Author: Francisco B. Ortega

Is the brain of fitter individuals different from that of less fit individuals? Yes, several investigations support that there are indeed important structural differences in the brain in people with different physical fitness levels.

As an example, a recent study conducted by our group in 100 overweight-obese children explored the whole brain and observed that the children with higher aerobic fitness (capacity of a person to do exercise for a long time and efficiently, also known as cardiorespiratory fitness) have higher volume in 9 cortical and subcortical brain regions relevant for cognition, executive function, and academic achievement ^[1]. In addition, we observed in a different study and group of children that aerobic fitness level was associated with the shapes of subcortical brain regions, showing therefore a link between physical fitness and brain morphology ^[2]. Similarly, other researchers have observed that hippocampus and dorsal striatum, key brain structures responsible for memory and other high cognitive functions, are markedly larger in fitter kids compared with less fit kids ^[3,4].

 

Image taken from: https://pixabay.com/es/salud-mental-la-formaci%C3%B3n-del-cerebro-2313426/

 

But differences in brain volumes according to physical fitness are not only observed in the growing brains of children, but also in adults and in older adults in which brain volume is known to shrink as a person ages. Several investigations have consistently shown that hippocampus volume is larger in fitter older adults than in their less fit peers ^[5]. However, even more important are the results of another study which demonstrated that 1 year of aerobic training in older adults did not only attenuate the natural decline in hippocampus volume observed in the control group that did not train, but did even successfully reverse the natural trend, increasing hippocampal volume by 2% and leading to improvements in memory function ^[6].

 

Collectively, existent evidence concisely supports that individuals with a better aerobic fitness level, have more developed certain regions of the brain, which in turn has shown to positively influence cognition. Therefore, there is emerging evidence suggesting that to exercise and be in a good fitness level is healthy not only for the body, but also for the brain and cognition. Thus, as stated in the title of a landmark review article in this topic ^[7]… “Be smart, exercise your heart”.

 

 

Francisco B. Ortega, Adrià Muntaner-Mas, Antonio Martínez-Nicolás and Irene Esteban-Cornejo

The PROFITH research group: http://profith.ugr.es/

University of Granada, Spain.

 

 

References

[1]       Esteban-Cornejo I, Cadenas-Sanchez C, Contreras-Rodriguez O, et al. A whole brain volumetric approach in overweight/obese children: Examining the association with different physical fitness components and academic performance. The ActiveBrains project. Neuroimage 2017;159:346-354.

[2]       Ortega FB, Campos D, Cadenas-Sanchez C, et al. Physical fitness and shapes of subcortical brain structures in children. Br J Nutr 2017:1-10.

[3]       Chaddock L, Erickson KI, Prakash RS, et al. A neuroimaging investigation of the association between aerobic fitness, hippocampal volume, and memory performance in preadolescent children. Brain Res 2010;1358:172-183.

[4]       Chaddock L, Erickson KI, Prakash RS, et al. Basal ganglia volume is associated with aerobic fitness in preadolescent children. Dev Neurosci 2010;32:249-256.

[5]       Erickson KI, Prakash RS, Voss MW, et al. Aerobic fitness is associated with hippocampal volume in elderly humans. Hippocampus 2009;19:1030-1039.

[6]       Erickson KI, Voss MW, Prakash RS, et al. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A 2011;108:3017-3022.

[7]       Hillman CH, Erickson KI, Kramer AF. Be smart, exercise your heart: exercise effects on brain and cognition. Nat Rev Neurosci 2008;9:58-65.

 

 

 

Health and fitness apps enable researchers, physicians, sport specialists and healthcare practitioners to maximize health and gather data from large numbers of people (Savage, 2015). Nowadays, the apps have the potential to reach nearly all populations, regardless of gender or ethnicity, even for those who have limited access to healthcare. Another remarkable point is that smartphones allow to perform assessments without be physically present on specific location.

Smartphones made to measure

In this context, several apps are being validated for obtaining data of sports performance and public health issues. In this context, The MyHeart Counts Cardiovascular Health Study is a very good example (McConnell et al., 2017). In this study physical activity was recorded through the motion coprocessor chip of the smartphone. The motion chip was able to include triaxial accelerometer, gyroscope, compass and barometer. Fitness was measured with the 6-minute walk test and final time was registered by the app. Sleep patterns were also registered by the motion chip. MyHeart Counts has demonstrated the feasibility, large-scale and real world assessment of physical activity, fitness and sleep using a smartphone in more than 40.000 people. Smartphones are definitely made to measure!

 

Apps for measuring fitness

More specifically, apps offer a large potential on fitness assessment, making it inexpensive, easier, accessible, feasible and last leading a laboratory into the pocket.

In fact, considering the importance reached by physical fitness as a powerful indicator not only of sport performance, but also and mainly as a maker of current and future health/disease, it is relevant to known about the currently available apps allowing assessment of the main health-related physical fitness components. An example is My Jump, which has been developed by Balsalobre-Fernandez, Glaister, & Lockey (2015) for measuring vertical jump height. Vertical jump is the most common field test to evaluate lower limb power in various populations and it has been recognized as an important tool to quantify neuromuscular fatigue.

