We recently had the chance to speak with Dr. John Ratey, author of the book Spark: The Revolutionary New Science of Exercise and the Brain. While the evidence that exercise improves mood and cognition in addition to physical health has been steadily accumulating for many years, Dr. Ratey does the important work of putting it all together into a clear and convincing case. If you are trying to motivate yourself to start working out, or to convince a loved one to join you, this book offers plenty of support in the form of rigorous scientific studies as well as compelling anecdotes of success from Dr. Ratey's private practice.
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TOL: Hello Dr. Ratey. Thank you for talking with me today. How are you?
JR: I'm well, and you?
TOL: I ran to work today and walked up the stairs instead of taking the elevator.
JR: Great, we are already getting treatment started here.
TOL: Your book makes it much easier for individuals to motivate themselves. Have governments and businesses also come around to the importance of exercises as a treatment?
JR: Certainly some governments have. In England, in 2001, the House of Commons designated exercise as a treatment for depression. And this has gotten a lot of community organizations going.
TOL: So it is definitely happening.
JR: Its happening slowly. Very slowly. Plans are there, but its different to actually get things happening. Over here [in America], even though physicians are aware of the science and the papers that come out, its hard for people to make that paradigm shift to see it as a treatment for things in the brain, whether its Parkinson's or depression.
TOL: Do you think that there is a reason why people are resistant to thinking of exercise as a treatment on par with medication?
JR: Well, I do. Partly because we are so enamored of medication. And in many cases its well-founded. And exercise is hard. We are geared to take a break because when we were hunter-gathers, when you had time to relax, it was the wise thing to do. When we were averaging 10-12 miles of walking a day, you wanted to take it easy when you could. So we have a tendency to do that unless we can get ourselves engaged in movement and then it becomes self-reinforcing.
TOL: Now that our environment is so different from the world of physical toil that our ancestors lived in, do you think that our natural instincts about exercise can often be trusted? Will common sense get you close to maximum benefit, or are studies revealing non-intuitive methods?
JR: It depends on the person, and it depends on their age. If a person is coming from a sedentary lifestyle, it certainly makes sense to go slowly and trust your intuition, because you don't want to injure yourself. I do think that in large part people's intuition is pretty good. But they have to know that its not just walking, which is a good place to start, or biking or swimming in leisurely way, because you want to challenge yourself as much as you can. Because its the challenge that our brains and bodies rise to. Run faster, longer, or break it up with sprints in between.
TOL: Do you have trouble convincing your family and friends to exercise? Is that a different challenge than convincing colleagues, convincing scientists?
JR: Not really. Everyone knows that its good for you. I see patients, and they know also. They think about it in terms of benefits to their body, so to convince them sometimes of the cognitive benefits takes showing them papers and studies, which are valuable for starting them up and keeping them at it.
TOL: Do you think that there is a minimum threshold, below which you don't get any benefit. Is getting up to change the channel instead of using the remote going to help?
JR: It would be minimal, but I think that you are going to have some stress from any exertion, and that stress will help somewhat. But, you know, people can vary quite a lot. People who are stuck, say, writing a paper in their room and can't think about what to do, they can drop and do twenty push-ups, something, and that can really change up their brain chemistry and perhaps break through the problem.
TOL: You talked about how having a sense of control over your mind and your emotions has a crucial therapeutic benefit. Do you think that is something that makes exercise superior to medication, if you had a choice between doing only one or the other?
JR: The idea of doing it on your own is so much more powerful, which is what I sort of hinted at in the book with the study that looked at the long term effects over six months compared to antidepressants. The issue of you being the agent of change means quite a lot.
TOL: Do you think that therapists are open to the idea of not only recommending exercise to their patients but incorporating that into their sessions. We have a psychiatrist here who was just telling me that he wishes he could have some sort of workout before or during his psychotherapy, but isn't sure if that would be accepted. Do you think that is something that will work?
JR: I think that it would work. Walking therapy is something that people have done in the past. I do think that there are great possibilities there. There are a whole line of new exercise machines in our lives, like tread-desks, that will have a big draw. Moving one mile-an-hour while your at your computer can catch on.
TOL: The tread-desks are a fascinating idea. There are so many opportunities we lose to exercise in our daily lives, outside of a chunk of time set aside exclusively for exercise. You mention how our bodies are meant to be connected to our minds, that motion is evolutionarily tied to cognition. Do you think there is also an unhealthy disconnect now between our physical effort and actual achievement? Could tying, say, a treadmill to our electrical appliances, our calorie output to lights and computers, give us more of an emotional benefit and a sense of satisfaction?
