Foggy Brain – What you need to know?

Brain fog is one of the more common symptoms we see in practice, as well as being one of the most elusive and hard to pin down. A sudden onset of poor concentration, mental fatigue, inability to focus, confusion, and memory issues make even the simplest tasks seem overwhelming and can negatively affect all aspects of life. Let’s take a look at the various causes of brain fog, and what you can do to clear things up.

What Causes Brain Fog?

It may surprise you to read that brain fog is a well-documented symptom of a number of chronic conditions. It is particularly prevalent in diseases involving inflammation, fatigue, and blood sugar imbalance such as diabetes, depression, and autoimmune diseases, as well as Chronic Fatigue Syndrome (CFS/ME), and Fibromyalgia.
Research into the factors that contribute to brain fog identify the following triggers:

Hormone Imbalance

Brain fog is perhaps most commonly reported by women going through hormonal changes, such as in pregnancy and perimenopause. Why is that? The brain is sensitive to the fluctuations of estrogen and progesterone that occur during both of these life events, contributing to ‘mommy brain’ and the memory issues that are often attributed to menopause.

Menopause-Related Cognitive Impairment

Perimenopausal women report that brain fog significantly impacts their quality of life, overall health, and productivity. The Study of Women’s Health Across the Nation (SWAN) has observed over 3,300 women throughout the menopausal transition, measuring cognitive abilities before, during, and after menopause.

The good news is that while the results showed that cognitive performance was impaired during the transition to menopause (aka perimenopause), it did go back up to pre-perimenopause levels once menopause had been reached.

Stress and Anxiety

When faced with chronic stress and anxiety, our fight or flight response gets stuck in overdrive. This means our adrenal glands, designed to pump out stress hormones in short bursts, end up releasing continued high levels of cortisol and adrenaline which can contribute to cloudy thinking.

During the stress response, the part of your brain that thinks deeply and stores memories is put on the back burner while the part that allows you to respond immediately to protect you from danger is prioritized. This works well in a real emergency, but not so well when you need to dig into that work report or solve a complex problem.

Yeast Infections
Candida albicans is a yeast naturally present in our bodies, which when unbalanced is the biggest cause of human fungal infections in the world. Under the right conditions, candida populations can quickly overgrow, displacing good microbes and colonizing the gut, urinary tract, genitals, mouth and skin.

Brain fog is a classic sign of Candida overgrowth. A ground-breaking 2019 study showed that Candida can actually enter the brain and cause neuroinflammation, contributing to brain fog. When the Candida infection was cleared out, memory improved.

Food Sensitivities

If you can’t think clearly after eating certain foods, you may have a food sensitivity. Brain fog is a hallmark symptom. Food sensitivities are very individual, but common offenders include dairy, wheat, nuts and food additives like red food colouring, MSG and aspartame.

Celiac Disease

Celiac Disease sufferers commonly report attention difficulties and unclear thinking. In a 2014 study, 11 Celiac Disease patients were given a gluten-free diet for a year. As their intestinal lining healed, their cognitive measurements improved.

Nutrient Deficiencies

Research has linked low levels of iron, vitamin D and folate (vitamin B9) with brain fog. B12 is the best-known deficiency associated with foggy thinking and memory issues. Studies have demonstrated that B12 supplementation can improve symptoms of Alzheimer’s and as well as minor cognitive impairments.

One study involving over 2,500 participants demonstrated that supplementation with vitamin B12 improved cognitive performance, especially when combined with vitamins B6 and B9 (folate).

Chronic Infections

Chronic infections such as Hepatitis C, Epstein Barr Virus and HPV have all been connected to the symptom of brain fog. If your immune system isn’t functioning optimally, these infections can infiltrate your cells. Chronic Hepatitis C sufferers report that frequent problems with focus and memory recall significantly interfere with their ability to perform daily activities. And these symptoms often stick around long after the initial infection is gone.

Chemotherapy

Many patients receiving chemotherapy for breast or prostate cancer experience a degree of cognitive dysfunction affecting their working memory, concentration, information processing speed, reaction time, visuospatial ability, and executive function. Often Labelled as “chemo brain”, these symptoms typically persist for approximately 6 months after the end of treatment.

How to Banish Brain Fog

1 – Drink Plenty of Water

Even mild dehydration can make it hard to concentrate. Space out the recommended 8 glasses per day and sip slowly. This will allow your body to properly absorb and use the water.

