Aerobic exercise may be most effective for relieving depression/anxiety symptoms

 

Supervised group exercise may be best for depression; shorter lower intensity exercise may be best for anxiety ; But all forms of exercise as good as, or better than, medication/talking therapies

Aerobic exercise, such as running, swimming, and dancing, may be most effective for relieving the symptoms of depression and anxiety, finds an overarching (umbrella) review and data synthesis of the available evidence, published online in the British Journal of Sports Medicine.

While supervised and group exercise may be best for reducing depression, shorter (up to 8 weeks) lower intensity exercise may be best for relieving anxiety.

 

But all forms of exercise are as good as, or better than, medication and talking therapies, regardless of age or sex, the findings indicate.

 

Depression and anxiety affect up to 1 in 4 people worldwide, with the highest prevalence among young people and women, note the researchers. And previously published research suggests that exercise compares favourably with psychotherapy and medication for easing the symptoms, they add.

 

But it’s not clear how well exercise might work at different ages, frequency, and intensities.And previous overarching syntheses have focused only on adults or included participants with potentially influential factors, such as long term conditions.

 

The researchers therefore set out to comprehensively estimate the impact of exercise on depression and anxiety symptoms across all age ranges, including in those with and without a clinical diagnosis; and to find out whether the type, length, frequency, intensity, and supervision of exercise, and individual or group participation might influence outcomes.

 

They scoured research databases for pooled data analyses of randomised controlled trials that compared exercise with either another type of activity, or a placebo, or no active intervention, and published in English up to July 2025.

 

Eligibility criteria included planned, structured, repetitive and purposeful physical activities to improve physical and mental health; and all forms, intensities, frequencies and settings (individual or group) of exercise.

 

For depression, 57 pooled data analyses, comprising 800 component studies, involving 57,930 participants aged between 10 and 90, were included in the overarching synthesis.

 

These participants had been diagnosed with clinical depression or were experiencing depressive symptoms, but had no other co-existing conditions. Exercise interventions were categorised as aerobic (19 pooled data analyses); resistance, such as strength training (8); mind–body, such as yoga, tai-chi, and qigong (16); or a mix (39).

 

For anxiety, 24 pooled data analyses, comprising 258 component studies, involving 19,368 participants, aged between 18 and 67, were included in the overarching synthesis. Exercise interventions were categorised as aerobic (7); resistance (1); mind–body (9); or mixed (13).

 

Synthesis of the pooled data analyses showed that exercise had a medium sized effect on depression symptoms and a small to medium sized effect on anxiety symptoms, with the most substantial effects found for young adults (18-30) and women who had recently given birth.

 

All forms of exercise were associated with positive effects, with aerobic, group based and supervised formats the most effective for relieving depression symptoms. Aerobic, resistance, mind–body and a mix of different exercise formats had a medium sized impact on the relief of anxiety symptoms.

 

The effects were on a par with, or better than, medication or talking therapies.

 

The researchers acknowledge some limitations to their findings. These include the variable interpretations of exercise intensity and length among the pooled data analyses, and the relative paucity of pooled data analyses on the impact of exercise across the lifespan.

 

But they nevertheless conclude: “This meta-meta-analysis provides robust evidence that exercise effectively reduced depression and anxiety symptoms across all age groups, comparable with, or exceeding, traditional pharmacological or psychological interventions.

 

“Group and supervised formats gave the most substantial benefits, underscoring the importance of social factors in mental health interventions. With evidence that different characteristics of exercise appear to impact depression and anxiety at varying magnitudes, tailored exercise programmes must be prescribed.”

 

They continue: “Given the cost effectiveness, accessibility, and additional physical health benefits of exercise, these results underscore the potential for exercise as a first line intervention, particularly in settings where traditional mental health treatments may be less accessible or acceptable.”

Can a vegan or vegetarian diet support the rapid growth required in the first two years of life?

While the global shift toward plant-based living continues to accelerate, a critical question has lingered for parents and pediatricians: Can a vegan or vegetarian diet support the rapid growth required in the first two years of life?

A landmark study of nearly 1.2 million infants led by Ben-Gurion University of the Negev (BGU) researchers and the Nutrition Division of the Israeli Ministry of Health suggests the answer is a reassuring yes. The research, published last week in JAMA Network Open (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2844665), found that infants from vegan and vegetarian households follow growth trajectories nearly identical to their omnivorous peers by age two.

This study analyzed a decade of records (2014–2023) provided by the Israeli Ministry of Health, which tracks the development of approximately 70% of the children in the country. This massive dataset allowed the team—led by Kerem Avital, MPH, and Prof. Danit R. Shahar, PhD, of BGU —to move beyond small-scale debates and provide population-level evidence.

