Building Brain Through Brawn


Dr. Vincent Fortanasce

Dr. Vincent Fortanasce

Can you build brain by building muscle? Yes

Despite the misconception that brain and brawn do not mix, recent studies show that exercise does more than just build your healthy body and heart. Exercise builds new brain tissue through a process called neurogenesis and neuroplasticity (the production of new cells and dendrites). Exercise is also essential for decreasing our Alzheimer’s sentinel risk factors : sleeplessness and stress. Additionally, exercise is a primary and essential component to balancing our hormones.

A primary component of aging is the imbalance that occurs in our hormones. This I call the “Hormonal Symphony.” When our anabolic hormones and catabolic hormones are in balance, our body and brain are in harmony.

Insulin is the conductor of our Hormonal Symphony. If it is stable, we are in harmony. If it is suddenly increased, it becomes a prime cause of amyloid deposition in the brain, called “Insulin peaking”( Amyloid is the toxic substance that we find in Alzheimer’s disease )

An analogy can be drawn between cigarette smoking and the lungs, and high insulin levels and the brain. Each time we smoke, we leave a tar stain on the lung. Each time we eat unrefined carbohydrates, our insulin peaks, leaving an amyloid stain on the brain.

As we age, our useful and reparative hormones ( growth hormone, testosterone, estrogen, and thyroid hormone ) decrease. Growth hormone and testosterone decrease by 90% from 20 to 70 years of age.

Our catabolic hormones ( or aging hormones ) increase as we age, as the brain stops turning off cortisol as we grow older. This is why older people are prone to be more irritable, stressed, and sleepless. Cortisol also increases carbohydrate craving, stimulated by the hormone ghrelin, which increases insulin secretion.

Ask anyone going through menopause and they will tell you how weight goes up and muscle tone goes down as fatigue increases and willpower decreases.

Most people do not realize that the first pathological signs of Alzheimer’s sometimes occur 30 years before the first symptom. This means at the top of your game ( 40-50 years of age ), you may already be on your way towards Alzheimer’s.

The Anti-Alzheimer’s Prescription for exercise has 3 elements = the 3 S’s :

Stretching, Steps, and Strengthening.

  1. Stretching — flexible exercise
  2. Steps = cardiovascular and aerobic exercise
  3. Strengthening = lean muscle building exercise

All 3 components are essential. In weightlifting, there is a saying = “you’re as strong as the weakest of your parts.” In exercising, the same holds true. A bad knee joint affects both waling and strength exercising. The same can be said for a weak heart or a reconditioned weak body. When your body is healthy you handle stress and you sleep better. Your youthful hormones soar and your levels of self satisfaction increases. Life simply becomes enjoyable.


  1. For the brain, exercise stimulates the hormone BDTF that causes neurogenesis and neuroplasticity. Thus, you have increased brain cells and increases brain connections.
  2. Exercise increases growth hormone, testosterone, estrogen, and thyroid hormone, which are rapidly falling and decreases cortisol.
  3. Exercise, especially after eating, decreases glucose and stabilizes insulin. It also suppresses our appetite by increasing a central nervous system hormone-leptin
  4. Exercise increases lean muscle mass and decreases fat deposits. Why is this good? Because lean body cells burn 4 times more calories per day than fat cells burn.

(additionally, fat cells stimulate insulin production & eventually can cause diabetes. ) Fat cells are alive and stimulate insulin production. Insulin production does three things:

  1. The insulin inactivates two-aging genes.
  2. Insulin turns glucose into fat; therefore fat begetting fat.
  3. Insulin peaking leads to amyloid deposits in the brain


The Fort-formula exercise program is unique as it maximizes brain growth ( new brain cells and brain connections ) capacity while minimizing the need for a gym or expensive equipment. The home program can be done in your living room, kitchen, bedroom without equipment. There is no excuse for not exercising.

Unlike other programs, the Fort Gym Program takes into considerations

  • Age and disabilities
  • Time deficiency inherent to Americans
  • Exercise for maximized increased brain function and core strength needed for safety and balance as we age.