2 – Keep a Food Journal to Identify Food Sensitivities

Try keeping a food journal for a month, noting what you eat and when you feel cloudy thinking coming on. Chances are that you will find a pattern that points to the culprit foods. The ultimate test? Eliminate those foods entirely for 2 weeks and see if your thinking comes into focus.

3 – Eat Good Protein, Fat and Sugar

Your brain needs high-quality protein, fat and sugar to function at its best.
Eat less sugar and processed foods to avoid feeding Candida. Did you hear that Ireland recently declared that Subway bread could not legally be called ‘bread’ because of its high sugar content? Sugar lurks where you least suspect it – read food labels or ask for ingredient lists.
Fresh fruit is your best sugar source. Include antioxidant-rich fruits like blueberries, strawberries, goji berries and raspberries and your brain will thank you!

Get both fat and protein with cold-water fish like salmon, sardines, mackerel and herring. Healthy fat sources include virgin olive oil, walnuts, avocado and coconut oil.

4 – Improve Sleep Quality and Quantity

Weekend sleep catch up doesn’t work. Implement a predictable night-time routine so your body knows when to get into sleep mode. Make sure your bedroom is completely dark, which ramps up melatonin (the ‘sleep hormone’) production to bring on sleepiness.

5 – Reduce Stress by Focusing on the Now

Anxiety and stress often involve constant worry. Listen to your thoughts – what are you worrying about? Are you caught in a thought loop about a past conversation or a worry about the future?
As Buddhist monk Thich Nhat Hanh says: “The past is gone, the future is not yet here, and if we do not go back to ourselves in the present moment, we cannot be in touch with life.” Next time you catch yourself ruminating, do something physical that will bring your focus back to the present moment. Go for a walk, take a bath – anything that connects you with the here and now.

With so many potential causes of brain fog, where do you start? Let’s get to the root of what’s really going on. We can do testing for food sensitivities, Candida and nutritional deficiencies. We can check your hormone status. Let’s work together on a solid treatment plan involving brain-nourishing nutrients, foods and lifestyle changes. Isn’t it time to clear the fog and get back to a life lived with clarity, vision and joy?

References:

About Candida albicans: Natural yeast and problematic infections. Medical News Today. Accessed October 10, 2020
.
Adinolfi LE, Nevola R, Lus G, Restivo L, Guerrera B, Romano C, Zampino R, Rinaldi L, Sellitto A, Giordano M, Marrone A. Chronic hepatitis C virus infection and neurological and psychiatric disorders: an overview. World J Gastroenterol. 2015 Feb 28;21(8):2269-80. doi: 10.3748/wjg.v21.i8.2269. PMID: 25741133; PMCID: PMC4342902.

An Y, Feng L, Zhang X, Wang Y, Wang Y, Tao L, Qin Z, Xiao R. Dietary intakes and biomarker patterns of folate, vitamin B6, and vitamin B12 can be associated with cognitive impairment by hypermethylation of redox-related genes NUDT15 and TXNRD1. Clin Epigenetics. 2019 Oct 11;11(1):139. doi: 10.1186/s13148-019-0741-y. PMID: 31601260; PMCID: PMC6787977.

Brain Fog, Foggy Head Anxiety Symptoms. Anxiety Centre. Accessed on October 10, 2020. https://www.anxietycentre.com/anxiety-symptoms/brain-fog.shtml

Candida infection can reach brain and impair memory. Medical News Today. Accessed on October 10, 2020.https://www.medicalnewstoday.com/articles/324106#Why-study-C.-albicans-and-the-brain?

Carnitine Health Fact Sheet for Professionals. National Institutes of Health Office of Dietary Supplements. Accessed October 10, 2020. https://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/

Gava G, Orsili I, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC. Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. Medicina (Kaunas). 2019 Oct 1;55(10):668. doi: 10.3390/medicina55100668. PMID: 31581598; PMCID: PMC6843314.

Lanza G, Bella R, Cantone M, Pennisi G, Ferri R, Pennisi M. Cognitive Impairment and Celiac Disease: Is Transcranial Magnetic Stimulation a Trait d’Union between Gut and Brain? Int J Mol Sci. 2018 Jul 31;19(8):2243. doi: 10.3390/ijms19082243. PMID: 30065211; PMCID: PMC6121508.

