Brain Health on the Move

00:00:03: Welcome to the Brain Health Mission Podcast, exploring how science, policy and everyday choices shape the health of your brain and what you can do to protect it.

00:00:15: We are looking into the fascinating link between physical activity and brain health.

00:00:39: And I'm joined actually by a very special guest, Ulepeter Jelle, physician, neuroscientist and a former national marathon champion.

00:00:48: Welcome Ulepeter.

00:00:50: Thank you Janna, thanks for having me.

00:00:54: It's great to have you here.

00:00:55: Before we start, should we do a short introduction?

00:00:59: Could you tell our listeners a little about yourself and your journey from being an athlete to physician and neuroscientist?

00:01:07: Yes, sure.

00:01:09: I'm fifty-five years old.

00:01:10: I live in Hamar, a small town and now we're outside north of Oslo with my three children.

00:01:17: Right now I work as a general practitioner once or twice a week.

00:01:23: And I also have a position at the University of Inland College where I do research on exercise and how it affects our physical and probably mostly mental health.

00:01:37: My background is as a doctor, obviously.

00:01:40: I've been working as a general practitioner for ten or fifteen years.

00:01:45: We're actually started an exercise group with my patients.

00:01:49: Probably more about that later.

00:01:51: Studied medicine in Oslo started in nineteen ninety six and I was really really motivated by a couple of lectures on the on the brain by Professor Per Brudal, which is probably known to a lot of people as.

00:02:08: great neuroanatomist and olipethylopticin is a really great environment for neuroscience at the University of Oslo.

00:02:17: So I took a year off my studies to do research on the brain.

00:02:23: And at the time I was also competing competitive or running competitively in marathons.

00:02:29: So I was really fascinated.

00:02:33: by the fact that there was not a lot of knowledge at that time.

00:02:38: or I think we on an intuitive level knew that moving and exercise and physical activity was good not only for the body but for the brain as well.

00:02:48: I think most people can intuitively tell that when you exercise, when you finish, you feel better, more energy, maybe you're more alert.

00:02:58: Things like that.

00:02:58: There was not a lot of knowledge.

00:03:01: on that topic.

00:03:02: so that's kind of become what I've been mostly working on writing books and doing research on how physical activity affects our brain not only the normal day-to-day neural functions but also brain health.

00:03:23: That is amazing.

00:03:24: and to you other European listeners.

00:03:27: Ole Petter is a very famous Norwegian author and his book has many books.

00:03:31: Some of them I've given to my parents and I read them myself.

00:03:35: And you also do podcasts and we are very happy to have you on this podcast because we are very keen on exploring the role of physical activity and brain health.

00:03:46: Ulpete, if we just go to the core, you have spent your career connecting neuroscience and physical activity with being a doctor as well.

00:03:56: Can you explain actually why exercise is so vital and critical for brain health and for cognitive function?

00:04:05: I think to understand that we have to look through the lens of evolution actually because If you go back thousands of years when we were hunters and gatherers on the savannah, we had to run to survive.

00:04:22: It was the only way we could catch around food.

00:04:23: We had to escape from our enemies.

00:04:26: And if you were hurt or couldn't run or couldn't move, your days were numbered because you weren't able to catch around food, you would start to death or you couldn't escape.

00:04:38: And when you need... to survive and catch animals and escape from your enemies, you really have to be focused, concentrated.

00:04:49: All these brain functions that we take kind of for granted today, those were vital in order to survive back in the days.

00:04:58: So you had to be focused to catch wild animals, gather your own food.

00:05:04: You had to have good memory to remember where the animals were hiding, what mistakes you made last year.

00:05:11: when you were trying to get food, all of these things.

00:05:13: So I think it's natural that all of our brain functions are strengthened when we move.

00:05:21: So I think that's kind of an evolutionary view on it.

00:05:26: And when it comes to more neurological and neuroscientific explanation, we are not one hundred percent sure.

00:05:36: still quite a few pieces of the puzzle that needs to be found.

00:05:41: We know that exercise is, as you said, vital for brain function and brain health.

00:05:49: And we think there's several reasons for it, but I think one of them is molecular changes in the brain when we start moving.

00:05:59: I remember really well when I was in medical school, I learned that the profusion to the brain was pretty much constant.

00:06:07: Auto-regulation didn't matter if you were moving or sleeping or sitting.

