Another reason why exercise can rescue you from depression

Whilst anti-depressants are still the number one choice for treating depression they have many limitations.   Exercise on the other hand has very few limitations and many benefits. Lets compare these two treatment options.

Anti-depressant drugs

The first major limitation that may surprise you is that Anti-depressant medication is only effective in less than 50% of  patients (1).  Anti-depressants have numerous side effects including loss of libido, increased sleep, weight gain, dry mouth, and many of these side effects seem to plague older adults (2).  Anxiety and diarrhea are often experienced on onset of treatment and there are well documented withdrawal side effects that can be mistaken for the return of depression / anxiety (3).

Independent reviews  of anti-depressant clinical trails have found that  the drugs are no better than placebo (4) and the original “monoamine hypothesis ” which taught us that depression is caused by a serotonin (5-HT) deficiency (a chemical imbalance in the brain) is flawed (5).  If it had been true  than wouldn’t you expect the drugs to work for 100% of people correctly diagnosed with MDD? Today scientists are still trying to explain how SSRIs/SRNIs alter the brain , but they can’t precisely  explain this because it turns out our brain chemistry is immensely complicated. The validity of the original drug trials remain controversial , but despite our new understanding of the human nervous system and its interdependency with the whole body , these out-dated ineffective drugs are still prescribed.


Exercise for depression

There are numerous studies proving regular exercise significantly relieves depression quickly and long term. These studies have proven exercise is just as effective at relieving MDD as anti-depressants drugs and keeps you in remission (6). Exercise wont cure everyone, but it’s consistently more effective than the anti-depressant drugs, it has no side effects, except perhaps  sore muscles and it will give you more energy, help you sleep better , strengthen your immune system  and it’s free!

A recent study on exercise and depression measured the effects of exercise on particular brain chemical called brain-derived-neurotropic factor or BDNF. BDNF has been implicated in the pathogenesis of major depressive disorder (MDD) (7). Many preclinical and clinical studies provide direct evidence suggesting that modulation in expression of BDNF could be involved in behavioral phenomenon associated with depression (4). Studies in humans have shown decreased plasma levels of BDNF in bipolar disorder, manic and depressed patients (8).


Study Abstract (4)

Exercise increases serum brain-derived neurotrophic factor in patients with major depressive disorder


Brain derived neurotrophic factor (BDNF) has been implicated in the pathogenesis of major depressive disorder (MDD). Existing data on exercise treatment in people with MDD are inconsistent concerning the effect of exercise on BDNF pointing either to increased or unaltered BDNF concentrations. However, studies in non-depressed persons demonstrated a significant effect on resting peripheral BDNF concentrations in aerobic training interventions. Given the lack of clarity mentioned above, the current study aimed at examining the effect of adjunctive exercise on serum BDNF levels in guideline based treated patients with MDD.

depressed inpatients were included, and randomized either to a 6 week structured and supervised exercise intervention plus treatment as usual (EXERCISE, n=22), or to treatment as usual (TAU, n=20). BDNF serum concentrations were assessed before and after the intervention in both study groups with established immunoassays.


Serum BDNF slightly decreased in the TAU group, whilst there was an increase in BDNF levels in the exercise group. There was a significant time x group effect concerning sBDNF (p=0.030) with repeated ANOVA measures with age and BMI as covariates, suggesting an increase in BDNF concentrations in the EXERCISE group compared to TAU.


Though there was no statistic difference in the antidepressant medication between EXERCISE and TAU potential interactions between exercise and medication on the effects of exercise in BDNF cannot be excluded. Gender was not considered as a covariate in ANOVA due to the small number of objects.


Exercise training given as adjunct to standard guideline based treatment appears to have additional effects on BDNF serum concentrations in people with MDD. Our results add further evidence to the beneficial effects of exercise in the treatment of MDD.