Age and disabilities:

  1. After 50, every ten years, joint and muscle injuries double.
  2. Strength and balance are cut in half every ten years after 50
  3. Obesity causes increased likelihood of joint injury in most aerobic exercises.

The primary reason for stopping these programs are:

  1. Injury
  2. No fun
  3. No Time

Time deficiency and socialization

  1. Most Baby Boomers main excuse for not exercising is that they cannot spare one hour, 3 times a week; therefore, a practical home program is needed.
  2. The gym exercise program maximizes aerobic and anaerobic strengthening exercises through circuit-training.
  3. We provide both 10 30 and 60 minute programs.

Socialization is especially important in our exercise program. Socialization dramatically decreases as we age, but it has been found to be essential for brain health and is advised but not necessary for the exercise program.

The Home Program

The home program has 3 parts, requires no equipment and requires only space for a chair. It is based on an Isotonic and Isometric requiring no equipment or gym. Isotonic and Isometric exercise is know by most exercise physiologist as the most effective and safest means to increase muscle strength and mass in the shortest amount of time.

The American Rheumatology Association has said that Isometric/Isotonic exercise is one of the only ways to fight osteoporosis without pills. You may be asking yourself

“why haven’t I been told this before”

The answer is obvious, with equipment, a gym membership to sell or a pill to buy; there is no money to be made! What business is going to promote that?

The Anti-Alzheimer’s Prescription book or DVD will show you these exercises that can be done in 10 minutes a day, right at the dinner table or in front of the T.V.

If you schedule the exercise between or before the shows you will be less likely to snack. This will lower your cortisol level, decrease your insulin levels and increase your brain blood flow while increasing the number of brain cells and connections ( Neurogenisis & Neuroplasticity. By doing these exercises with only very short breaks you will increase your heart rate and cardiac performance. If you have balance problems and weakness, six weeks of these exercises may increase your core strength by 25-50%. This can decrease the likelihood of falls while increasing your bone density.

Exercise for maximum brain function and core strength :

The exercise programs stress core strengthening necessary for balancing and preventing injuries and falls.


To minimize injury and maximize success, a physical therapist or a Dear Program assist will assist each patient for joint problems or other issues and set up a specialized program.

  1. The program will include a warm-up followed by aerobic and anaerobic circuit training.
  2. A slow isometric program is used to minimize muscle injury and maximize the amount of muscle activity. We try to synchronize it with music at the gym. It has been shown that music both stimulates the brain and makes the exercise more pleasurable, therefore increasing the likelihood of the exercise being repeated.

The gym program highlights the super slow method. Here, a light weight ( to protect the joints ) is used. First, there are 5 seconds of slow movement. At maximum strength you stop and hold the weight for 5 seconds, and then continue the exercise for 5 seconds though its full range of motion. At that time, you stop and return back for 5 seconds to the point of maximum strength. Then, you hold the weight isom0.etrically for 5 seconds and then slowly release to its beginning point. 6 reps are advised to start, if you can easily do the exercise without burning, then increase the weight or the time of the isometric portion to 10 or 20 seconds. The exercise should continue until muscle burning occurs. This will vary according to the weight used.

You then move immediately to the next exercise without rest. We begin with abdominals then go to chest, biceps, triceps, and shoulder girdle. Next, there are knee extensions, leg curls, the abductors and adductors are strengthened, and finally, the deep knee bends for the quadriceps. The idea is to keep the pulse in the 60-80% maximum pulse range for the entire half-hour or hour long workout.

The benefits : One hour of circuit training can burn up to 800 calories per hour, more than almost any other exercise that can be done. If it is performed for one hour 3 times per week, you will burn 2400 calories (or 9600 calories a month ), which is approximately 3 pounds of fat loss per month. This is an excellent way to lose weight without dieting. The added benefit is that each pound of muscle mass increases your metabolism! ( Muscle burns 4 to 5 the amount of calories than fat. Yes, you lose weight by increasing muscle mass, that is you lose fat.