00:06:12: Your brain were perfused with the pretty much the same amount of blood.

00:06:16: Turns out that's not really the case.

00:06:18: When we start exercising, the brain circulation increases.

00:06:23: Just going from sedentary sitting to standing up, it's about ten percent increase in perfusion to the brain.

00:06:31: And it can be as much as a thirty percent increase when you exercise.

00:06:37: And we think that this increase in perfusion triggers several key reactions.

00:06:47: that ends up with a cascade of reactions, which terminates in us producing quite a few growth factors.

00:06:55: Brain derived neurotrafic factor, BDNF, vascular endothelial growth factor, insulin like growth factor, there are a whole host of them.

00:07:05: And these growth factors may turn out to be really important for brain function and brain health.

00:07:13: And we think they do several things in the brain.

00:07:16: They can increase synaptogenesis so that you get more synapses and physical connections between the nerve cells, which is critical for brain function.

00:07:26: It can even stimulate neurogenesis.

00:07:29: We can make new nerve cells, although in a little bit... limited amount and in some few key areas of the brain it's been documented like the hippocampus and the olfactory bulb.

00:07:42: So there are key of chemical changes.

00:07:44: that I think explains at least part of why physical activity is so good for brain function and brain health.

00:07:55: And probably this is just a short reflection of mine, Olle Petter, but maybe it's because it was crucial for us to move that we also have a sort of rewarding function.

00:08:08: I mean, the runner's high, I sometimes think that is because we need to be rewarded when we run away from that tiger in order to survive as a species.

00:08:17: Do you agree or no?

00:08:18: Absolutely, and we can measure that today, you know, with advanced methods, we can see all of these chemicals.

00:08:26: that floods the brain, both when you exercise and afterwards.

00:08:31: And I think your point is really good.

00:08:34: I think that's part of the evolutionary process as well, that it was really critical for us to run.

00:08:41: It was the only way to survive.

00:08:43: And of course, in order to make us run, we would get a boost of endorphins and dopamine and different chemicals flooding our reward centers.

00:08:53: So of course you do something, it makes you feel good, you're more likely to repeat the behavior.

00:08:59: So I think this has been crucial for our survival.

00:09:04: I agree completely.

00:09:05: I think that was very nicely said from you.

00:09:07: But as doctors, we are concerned about doses and also for physical activity.

00:09:16: What should you communicate to people who are asking?

00:09:20: What is actually enough activity, physical activity, for a brain?

00:09:26: What will give you the brain health you need in order to try to avoid dementia or neurological disease or just to have a good life?

00:09:38: I sometimes read that less is more.

00:09:42: Is that true?

00:09:43: That it's more important to do something than not to do anything?

00:09:47: or is there a threshold?

00:09:50: Could you like say one hour is good, two hours is better?

00:09:54: Yeah, I think now we're touching upon an area where we have the least amount of knowledge.

00:10:00: I mean, we know and it's been well documented that regular exercise and movement is vital and important for human brain functions, for brain health and of course physical health as well.

00:10:13: But what we do not know A whole lot about is the dose-response relationship.

00:10:21: In other words, how much do we have to prescribe of this treatment in order to get a certain effect?

00:10:26: When it comes to pharmaceuticals or drugs, we know a lot about that.

00:10:31: We have a lot of knowledge.

00:10:33: When it comes to exercise, we don't know that much.

00:10:37: But what we do see is that the dose-response relationship is not linear.

00:10:45: In other words, if you double the amount of exercise you do, you're probably not going to double the benefit or the reward.

00:10:53: The biggest reward or benefit, both on physical and mental health neurological functions, are given to those who call it the worst starting points.

00:11:03: The ones have been inactive for the longest, maybe the oldest part of the population who are maybe chronic diseases, frail.

00:11:13: For those you're in the really steep segment in the dose really those response relationship.

00:11:19: So just very tiny amounts of movement will make a great Difference.

00:11:25: like I have patients who are in their eighties.

00:11:28: Maybe they're healthy But they're frail they don't have a lot of muscular strength and most of the time they're sitting or lying around.

00:11:35: They don't have a high quality of life.

00:11:38: For some of those people if we can get them to stand up and maybe just walk for five minutes maybe with the help of a nurse or something on a walker.

