Qualy #9 - The importance of exercise for brain health

**Peter Attia** (0:05)
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That's another change in my belief system, I think today versus, I don't know, five or six years ago. I think five or six years ago, I didn't think exercise was that important to longevity, which actually sounds ridiculous for anyone who knows me because I was probably exercising four hours a day, but not because I believed it would make me live longer. It was just sort of soothing my addictions. But I think today I feel, I am much more convinced by a lot of the data you've described, certainly the central stuff. When we published this paper earlier this year with Richard Isaacson that you and I were talking about before we started recording, we wanted to get a sense of like, if you took a completely unbiased approach and look at the literature, what was the single most compelling thing you could do to generate or preserve brain health?
And we came away thinking that it was actually exercise.
And I remember when the analysts were kind of going through this and showing me all the data, I was like, come on guys, there's no way exercise could be the most important thing for brain health. And again, I'm saying this as a guy who loves exercise more than anybody, but it just struck me as there's no way. And again, I think part of it was I was just thinking about it through the vascular lens.
And obviously, you know, I think better than I do that when you start to think about brain health, you have to think about it through a vascular lens, a metabolic lens, growth factor lens. I mean, there are overlapping but distinct pathways that are going to influence brain health. And so I was kind of humbled by that. And now I guess in many ways, I'm a little more adamant about it with my patients. Not that I wasn't adamant before, but this is like, boy, if you're not active every day, we gotta change that.

**Rhonda Patrick** (2:44)
I actually, the main reason I exercise is for my brain. It's certainly just not only for preventing neurogenetic disease and atrophy and all that, but just because it affects my executive function and affects my anxiety levels, it affects my ability to make decisions.
I absolutely, if I have something that's bothering me or giving me anxiety or have to make a really important decision, going for a long run really helps me. And there's been studies showing that it helps with executive function, long-term planning, like aerobic exercise specifically, and the high-intensity interval training, all that stuff. They all do different things.

**Peter Attia** (3:19)
Well, that's the thing, we couldn't tease this out of the literature, which again, probably is just a limitation of shitty human clinical trials, but that's the second-order question, right? Which is, if you're gonna take the Tim Ferriss approach, which is what's the minimum effective dose? Because there are some people, like maybe you or I, who I think just generally like exercise, and also get these other benefits, these endorphin benefits.
But there are some people who are like, look, what do I need to do? I'm gonna treat exercise like medicine. And I think in that setting, I'm still not clear. So if you were that person, would I say, Rhonda, as long as you are lifting weights, one hour, three times a week, if you can only give me three hours, would that be how I'd want you to spend it? Or would I rather you be doing anaerobic aerobic type thing? I mean, to me, those are where these biomarkers start to become very important because we're not gonna generate hard outcome studies with that level of control. Once you try to control that many variables and be that strict about it, you're gonna very much lose a hard outcome prospectively.