In this sense, we have recently reviewed the apps for measuring the main health-related fitness components available in Google Play and App Store (unpublished material). Therefore, we have concluded some important points: 1- All validated apps conducted under research conditions have been developed for App Store; 2- Course-Navette field-test has been the most use for apps aiming to estimate aerobic capacity; 3- Regarding the muscular strength component most of the apps has been designed to calculate the maximum repetition; 4- Few apps are available to measure velocity and agility; 5- The flexibility category is the one that contains more scientifically validated apps.

 

Take home message

If you are planning to use an app to measure your fitness, you should pay attention to the following recommendations:

• If you have a Smartphone you have a lab in your pocket.
• Demand scientifically validated apps.
• Check out the ratings and user reviews of the apps.
• Take a look to security aspects.

 

Adrià Muntaner-Mas, Antonio Martínez-Nicolás and Francisco B. Ortega

The PROFITH research group: http://profith.ugr.es/

Dept. Physical Education and Sports, Faculty of Sports Sciences, University of Granada, Spain.

 

 

References

Balsalobre-Fernandez, C., Glaister, M., & Lockey, R. A. (2015). The validity and reliability of an iPhone app for measuring vertical jump performance. Journal of Sports Sciences, 33(15), 1–6.

McConnell, M. V., Shcherbina, A., Pavlovic, A., Homburger, J. R., Goldfeder, R. L., Waggot, D., … Ashley, E. A. (2017). Feasibility of Obtaining Measures of Lifestyle From a Smartphone App. JAMA Cardiology, 2(1), 67.

Savage, N. (2015). Mobile data: Made to measure. Nature, 527(7576), S12–S13.

 

Given the strong link between physical activity and health, the promotion of physical activity is a major goal internationally, regardless of income, gender or ethnicity. However, intervention programs are usually conducted on specific cities or locations, excluding many potentially interested people who live geographically too far or those that for whatever reason cannot be physically present on the intervention place.

 

Can smartphones help to solve this problem, so that any person living anywhere, can benefit from an exercise-based intervention program?

The answer is YES, there is a great potential for improving lifestyle through mobile phones, and particularly for increasing physical activity using smartphone technology (Fanning et al. 2012). Smartphone technology is useful to disseminate information about lifestyle modification (e.g. physical activity) to the general population and to populations at risk (Liu et al. 2015). Mobile phones are becoming an essential part of the lifestyle in the World as indicates the growing percentage of worldwide population owning a smartphone (higher than 45%) and the fact that smartphones are carried all throughout the day (Ganesan et al. 2016). There is nowadays a wide range of apps and wearable devices are excellent in engaging people into activities, and in measuring and influencing behaviours in real time (Bort-Roig et al. 2014).

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It is well known that exercise has health benefits as a monotherapy or in combination in the treatment of depression and anxiety (Blumenthal et al. 2007, Dunn et al. 2005). In addition, exercise has also been shown to prevent or reduce weight gain and improve sleep (Sugaya et al. 2007, Youngstedt 2005). Although systematic studies on ADHD symptoms are still lacking, preliminary evidence suggests that exercise enhances the effect of medication, benefits multiple areas of ADHD dysfunction and does not provoke any adverse effects (Hoza et al. 2016). Exercise may be a prime intervention to target comorbidities of ADHD as obesity (closely related to low fitness, for more details read our post Low fitness and ADHD: An additional comorbidity?). Although it is widely described the benefit of exercise as an adjunctive therapy to ADHD, there is lack of research in the use of exercise as a sole intervention (Hoza et al. 2016).

Under the umbrella of the CoCA project, a pilot clinical trial based on an exercise m-health approach in ADHD young patients will provide new insights about the potential of smartphones to improve ADHD symptomatology and its comorbidities, such as obesity and depression.

 

Antonio Martínez-Nicolás, Adrià Muntaner-Mas, and Francisco B. Ortega

The PROFITH research group: http://profith.ugr.es/

University of Granada, Spain.

 

References

Blumenthal JA, Babyak MA, Doraiswamy PM, Watkins L, Hoffman BM, Barbour KA, Herman S, Craighead WE, Brosse AL, Waugh R, Hinderliter A, Sherwood A. (2007). Exercise and pharmacotherapy in the treatment of major depressive disorder. Psychosomatic Medicine 69(7): 587-596.

Bort-Roig J, Gilson ND, Puig-Ribera A, Contreras RS, Trost SG. (2014). Measuring and influencing physical activity with smartphone technology: A systematic review. Sports Medicine 44: 671-686.

Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO. (2005). Exercise treatment for depression: Efficacy and dose response. American Journal of Preventive Medicine 28(1): 1-8.

Fanning J, Mullen SP, McAuley E. (2012). Increasing physical activity with mobile devices: A meta-analysis. Journal of Medical Internet Research 14(6): e161.