00:11:52: I mean that will give them a tremendous health benefit.

00:11:56: And then we see that the more you exercise, the larger the benefit, but the curve really flattens out.

00:12:06: I don't think anyone is able to say exactly what is the optimum amount of exercise.

00:12:12: I think it really depends on what you're trying to achieve.

00:12:16: You mentioned dementia.

00:12:17: There is solid documentation that in order to prevent dementia, exercise is vital.

00:12:26: But it probably doesn't have to be of high intensity.

00:12:29: There are some really large meta-analysis from the US showing that maybe two or three brisk walks, kind of low intensity, can as much as half the risk of getting Alzheimer's dementia.

00:12:48: Whereas I know when it comes to treatment of depression, There's quite a bit of research showing that the most effective exercise is the one in the higher intensity zones.

00:13:03: So I would think that there are probably different doses and intensities depending on what you're trying to achieve.

00:13:10: Are you trying to lift your mood?

00:13:15: Is your main concern to prevent dementia or is it treatment?

00:13:19: you know, exercises medicine or depression, maybe there's another dose or intensity, we don't know for sure.

00:13:26: But I think one of the most interesting findings is that there seems to be no lower limit to what helps.

00:13:35: I mean, we know for medications, drugs, if the plasma concentration of a drug gets too low in the blood, It has virtually no biological effect on lowering the blood pressure or blood sugar or whatever drug you're taking.

00:13:50: That doesn't seem to be the case for exercise.

00:13:52: So, like, anything is better than nothing.

00:13:56: And, you know, most Western countries have recommendations for how much physical exercise you should be doing during a week or a day.

00:14:07: And it has changed over the years, based on new findings and research.

00:14:13: And right now, at least in Norway, it's a hundred and fifty minutes of moderate intensity a week, or three hundred minutes of moderate intensity per week if you have a sedate or you sit still most of the day during your work day, which eighty percent of Norwegians do.

00:14:30: So for eighty percent of Norwegians, the daily recommend... recommendation is or the weekly is three hundred minutes a week, which is quite a bit.

00:14:41: But it turns out it doesn't have to be that much.

00:14:45: No one has found the lower limits for when it starts to help.

00:14:48: And in a really large European effort just published last year, they looked at data from thirty two million people to look at the association between exercise.

00:15:00: and general health, morbidity and mortality.

00:15:05: And it turns out one of the key findings was that less is needed than what we thought.

00:15:09: I mean, you get a huge benefit from less amounts of exercise than what we previously thought you had to do.

00:15:16: So we don't quite know yet, but we know that probably less than what most people think.

00:15:22: And the biggest benefit is given to those who need it the most, which I think is good news.

00:15:28: I think it's very good news, so less is more definitely.

00:15:31: And we also need to look at physical activity as something that should be targeted towards what we're trying to achieve, if I understand you correctly.

00:15:41: And you also say it doesn't have to be of such high intensity, but then again.

00:15:46: I've been listening to one of your podcasts and you said then you had a weakness for high pulse that when you were training with your patients you usually finished with a little sprint.

00:15:56: and that is actually the reason that I'm forcing one of my friends when we are running to sprint at the end and she says I don't believe in that training physician.

00:16:06: I'm so fed up.

00:16:07: And I say, it's very few.

00:16:09: I read that.

00:16:09: He has evidence for that.

00:16:11: So isn't that true?

00:16:12: You have a little weakness for being a little more intense at the end.

00:16:17: Yeah.

00:16:17: I mean, I think if I were to summarize all the research that's been done on this, I think we can say that any exercise is good.

00:16:25: But the greatest benefit is generally when you have some of the exercise in high intensity zones.

00:16:34: We think we have a molecular explanation for that as well.

00:16:39: This is some research done at the University of Oslo, actually, by a group led by Linda Balician.

00:16:44: She's a professor.

00:16:46: It's done on mice and rats.

00:16:48: It turns out that when... So what they have done is looking at brain volume, especially for the hippocampus and brain function when it comes to memory and things like that.

00:16:59: And they have had two groups of... of mice and one group is exercising high intensity in a running wheel.

00:17:08: The mice love that and they measure the lactate to see how much lactate they produce.

00:17:14: and then they have a second group of mice who do not exercise but they get subcutaneous injections of lactate in exactly the same amount as the running mice are producing.

