into intervention methods to improve fluid intelligence. Here we use magnetic resonance spectroscopic imaging (MRSI) to measure N-acetyl aspartate (NAA), a biochemical marker of neural energy production and efficiency. We use principal components analysis (PCA) to examine how the distribution of NAA in the frontal and parietal lobes relates to fluid intelligence. We find that a left lateralized frontal-parietal component predicts fluid intelligence, and it does so independently of brain size, another significant predictor of fluid intelligence. These results suggest that the left motor regions play a key role in the visualization and planning necessary for spatial cognition and reasoning, and we discuss these findings in the context of the Parieto-Frontal Integration Theory of intelligence.

“Multivariate Associations of Fluid Intelligence and NAA” by Aki Nikolaidis, Pauline L. Baniqued, Michael B. Kranz, Claire J. Scavuzzo, Aron K. Barbey, Arthur F. Kramer, and Ryan J. Larsen in Cerebral Cortex. Published online March 22 2016 doi:10.1093/cercor/bhw070

Brain Benefits of Aerobic Exercise Lost to Mercury Exposure

Summary: Researchers report adults with higher prenatal exposure to methylmercury, as a result of fish consumption, did not experience faster cognitive processing or short term memory benefits following exercise.

Source: NIH/NIEHS.

Cognitive function improves with aerobic exercise, but not for people exposed to high levels of mercury before birth, according to research funded by the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health. Adults with high prenatal exposure to methylmercury, which mainly comes from maternal consumption of fish with high mercury levels, did not experience the faster cognitive processing and better short term memory benefits of exercise that were seen in those with low prenatal methylmercury exposures.

This is one of the first studies to examine how methylmercury exposure in the womb may affect cognitive function in adults. Mercury comes from industrial pollution in the air that falls into the water, where it turns into methylmercury and accumulates in fish. The scientists, based at the Harvard T.H. Chan School of Public Health, suspect that prenatal exposure to methylmercury, known to have toxic effects on the developing brain and nervous system, may limit the ability of nervous system tissues to grow and develop in response to increased aerobic fitness.

“We know that neurodevelopment is a delicate process that is especially sensitive to methylmercury and other environmental toxins, but we are still discovering the lifelong ripple effects of these exposures,” said Gwen Collman, Ph.D., director of the NIEHS Division of Extramural Research and Training. “This research points to adult cognitive function as a new area of concern.”.

The 197 study participants are from the Faroe Islands, 200 miles north of England, where fish is a major component of the diet. Their health has been followed since they were in the womb in the late 1980s. At age 22, this subset of the original 1,022 participants took part in a follow-up exam that included estimating the participants’ VO2 max, or the rate at which they can use oxygen, which increases with aerobic fitness. Also, a range of cognitive tests were performed related to short-term memory, verbal comprehension and knowledge, psychomotor speed, visual processing, long-term storage and retrieval, and cognitive processing speed.

Overall, the researchers found that higher VO2 max values were associated with better neurocognitive function, as expected based on prior research. Cognitive efficiency, which included cognitive processing speed and short term memory, benefitted the most from increased VO2 max.

Image shows a man riding a bike.

But when the researchers divided the participants into two groups based on the methylmercury levels in their mothers while they were pregnant, they found that these benefits were confined to the group with the lowest exposure. Participants with prenatal methylmercury levels in the bottom 67 percent, or levels of less than 35 micrograms per liter in umbilical cord blood, still demonstrated better cognitive efficiency with higher VO2 max. However, for participants with higher methylmercury levels, cognitive function did not improve as VO2 max increased.

“We know that aerobic exercise is an important part of a healthy lifestyle, but these findings suggest that early-life exposure to pollutants may reduce the potential benefits,” added Collman. “We need to pay special attention to the environment we create for pregnant moms and babies.”