Ganesan AN, Louise J, Horsfall M, Bilsborough SA, Hendriks J, McGavigan AD, Selvanayagam JB, Chew DP. (2016). International Mobile-Health intervention on physical activity, sitting, and weight: The Stepathlon cardiovascular health study. Journal of the American College of Cardiology 67(21): 2453-2463.

Hoza B, Martin CP, Pirog A, Shoulberg EK. (2016). Using physical activity to manage ADHD symptoms: The state of the evidence. Current Psychiatry Reports 18: 113.

Liu F, Kong X, Cao J, Chen S, Li C, Huang J, Gu D, Kelly TN. (2015). Mobile phone intervention and weight loss among overweight and obese adults: A meta-analysis of randomized controlled trials. American Journal of Epidemiology. 181(5): 337-348.

Sugaya K, Nishijima S, Owan T, Oda M, Miyazato M, Ogawa Y. (2007). Effects of walking exercise on nocturia in the elderly. Biomedical Research 28(2): 101-105.

Youngstedt SD. (2005). Effects of exercise on sleep. Clinics in Sports Medicine 24(2): 355-365.

It is well known that depression and obesity are comorbidities highly prevalent in ADHD patients (Cortese et al., 2016; Michielsen et al., 2013). Given that obesity and depression are closely related with a lower physical fitness level, it is reasonable to think that a poor physical fitness could potentially be a novel, less studied, comorbidity associated with ADHD.

Physical fitness is a set of attributes related to a person’s ability to perform physical activities that require aerobic fitness, endurance, strength or flexibility and and also makes reference to a full range of psychological qualities (Ortega, Ruiz, Castillo, & Sjöström, 2008). Epidemiological studies have consistently demonstrated that being physically fit have a crucial role in overall health status. In fact, Ortega, Silventoinen, Tynelius, & Rasmussen (2012) observed in more than one million of Swedish adolescents than those who had low muscle strength had a higher risk of being diagnose with a psychiatric in the future disorder and to die due to suicide.

Information about physical fitness levels in ADHD patients compared with age-matched controls is scarce. Jeoung (2014) found that those university students with low muscular strength and muscular endurance were more likely to have ADHD than those with greater muscular strength and endurance. Children with ADHD had lower performance on aerobic capacity using a field shuttle run test (Verret, Gardiner, & Beliveau, 2010). Harvey & Reid (2003) indicated on their systematic review that children with ADHD are at risk for poor levels of physical fitness. In contrast, Golubović, Milutinović, & Golubović, (2014) found no differences on physical fitness among children with and without hyperactivity.

Although the information is limited, there seems to be emerging evidence suggesting that a low fitness level could be another comorbidity of ADHD, yet further study on this is warranted. CoCA project includes measures of cardiorespiratory fitness and muscular fitness, and will provide new and fresh data about the relationship of fitness with ADHD symptomatology and comorbidities. Waiting for the results of the CoCA project!

 

Adrià Muntaner-Mas, Antonio Martínez-Nicolás and Francisco B. Ortega

The PROFITH research group: http://profith.ugr.es/

University of Granada, Spain.

 

References

 

Cortese, S., Moreira-Maia, C. R., St Fleur, D., Morcillo-Peñalver, C., Rohde, L. A., & Faraone, S. V. (2016). Association between ADHD and obesity: A systematic review and meta-analysis. American Journal of Psychiatry.

Golubović, Š., Milutinović, D., & Golubović, B. (2014). Benefits of physical exercises in developing certain fitness levels in children with hyperactivity. Journal of Psychiatric and Mental Health Nursing, 21(7), 594–600.

Harvey, W. J., & Reid, G. (2003). Attention-deficit/hyperactivity disorder: A review of research on movement skill performance and physical fitness. Adapted Physical Activity Quarterly. Retrieved from

Jeoung, B. J. (2014). The relationship between attention deficit hyperactivity disorder and health-related physical fitness in university students. Journal of Exercise Rehabilitation, 10(6), 367–71.

Michielsen, M., Comijs, H. C., Semeijn, E. J., Beekman, A. T. F., Deeg, D. J. H., & Sandra Kooij, J. J. (2013). The comorbidity of anxiety and depressive symptoms in older adults with attention-deficit/hyperactivity disorder: A longitudinal study. Journal of Affective Disorders, 148(2–3), 220–227.

Ortega, F. B., Ruiz, J. R., Castillo, M. J., & Sjöström, M. (2008). Physical fitness in childhood and adolescence: a powerful marker of health. International Journal of Obesity (2005), 32(1), 1–11.

Ortega, F. B., Silventoinen, K., Tynelius, P., & Rasmussen, F. (2012). Muscular strength in male adolescents and premature death: cohort study of one million participants. BMJ, 345, e7279.

Verret, C., Gardiner, P., & Beliveau, L. (2010). Fitness level and gross motor performance of children with attention-deficit hyperactivity disorder. Adapted Physical Activity Quarterly : APAQ, 27(4), 337–351.