Exercising your muscles (also) protects the brain. That is why it should be prescribed like a medicine

“Physical exercise should no longer simply be recommended: it should be prescribed like a medicine. To protect the brain.” So said Eric Topol, the renowned American cardiologist, founder and director of the Scripps Research Translational Institute in California, and one of the world’s leading health influencers, in a post on X. The fact that physical exercise is a genuine ‘medicine’ in both the prevention and treatment of many chronic diseases is nothing new. However, an article published in Brain Health by Canadian researchers from the Universities of Ottawa and Toronto adds an important new piece to this narrative. And this is the basis for Topol’s endorsement. The Canadian researchers conducted a review of the ever-growing body of scientific literature documenting the benefits of physical activity on depression, anxiety, psychological wellbeing and, in certain populations, even on some cognitive functions. That is why, in their article “Exercise is critical for brain health”, they write that the time has come to change doctors’ approach to physical activity, moving away from a generic encouragement to ‘move more’ – accompanied by a pat on the back – towards a genuine therapeutic prescription, tailored to the individual in terms of type, intensity, frequency and duration.

The focus of this important review is the so-called ‘muscle-brain axis’. When we exercise, our muscles do not merely consume energy in the form of glucose: they also produce signalling molecules, known as myokines, which help to regulate various biological processes. These signals are involved in metabolic, inflammatory, neuroendocrine and neurotrophic mechanisms, all of which are important for brain health. Physical activity can also promote cerebral circulation, neuronal plasticity and mood regulation. Exercising the muscles therefore also means influencing a range of mechanisms that contribute to brain health.

The evidence produced so far is particularly convincing with regard to the reduction of depressive symptoms. When it comes to the prevention of cognitive decline and dementia, however, the picture is more nuanced: there are encouraging results, but further in-depth research is needed.

But apart from brain health, the benefits of physical exercise in terms of prevention – and as an adjunct to the treatment of many chronic and metabolic conditions – have long been recognised. It is a genuine, low-cost ‘medicine’ that must be ‘dosed’ and prescribed with care, just like any other medicine. There can be no ‘one-size-fits-all’ advice. These messages have moved beyond the narrow confines of the scientific community to reach the desks of policy-makers.

At present, a number of bills are under consideration with a view to recognising physical activity and sport as structured tools for prevention, treatment and public health.