00:17:26: And it turns out you see the same growth of the hippocampus.

00:17:31: Growth, vesicular endothelial factor, BDNF increases things like that.

00:17:37: And then they do transgenic mice with the blocked receptor for lactate in the brain.

00:17:45: Then it turns out there is no benefit on the hippocampus of running or injection.

00:17:51: We actually think that lactate is one of the molecules that is important for us to get the optimum benefit of exercise.

00:18:02: So obviously, the higher intensity, the more lactate you produce.

00:18:07: And there are also some signs that... the reward you feel like the secretion of endorphins or endocannabinoids and dopamine etc.

00:18:18: is also higher when you have higher intensity.

00:18:24: So listeners, don't fall for the easy solution here to get lactate injected, do the whole thing so that you also have the other effects.

00:18:33: And I think here we are, here is called a bit of a dilemma.

00:18:38: that I'm seeing when I'm talking to my patients about this.

00:18:41: Because we know that in most Western countries, a majority of our population is quite sedate.

00:18:48: I mean, we are quite inactive.

00:18:51: And it would be a tremendous health benefit, both on an individual level and a public health level and financially as well, if more people exercised.

00:19:00: I mean, inactivity costs around two hundred and thirty nine billion Kroners every single year.

00:19:07: So it's really expensive, but So on one side we know that the more you exercise and the higher the intensity the better the bigger the reward, but the difficulty for most people isn't.

00:19:20: I mean, it's just getting out there to do something.

00:19:23: and most it's easier to motivate people to do a little bit and not be too tired than to try to make them do a lot and hard intensity.

00:19:35: So I usually say that the biggest difference is not between low intensity and high intensity.

00:19:41: The biggest difference is between doing nothing and doing something.

00:19:45: So it's much better to go for a brisk walk than to do nothing.

00:19:51: If you're motivated to do four by four intervals and having lactate coming out of your ears and being really tired, that's great.

00:19:58: But you don't have to do that.

00:20:00: So I always tell my patients, you know, it's There's a lot of research done on the following question.

00:20:06: What is the best exercise?

00:20:10: And they go, yeah, tell me what is the best exercise?

00:20:12: Is it is it cardiovascular exercise?

00:20:15: is his strength exercise?

00:20:16: What is it?

00:20:17: And I say, well, the best exercise is the one you're able to complete.

00:20:22: So the one you're able to do the one you end up doing so it's You know, a lot better to go for a walk with your dog for twenty minutes than having written down a hard interval workout on a piece of paper that you are never able to complete.

00:20:39: I think that's a very good argument.

00:20:41: But do you have any patient story?

00:20:45: Like, of course, anonymized that you could share with us where you found that physical activity actually helped that person in recovering or improving his or her.

00:20:57: quality of life?

00:21:00: Yeah, I have a lot of them.

00:21:03: But I have one I would like to tell.

00:21:06: And it's actually about myself.

00:21:09: It is a personal story.

00:21:11: So you know that I've been a runner most of my life.

00:21:17: And since I was maybe fifteen, fifteen years old, I've been exercising pretty much every single day of my life.

00:21:24: And I love it.

00:21:25: It's never been hard for me to do it.

00:21:27: It's one of the things I love the most.

00:21:30: And sometimes when I talk to my patients, I have to admit that it was a little hard for me to resonate when they said, well, you know, my life is so busy and I don't really have time for exercise.

00:21:42: And I didn't say it to my patients, but I thought, how hard can it be?

00:21:48: Maybe like, fifteen, twenty minutes a day, I think that most people should be able to do that.

00:21:52: That's what I was thinking, but I didn't say it.

00:21:55: So, forward to... I ended up having a couple of things happening in my life at the same time.

00:22:09: I got divorced and I had a really traumatic and difficult situation at my work.

00:22:16: And I had a really high workload and all of a sudden I kind of collapsed mentally.

00:22:26: like I woke up in the morning and I thought, or I went to bed at night and thinking that, well, it doesn't matter if I don't wake up tomorrow morning.

00:22:34: I mean, I was depressed.

00:22:37: And I went to my doctor and got the diagnosis.

00:22:42: Obviously, there's no blood sample, but a questionnaire.

00:22:45: and he said, you know what?

00:22:46: You are depressed.

00:22:47: You have all the symptoms of a moderate depression.