Lichtwark IT, Newnham ED, Robinson SR, Shepherd SJ, Hosking P, Gibson PR, Yelland GW. Cognitive impairment in coeliac disease improves on a gluten-free diet and correlates with histological and serological indices of disease severity. Aliment Pharmacol Ther. 2014 Jul;40(2):160-70. doi: 10.1111/apt.12809. Epub 2014 May 28. PMID: 24889390.

Matza LS, Deger KA, Vo P, Maniyar F, Goadsby PJ. Health state utilities associated with attributes of migraine preventive treatments based on patient and general population preferences. Qual Life Res. 2019 Sep;28(9):2359-2372. doi: 10.1007/s11136-019-02163-3. Epub 2019 Mar 28. PMID: 30924071; PMCID: PMC6698266.

Senzolo M, Schiff S, D’Aloiso CM, Crivellin C, Cholongitas E, Burra P, Montagnese S. Neuropsychological alterations in hepatitis C infection: the role of inflammation. World J Gastroenterol. 2011 Aug 7;17(29):3369-74. doi: 10.3748/wjg.v17.i29.3369. PMID: 21876628; PMCID: PMC3160562.

Traina G. The neurobiology of acetyl-L-carnitine. Front Biosci (Landmark Ed). 2016 Jun 1;21:1314-29. doi: 10.2741/4459. PMID: 27100509.

Vitamin B12 Health Fact Sheet for Professionals. National Institutes of Health Office of Dietary Supplements. Accessed October 10, 2020. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

Wu, Y., Du, S., Johnson, J.L. et al. Microglia and amyloid precursor protein coordinate control of transient Candida cerebritis with memory deficits. Nat Commun 10, 58 (2019). https://doi.org/10.1038/s41467-018-07991-4

Xu J, Zhu XY, Sun H, Xu XQ, Xu SA, Suo Y, Cao LJ, Zhou Q, Yu HJ, Cao WZ. Low vitamin D levels are associated with cognitive impairment in patients with Hashimoto thyroiditis. BMC Endocr Disord. 2018 Nov 26;18(1):87. doi: 10.1186/s12902-018-0314-7. PMID: 30477467; PMCID: PMC6260768.

6 Possible Causes of Brain Fog. Healthline. Accessed on October 10, 2020. https://www.healthline.com/health/brain-fog

Are You Chronically Inflamed? Here’s What to Do

Inflammation has become a bit of a buzzword recently, and rightly so. Did you know that systemic inflammation plays a role in the development of many chronic conditions such as diabetes, cancer and heart disease? With 2 out of every 3 deaths in North America attributed to these lifestyle diseases, it makes sense to nip inflammation in the bud.

As we get older, we tend to think of chronic inflammation as par for the course. Aches and pains, digestive issues, mood or memory issues and weight gain are all among the symptoms of system-wide inflammation that tends to be ignored. But is chronic inflammation really an inevitable part of aging? Let’s take a look at what’s happening inside the body as we get older, factors contributing to aging, and what you can do to age gracefully and inflammation-free!

What Is Inflammation?

Inflammation plays a central role in the body’s healing process – it is an essential part of our immune response. Short term inflammation protects us against invaders like viruses and bacteria by triggering heat and swelling after an injury. But when the immune system is overactive or dysfunctional, it mobilizes a defence against harmless substances, and can even damage its own cells. That is when inflammation becomes chronic. In fact, uncontrolled chronic inflammation plays a role in almost every major disease.

The Inflammatory Mechanism

One example of inflammation at play is the development of atherosclerosis in the arteries. When there is arterial wear and tear caused by high blood pressure or irritation, inflammation triggers a protective band-aid to be built over the injured area, in the form of a cholesterol-rich plaque build-up. However, as this plaque grows it causes a hardening and narrowing of the blood vessels that increases blood pressure. Furthermore, if the plaque ruptures, its contents mingle with blood, forming dangerous blood clots.

Why does Inflammation Become Chronic?

Inflammation can become chronic for a variety of reasons, and sometimes the reason isn’t apparent at all. It may be brought on by a condition such as obesity, an abnormal immune reaction, environmental toxin exposure, or an infection that doesn’t go away. Or it may stem from a disease that is characterized by inflammation such as colitis, pancreatitis, or hepatitis. As time goes on, this inflammation can damage the body’s tissues and even DNA, leading to conditions like heart disease, type 2 diabetes, stroke and cancer.

Genetics are also believed to play a strong role in our susceptibility to chronic inflammation. Research has identified a number of genetic SNPs (single nucleotide polymorphisms) that cause some individuals to quickly produce large numbers of inflammatory cytokines, making a preventive lifestyle particularly important.