The U.S. Food and Drug Administration recommends that children and women of childbearing age eat two to three weekly servings of fish low in mercury as part of a healthy diet. Low mercury fish include salmon, shrimp, pollock, canned light tuna, tilapia, catfish, and cod. Four types of fish should be avoided because of typically high mercury levels — tilefish from the Gulf of Mexico, shark, swordfish, and king mackerel.


Funding: In addition to NIH funding, the research was supported by the Danish Council for Strategic Research, Programme Commission on Health, Food, and Welfare.

Source: Virginia Guidry – NIH/NIEHS
Image Source: This image is in the public domain.
Original Research: Full open access research for “Aerobic Fitness and Neurocognitive Function Scores in Young Faroese Adults and Potential Modification by Prenatal Methylmercury Exposure” by Youssef Oulhote, Frodi Debes, Sonja Vestergaard, Pal Weihe, and Philippe Grandjean in Environmental Health Perspectives. Published online September 9 2016 doi:10.1289/ehp274

NIH/NIEHS. “Brain Benefits of Aerobic Exercise Lost to Mercury Exposure.” NeuroscienceNews. NeuroscienceNews, 16 September 2016.


Aerobic Fitness and Neurocognitive Function Scores in Young Faroese Adults and Potential Modification by Prenatal Methylmercury Exposure

Background: Exposure to methylmercury was shown to decrease neural stem cell populations, whereas aerobic fitness has beneficial effects on the adult brain that relies on improved neurogenesis in the hippocampus.

Objectives: To examine the association between aerobic fitness and neurocognitive outcomes at young adult age, along with the potential moderating effect of prenatal exposure to methylmercury.

Methods: At age 22 years, 262 members of a Faroese birth cohort, established in 1986-1987, underwent a graded exercise test of aerobic fitness to measure maximal oxygen uptake (VO2Max). Their prenatal methylmercury exposure had been assessed from the mercury concentration in cord blood. We estimated cross-sectional associations between VO2Max and multiple measures of neurocognitive function. In addition, we compared groups with low and high prenatal methylmercury exposure.

Results: A one standard deviation (SD) increase in VO2Max was associated with better scores on short-term memory and cognitive processing speed by 0.21 SD (95% CI: -0.04, 0.46) and 0.28 SD (95% CI: 0.02, 0.54), respectively. In the group with lower prenatal methylmercury exposure, a one SD increase in VO2Max was associated with increased scores on cognitive processing speed by 0.45 SD (95% CI: 0.08, 0.81) and with a slightly lesser benefit in short-term memory. No such association was observed in the group with high prenatal methylmercury exposure.

Conclusions: Higher aerobic capacity was associated with better performance in short-term memory and processing speed. However, prenatal methylmercury exposure seemed to attenuate these positive associations.

“Aerobic Fitness and Neurocognitive Function Scores in Young Faroese Adults and Potential Modification by Prenatal Methylmercury Exposure” by Youssef Oulhote, Frodi Debes, Sonja Vestergaard, Pal Weihe, and Philippe Grandjean in Environmental Health Perspectives. Published online September 9 2016 doi:10.1289/ehp274

How to test movement in the gym using ROM as biofeedback

Exercise and Biofeedback

Biofeedback testing is a way to measure your body’s own feedback in response to a stimulus like exercise. While advanced hardware technology exists to measure things like heart rate variability (HRV), muscle strength, or reflex speed testing your range of motion is free, easy, and you already have all the equipment you need: your body.

You can test any range of motion of the body. Some of the easiest and most obvious to detect changes are:

  • Forward flexion – toe touch
  • Arm abduction – side arm raise
  • Arm flexion – front arm raise
  • Hip abduction – side leg lift

Range of Motion

In a healthy individual, any range of motion in which you can notice a change can be used. If someone has a restricted range of motion in a joint, it can be used to quickly assess improvement. For example, if a person had trouble abducting their leg at the hip, they could use hip abduction as a quick and easy test to see if a movement was making them better or worse.