00:22:52: And you know what?

00:22:53: I knew that somewhere in my toolkit I had the tools to become better.

00:22:58: I mean, I was travelling around in Norway internationally talking about how important exercise was, especially for your mental health.

00:23:06: I knew that was one of the tools, but I just couldn't get to it.

00:23:09: I've been running every single day of my life.

00:23:13: Never any problems getting outside.

00:23:15: All of a sudden, I mean, I hardly moved for three months.

00:23:21: Had a hard time getting out of bed.

00:23:23: There was COVID, so there wasn't much work either.

00:23:27: And I remember,

00:23:29: yeah,

00:23:31: I knew that I should go outside and exercise, but I just couldn't get myself to do it.

00:23:38: And it took a little while, maybe a month or two before I actually did something.

00:23:46: And I remember what I did.

00:23:48: I called my friends and I said, you know what?

00:23:50: I know that I have to do something.

00:23:52: I have to get out of the house.

00:23:54: Not in a good place.

00:23:56: I need some help.

00:23:57: I need someone to talk to.

00:23:59: But most of all, I need to move a little bit.

00:24:00: Can you please come and pick me up?

00:24:03: And luckily, I had some really good friends.

00:24:05: They didn't ask much questions, but they showed up.

00:24:07: And I had told them as well that if I say that I don't want to go outside, force me.

00:24:14: So they came and they took me outside.

00:24:15: And this was not four by four intervals.

00:24:18: It was probably the most effective treatment for depression would be that.

00:24:23: I couldn't get myself to do that.

00:24:25: I walked for five minutes and talked twice a week.

00:24:29: And then they started coming by a little more often and we ended up walking maybe half an hour at a time.

00:24:36: And after a month and a half, I was out jogging thirty minutes.

00:24:41: And of course, that was not the only reason why I got better.

00:24:44: Time healed some of the wounds and I had other people to talk to.

00:24:49: But I think the exercise part was the biggest thing that got me back on track and after three or four months I was back at work traveling around doing lectures and things like that and it was a really painful experience but a really good one for me as well.

00:25:09: because now when I'm seeing my patients my way of thinking is a little bit different because I felt it on myself that sometimes it's not that easy.

00:25:21: Twenty minutes, thirty minutes a day doesn't sound that difficult but Especially when you have mental illness and there could be stress in your life, there could be a whole variety of things that makes it harder.

00:25:33: So I've gotten a new appreciation for the fact that it's not always that easy.

00:25:40: It's not, that's true.

00:25:42: Thank you for sharing, Rula Peta, because that was a very touching story and I think it's very true and also for many of us physicians that... what we sometimes question.

00:25:53: so patients like it's easy to take the right choices.

00:25:58: when we are in that situation we see that it's not always and it's a as you say it's a tough experience but it's a very rewarding for your future work as a doctor.

00:26:11: yes definitely and I also think the way you handle it by by phoning friends and say, I need your help and I need your help through something concrete, something that we can do in common.

00:26:26: It's also a very good message to people out there.

00:26:32: But we've also shown that it's good for mental health, not only to be in physical activity, but also to be engaged socially.

00:26:41: And if you combine these things, if you walk with somebody, if you dance with somebody, whatever, you have an even more higher impact of what you're doing that when you're only doing it on your own.

00:26:56: Absolutely.

00:26:58: Thank you.

00:26:59: And I also think that, yeah, I think that's an important message as well.

00:27:04: I mean, there are a whole bunch of things that impact and decide our physical and mental health.

00:27:11: Physical exercise obviously is one of them, but the social relations part is just as important and I think you get an added benefit if you can combine physical exercise with socializing.

00:27:25: And I think that was one of the key factors for me getting better as well.

00:27:29: Men, as men we have a tendency to maybe suffer in silence when it comes to mental health especially.

00:27:36: So I'm very glad that I... Yeah, I actually found the courage to to open up to my friends because Some of these things are still difficult to talk about for a lot of people.

00:27:48: So I think that was maybe the most important factor was that I actually opened up and told people around me what was bothering me and they and they showed up to help.

00:28:01: and in that way you're also a role model not only by being a physician and also an athlete but also by showing that there is a a way out of the darkness, but that you need to ask for help and you need to get people to get you moving and to employ the tools that you know are good for you.