Lifestyle Factors Can Contribute to Inflammation

A lot of research has been carried out in regards to the lifestyle factors that can lead to inflammation. Far from being passive within the body, recent research shows that fat is a major player in systemic inflammation. The more fat we have, the higher the risk of chronic inflammation. And because we tend to put on weight as we age, this further increase inflammation risk. Understanding these relationships allows us to make the changes necessary to live a lifestyle that is preventive in nature, reducing our chances of developing chronic disease.

9 Ways to Prevent and Reduce Inflammation

Chronic inflammation does not need to be a part of ageing, there is a lot that can be done to quell the fire so that you can live the healthy, active life you want. The good news is that daily lifestyle habits are the key, and results can happen fast. It’s never too late to take action against inflammation. Here are 9 ways to do just that!

1 – Exercise

Research points to exercise as the single most effective step you can take to reduce systemic inflammation. Our current sedentary pandemic lifestyle is not making us any healthier – in fact one 2019 study coined the term ‘inflamm-inactivity’ to reflect that lack of exercise and the resulting fat accumulation may be the main drivers behind inflammation.
Here are some tips for getting back into a strong exercise routine with the goal of reducing inflammation:

Mix Up Exercise Intensity

Don’t put all your eggs in one exercise basket. Research shows the strongest anti-inflammatory effects come from including both high intensity (sprinting, jumping rope) and low-intensity (swimming, walking yoga, Tai Chi) exercises.
Some exercises are naturally high or low intensity. But many exercises can go either way – you have control over the intensity. Walking can be a gentle stroll or an invigorating speed walk. Swimming can be leisurely, or an intense lap swim.
Mixing things up will prevent boredom, and keep you motivated to stick with your routine.

Include Resistance Training

Weight training is a vital part of an anti-inflammatory exercise regime, perfectly complementing aerobic exercise. Ironically, the muscle damage that happens when we lift weights actually spurs our immune system to remove inflammatory cellular waste products faster.

Try Endurance Exercise

Research shows that endurance athletes usually live much longer than the general population, and have lower levels of inflammation.
You don’t have to be training for a marathon or the Tour de France to partake. Brisk walking is a great way to hit that happy medium between strolling and sprinting.

Exercise Regularly

Regular, long term exercise strategies are optimal, with the best results being seen at the 12 – 24 week mark. For most kinds of exercise 8 weeks is the minimum to see reductions in inflammation, with the exception is HIIT (high-intensity interval training), where even 6 weeks can effectively lower it.
7 hours per week of moderate-to-vigorous exercise is associated with longer life expectancy. Not currently exercising? Avoid injury by slowly working up to one hour a day. Start with 10 or 15-minute exercise increments and gradually increase as your body gets comfortable with your new routine.

Some Exercise is Better Than None

With many gyms being closed, it may be harder to get regular exercise. The good news? Even one exercise session has a positive impact. A 2018 study showed that just one bout of resistance training increased removal of senescent cells for up to 48 hours afterwards.

2 – Drink Enough Water

Inflammation is the body’s natural response attempting to eliminate irritants, so it makes sense that providing the transport needed to escort these irritants out of the body can help. Our bodies are made up of 70% water, and it is absolutely crucial for cell-to-cell communication; the formation of gastric juices and enzymes; helping the muscles of the digestive system to function properly, and off course as the vehicle that provides mobility to the toxins and cellular refuse that needs to leave the body.

The recommendation is to make sure to drink at least 8 glasses of clear, filtered water per day. This shouldn’t include any other beverages, although it is a good idea to add herbal teas, such as rooibos or green tea, on top of that.

3 – Eat an Anti-Inflammatory Diet

Let food be your medicine! The right diet can increase your lifespan and improve markers of inflammation. Dairy and gluten are not usually inflammatory in healthy individuals (unless you have an allergy, intolerance, or celiac disease), but they can irritate inflammation that is already present in the body. Some people may find it beneficial to cut out dairy, gluten, or both for a few weeks while eating a diet rich in anti-inflammatory foods to give the body time to “calm down.” After those two weeks, start to incorporate dairy or gluten-containing foods slowly and watch out for any symptoms of irritation.