Yoga can be hard on your body. Crossfit might be too much (I only choose light weight and do a 30-min cross fit at ).
Mention Connie Dello Buono when you join for a 30min cross fit every day for $60 per month.
Seek a gym coach to help you reach your goals.
Seek a health coach for the nutrition and lifestyle changes. Email to be coached on this one.

Running marathons permanently damage the heart if you are not careful and do not know the tricks and prep.

It seems that no matter what exercise activity you choose, it has the potential to do a lot of harm.

On the other hand, the list of benefits conferred by strength training, yoga, cycling, running, and other exercise activities is nearly endless. So, exercise is good for you? What is the explanation for this contradiction?

Everything is an experiment.

The reality is that there is no such thing as a “good movement” and there is no such thing as “bad movement”. There is only movement that is good for you and movement that is bad for you right now.

In addition to the millions of movements the body is capable of, there is also the question of how much? This is the source of endless debate in the fitness and training world. Ask 10 trainers, and you’ll get 10 answers as to how many reps to do for a given movement and the desired outcome. They’re all right, and they’re all wrong.

No matter how good a trainer or coach is, they can not possibly know all of the interactions going on in your body. Only your body knows what the entire roadmap looks like, and whether you realize it or not your body knows exactly what it needs.

The Gym Movement protocol teaches you how to perform certain tests to unlock this knowledge already inside you.

Other gym coaches are also helpful. Listen to your body.

Since everything is either good or bad and affects us immediately, testing can be accomplished by measuring the change in any quantity in the body. Examples include finger tapping rate, eye blink rate, movement speed, hand grip strength, or range of motion.

How exactly we test is beyond the scope of this article, but why we test is that it tells us the following things in real-time:

  • Whether or not a given movement is good or bad for the body, right now.
  • How we might improve the movement with a small change to make it even better, right now.
  • Whether or not we’ve done the right number of repetitions of a movement, right now.
  • When we should stop doing a movement for the day.
  • Allowing our body to answer these questions for us eliminates almost all points of debate in a training program.
  • We have a saying within The Movement community that is a sort of go-to response for any discussion about training.
  • The saying is: “Or…you could just do whatever tests well.” The point is, there is no sense in discussing whether 3 reps or 5 reps is better when your body can tell you exactly how many reps to do.
  • Simply put: We’ve found we get better results when we test our movement.

Contributing factors to aging

It has been a long standing goal to develop molecular biomarkers of biological age. Recent studies demonstrate that powerful epigenetic biomarkers of aging can be defined based on DNA methylation levels. For example, the epigenetic clock (PMID: 24138928) is a multivariate age estimation method that applies to sorted cell types (CD4T cells or neurons), complex tissues, and organs and even prenatal brain samples. The epigenetic clock is an attractive biomarker of aging because a) it applies to most human and chimpanzee tissues, b) its accurate measurement of chronological age is unprecedented, c) it is predictive of all-cause mortality even after adjusting for a variety of known risk factors, d) it correlates with measures of cognitive and physical fitness in the elderly, and e) it has been found useful for detecting accelerated aging effects due to obesity, Down syndrome, and HIV infection. Recent genomewide association studies shed light on the underlying biological mechanisms.

For more information go to

Author: Steve Horvath, Sc.D., Ph.D., University of California, Los Angeles

Permanent link:…

Exercise beyond menopause: Dos and Don’ts

With a significant number of women belonging to the status of menopause and beyond, it is imperative to plan a comprehensive health program for them, including lifestyle modifications. Exercise is an integral part of the strategy. The benefits are many, most important being maintenance of muscle mass and thereby the bone mass and strength. The exercise program for postmenopausal women should include the endurance exercise (aerobic), strength exercise and balance exercise; it should aim for two hours and 30 minutes of moderate aerobic activity each week.

Every woman should be aware of her target heart rate range and should track the intensity of exercise employing the talk test. Other deep breathing, yoga and stretching exercises can help to manage the stress of life and menopause-related symptoms. Exercises for women with osteoporosis should not include high impact aerobics or activities in which a fall is likely.