The research revealed several key insights regarding infant development:

• Similar Growth Trajectories: Infants from vegan households closely tracked their omnivorous peers across all measurements, weight, length, and head circumference, with mean differences that were clinically minor (WHO z-score <0.2) and diminished further when adjusted for birth weight.
• Early Differences Diminish: While infants in vegan households had higher odds of being underweight in the first 60 days of life (adjusted odds ratio 1.37), this disparity diminished and was no longer statistically significant by 24 months of age.
• Low Stunting Across All Groups: By age 24 months, stunting rates remained low across all dietary patterns (3.1% for omnivores, 3.4% for vegetarians, and 3.9% for vegans) with no statistically significant differences in odds between groups.
• Diet Quality and Support: The researchers emphasize that well-planned plant-based diets with access to nutritional counseling during pregnancy and infancy are important to support optimal infant development.

“In the context of developed countries, these findings are highly reassuring,” said Kerem Avital, lead researcher and PhD candidate at Ben-Gurion University. “The data suggests that with the proper environment, plant-based diets do not compromise the fundamental physical development of infants.”

As veganism moves from a niche lifestyle to a global health trend, BGU’s research provides the scientific "bridge" needed to inform international public health policy and nutritional counseling for the next generation. 

Strength (resistance) training is the most effective tool for achieving “high-quality” weight loss

 A new study conducted at the Gray Faculty of Medical and Health Sciences and the Sylvan Adams Sports Science Institute at Tel Aviv University reveals a clear conclusion: strength (resistance) training is the most effective tool for achieving “high-quality” weight loss, reducing body fat while preserving, and even increasing, muscle mass.

 

The study was led by Prof. Yftach Gepner, together with Yair Lahav and Roi Yavetz, and was published in the scientific journal Frontiers in Endocrinology. The researchers analyzed data from hundreds of women and men aged 20–75 who participated in a structured weight-loss program. All participants adhered to a low-calorie diet with a controlled energy deficit but were divided into three groups based on their chosen activity: no physical exercise, aerobic exercise, or resistance training.

 

The findings show that while total weight loss was similar across all groups, a significant difference was found in the composition of the weight loss. Participants who performed strength training lost more fat than those in the other groups, and at the same time were the only ones who succeeded in preserving  and even increasing their muscle mass. In contrast, participants who did not exercise, as well as those who engaged in aerobic activity alone, lost a substantial portion of their muscle mass as part of the weight-loss process.

 

The research team explains: “Although total weight loss was similar among all participants, the key difference lay in the composition and quality of that loss. While weight loss without strength training, and even with aerobic activity alone, was accompanied by loss of muscle mass, strength training led to weight loss based primarily on loss of fat, while preserving and even increasing muscle mass. This means that weight loss achieved through strength training is not just a decrease on the scale, but a healthier, more stable, and more effective long-term process.”

 

Muscle mass plays a central role in health and metabolism. Muscle constitutes about 40% of body weight and is responsible for a significant portion of daily energy expenditure, even at rest. When muscle mass declines, metabolic rate decreases, weight loss becomes more difficult, and the likelihood of regaining weight after dieting increases. Therefore, weight loss that does not preserve muscle may be less sustainable and potentially harmful in the long term.

 

 

Beyond that, maintaining muscle mass is essential for everyday functioning, strength, stability, and balance. Loss of muscle can impair physical ability, increase the risk of injuries and falls, and may even accelerate the development of sarcopenia age-related muscle degeneration that can also affect relatively young individuals during unbalanced dieting.

 

The study also demonstrated a clear advantage of strength training in reducing waist circumference  a key indicator of abdominal obesity and cardiometabolic risk. The greatest reductions in waist circumference were observed among the participants who engaged in strength training and were found to be strongly associated with fat loss, highlighting this type of exercise’s contribution to heart and metabolic health.

 

According to the researchers, the findings underscore that not all weight loss is equal in quality. “Good” weight loss reduces body fat, preserves muscle, and supports health and long-term weight maintenance. The study’s conclusion is clear: incorporating strength training into weight-loss programs is not a luxury, but an essential component of healthy, effective, and sustainable weight loss for both women and men.

 

Prof. Gepner concludes: “Our study shows that weight loss should not be measured only by how many kilograms we lose, but by the quality of that loss. When appropriate nutrition is combined with strength training, it is possible to reduce fat effectively while preserving and even improving muscle mass, a critical factor for metabolic health, daily functioning, and long-term weight maintenance. Our findings make it clear that strength training is not just for athletes, but a vital tool for anyone who wants to lose weight in a healthy, safe, and sustainable way, women and men alike.”