JR: It certainly can add. There are a number of people who are looking into harnessing the energy from something like a stationary bike and feeding it back into the grid, or putting it into a battery to power your laptop. Its not farfetched and it might be more appealing that way. There are certainly a lot of calories burned in the gym. Even if you are talking about the kind of desk where you sit and pedal away to light the room, it may be more gratifying.
There are a bunch of things coming, now that we are beginning to recognize how sedentary our lives have become. The whole exergaming thing is ready to explode.
TOL: Exergaming? Like the Wii with its motion sensor?
JR: Yes. Things like the Wii and Dance Dance Revolution, which I mention in the book. And various other movement-involved video games that make it kind of forever fun and challenging. There is a whole group of inventors out there working on some pretty amazing things.
TOL: So you are hopeful that new technology will facilitate better exercise. You mention the heart-monitors that Naperville schools used, and how great of a boon they were because of their cheapness and ease of use. They changed P.E. from a place for good athletes to succeed to a place where everyone could do well simply by keeping their heart working hard. And you are expecting greater things to come?
JR: Oh yes sure. There is going to be lots more good stuff, and the good stuff is going to getter cheaper and more convenient.
TOL: I look forward to it. To move to the process of writing this book rather than the content, was it difficult to balance scientific accuracy with convincing layman arguments?
JR: Yes. It is always difficult to capture what science does and bring it into human translation. Rats aren't humans. Humans are so much harder to study, and there are so many confounding variables that unless you have really big numbers, like in a school study, it is going to be difficult to reach any conclusions.
TOL: Rats will automatically run on a wheel if you put one in their cage, but you can't make humans exercise. Do you feel that studies are problematized by the fact that maybe the people who can be convinced to exercise are the ones with the healthiest minds?
JR: Yes, it is much harder to work with subjects that must volunteer. And of course, we can't do biopsies of people to capture exactly how their brains are changing.
TOL: The Naperville case study was a very strong way to begin the book, but it was also the most questionable section scientifically. Do you agree with that assessment?
JR: There is some science in that case study, but Naperville is just, there is no causal relationship there. But there is proof there that exercise didn't take away from their academic prowess. The fact that they spend 45 minutes a day on physical activity rather than study, but don't suffer academically, is the main thing to take away from the Naperville section, not that exercise made the kids so much smarter. I think that it did, but that's my opinion, not the fact.
TOL: So there are different sections in the book, each there to be one form of support for your argument. You have anecdotes and the case study to show people how this can work in the real world, but you don't lean on that to provide scientific evidence. You leave that for other sections. Is that a good way of characterizing how you put the book together?
JR: Yes. And the very next chapter after Naperville relies on human and animal studies.
TOL: It was definitely a good way to spark people's imagination and interest from the start. I have one more difficult question: do you think that it is possible that exercise boosts some cognitive functions to the exclusion, or even at the expense, of other functions? Are there significant studies where exercise groups have been given full intelligence tests rather than narrow tests of only executive function or memory?
JR: I think that it is going to be patchy. Even with executive function, which is highly correlated with IQ, you are going to have hills and valleys. There are certainly some things that don't improve, dependent maybe on more hard-wired or genetic things.
TOL: But there is no evidence of any trade-offs?
JR: I don't think that we know whether people get worse in some areas, but its a matter of some areas not being helped or not noticed at all.
TOL: Do you think that there are some people that benefit significantly more from exercise, maybe from their age or their genetic profile? Is it more important for the elderly to exercise?
JR: Well, I think that in terms of cognition that is certainly the case. Though that may be because we have studied them the most. They get so much more because they are stopping the erosion and maybe encouraging growth. Not only that, they have a lot of free time.
It is a fact that there are genetic differences and that some people absolutely don't feel the joy and satisfaction. But they are a very small percent.
TOL: I have one more fun, speculation question. You don't have to answer if you don't want to. Are there any things that you feel intuitively are true about exercise that you didn't yet have the evidentiary support to include in your book?
JR: Good question actually. The one area that is just starting is the addiction. We are just now turning our attention to it. And that is a huge area where exercise can play a very, very profound therapeutic role. More so maybe than in anything I've read so far.
TOL: So your gut tells you that there is a lot more to uncover about treating addiction with exercise, but the evidence hasn't quite accumulated yet?
JR: Not yet. It's hard to get coke-addicts on a routine, so you get anecdotal reports and things like that, but I think; I know that there is a lot more to be done. But it is hard to do these studies.
TOL: It must be hard, but I hope that your work encourages other people to do that research because this is a topic that is very interesting.
JR: It will get done but don't wait. Keep on walking up those stairs.
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For help or more information on taking that first step, visit Dr. Ratey's website.
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