Your body was designed to move—a lot. When our ancestors began transitioning from a more sedentary existence toward a hunter-gatherer lifestyle, the increase in aerobic activity may very well have contributed to the evolution of greater longevity. As hominids appeared, we came down from the trees onto the savanna and began traveling long distances in our search for food and running to chase our prey. Our longevity increased in direct proportion to our activity level. The same strategy that enabled our ApoE4 predecessors to thrive provides important clues for optimizing our lives today. Evolution suggests that we were born to run. In fact, of all of the strategies we recommend, none has more scientific evidence than exercise. Being active is the single most important strategy you can employ to prevent and remediate cognitive decline. But it alone is rarely sufficient—it exerts its best effects when used in concert with the other features of the protocol, like fasting and diet.

Exercise protects us at a cellular level.

It upregulates Nrf2, which protects our cells by conferring epigenetic protection for greater resilience to environmental stressors and by increasing the cells’ capacity to prevent and resist disease. Exercise is also an important strategy to heal the damaged mitochondria that accompany insulin resistance.

Exercise is beneficial in many other ways.

It can help you maintain a healthy BMI and reduce insulin resistance, blood pressure, and the risk for heart disease and stroke. It also reduces stress and anxiety while improving mood and sleep. The great news is that any form of exercise helps by increasing brain volume—everything from walking to gardening to dancing. When starting any exercise program, be sure to check with your physician to make sure that you’re healthy enough to engage in your preferred activity. It’s always tempting to overdo, but you ultimately hurt yourself if you sustain an injury and have to refrain from exercise while you heal.

Everyone wants to know the best form of exercise for brain health.

Aerobic exercise has been studied in greater depth than strength training and might take a slight lead, but both have been found to be vitally important as we age. The term aerobic exercise is used for any sustained physical activity—examples are walking, jogging, cycling, or rowing—that improves the efficiency of the body’s cardiovascular system.

Aerobic exercise is thought to be helpful in several ways. Most important, it provides a more constant and sustained level of cerebral blood flow. Increasing blood flow to the brain is vitally important, as a deficit in this is one of the first measurable manifestations of the Alzheimer’s disease process.

Strength training as it relates to cognitive health hasn’t been as well studied, but being strong is an important part of general health. Strength training prevents sarcopenia, the natural loss of lean muscle mass that occurs with aging. Sarcopenia is correlated with cognitive decline. Strength training also prevents the loss of bone, which reduces the risk of cognitive decline, slows aging, and prevents brain atrophy.

Rethink exercise.

Rather than viewing your workout as an obligation, make it the highlight of your day. Whether it’s a long meditative hike in nature or a social group bike ride, schedule everything else around this sacred time. This is your dedicated time to move your strong body. If you keep the experience joyful and fun, it will soon become a self-perpetuating habit. Intellectually understanding that exercise is a powerful neuroprotective strategy is important, but translating that knowledge into daily practice is what matters.

One of the simplest forms of aerobic exercise, which incorporates strength training because it’s naturally weight bearing, is walking. Try to incorporate a daily walk into your routine. Walk with purpose, as if you were late for an appointment. Depending on your current fitness level, you may need to start slowly. That’s okay. Just try to increase the length of your walk by a few minutes per day until you reach thirty minutes or more.

Below are strategies for getting the most out of your walk.

• Walk with a friend. Connecting with others is vital for brain health. Socialize as you exercise.
• Play with speed. As you feel stronger on your daily walk, consider increasing your speed and even adding periods of running or sprinting.
• Add music. When you are walking alone, listen to your favorite music and even sing along. You could also listen to meditative music to unwind as you walk.
• Train your brain. Incorporate cognitive training into your daily walk. While walking, practice saying the alphabet backward. Try to count backward from one hundred by sixes, sevens, eights, and nines.
• Learn while you “burn.” Use exercise as a time to learn while you’re burning your own body fat, harnessing the power of the mind/body connection.
• Use a weighted vest. This is especially helpful for those working to increase bone density. Research has shown that this is a safe and effective way of increasing the demand on your body and improving bone density. Start with a low weight and slowly move up.
• Add walking lunges. Incorporating a few sets of walking lunges adds variety to your walk, while increasing your leg strength.
• Make nature your gym. Look for opportunities to add other calisthenics on your walk. When you pass a bench or a log, for instance, stop for a set of triceps dips or push-ups.
• Consider getting a dog. There are many healthful aspects to pet ownership, but the responsibility of having to walk a dog several times throughout the day may provide the motivation you need for a number of daily walks.
• Track your progress. Use a pedometer to monitor your motion.

Remember, there are no FDA-approved medications (nor any in the pipeline) that come close to demonstrating the improvements seen with daily exercise. None. Exercise is free and accessible to everyone. Baby steps turn into exhilarating hikes through nature. The more active you become, the better you’ll feel and the more you’ll want to exercise.

Excerpted from THE END OF ALZHEIMER’S PROGRAM by arrangement with Avery Books, a member of Penguin Group (USA) LLC, A Penguin Random House Company. Copyright © 2020, Dale E. Bredesen.