Blog Post References

  1. Yu H, Chen Z. The role of BDNF in depression on the basis of its location in the neural circuitry. Acta Pharmacologica Sinica. 2011;32(1):3-11. doi:10.1038/aps.2010.184.
  2. Garfield LD, Dixon D, Nowotny P, et al. Common SSRI side-effects in older adults associated with genetic polymorphisms in the serotonin transporter and receptors: Data from a randomized controlled trial. The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. 2014;22(10):971-979. doi:10.1016/j.jagp.2013.07.003.
  4. Irving Kirsch , The Emperor’s New Drugs
  5. Nestler, Eric J. et al. Neurobiology of Depression Neuron , Volume 34 , Issue 1 , 13 – 25
  6. Blumenthal JA, Babyak MA, Murali Doraiswamy P, et al. Exercise and Pharmacotherapy in the Treatment of Major Depressive Disorder. Psychosomatic medicine. 2007;69(7):587-596. doi:10.1097/PSY.0b013e318148c19a.
  7. Kerling, M. Kück, U. Tegtbur, L. Grams, S. Weber-Spickschen, A. Hanke, B. Stubbs, K.G. Kahl, Exercise increases serum brain-derived neurotrophic factor in patients with major depressive disorder, Journal of Affective Disorders, Volume 215, June 2017, Pages 152-155, ISSN 0165-0327,
  8. Yu H, Chen Z. The role of BDNF in depression on the basis of its location in the neural circuitry. Acta Pharmacologica Sinica. 2011;32(1):3-11. doi:10.1038/aps.2010.184.

A diet rich in whole grains may lead to modest improvements in gut microbiota and immune response in healthy adults

A recent study reminds  us that bread is actually good for you, but it has to be bread made from whole wheat.  A recent 6 week study on diets high in whole grains found that  eating more whole grains foods (such as  wholewheat bread, brown rice, oats) can improve your immune system and your gut microbiota. Here’s the original article and reference.

6 APR 2017 |

Dietary fibre is a key nutrient for optimizing gut health through fermentation by commensal microbiota in the colon. The vast majority of studies that support the health benefits of dietary fibre are observational, whereas little evidence from interventional studies is available and mechanisms involved in their effects on gut microbiota and immune response are poorly understood.

A recent study, led by Dr. Simin Nikbin Meydani from the Jean Mayer USDA Human Nutrition Research Centre on Aging at Tufts University in Boston (USA), has found that consuming a diet rich in whole grains may lead to modest improvements in gut microbiota and immune response in healthy adults.

For the first 2 weeks (the weight maintenance run-in period), 81 metabolically healthy adults (49 men and 32 postmenopausal women, age range: 40-65 years, body mass index less than 35 kg/m2) consumed the same weight-maintaining Western-style diet high in refined grains (with high consumption of saturated fats, red meats, simple carbohydrates, and processed or refined foods and low consumption of fresh fruit and vegetables, whole grains, seafood, and poultry). For the next 6 weeks, 40 of those participants stayed on that diet (refined grains group: 8g fibre/1000 kcal), whereas 41 participants switched to a diet rich in whole grains but matched in all other ways (whole grain group: 16 g fibre/1000 kcal, which met the recommended dietary guidelines for Americans of 35 g/day). It is noteworthy to highlight that all meals were provided to the volunteers by trained staff, which aims to improve compliance and, thus, diet is not a factor of variability.

The researchers assessed the effects of the diet rich in whole grains compared with refined grains on immune and inflammatory responses: systemic and stool inflammatory cytokine concentrations and plasma lipopolysaccharide-binding protein concentrations, phenotypic and functional immune variables, and gut microbiota and microbial products. Stool, 12-h fasting blood, and saliva samples were collected, and delayed-type hypersensibility (DTH) tests were conducted at or near the end of week 2 of the run-in period and at or near the end of week 8 of the study.

Participants who consumed the whole-grain diet had increased stool weight and frequency and a modest increase in the short-chain fatty acid (SCFA) producer Lachnospira, together with decreased pro-inflammatory Enterobacteriaceae, which was associated with a higher concentration of acetate and butyrate in the stool samples. Increased SCFA production after whole grain consumption was suggested to be related to a decrease in stool pH, as lower pH favours the production of SCFAs. Adherence to the assigned diets was assessed by measuring plasma concentrations of alkylresorcinol, a biomarker of whole grain intake. The whole grain group had significantly increased plasma alkylresorcinol compared with refined grain group.

Besides this, eating whole grains resulted in a modest increase in levels of memory T cells and tumour necrosis factor-alpha production by lipopolysaccharide stimulated immune cells. There was no change in the levels of other markers of cell-mediated immunity and inflammatory cytokines.