Consume Less of These Inflammatory Foods
Sugar
Saturated fat
Alcohol
Red meat
Processed meats
Sugar-sweetened beverages

Consume More of These Anti-Inflammatory Foods
Leafy green vegetables
Seaweed
Fiber
Beans
Nuts & seeds
Berries
Fish
Olive oil
The occasional glass of red wine

4 – Take Turmeric

Turmeric is a spice which has long been used in traditional medicine. Its active component, Curcumin, has been heavily researched of late for its ability to reduce acute and chronic inflammation, and is recommended as a food-based supplement to patients with arthritis, metabolic syndrome and cancer.

Turmeric powder can be taken as a capsule, tea, or whipped into a chai latte. You can also buy the fresh root and blend it into any smoothie, or add it to salad dressings and hummus.

5 – Practice Intermittent Fasting

Did you know that digestion takes up 80% of the body’s energy? That’s why intermittent fasting (eating for only a set number of hours per day) so effectively frees up the body’s energy to focus on tasks like removing senescent cells.

When combined with a healthy diet, this fasting style has also been shown to reduce inflammation, improve mitochondrial health and reduce fat levels. Start easily by eating an early dinner so that you are naturally fasting for 12 hours a day, and slowly increase the time to 14-16 hours a day. Remember to drink your water during the fasting time!

6 – Improve Your Sleep Hygiene

Inadequate rest may make you more sensitive to stress, which in turn causes inflammation. Remember the basics of sleep hygiene:

Eat an earlier dinner to avoid going to bed on a full stomach
Do some mild exercise, such as a walk, after dinner
Switch off all technology 1 hour before bed
Sleep in a cool, dark room.

7 – Get a Massage

A massage isn’t just a treat. It can play an integral part in staying healthy. Receiving a 45-minute Swedish massage can greatly lower levels of two key inflammation-promoting hormones, according to a study in The Journal of Alternative and Complementary Medicine. “Massage may decrease inflammatory substances by [appropriately] increasing the amount of disease-fighting white blood cells in the body,” says Mark Hyman Rapaport, M.D., co-author of the study. “It may also lower stress hormones. Either way, these results can be seen after just one massage.”

8 – Reduce Stress

If you have an inflammatory condition such as Crohn’s disease, you know very well the effect that stress has – any stressful event can bring on a flare-up. The high cortisol levels that stress triggers increase inflammation throughout the body. Stress also increases blood pressure and heart rate, making your blood vessels work harder and creating damage. If that damage happens over and over, inflammation persists.

The key to stress management is breaking the cycle of stress chemicals in the body. A daily relaxation, meditation or yoga practice is key. Take 10-30 minutes daily to be with yourself and bring your cortisol levels back to neutral – this will allow you to approach each day anew.

9 – Look After Your Gut Microbiome

A good quality probiotic supplement is soothing to the gut. Researchers have found that taking probiotics for 8 weeks helped to reduce markers of inflammation in arthritis patients. Try to find a high-quality professional supplement, or if you prefer you can take your daily probiotics in food form such as kefir, kombucha or kimchi.

If you are ready to make a positive change in your lifestyle to reduce inflammation and reduce future disease risk, give us a call. We can run lab tests that will show you your current inflammatory status, and help fast-track your journey to a healthier future.

References:

Alvarez-Rodríguez L, López-Hoyos M, Muãoz-Cacho P, Martínez-Taboada VM. Aging is associated with circulating cytokine dysregulation. Cell Immunol. 2012;273:124–132. doi: 10.1016/j.cellimm.2012.01.001

Baker DJ, Childs BG, Durik M, Wijers ME, Sieben CJ, Zhong J, Saltness RA, Jeganathan KB, Verzosa GC, Pezeshki A, Khazaie K, Miller JD, van Deursen JM. Naturally occurring p16(Ink4a)-positive cells shorten healthy lifespan. Nature. 2016 Feb 11;530(7589):184-9. doi: 10.1038/nature16932. Epub 2016 Feb 3. PMID: 26840489; PMCID: PMC4845101.

Balan E, Decottignies A, Deldicque L. Physical Activity and Nutrition: Two Promising Strategies for Telomere Maintenance? Nutrients. 2018 Dec 7;10(12):1942. doi: 10.3390/nu10121942. PMID: 30544511; PMCID: PMC6316700.