00:28:23: We thought about how physical activity not only influences the way that you feel, apparently, but also that you can see it on the structure, on pictures of the brain.

00:28:34: You already ventured a little bit into that.

00:28:37: But regular aerobic exercise can actually increase the brain region important for memory, the so-called vocampus region.

00:28:46: You already said that, but I found that actually in a study done on twins that you saw the twin that was exercising, he or she had really increased the area in comparison to the twin that had been passive or not doing something actively.

00:29:02: And for me, that was quite new, but... Was this new to you, Olle Petter, or do you say like, no?

00:29:10: Well, if you would have asked me in two thousand eighteen, I would say I didn't know that.

00:29:15: But I wrote a book in two thousand and eighteen called Stelkjärne.

00:29:20: A strong brain with an exercising body, basically.

00:29:26: the English translation.

00:29:28: And of course, when I wrote that book, I had to go through all the literature that I can find on exercise and how it affects different brain regions and health brain functions.

00:29:38: And hippocampus is one of the areas of the brain that most of the research has been done on.

00:29:44: And I've seen several studies there where you see that the hippocampus can actually grow in volume.

00:29:52: and also the amount of nerve cells.

00:29:53: I even saw one study where they show that on average, people who exercise thirty minutes, three times a week, they were actually able to produce around two thousand new nerve cells in the hippocampus region alone every single day.

00:30:09: And this turns out that you can do all through life from the cradle to your grave, which is pretty amazing.

00:30:16: I mean, what else can you do to make brain regions grow?

00:30:22: Yeah, that is so cool actually and that's probably why sometimes I wouldn't say always but it's because that's not true.

00:30:28: But sometimes after exercise I suddenly Understand something that I didn't understand earlier that day like wow, that's the way it is.

00:30:37: So that's how I'm going to say it or write it and so on.

00:30:40: so that's really cool

00:30:41: and that's actually kind of funny because we have a saying Let me sleep on it.

00:30:49: So if people ask you a difficult difficult question and maybe my kids will come to me and say, dad, can I get on a bike?

00:30:55: And I'll say, let me sleep on it.

00:30:59: It's a difficult question.

00:31:00: I have to think about it.

00:31:02: Of course, we say that because we know that sleep clears our mind.

00:31:07: And sometimes when you then wake up, maybe you have a solution to the problem.

00:31:10: It turns out that exercising is probably even more profound.

00:31:14: So when people ask me now a difficult question, I always say, I'll run on it.

00:31:20: I'll run on it or I I will exercise on it.

00:31:23: Yeah, so And and of course the hippocampus.

00:31:28: The hippocampus is a really important region.

00:31:30: We know that in depressed patients We tend to see an atrophy of the hippocampus in Alzheimer's dementia, of course Here hippocampus is one of the first areas where we see atrophy.

00:31:42: So and this is a really important brain region for memory for learning for spatial memory to find your way.

00:31:51: You know, we have the Norwegians who got the Nobel Prize in Medicine for working on the hippocampus and these grid GPS cells in there.

00:31:59: So yeah, so there are a lot of functions that are strengthened through the hippocampus by hippocampus growing when you exercise.

00:32:08: That's amazing.

00:32:11: So once you definitely work out for one's hippocampus, but talking about work before we wrap up here.

00:32:18: Do you like share with our listeners simple and evidence-based ways to, of course, evidence-based, integrate more physical activity into their daily life?

00:32:31: How should you combat the little voice that says, go to the sofa, go to the sofa instead of like put on your running shoes?

00:32:39: What are your strategies for that, even though you say you are a keen runner and you've done that most of your life?

00:32:45: Yeah.

00:32:46: What

00:32:46: would you do?

00:32:47: Yeah.

00:32:48: I would like to answer that twofold or in two ways.

00:32:51: I think if we want more people to move or become physically active, which I think is important for individual health and public health and the economy as well, because it is expensive to be inactive, I think we need to work on different areas.

00:33:09: We need to work as a society.

00:33:12: Making sure that it's easier to make the good choices that we all know about exercising.

00:33:17: So in other words, in the area where you live, there should be bike paths.

00:33:22: There should be places where you can go out in nature.

00:33:25: There should be safe sidewalks so the kids can ride their bike or walk to school.

00:33:31: We need to have more exercise in school.

00:33:33: We need to have more focus on it in the workplace.