“The strength of the study is that we found modest effects of whole grain on gut microbiota and measures of immune function in the context of a controlled energy and macronutrient diet where all food was provided to participants, allowing them to maintain their body weight constant, thus eliminating the confounding effect of weight loss associated with increasing fibre consumption on immune and inflammatory markers. Additionally, our study incorporated markers of diet adherence and whole grain consumption, allowing us to more confidently determine the effect whole grains have on the gut microbiota and inflammatory responses,” said Dr. Simin Nikbin Meydani in a Tufts news release.

To sum up, 6 weeks of whole grain consumption over refined grain consumption resulted in a modest effect on gut microbiota composition, stool short-chain fatty acid concentrations, and certain indicators of the immune response in healthy adults. Further long-term interventional studies in humans are needed in order to explore the role of the gut microbiota in the health benefits of whole grains.




Vanegas SM, Meydani M, Barnett JB, et al. Substituting whole grains for refined grains in a 6-wk randomized trial has a modest effect on gut microbiota and immune and inflammatory markers of healthy adults. Am J Clin Nutr. 2017; doi: 10.3945/ajcn.116.146928.

Prostate Cancer stems cells resist radiation and we now might know why

movemberIt may not be commonly known by the general public but radiotherapy treatment for prostate cancer is not as effective as we would have hoped. In fact it is now understood that radiotherapy is not consistently eradicating 100% of the prostate cancer and instead leaving behind cancer stem cells .

Cancer stem cells are  necessary to form new tumours and when these are left circulating in the  body it  increases the likelihood of the cancer returning.  Until now the reasons why stems cells resist radiotherapy have not been  understood. A recent study may be bringing us closer to  understanding why cancer stem cells survive radiotherapy. However this doesn’t provide a solution for patients today. So until science has a solution it maybe the right time to  discuss this issue with  your oncologist  and learn about the actual risks associated with  radiotherapy and  how the risks can be mitigated.


Full Article below


A new study has shown that a standard hormone supplement, used to boost energy levels in prostate cancer patients following radiotherapy, could potentially increase the chances of the cancer returning.

The research is published in the journal Oncotarget.

Studies led by Professor Norman Maitland at the University of York Department of Biology, have shown that stem cells inside the cancer are resistant to radiotherapy treatment.

This means that the bulk of the cancer dies following treatment, but the ‘core’ does not, increasing the risk of the cancer returning.

Until now, however, it was not clear why stem cells — which are present in all cells of the body — should survive when the rest of the tumour is killed off by radiotherapy.

Using cancerous cells from patients diagnosed with prostate cancer, researchers showed that proteins called SMARCs, inside the stem cells, help to keep the ‘core’ of the cancer alive.

The research team, including York scientists Dr Jayant Rane and Dr Holger Erb, were surprised to find, however, that cancer cells that had been treated in the laboratory with a glucocorticoid hormone, which is normally administered to patients in tablet form to boost energy levels following radiotherapy, became more resistant to cancer treatment.

Professor Maitland said “This was a really unexpected result of our investigation, so we took a slightly different direction in order to find out why these stem cells would become more resistant to cancer treatment.”

Tiny molecules that respond to changes in the body are present in all ‘normal’ cells and can be regulated by hormones.

These are kept at very low levels in cancer stem cells.

The researchers found, however, that any increase in these molecules, called MicroRNAs, impacts on the levels of SMARCs in the stem cells.

Professor Maitland continued “When more glucocorticoid hormones are ingested, the levels of MicroRNAs decrease even further, resulting in an increase in SMARCs. These SMARC proteins wind up chromosomes inside the cancer cells to make them resistant to treatment.

“Hormone injections to counter the energy-sapping effects of radiotherapy and chemotherapy have been a standard part of after-care for 15 years or more, so we were surprised to find that the treatment was actually to the detriment of radiotherapy.”

When the researchers looked at what would happen if the natural levels of glucocorticoids were blocked, they saw an increase in the number of MicroRNAs and the expected decrease in the levels of SMARCs.

It is now possible that the same radiotherapy dose could kill more cancer stem cells – the root of cancer recurrence after treatment.