Exercise Myths

The leading anti-aging researchers agree that the silver bullet against the aging vampire that saps us of our essence ( brain power ) is exercise. The research is conclusive: those who exercise live longer, healthier, and smarter lives.

It is not a question of whether you should exercise or not, it is a question of what the best exercise is. How to do it, how often, and how much. As the body goes, so goes the mind.

Below, we take a look at some common exercise myths.

The 6 myths of Exercise

  1. Lifting weights makes you inflexible and muscle bound
    Research has shown just the opposite. Strenuous weightlifting is best for brain power, stimulating both growth and sex hormones. A leaner more muscular physique is associated with longevity; increased muscle mass burns more calories and is associated with higher metabolism. The proper exercise prior to exams has been proven to increase test scores.
  2. You must do at least a half an hour of aerobics per day to stay fit
    Research has shown that consistency is more important than the actual length of time you spend exercising. People who exercise 10 minutes daily can do as well as those who exercise for 30 minutes intermittently. However, it is important to keep in mind that working at 60% of maximum heart rate is best for burning fat and that working at 80% maximum heart rate results in the burning of even more calories.
  3. Heavy weight training is needed to build lean muscle mass
    False! Heavier loads can build increased muscle mass, but at a possible cost of injury. What builds muscle mass is fatiguing your muscles. This can be done by using a lightweight or no weight at all ( Isotonic ) and increases the amount of time of each repetition. So lifting 100 pounds 10 times at a second per repetition equals 1000 pounds of effort . However, lifting 25 pounds for ten repetitions but taking 10 seconds to do each lift = 2500 pounds of effort.
  4. Running is the best form of aerobic exercise, and the longer you run, the better
    False! In fact, running is often dangerous for those over 60; it is a cause for knee, ankle, and hip degenerative disease, especially if you are overweight. Walking is preferable; but the use of a stationary bike is best.
  5. Aerobic exercise only helps the heart
    False! Aerobic exercise at 80% of maximum heart rate ( calculated by subtracting your age from the number 220 ) increases growth hormone release, which helps your muscle and your brain.
  6. You should eat carbohydrates before aerobic exercise
    False. The first twenty minutes of exercise uses carbohydrates as fuel and then uses fat. If one wants to burn fat, it is better not to have carbohydrates first. Drink caffeinated coffee prior to exercise, it increases lean muscle mass production by stimulating an important hormone.

Exercise Facts

Fat America

Before 1965 = 29% of the U.S population was overweight or obese.

In 1980, approximately 45% of the population was fat, either regarded as overweight or obese. In 2010 the number rose dramatically to 67%


  • 13.5 million people have coronary artery disease
  • 1.5 million people per year have a heart attack
  • 17 million people have type II diabetes
  • 95,000 people are diagnoses with colon cancer each year
  • 250,000 people per year suffer a hip fracture
  • 50 million people have high blood pressure
  • 220 million people are overweight
  • 50% of woman by 70 years old will fracture a bone

Several studies have shown that people, regardless of weight, who are inactive, had twice the rate of death. Only 31.3% of people age 18 and older in the U.S. engage in any regular leisure time activity. The rest (nearly 70% physically inactive people) have a 45% chance of developing coronary artery disease, a 60% increase rate of osteoporosis , and a 40% increase in colon cancer.

Weighty Woman

The risk of death in obese woman is almost five times that of fit woman who are not obese. In woman over 60 years of age, woman who are fit are 60% less likely to die than those who have a low level life of activity. The risk of Alzheimer’s is sevenfold.

What is obesity

Recent studies show that waist size is more than BMI ( body mass index ) for predicting medical illness susceptibility. Obesity is defined in a woman as a waist size of 35″ or greater. In men 40″ or greater. Now the real bad news; this is measures across the belly-button, not the hips. Therefore you would generally add 3″ to your belt size to get your real waist size.

Disease dangers for those who lack activity

  • Stroke increased by 24%
  • Osteoporosis 24%
  • Type II diabetes 21%
  • Coronary artery disease 19%
  • Colon cancer 18%
  • Hypertension 14%
  • Breast cancer

Working Out

Often, when I’m in the gym working out next to one of my patients, I am asked, “Is all of this exercise really worth it?” Well, for those 65 and older, this is what 30 days of exercise can do.