 

Link to the article:

https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1725500/full

Moderate to high caffeinated coffee and tea intake can lower dementia risk

A new prospective cohort study by investigators from Mass General Brigham, Harvard T.H. Chan School of Public Health, and the Broad Institute of MIT and Harvard analyzed 131,821 participants from the Nurses’ Health Study (NHS) and Health Professionals Follow-Up Study (HPFS), finding that moderate consumption of caffeinated coffee (2-3 cups a day) or tea (1-2 cups a day) reduced dementia risk, slowed cognitive decline, and preserved cognitive function. Their results are published in JAMA.

“When searching for possible dementia prevention tools, we thought something as prevalent as coffee may be a promising dietary intervention—and our unique access to high quality data through studies that has been going on for more than 40 years allowed us to follow through on that idea,” said senior author Daniel Wang, MD, ScD, associate scientist with the Channing Division of Network Medicine in the Mass General Brigham Department of Medicine and assistant professor at Harvard Medical School.  Wang is also an assistant professor in the Department of Nutrition at Harvard Chan School and an associate member at the Broad Institute. “While our results are encouraging, it’s important to remember that the effect size is small and there are lots of important ways to protect cognitive function as we age. Our study suggests that caffeinated coffee or tea consumption can be one piece of that puzzle.”

Early prevention is especially crucial for dementia, since current treatments are limited and typically offer only modest benefit once symptoms appear. Focus on prevention has led researchers to investigate the influences of lifestyle factors like diet on dementia development.

Coffee and tea contain bioactive ingredients like polyphenols and caffeine, which have emerged as possible neuroprotective factors that reduce inflammation and cellular damage while protecting against cognitive decline. Though promising, findings about the relationship between coffee and dementia have been inconsistent, as studies have had limited follow-up and insufficient detail to capture long-term intake patterns, differences by beverage type, or the full continuum of outcomes—from early subjective cognitive decline to clinically diagnosed dementia.

Data from the NHS and HPFS help to overcome these challenges. Participants repeated assessments of diet, dementia, subjective cognitive decline, and objective cognitive function and were followed for up to 43 years. Researchers compared how caffeinated coffee, tea, and decaffeinated coffee influenced dementia risk and cognitive health of each participant.

Of the more than 130,000 participants, 11,033 developed dementia. Both male and female participants with the highest intake of caffeinated coffee had an 18% lower risk of dementia compared with those who reported little or no caffeinated coffee consumption. Caffeinated coffee drinkers also had lower prevalence of subjective cognitive decline (7.8% versus 9.5%). By some measurements, those who drank caffeinated coffee also showed better performance on objective tests of overall cognitive function.

Higher tea intake showed similar results, while decaffeinated coffee did not—suggesting that caffeine may be the active factor producing these neuroprotective results, though further research is needed to validate the responsible factors and mechanisms.

The cognitive benefits were most pronounced in participants who consumed 2-3 cups of caffeinated coffee or 1-2 cups of tea daily. Contrary to several previous studies, higher caffeine intake did not yield negative effects—instead, it provided similar neuroprotective benefits to the optimal dosage.

“We also compared people with different genetic predispositions to developing dementia and saw the same results—meaning coffee or caffeine is likely equally beneficial for people with high and low genetic risk of developing dementia,” said lead author Yu Zhang, MBBS, MS, PhD student at Harvard Chan School and a research trainee at Mass General Brigham.

Decades later, brain training lowers dementia risk

 

The speed training used in the study is now available through the company BrainHQ.

Beginning in the late 1990s, nearly 3,000 older adults received brain training as part of a study to evaluate the training's effect on thinking and memory. Twenty years later, participants continued to reap the benefits.

In the latest follow-up from the Advanced Cognitive Training for Independent and Vital Elderly, or ACTIVE, study, investigators report that participants who received cognitive speed training, plus booster sessions one and three years later, were 25% less likely to be diagnosed with dementia in the next two decades.

Researchers say it is one of the first results from a large randomized, controlled trial to demonstrate that any intervention, whether it is cognitive training, brain games, physical exercise, diet or drugs, can lower the incidence of Alzheimer's disease and related dementias. Findings appear in the journal Alzheimer's & Dementia: Translational Research and Clinical Interventions.

Previous studies of the ACTIVE training had shown participants maintaining improvements at five and 10 years after training, but seeing benefits this long-lasting was a surprise even to Michael Marsiske, Ph.D., one of six study principal investigators and a professor and interim co-chair of the Department of Clinical and Health Psychology at the University of Florida College of Public Health and Health Professions.