The women and the treating medical practitioner should also be aware of the warning symptoms and contraindications regarding exercise prescription in women beyond menopause. The role of exercise in hot flashes, however, remains inconclusive. Overall, exercising beyond menopause is the only noncontroversial and beneficial aspect of lifestyle modification and must be opted by all.


The most remarkable demographic change observed in the new millennium is the increased life expectancy of women in India. It is estimated that by the end of 2015, there will be 130 million elderly women in India, necessitating a substantial degree of care.[1] Menopause brings in a whole lot of changes in the body of women and in most of them leads to troublesome symptoms namely vasomotor, sleep disturbances, fatigue, aches and pains, altered cognitive functions, genitourinary problems like vaginal dryness, irritation, recurrent urinary tract infections, and weakness of connective tissue supporting the pelvic viscera.[2] All these short and medium-term effects influence the quality of life of these women adversely. Long-term sequelae, such as, osteoporosis, sarcopenia, pathological neurological problems and cardiovascular events also tend to increase.[3] The lack of estrogen beyond menopause also compounds the cardiovascular disease risk factors from a female to a male pattern. This puts these women at an equal risk of coronary heart disease as their male counterparts.

The problems arising due to the hypo-estrogenic status should be managed by planning a good health program strategy, involving lifestyle modifications. A short-term hormone therapy in minimum doses is recommended exclusively for symptomatic women, after proper counselling.[4,5] It is the mainstay of the treatment of vasomotor symptoms and is proclaimed to be comparatively safe in women of 50 to 59 years of age.[6] The same may not hold true for older women. There has been a marked controversy in the menopausal hormone therapy following the publication of Heart and Estrogen/progestin Replacement (HERS),[7] Women’s Health Initiative (WHI)Trial[8] and Million Women Study (MWS).[9] This has led to polarization of opinion regarding hormone therapy all around the world. The acceptance of hormone therapy is quite low in India.

The social scenario of senior women in our country is sadly that of reduced activity. Women often exercise less when they enter menopause, which can lead to weight gain. To further complicate matters, the metabolism is also decreased. One reason of this metabolism decline with age is the loss of muscle mass (about half-a-pound a year). Muscle burns more calories than fat, so whenever the muscle is not preserved with weight training exercise, the body simply does not burn as many calories. There is also a tendency to increase the intake of calories. As the metabolism drops, many women do not adjust their calories accordingly, which often leads to weight gain. The prevalence of the metabolic syndrome is reported to be significantly higher in postmenopausal women in India.[10] Finally, the role played by the genetics has also got to be emphasized. The genetic makeup and the site predisposed to inches gain and storage of fat also plays a role in weight gain, making it more difficult to control.

Despite all the physiological changes, menopause should not be viewed as a sign of impending decline, but rather a wonderful beginning of a good health program including lifestyle changes in diet, exercise, including yoga and limiting smoking as well as alcohol.


The most important, noncontroversial and simple thing everybody can and should do is to exercise. The benefits are-

  1. Exercise increases the cardiorespiratory function. If done regularly, it reduces the metabolic risks associated with declining estrogen. It increases HDL, reduces LDL, triglycerides and fibrinogen. There is an additional benefit of a reduced risk of high blood pressure, heart attacks, and strokes.
  2. Exercise can help create a calorie deficit and minimize midlife weight gain.
  3. It increases the bone mass. Strength training and impact activities (like walking or running) can help to offset the decline of bone mineral density and prevent osteoporosis.[12]
  4. It also reduces low back pain.[13]
  5. It is proven to help reduce stress and improve the mood.[14]
  6. It may help to reduce hot flashes, thereby minimizing the “Domino effect.”

Although no conclusive evidence was derived from randomized controlled trials on whether exercise is an effective treatment for reducing hot flushes and night sweats in menopausal women, the latest Cochrane review did find a weak trend for exercise to be more effective than no intervention.


