Exercise Is ADHD Medication
Physical movement improves mental focus, memory, and
cognitive flexibility; new research shows just how critical it is to
academic performance.
The Atlantic | 29 September 2014
Mental exercises to build (or rebuild) attention
span have shown promise recently as adjuncts or alternatives to
amphetamines in addressing symptoms common to Attention Deficit
Hyperactivity Disorder (ADHD). Building cognitive control, to be better
able to focus on just one thing, or single-task, might involve regular practice with a specialized video game that reinforces "top-down" cognitive modulation, as was the case in a popular paper in Nature last year. Cool but still notional. More insipid but also more clearly critical to addressing what's being called the ADHD epidemic is plain old physical activity.
This morning the medical journal Pediatrics published
research that found kids who took part in a regular physical activity
program showed important enhancement of cognitive performance and brain
function. The findings, according to University of Illinois professor
Charles Hillman and colleagues, "demonstrate a causal effect of a
physical program on executive control, and provide support for physical
activity for improving childhood cognition and brain health." If it
seems odd that this is something that still needs support, that's
because it is odd, yes. Physical activity is clearly a high, high-yield
investment for all kids, but especially those attentive or hyperactive.
This brand of research is still published and written about as though it
were a novel finding, in part because exercise programs for kids remain
underfunded and underprioritized in many school curricula, even though
exercise is clearly integral to maximizing the utility of time spent in
class.
The improvements in this case came in executive control, which consists of inhibition (resisting distraction, maintaining focus), working memory, and cognitive flexibility (switching between tasks). The images above show the brain activity in the group of kids who did the program as opposed to the group that didn't. It's the kind of difference that's so dramatic it's a little unsettling. The study only lasted nine months, but when you're only seven years old, nine months is a long time to be sitting in class with a blue head.
Earlier this month, another study found that
a 12-week exercise program improved math and reading test scores in all
kids, but especially in those with signs of ADHD. (Executive
functioning is impaired in ADHD, and tied to performance in math and
reading.) Lead researcher Alan Smith, chair of the
department of kinesiology at Michigan State, went out on no limb at all
in a press statement at the time, saying, "Early studies suggest that
physical activity can have a positive effect on children who suffer from
ADHD."
Last year a very similar study in the Journal of Attention Disorders
found that just 26 minutes of daily physical activity for eight weeks
significantly allayed ADHD symptoms in grade-school kids. The modest
conclusion of the study was that "physical activity shows promise for addressing ADHD symptoms in young children." The researchers went on to write that this finding should be "carefully explored with further studies."
"If physical activity is established as an effective intervention for
ADHD," they continued, "it will also be important to address possible
complementary effects of physical activity and existing treatment
strategies ..." Which is a kind of phenomenal degree of reservation
compared to the haste with which millions of kids have been introduced
to amphetamines and other stimulants to address said ADHD. The number of
prescriptions increased from 34.8 to 48.4 million between 2007 and 2011
alone. The pharmaceutical market around the disorder has grown to
several billion dollars in recent years while school exercise
initiatives have enjoyed no such spoils of entrepreneurialism. But, you
know, once there is more research, it may potentially be advisable to
consider possibly implementing more exercise opportunities for kids.
Over all, the pandemic of physical inactivity, as Hillman and colleagues put it in their Pediatrics
journal article today, is "a serious threat to global health"
responsible for around 10 percent of premature deaths from
noncommincable diseases. But it clearly manifests in ways more subtle
than deaths, including scholastic performance, which we're continuously learning. I talked last week with Paul Nystedt, an associate professor of economics and finance at Jönköping University in Sweden, who just published a multi-country study that found
that obese teenagers go on to earn 18 percent less money as adults than
their peers, even if they are no longer obese. He believes that's most
likely because of the adversity that obese kids experience from
classmates and teachers, which leads to both cognitive and noncognitive
disparities between obese and non-obese kids. Because obese children are
more likely to come from low-income homes to begin with, that only
perpetuates wealth gaps and stifles mobility. Nystedt and his coauthors
conclude, "The rapid increase in childhood and adolescent obesity
could have long-lasting effects on the economic growth and productivity
of nations."
John Ratey, an associate professor of psychiatry at Harvard, suggests that
people think of exercise as medication for ADHD. Even very light
physical activity improves mood and cognitive performance by triggering
the brain to release dopamine and serotonin, similar to the way that
stimulant medications like Adderall do. In a 2012 TED talk,
Ratey argued that physical exercise "is really for our brains." He
likened it to taking "a little bit of Prozac and a little bit of
Ritalin." As a rule, I say never trust anyone who has given a TED talk.
But maybe in this case that's a constructive way to think about moving
one's body. But not the inverse, where taking Ritalin counts as
exercise.
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