"Participants who had the greatest advantage had a maximum of 18 training sessions over three years. It seemed implausible that we might still see benefits two decades later," Marsiske said. "Our initial findings had shown benefits of several training arms up to 10 years after training, with participants reporting fewer impairment in tasks of daily living and experiencing fewer motor vehicle crashes. Adding in these 20-year findings strongly suggests that engagement in cognitive training does no harm and may confer substantial benefit."

The researchers believe the impacts from the cognitive speed training were the most durable because the training was adaptive and personalized.

Funded by the National Institute on Aging and the National Institute of Nursing Research, the multisite ACTIVE study involved 2,832 older adults who were randomly placed in groups for 10 training sessions in memory, reasoning or speed of processing. Training was conducted in 60- to 75-minute sessions over about six weeks. Some participants were randomly selected to receive booster training 11 and 35 months following the initial training. A control group received no training.

After five years, participants in all trained groups retained benefits. Participants reported less difficulty performing tasks such as cooking, taking medication and managing finances than their peers in the control group. Ten years on, researchers found that participants who received training in reasoning and speed of processing maintained cognitive improvements.

For the 20-year follow-up — those still living were now mostly in their 90s — the investigators reviewed participants' medical records to determine how many had been diagnosed with dementia. Those in the speed training group had cut their risk of dementia by one-quarter compared with participants in the control group.

The speed training requires participants to process visual information on a computer screen and make quick decisions. As participants' speed and accuracy improved, the training got progressively more difficult. Speed training may cause physical changes to the brain, leading to new and stronger connections between brain networks. The speed training used in the study is now available through the company BrainHQ.

For those interested in incorporating cognitive training into their own health practice, it's never too late to begin, said Marsiske, who is also the leader of the Data Management and Statistics Core of the 1Florida Alzheimer's Disease Research Center.

"At enrollment, our participants ranged in age from 65 to 94 years," he said. "We found no substantial reduction of training benefit with age, suggesting that training can be started at any time."

The ACTIVE study has inspired the investigators to launch follow-up trials, develop new interventions and explore how older adults may benefit from pairing cognitive training with other lifestyle habits such as physical exercise, nutrition and hypertension management.

"We think this study encourages us, and the field, to continue incorporating cognitive training into multicomponent intervention programs for older adults," Marsiske said.

Obesity and aging = inflammation = cognitive decline

 Obesity and older age are strongly associated with low-grade inflammation in the body, a condition that appears closely linked to cognitive decline and dementia.

A new Baycrest study found that participants with elevated inflammation levels make up roughly two‑thirds of those with cognitive impairment, compared with only about one‑third of cognitively healthy adults, suggesting that systemic inflammation may play an important role in the cognitive changes that often accompany aging. The findings point to lifestyle factors that influence inflammation as potential targets for early risk reduction.

Often referred to as “inflammaging,” chronic low-grade inflammation gradually increases with age and contributes to vulnerability to age-related diseases, including dementia. While inflammation tends to rise naturally over time, its severity is strongly influenced by factors such as body weight, cardiovascular health and other aspects of physical health. Over time, this persistent inflammation, even when it occurs outside the brain, may contribute to changes in brain function.

“This study provides new evidence that systemic inflammation, shaped by lifestyle and overall health, may be a key mechanism connecting physical health to long-term brain function,” says Dr. Bruna Seixas-Lima, Scientific Associate at Baycrest’s Rotman Research Institute and lead author of the study, titled “Peripheral inflammation in a Canadian cohort of neurodegenerative conditions: Occurrence, determinants, and impact,” recently published in the Journal of Alzheimer’s Disease.

This is the first study to examine inflammation levels across a large and diverse group of older adults living with different forms of dementia, mild cognitive impairment and no cognitive impairment. Participants were drawn from the Comprehensive Assessment of Neurodegeneration and Dementia Study (COMPASS-ND), part of the Canadian Consortium on Neurodegeneration in Aging (CCNA).

This uniquely diverse cohort allowed researchers to examine how lifestyle and health factors contribute to inflammaging across a wide range of real-world cognitive and medical conditions. While diet quality and sleep also influenced inflammation, obesity emerged as the strongest contributor.

Extensive data were collected from 514 participants and included measures of systemic inflammation, age and sex, cardiovascular and medical history, lifestyle factors such as diet, sleep, smoking and body weight, cognitive assessments and changes in brain white matter observed through magnetic resonance imaging (MRI).

Main study findings:

• Elevated inflammation was more common and more pronounced in participants with cognitive impairment.
• Obesity was the strongest lifestyle-related contributor to inflammation, exceeding the influence of diet and sleep quality.
• Among individuals living with dementia, those with vascular conditions showed higher levels of inflammation.
• Many contributors to inflammation in aging adults are modifiable through changes in habits and lifestyle.