It is never too late to start exercising. The key is to start slowly and do things one enjoys such as walking, cycling, vigorous yard work, swimming, cardio machines or attending group fitness classes. Regular exercising can help in improving the overall wellbeing. Even moderate physical activity like simply moving the body enough to get the heart pumping brings great health benefits including more energy. The activity should be fast enough to get the heart pumping without being out of breath or exhausted.

To determine the maximum heart rate for exercise one has to subtract the woman’s age from 220. For the target heart rate range, multiply maximum heart rate by 50/100 and 80/100. When starting an exercise program, aim at the lowest part of the target zone (50 percent) during the first few weeks. Gradually build up to the higher part of the target zone (75 percent). After six months or more of regular exercise, one may be able to exercise comfortably at up to 85 percent of one’s maximum heart rate.

Women on antihypertensive drugs should be cautioned of the fact that few high blood pressure medications, especially beta blockers, lower the maximum heart rate and thus the target zone rate. Such women should consult their physicians to find out if they need to use a lower target heart rate.

The talk test provides a convenient alternative for tracking the exercise intensity. Moderate intensity exercise, for example walking at 3.5 mph, allows a woman to talk, but not sing and should not be breathless. During vigorous aerobic exercise, such as step aerobics, she should be able to speak a few words, but not carry on a conversation. The benefit of exercising at the target heart rate increases the fitness and conditions the lungs, heart, circulation, and muscles.


Exercises that can help in building and maintaining the bone density and mass are as follows:

Weight bearing, high impact exercises: Includes dancing, high impact aerobics, running / jogging, jumping rope, stair climbing, and sports like tennis, basketball, volleyball or gymnastics. These are best for those who are not osteoporotic, not have low bone mass, and are not frail.

Weight bearing, low impact exercises: Are walking (treadmill/outside), elliptical training machines, stair step machines, and low impact aerobics. This group of exercises may be opted to build bones, by women who cannot do high impact exercises.

Weight or strength training or resistance training exercises: Include lifting weights, using elastic bands or weight machines for exercise, using simple functional movements such as standing or lifting the own body weight.

Nonweight bearing, nonimpact activities: Are cycling, swimming, stretching, and flexibility exercises. These should be included as components of a comprehensive exercise program. Alone these do not help building up the bones.

NonImpact exercises: Involve exercises that help in the balance posture and attitude,for example, T’ai Chi.

Menopause friendly exercise prescription: The exercise program for postmenopausal women should include, endurance exercise (aerobic), strength exercise, and balance exercise. Out of these aerobics, weight bearing, and resistance exercises are all effective in increasing the bone mineral density of the spine in postmenopausal women.[17]

An effective exercise prescription may be resistance and weight bearing exercise three days a week (on alternate days). Care should be taken to do the exercise for all the muscle groups by rotation preferably with a trainer. Brisk walking at the speed of five to six kilometres per hour, cycling, treadmill, gardening or dancing may be done on the remaining days of the week.[18]

Warming up beforehand can help to reduce exercise related injuries and pain following exercise. One should aim for two hours and 30 minutes of moderate aerobic activity each week. Other deep breathing, yoga, and stretching exercises can help to manage the stress of life and menopause-related symptoms.


Step 1: Stretch, walk on a treadmill for five minutes or go for a brisk walk to get ready for exercise. As owing to age, the body becomes less flexible, it is important to warm up the body before a work out.

Step 2: Engage in aerobic activity that elevates the heart rate and burns fat. Whether it is a dance class, aerobics class, going for a run or a bike ride, signing up for kickboxing or taking time on an elliptical machine, each helps to benefit the large muscle groups and helps the cardiovascular function.

Step 3: Lift weights, use resistance bands or try body weight strength training in order to keep the bones strong. Menopause is a common time for women to experience a loss of bone density or osteoporosis. They have to aid in keeping their bones strong by keeping the muscles strong. Strength training also can help to rev up the decreasing metabolism and help in burning the fat, even while resting, to avoid the dreaded menopausal weight gain.