00:33:36: Things like that.

00:33:37: That's on one side.

00:33:39: that's the politicians table, making it easier for us to make the decisions that we know are good for us.

00:33:46: On an individual level, at least when I talk to my patients, I have three advisors.

00:33:53: And one of them is that the health benefit of exercise seems to be quite regardless of what kind of activity you do, but you need to find something you enjoy at least a little bit, because if you hate to run, Don't run.

00:34:08: I mean you'll be able to do it for a few weeks But you need something that you enjoy maybe maybe more so you can walk You can work in your backyard.

00:34:18: I mean you can play with your kids You can cycle you can swim you can go skiing.

00:34:23: I mean it really doesn't matter.

00:34:25: It seems that the health benefit is not connected to any specific type of activity.

00:34:31: It's the amount of time you move and what kind of intensity.

00:34:35: so find something you like.

00:34:37: I think that's one of my key advisors.

00:34:41: And the second one is that at least when you ask Norwegians, we did a study a few years ago where it turns out that eighty six percent of inactive Norwegians say that they would like to get more exercise into their lives, but they're having trouble getting it done.

00:34:56: I mean, they know it's good for them, but it's hard to do it.

00:35:01: and they want some help.

00:35:03: So it turns out that if you make an appointment with someone, if you exercise with someone, you double the chance of succeeding.

00:35:10: I mean, the numbers needed to treat, the amount of people you need to have in an intervention for one statistically to change behavior is halved.

00:35:20: So you double your chances of succeeding if you make an appointment with someone.

00:35:25: And I think that's intuitive maybe, but let's say that you have decided you will get up early in the morning, thirty minutes before normal, set your alarm for six thirty and then you're gonna go for a jog.

00:35:37: So you go to bed full of energy and motivation the night before and you sleep like a baby.

00:35:44: You're brutally awakened by the alarm the next morning at six thirty.

00:35:47: You've probably become a completely different person overnight.

00:35:51: All the motivation is gone, you're tired, you mute the snooze button is there and you keep sleeping.

00:35:57: But if you made an appointment with a neighbor, with a friend, with a colleague who's standing on the street corner waiting for you, you will get up and out.

00:36:06: So make an appointment with someone.

00:36:08: It could be a group, it could be one other person.

00:36:11: I think that's a key element to it.

00:36:14: And the third advice I give is that... Don't be too hard on yourself.

00:36:21: Most people are very ambitious and they're concerned about what is the perfect exercise regimen.

00:36:27: And I usually say, you know, forget about the perfect regimen because none of us are able to do that.

00:36:32: So lower your... We set the bar very often so high that we're kind of doomed to fail.

00:36:42: So maybe you are going on a journey from A the couch to Z becoming a great athlete.

00:36:49: But you can't take that step in one leap.

00:36:52: you have to go from A to B from B to C. So I try to tell my patients make small changes at a time Find a goal that's close in time that you think you're able to do and that you're motivated to do and start there.

00:37:10: and For some of my patients, it could be walking to the mailbox.

00:37:15: Some of my depressed patients, they haven't been there for three weeks.

00:37:18: If they are able to succeed, just even if it's just walking to the mailbox, it creates mastery and self-efficacy, and it's easier to move on to the next target.

00:37:29: So don't set your bar too high.

00:37:32: I think that's one of the most important things.

00:37:37: I think that's a very nice last slogan, don't set your bar too hard.

00:37:42: And also that small changes are the sustainability ones.

00:37:47: So definitely yes.

00:37:50: Thank you so much, Olle Petter.

00:37:51: I really learned a lot.

00:37:53: I had great anticipation when I had you as a guest here and they were fulfilled.

00:38:00: I think you gave me and the listeners a very valuable insight into that.

00:38:04: the association between brain health and physical activity.

00:38:08: And I also hope that the listeners got encouraged in being more physical active.

00:38:15: You can start with a little, it's still much more than nothing at all.

00:38:20: Thanks to our listeners again for joining us on the Brain Health Mission podcast and if you enjoyed the episode, follow us on your preferred podcast platform, share it with your network and stay tuned for more exciting conversations on Brain Health.

00:38:39: You've been listening to the Brain Health Mission podcast where science meets action for a healthier brain.

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00:39:03: Until next time, take care of your brain.

00:39:05: It's the only one you've got.