COMPASS-ND is one of the world’s most detailed collections of health and brain data, comprising nearly 1,200 Canadians between the ages of 50 and 90 who are living with or at risk of developing dementia. The study includes individuals with mixed dementia, multiple health conditions, complex diagnoses and frailty, reflecting real-world aging and cognitive decline. COMPASS-ND is the signature observational cohort study of the CCNA, Canada’s largest dementia research initiative, headquartered at Baycrest.

While it remains unclear whether directly treating inflammation can prevent dementia, these findings may help inform strategies for earlier identification of risk and prevention. The research team is currently conducting follow-up studies to further explore the relationship between inflammation and cognitive decline.

Study links ultra-processed foods to greater heart attack, stroke risk

 Ultra-processed foods (UPFs) are industrially modified products loaded with added fats, sugars, starches, salts and chemical additives like emulsifiers. From sodas to snacks and processed meats, these foods are stripped of natural nutrients. UPFs introduce many ingredients that our bodies have never encountered. In the United States today, UPFs make up nearly 60% of adults’ and 70% of children’s diets.

Prior studies have shown that people who consume large amounts of UPFs have higher risks of metabolic syndrome, a constellation of overweight and obesity, hypertension, dyslipidemia and insulin resistance, as well as increased levels of high sensitivity C-reactive protein, a sensitive marker of inflammation and accurate predictor of future cardiovascular disease (CVD), which is mainly comprised of heart attacks and strokes. However, data are sparse on whether people who consume higher amounts of UPFs have increased risks of CVD.

With consumption of UPFs on the rise and CVD remaining a leading cause of death in the U.S. and increasing around the world, understanding the link between the two is more urgent than ever – as insights could have profound implications for individual patient care as well as the health of the general public.

Researchers from Florida Atlantic University’s Charles E. Schmidt College of Medicine explored this possible link by examining data from the U.S. National Health and Nutrition Examination Survey (NHANES). The results of the study, published in The American Journal of Medicine, provide more troubling news for individuals who consume high amounts of UPFs.

“The findings from our study, based on a large, nationally representative sample of 4,787 U.S. adults, show that those with the highest intake of UPFs suffer a statistically significant and clinically important 47% higher risk of cardiovascular disease,” said Charles H. Hennekens, M.D., FACPM, FACC, senior author, First Sir Richard Doll Professor of Medicine and Preventive Medicine, and senior academic advisor, FAU Schmidt College of Medicine. “These results have major implications for future research as well as clinical care and public policy.”

The researchers analyzed data from the NHANES, which collects health, diet and lifestyle information from a large, random sample of U.S. adults. They analyzed the 4,787 participants aged 18 and older from 2021 to 2023 who had at least one day of detailed dietary records and information about heart attack or stroke. Participants reported everything they ate over two days, and researchers calculated what percentage of each person’s total calories came from UPFs, using a validated and widely used system that classifies foods. People were then grouped into four categories, ranging from low to high UPF food intake.

The study focused on CVD, defined as a self-reported history of heart attack or stroke. Researchers also accounted for factors such as age, sex, race and ethnicity, smoking and income. Average age of participants was 55 years, and 55.9% were women. After adjusting for these confounding factors, those in the highest quartile of UPFs intake had a statistically significant and clinically important 47% higher risk of CVD compared with those in the lowest quartile.

The researchers note increasing public awareness and policy change around UPFs may mirror that of tobacco in the last century. Just as it took decades for the dangers of cigarettes to become widely recognized, changing consumption habits around UPFs will likely take time, given the influence of multinational companies that dominate the market. At the same time, many people face real barriers to access healthier options, highlighting the need for a broader public health approach.

“Addressing UPFs isn’t just about individual choices – it’s about creating environments where the healthy option is the easy option,” said Hennekens. “Clinical guidance and public health education are necessary to make nutritious foods accessible and affordable for everyone.”

The researchers also address the rising rates of colorectal cancer in the U.S., particularly among younger adults as the risk factors are similar to those of CVD.  

“The increasing consumption of UPFs may be a contributing factor, along with other dietary and lifestyle influences that affect a range of common and serious gastrointestinal diseases,” said Allison H. Ferris, M.D., FACP, co-author and professor and chair of the Department of Medicine at the FAU Schmidt College of Medicine. “Awareness is the first step toward prevention.”

Although large scale randomized trials are needed, the researchers say that in the meantime, health care providers should advise patients to decrease consumption of UPFs in addition to adopting other therapeutic lifestyle changes and adjunctive drug therapies of proven benefit.