Step 4: Foster better flexibility by trying workouts that cause the stretching of muscles, such as yoga and Pilates. This can promote better muscle function. The woman must take time for yoga and meditating each night to reduce some of the anxiety that also is a common symptom of menopause.

Step 5: Cool down at the end of a workout by walking for a few minutes and stretching to relieve any pain as a side effect from a particularly gruelling workout. This gives the body a chance to relax and promotes regular breathing and a slowing of the heart rate as one finishes exercising for a healthy end to this menopausal friendly workout.

The best regimen

A regimen of twice a day calcium citrate supplementation (800 mg) and resistance training three times a week improves bone density in postmenopausal women, whether or not the women is taking estrogen. By taking simple steps including eating a balanced diet with plenty of calcium and Vitamin D, and engaging in weight bearing exercise, the risk of osteoporosis can be reduced in the typically vulnerable areas of the spine and hip using six core exercises:

  1. Wall or smith squat
  2. Lat pull down
  3. Leg press
  4. One arm military press
  5. Seated row
  6. Back extension

Description of a few important exercises is as follows:

The squat

The squat is one of the best ways to build and display raw strength. Slap a few plates of iron on the bar, put it across your shoulders, squat until the thighs are parallel to the ground, then stand back up. It sounds simple, but it is one of the most intense exercises there is for increasing bone density. Although many casual lifters prefer a higher rep range, it turns out that alternating between moderate and heavy lifting of six to eight and four to six reps gives the biggest results.

Shoulder press

The shoulder press, lifting a barbell straight over your head, is another way to display impressive strength. The shoulder press is also one of the exercises that most increases bone density. Although doing shoulder presses with dumbbells helps to strengthen the stabilizer muscles. When one is trying to build bone density, weight is what matters most, so find a shoulder press station or a power cage and use a barbell.

Lat pull down

The lat pull down exercises the lats, biceps, and forearms. At the top of the movement, one should feel a good stretch in the lats, just under the arms. Once one gets strong enough, they may consider switching to pull ups, and even weighted pull ups.

Leg press

The leg press allows to test the true strength of the quads, hamstrings, glutes, and calves, without worrying about balance or the lower back. A lot of weight can be moved with this exercise, and that stress, results in an increase of bone mineral density.

Seated row

The seated row includes exercising the similar muscles to the lat pull-down, but also uses the lower back and glutes as stabilizers, and hits the traps. The key to performing this exercise safely is to not sway as one performs the movement. The buttock should lock the body into a comfortable angle at the hips, and that angle should not change.

In each session of workout atleast seven to ten minutes of cardiovascular weight-bearing activity, such as weighted walking, stair climbing, and jogging, and small muscle group exercises involving thera-bands and physio-balls round out the study regimen. The key to achieving the goal of improved bone health is in the intensity of the weight-bearing workout and the level of the resistance training. Progressively increasing the weight lifted and consistently exercising two to three times a week are essential for success.

T’ai chi

This is the most commonly practiced balance exercise. T’ai Chi Ch’uan techniques are said to physically and energetically balance yin (receptive) and yang (active) principles: ‘From ultimate softness comes ultimate hardness.’

The core training involves two primary features: the first being the solo form, a slow sequence of movements that emphasize a straight spine, relaxed breathing, and a natural range of motion; the second being different styles of pushing hands, for training sensitivity in the reflexes through various motions from the forms, in concert with a training partner, in order to learn leverage, timing, coordination, and positioning, when interacting with another.

The participants are taught not to fight or resist an incoming force, but to meet it in softness and ‘stick’ to it, following its motion, while remaining in physical contact until the incoming force of attack exhausts itself or can be safely redirected the result of meeting yang with yin. Done correctly, achieving this yin/yang or yang/yin balance in combat (and, by extension, other areas of one’s life) is the primary goal of T’ai Chi Ch’uan training. ‘The soft and the pliable will defeat the hard and strong.’ There is also an emphasis in the traditional schools on kindheartedness. One is expected to show mercy to one’s opponents.