Professor Maitland added “We now need to move into clinical trials to see whether blocking, rather than boosting, the glucocorticoids in patients could bolster the success rate of radiotherapy. It would ultimately mean that the patient is more tired after treatment, but there are other non-hormone treatments that could be used to improve energy levels that would not interfere with how we now believe stem cells to behave in cancer.”


Some References

Moncharmont C, Levy A, Gilormini M, Bertrand G, Chargari C, Alphonse G, Ardail

D, Rodriguez-Lafrasse C, Magné N. Targeting a cornerstone of radiation
resistance: cancer stem cell. Cancer Lett. 2012 Sep 28;322(2):139-47. doi:
10.1016/j.canlet.2012.03.024. Review. PubMed PMID: 22459349.

Pajonk F, Vlashi E, McBride WH. Radiation Resistance of Cancer Stem Cells: The 4 R’s of Radiobiology Revisited. Stem cells (Dayton, Ohio). 2010;28(4):639-648. doi:10.1002/stem.318.

Skvortsova I, Debbage P, Kumar V, Skvortsov S. Radiation resistance: Cancer
stem cells (CSCs) and their enigmatic pro-survival signaling. Semin Cancer Biol.
2015 Dec;35:39-44. doi: 10.1016/j.semcancer.2015.09.009. Review. PubMed PMID:

Research shows exercise improves Quality of life for men who have prostate cancer with bone metastasis

movemberIt’s Movember this month and in many countries men are asked to  think about their health, to learn more about prostate cancer and to help each other live a healthy long life.

Like any cancer prostate cancer  is feared by men and women, but we can alleviate some of these fears by educating ourselves and sharing the important information that helps men see the bigger picture and understand the consequences of the choices they make to prevent cancer and perhaps one day the choices to  treat prostate cancer.

To begin here is a study of how exercise improves life for men who have bone metastasis , a serious health condition which occurs in advanced prostate cancer. This is not common and most men who have prostate cancer will never experiences this.

Associations between aerobic exercise levels and physical and mental health outcomes in men with bone metastatic prostate cancer: a cross-sectional investigation

Cancer patients with bone metastases have previously been excluded from participation in physical activity programmes due to concerns of skeletal fractures. Our aim was to provide initial information on the association between physical activity levels and physical and mental health outcomes in prostate cancer patients with bone metastases.

Between 2012 and 2015, 55 prostate cancer patients (mean age 69.7 ± 8.3; BMI 28.6 ± 4.0) with bone metastases (58.2% >2 regions affected) undertook assessments for self-reported physical activity, physical and mental health outcomes (SF-36), objective physical performance measures and body composition by DXA. Sixteen men (29%) met the current aerobic exercise guidelines for cancer survivors, while 39 (71%) reported lower aerobic exercise levels.

Men not meeting aerobic exercise guidelines had lower physical functioning (p = .004), role functioning (physical and emotional) (p < .05), general health scores (p = .014) as well all lower measures of physical performance (p < .05). Lower levels of aerobic exercise are associated with reduced physical and mental health outcomes in prostate cancer patients with bone metastases.

While previous research has focused primarily in those with non-metastatic disease, our initial results suggest that higher levels of aerobic exercise may preserve physical and mental health outcomes in prostate cancer patients with bone metastases.


UK Doctors list non-beneficial medical treatments

stopSource :

Maybe it’s time to take note of this list published by the The Academy of Medical Royal Colleges in London.

It might help next time you find yourself or your doctor demanding something that is of no benefit and may even do more harm than good.




Doctors have drawn up a list of treatments they say bring little or no benefit to the patient and should no longer be used.

The Academy of Medical Royal Colleges – which represents all 21 medical royal colleges in the UK – says doctors are giving patients too many tests and drugs that they don’t need.