Baylis D, Bartlett DB, Patel HP, Roberts HC. Understanding how we age: insights into inflammaging. Longev Healthspan. 2013;2:8. doi: 10.1186/2046-2395-2-8
Chung HY, Kim DH, Lee EK, Chung KW, Chung S, Lee B, et al. Redefining chronic inflammation in aging and age-related diseases: proposal of the senoinflammation concept. Aging Dis. 2019;10:367–382. doi: 10.14336/AD.2018.0324

Flynn MG, Markofski MM, Carrillo AE. Elevated inflammatory status and increased risk of chronic disease in chronological aging: inflamm-aging or inflamm-inactivity? Aging Dis. 2019;10:147–156. doi: 10.14336/AD.2018.0326

Garatachea N, Pareja-Galeano H, Sanchis-Gomar F, Santos-Lozano A, Fiuza-Luces C, Morán M, Emanuele E, Joyner MJ, Lucia A. Exercise attenuates the major hallmarks of aging. Rejuvenation Res. 2015 Feb;18(1):57-89. doi: 10.1089/rej.2014.1623. PMID: 25431878; PMCID: PMC4340807.

Lee JY, Jun NR, Yoon D, Shin C, Baik I. Association between dietary patterns in the remote past and telomere length. Eur J Clin Nutr. 2015 Sep;69(9):1048-52. doi: 10.1038/ejcn.2015.58. Epub 2015 Apr 15. PMID: 25872911.

Lettieri-Barbato D, Cannata SM, Casagrande V, Ciriolo MR, Aquilano K. Time-controlled fasting prevents aging-like mitochondrial changes induced by persistent dietary fat overload in skeletal muscle. PLoS One. 2018 May 9;13(5):e0195912. doi: 10.1371/journal.pone.0195912. PMID: 29742122; PMCID: PMC5942780.

Leung CW, Laraia BA, Needham BL, Rehkopf DH, Adler NE, Lin J, Blackburn EH, Epel ES. Soda and cell aging: associations between sugar-sweetened beverage consumption and leukocyte telomere length in healthy adults from the National Health and Nutrition Examination Surveys. Am J Public Health. 2014 Dec;104(12):2425-31. doi: 10.2105/AJPH.2014.302151. Epub 2014 Oct 16. PMID: 25322305; PMCID: PMC4229419.
Milan-Mattos JC, Anibal FF, Perseguini NM, et al. Effects of natural aging and gender on pro-inflammatory markers. Braz J Med Biol Res. 2019;52(9):e8392. doi:10.1590/1414-431X20198392

Pinti M, Cevenini E, Nasi M, De Biasi S, Salvioli S, Monti D, Benatti S, Gibellini L, Cotichini R, Stazi MA, Trenti T, Franceschi C, Cossarizza A. Circulating mitochondrial DNA increases with age and is a familiar trait: Implications for “inflamm-aging”. Eur J Immunol. 2014 May;44(5):1552-62. doi: 10.1002/eji.201343921. Epub 2014 Feb 13. PMID: 24470107.

Pizzorno J. Mitochondria-Fundamental to Life and Health. Integr Med (Encinitas). 2014 Apr;13(2):8-15. PMID: 26770084; PMCID: PMC4684129.
Rymkiewicz PD, Heng YX, Vasudev A, Larbi A. The immune system in the aging human. Immunol Res. 2012; 53:235–250. doi: 10.1007/s12026-012-8289-3.

Schnabel RB, Yin X, Larson MG, Yamamoto JF, Fontes JD, Kathiresan S, et al. Multiple inflammatory biomarkers in relation to cardiovascular events and mortality in the community. Arterioscler Thromb Vasc Biol. 2013; 33:1728–1733. doi: 10.1161/ATVBAHA.112.301174

Sellami M, Bragazzi NL, Slimani M, Hayes L, Jabbour G, De Giorgio A, Dugué B.
The Effect of Exercise on Glucoregulatory Hormones: A Countermeasure to Human Aging: Insights from a Comprehensive Review of the Literature. Int J Environ Res Public Health. 2019 May 15;16(10):1709. doi: 10.3390/ijerph16101709. PMID: 31096708; PMCID: PMC6572009.

Xia S, Zhang X, Zheng S, Khanabdali R, Kalionis B, Wu J, et al. An update on inflamm-aging: mechanisms, prevention, and treatment. J Immunol Res. 2016;2016:8426874. doi: 10.1155/2016/8426874

Yang C, Jiao Y, Wei B, Yang Z, Wu JF, Jensen J, Jean WH, Huang CY, Kuo CH. Aged cells in human skeletal muscle after resistance exercise. Aging (Albany NY). 2018 Jun 27;10(6):1356-1365. doi: 10.18632/aging.101472.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5664031/