T’ai chi training may help those suffering from osteoarthritis by strengthening the joint musculature and increasing the range of motion and flexibility, and may be used as an adjunct to the standard treatment.[20]

Impact of exercise on bone mineral density

Bones become strong when the muscles attached to them become strong. Bone changes are slow, much slower than strength changes. If high load and low rep routines of compound exercises are used, these stimulate muscle development around the hips, spine, and arms, building bone strength in those vulnerable areas and throughout the body. Even if the BMD is not improved as measured by the dexascan, resistance training with adequate intensity will dramatically lower the lifetime fracture risk.

The maximal load is most relevant in BMD changes, not the load frequency. A small number of loading cycles work best. The trabecular bone of the spine remodels more rapidly than the cortical bones of the hip and wrist.[21,23] The intensity with which the exercise is performed bears a direct correlation to the increase in the BMD.[24] It can take four to six months or more for the bone to remodel under the best conditions, and the measurable effects of exercise may only be apparent years later.[25] On the other hand BMD increases have been reported using just five resistance exercises, hip extension, knee extension, lateral pull-down, back extension, and abdominal flexion (3 × 8 at 80% 1RM) twice a week for one year.[26]

In India, the Indian Council of Medical Research (ICMR) has reported a significant centerwise difference in BMD.[27] The paradox of lower fracture rates among the IndoAsian population than those in caucasian women, despite lower skeletal mass at maturity in the former group, has also been noted.[28] This has led to the suggestion of the potential need of measuring bone mineral apparent density (BMAD) in Indian Women.[29]

What not to do

Although all postmenopausal women should be encouraged to employ lifestyle practices including appropriate exercises that reduce the risk of bone loss and osteoporotic fractures, these exercises for women with osteoporosis should not include high-impact aerobics or activities in which a fall is likely, such as exercising on slippery floors or step aerobics. Activities requiring repeated or resisted trunk flexion, such as sit-ups or toe touches, should also be avoided because of the increased loads placed on the spine during such activities that may result in spine fracture.[30]

Another factor for consideration is when to stop exercising? This is indeed a warning to all the women. Senior women should know how to read the signs of their body. One should make it a point not to ignore the signals of overwork, which may lead to major issues like heart attack and injury. If there is any problem while exercising, it is better to stop exercising and change the exercises. Care should also be taken not to practice excessive exercise without adequate caloric and protein intake.

When should they avoid exercise? Certain medical conditions absolutely negate exercise. These conditions include:

  • Recent electrocardiogram changes or recent myocardial infarction
  • Uncontrolled arrhythmia
  • Unstable angina
  • Third degree heart block
  • Acute progressive heart failure

There are other conditions that would contraindicate exercise on a case by-case basis, and should not be done unless there is medical approval. These conditions include:

  • Elevated blood pressure
  • Cardiomyopathy
  • Valvular heart disease
  • Complex ventricular ectopy
  • Uncontrolled metabolic disease.


Women can enjoy a good quality of life after menopause even without hormones. Research indicates that postmenopausal women who engage in the comprehensive exercise program, benefit by maintaining a healthy body, bone density levels, and good mental health. Osteoporosis, the greatest ailment in older women, can be kept under control with exercise. Even a moderate exercise schedule can not only keep the weight in check, but it also lowers the risk of stress, anxiety, and depression, all of which tend to show up liberally during and beyond menopause. Exercise works by improving muscle mass, strength, balance, and coordination. Therefore, unlike treatment with medicine, exercises work simultaneously on various aspects of one’s health. The role of exercise in hot flashes, however, remains inconclusive.

Connie’s comments: I love my coaches at NC Fit in the bay area for my 30-minutes cross-fit training every day. Join and do mention my name. It is worth it. You sweat, have a coach, and I only do it for 30min every day for $60 per month with a coach.