List of recommendations

  • Having fluids administered directly into a vein while under the influence of alcohol will not make you feel better any more quickly.
  • When discussing treatment for adult schizophrenia with your doctor or specialist nurse, you should consider whether medications taken by mouth or longer-acting medications given by injection would be better for you.
  • Back pain is not likely to need an x-ray.
  • You should only receive a blood transfusion if it is really necessary, such as for major bleeding.
  • Small fractures in the foot do not usually need to be put in a plaster cast – they can heal just as quickly in a removable boot.
  • Chemotherapy in the final months of life for cancer patients can “do more harm than good”.
  • If you are receiving palliative chemotherapy or radiotherapy, post-treatment CT scans and MRI scans are unlikely to benefit.
  • It is not necessary to have a calcium test for kidney stones, bone disease or nerve-related disorders unless you undergo major surgery.
  • Small fractures on the wrist in children do not normally need a plaster cast – a splint will do.
  • Breathing problems in children usually get better without medical treatment. Breathing tubes have little to no effect.
  • For children with chronic constipation, changes to diet and lifestyle should be considered first before medical treatment.
  • If this is ineffective, children should be given Polyethlene Glycol rather than lactulose.
  • For children having a prolonged seizure, giving medications that can be dissolved in the mouth are preferable to those which are injected – they are just as effective and may stop the seizures sooner.
  • Helmet therapy is not effective in treating what is known as flat-head syndrome in children. Adjusting sleep patterns and physiotherapy are more effective.
  • Women using the coil should be taught how to check its placement every month – professional advice only should be sought when the patient cannot feel the threads.
  • Quality tap water is just as effective for cleaning cuts as saline solution.
  • Routine screening programmes do not exist for dementia.
  • Ineffective antidepressants should be changed or additional medication added.
  • Discussions should be had with patients and families about maintaining life support for those at the end of life.
  • Those who are at the end of their lives should try to decrease the number of medicines they are on. Only those which control symptoms should be used.
  • Minor head injuries do not normally require imaging.
  • You should only be considered for medication to treat blood pressure, prevent heart disease or strokes if you have other risk factors.
  • Those taking statins for high cholesterol do not need to have their levels checked regularly unless they have pre-existing conditions.
  • Some injuries such as hip and shoulder dislocations do not need to go under general anaesthetic to be treated.
  • If you are over 45 you do not usually need blood tests to diagnose the menopause.
  • Pregnant women should not be prescribed sodium Valproate for migraines, epilepsy or bipolar disorder unless other medications are not working.
  • Aspirin, heparin or progesterone should not be used to reduce the risk of further miscarriages.
  • If you have a simple ovarian cyst of less than 5cm in diameter, and have not undergone the menopause, you are unlikely to need a follow up appointment or checking of protein levels.
  • If your doctor suspects you have polycystic ovaries you should have a blood test before other investigations.
  • If you are pregnant, aspirin is not recommended to help reduce the chances of blood clots.
  • Unless you have diabetes, ultrasounds should not be used to check if your baby is bigger than normal.
  • Electronic monitoring of the baby’s heart is only needed in labour if the mother is at high-risk of complication.
  • Unless you are at risk of prostate cancer due to family history, screening does not lead to a longer life.
  • CT or MRI scans of the head can only be used to diagnose psychosis in specific situations.
  • When considering surgery, you should be given the chance to discuss potential benefits and harms.
  • If you are having surgery, day surgery should be the default option to allow a quicker recovery.
  • You do not need to come into hospital the day before your surgery if you have had the right preparations beforehand.
  • Most vaginal discharge is normal and does not require being seen by a professional.

Obesity Is Linked to at Least 13 Types of Cancer (A NYT Article)


A review of more than a thousand studies has found solid evidence that being overweight or obese increases the risk for at least 13 types of cancer. The study was conducted by a working group of the International Agency for Research on Cancer, part of the World Health Organization.

Strong evidence was already available to link five cancers to being overweight or obese: adenocarcinoma of the esophagus; colorectal cancer; breast cancer in postmenopausal women; and uterine and kidney cancers.

This new review, published in The New England Journal of Medicine, links an additional eight cancers to excess fat: gastric cardia, a cancer of the part of the stomach closest to the esophagus; liver cancer; gallbladder cancer; pancreatic cancer; thyroid cancer; ovarian cancer; meningioma, a usually benign type of brain tumor; and multiple myeloma, a blood cancer.

According to the chairman of the working group, Dr. Graham Colditz, a professor of medicine and surgery at Washington University in St. Louis, these 13 cancers together account for 42 percent of all new cancer diagnoses.

Read full article here