  • Increases HDL cholesterol by 4.6% ( HDL is the good cholesterol that keeps the heart and blood vessels happy )
  • Increases muscle coordination and reaction time and strength necessary for balance and stability to prevent falls.
  • Increases endurance.
  • Decreases falls by 30% in the elderly and risk of hip fractures by up to 40%

Regarding Dementia

  • Evidence shows that physical activity slows cognitive decline related to aging by almost 50% in those patients who are over 65 years of age
  • Type II diabetes incidences go from 1 per 10,000 men to 1 per 100,000 men.
  • Exercise has been shown to add as many as two hours of life expectancy for every one hour of vigorous exercise.
  • Exercise lowers blood pressure and releases mood lifting hormones.
  • Exercise decreases the rate of breast cancer.

The above information was compiled from Steven Blair from the University of South Carolina, Harvard University, and the American Heart Association.

Exercise & Hormones

An important part of the D.E.A.R Program is understanding the hormonal symphony. It is based on increasing the youthful hormones and decreasing the aging hormones.

Regular exercise provides many physical, mental, and physiological benefits. One benefit is the positive impact that exercise has on many of your body’s hormones, resulting in more efficient metabolism, better health, and weight loss.

The following are common hormones ( chemical messengers ) within our body that are affected by exercise:

    1. Growth Hormone: = Youthful hormones
      • Stimulates protein synthesis ( muscle tone/ development ) and strength of bones, tendons, ligaments, and cartilage.
      • Decreases our glucose and increases the use of fat as fuel during exercise, helping to reduce body fat and keep blood glucose at a normal level, which in turn helps you to exercise longer.
      • Release of growth hormone from the pituitary gland is increased with increasing anaerobic and aerobic exercise time, especially more intense exercise such as interval training or fatiguing exercises such as isometrics or isotonics.
    2. Endorphins
      • Endogenous opioid from the pituitary gland that blocks pain, decreases appetite, creates a feeling of euphoria (exercise high), and reduces tension and anxiety.
      • Blood levels of endorphins increase up to 5 times resting levels during long duration aerobic exercise (more than 30 minutes) at moderate to intense levels.
      • After several months of regular exercise, you develop an increased sensitivity to endorphins ( a higher high from the same concentration of endorphins ). Endorphins that are produced tend to stay in your blood longer, making longer duration exercise easier (feeling no pain). Causing an exercise high to last longer after exercise.


      Remember – Exercise produces important pain-blocking enzymes, hormones + neurotransmitters, better than artificial opioids such as ( Vicodin), or ( Codeine )

The Nocebo Effect: Placebo’s Evil Twin

      Ten years ago, researchers stumbled onto a striking finding: Women who believed that they were prone to heart disease were nearly four times as likely to die as women with similar risk factors who didn’t hold such fatalistic views.
    The higher risk of death, in other words, had nothing to with the usual heart disease culprits — age, blood pressure, cholesterol, weight. Instead, it tracked closely with belief. Think sick, be sick.

  1. Testosterone :
    • Important in both males and females for maintaining muscle tone, volume, and strength, increasing basal metabolic rate ( metabolism ), and decreasing body fat.
    • Declines as woman reach menopause and in men when they reach their 40’s
    • Blood levels of testosterone increase with exercise about 20 minutes into a session and may remain elevated for 1 to 3 hours after exercise.
  2. Estrogen:
    • The most biologically active estrogen is 17 beta estradiol, which increases fat breakdown from body fat stores so that it can be used as fuel.
    • Increases basal metabolic rate, elevates mood, and increases libido.
    • Higher in females vs. males; declines near menopause.
    • Increases with exercise and may remain for 1 to 4 hours afterward.
  3. Thyroxine ( T4): — Hormone produced by the thyroid gland which raises the metabolic rate of almost all cells in the human body.
    • This increase in “metabolism” helps you feel more energetic and also causes you to expend more calories; thus it is important for weight loss.
    • Blood levels of thyroxine increase by about 30% during exercise and remain elevated for up to 14 hours afterward = this period of time is increased by an increase in intensity an.d/or duration of exercise. Regular exercise also increases thyroxine levels at rest.
  4. Epinephrine: — Hormone produced primarily by the adrenal medulla, it increases the amount of blood the heart pumps and directs blood flow to where it’s needed. It stimulates the breakdown of glycogen ( stored carbohydrate ) in the active muscles and liver to use as fuel. It also stimulates the breakdown of fat ( in stored fat and in active muscles ) to use as fuel.
    • Amount of epinephrine released from the adrenal medulla is proportional to the intensity and duration of exercise.
  5. Insulin: — An important hormone in regulating ( decreasing ) blood levels of glucose (blood sugar ) and in directing glucose, fatty acids, and amino acids into the cells. Insulin secretion by the pancreas is increased in response to a rise in blood sugar as is often the case after a meal. High levels of insulin are provoked by refined carbohydrates, a major cause of Alzheimer’s disease. Insulin resistance is epidemic in the U.S.A
    • Blood levels of insulin begin to decrease about 10 minutes into an aerobic exercise session and continue to decrease through about 70 minutes of exercise. Regular exercise also increases a cell’s sensitivity to insulin at rest, a great cure for insulin resistance.
  6. Glucagon: — Hormone that is also secreted by the pancreas, its job is to raise blood levels of glucose. When blood sugar levels get to low, glucagon is secreted and causes stored carbohydrate ( glycogen ) in the lover to be released into the blood stream to raise blood sugar to a normal level. It also causes a breakdown of fat so that it can be used as fuel. When Glucogon is in control, Leptin a satiating hormone helps you eat less.
    • Typically begins secreting beyond 30 minutes of exercise when blood glucose levels may begin to decrease.
    • As you can see, exercise has a powerful impact on your hormones, ultimately resulting in weight loss, a sense of well-being, and better general health

Exercise: Chemistry and the Brain

A recent study showed that when you exercise a muscle, the muscle elicits a chemical response including a protein called IGF-1 that travels into the brain. This IGF-1 growth factor stimulates the production of brain derived neurotropic factor ( BDNF ) that provokes new brain cells and nerve branches. These branches connect cells = this is the way we learn.

In an experiment at UCLA, Dr. Gomez-Pinilla did experiments with two sets of rats. In one set of rats, BDNF was blocked and in the other, it was not. Those with the blocked BDNF were not able to find a hidden object, where as those that had it did. It is thought that BDNF is important in creating memories and in recalling old ones. All it takes to get the ball rolling is exercise. One of the muscular exercises that can do this is called ‘Isometrics’

Type of Exercise

Isometric + Isotonic anaerobic exercise is best for the brain. Walking, bicycling, stairs and elliptical aerobics is a good cardiovascular exercise.

Thirty minutes of daily moderate exercise, or a brisk walk is beneficial. Even smaller ten minute walks are important, as long as you exercise on a steady basis.

10 minutes of Isometric / Isotonic exercise is essential when over 60 years old

Drinking water prior to exercise is important to maintain hydration. Listening to music or an audio book during exercise stimulates pleasure areas of the brain localized in the front and temporal area, increasing dopamine production

Definitions of Vigorous, Mild, and moderate Exercise

Vigorous exercise is defined as working at 80% or more of maximum adjusted heart rate. The maximum adjusted heart rate is 220 minus one’s age ( i.e 60 years: 220 = 60=160; 80% of 160 = 128 ).

Moderate is from 60-80% and low is less than 60%

At Harvard University School of Medicine, vigorous exercise was found to be detrimental compared to moderate exercise. In a recent study from Harvard, they divided 282 overweight adults into four categories, with ages ranging from 40-65. One group did the equivalent of running 20 miles per week; the second group did 12 miles per week, and the last group did no exercise.

The risk of dying of a heart attack went down by 24.5% with the first group and 14.5% with the second group ( not to mention a decrease in their LDL )

Manage Stress through Exercise

Regular exercise increases mood, decreases anxiety, increases sleep, and improves resilience and raises self esteem in the face of stress. This results from exercise-induced hormonal and transmitter alterations, along with increased blood flow carrying oxygen and glucose. First, an increase in blood and energy supply increases alertness. Second, the production of neurotrophic factors (BDNF) increases neuroplasticity and sometimes gives rise to nerve cells ( called neurogenesis ) increasing our ability to learn. Third, it stimulates the production of endorphins and the “happy” neurotransmitters, dopamine and serotonin. Aerobic and anaerobic, are essential elements to fight depression.

Acute stress can improve the immune system and sharpen short-term memory. However, if one’s stress is prolonged, it causes not only this immediate response, but provokes a longer term catabolic hormone ( cortisol ) production. Stress causes an imbalance of our anabolic versus catabolic hormones.

The series of events that occurs is as follows: the limbic system ( the emotional brain ) stimulates the hypothalamus, which then causes production of cortisol-releasing hormone, which then releases Adrenocorticotropic hormone ( ACTH ), as well as several other hormones from the pituitary. ACTH then stimulates the adrenal gland to produce cortisol. Cortisol will cause an increase in insulin levels that can lead to diabetes mellitus or insulin-resistant diabetes. It also depletes the neurotransmitter dopamine, serotonin, and adrenaline, and can increase blood pressure that’s says “No I Cant”. Exercise turns off this aging system and increases our youthful hormones that say “Yes I Can

Counter Natural Aging with Exercise

In people ages 20-60, BDNF levels remain stable initially but as an individual ages, the neurons slowly start to die off. Neurogenesis and neuroplasticity slow down and then stop. ( Neurogenesis is the formation of new brain cells ) In the proceedings of the National Academy of Science, Scott Small, A Columbia University Medical Center Neurologist, and Fred Gage at the Salk Institute, noted that with exercise new neurons form and transform from stem cells into full grown functional neurons. The area involved was the dendrite gyrus at the hippocampus of the brain in the area that controls learning and memory. This is the same part that helps the brain match names to faces, one of the first skills to erode as we age.

Exercise not only helps the hippocampus, but also the frontal lobes ( the seed of executive functioning ) Executive functioning is a type of higher thought that entails decision making, multitasking, and planning ahead. Scaling techniques show that exercise causes the frontal lobes to increase in size.

Several studies have shown that men and woman in their 60’s and 70’s with aerobic exercising have shown improvement in their executive functioning. There are several methods thought for this beneficial effect of exercise. First there is an increase in blood volume, which will almost double. Second, there is a decrease in inflammation. Thirdly, there are more astrocytes, or cells, to support neurons. Fourth, there is an increase in neurotransmitters, especially dopamine, serotonin, and norepinephrine. These transmitters will decrease in pulsivity and calm one down. It’s like a taking bit of Prozac; without the side-effects.

The effect seems to occur within 48 minutes. Exercise has a long lasting affect on the brain that is still developing. In one study, 3rd and 5th grade students sped up not just executive functioning, but a broad variety of skills ranging from math to logic to reading. Educators are trying to make physical education longer and giving more hope for brain-strengthening cardiovascular exercise. It is postulated that physical education starts in young individuals and will continue into adult life and slow the slide into mild cognitive impairment (MCI). America’s lazy lifestyle may be contributing to its high rates of the disease and there’s been a 10% increase with the diagnosis of Alzheimer’s in the past 5 years.

Those who exercise have lower levels of plaque in their brain and do better in memory test.

Maintain Overall Health with Exercise

The Columbia University Medical Center did a study that showed that intense aerobic exercise lowers levels of TNF ( tumor necrosis factor ), which plays part in the inflammatory process. The DLS Center ( Disease Control and Prevention ) recommends that adults engage in the last 30 minutes of moderate-intensity exercises 5 days a week, or 20 minutes of high intensity exercise 3 days a week.

Next: Accentuating The Brain