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Carol A. Butler, Ph.D.

Pilates Exercises Improve Physical Fitness and Brain Health

Carol A. Butler, Ph.D.
December 2022

Many of us will survive into old age, thanks to modern medicine. Health and longevity are influenced by genetics and environment as well as by our behavior, but it is unlikely that many of us will remain fully healthy and avoid cognitive decline if we aren't active. Most sedentary adults over age 45 are likely to have poor cardiovascular health, hypertension, obesity, and/or diabetes, all risk factors for age-related physical degeneration as well as for cognitive decline.

Research demonstrates that regular activity lowers the risk of cognitive decline because it stimulates the growth of new neurons in the brain, improves cerebral blood flow, and increases gray matter volume in brain structures that are central to cognitive functioning.


Pilates is an excellent choice for an adaptable form of exercise that requires both cognitive and motor learning. making it more beneficial for most people than doing simple repetitive exercises. Pilates exercises are slow and controlled. focusing on the core muscles in the back, hips, quadriceps, and hamstrings, all of which support the spine and pelvis. In addition to strengthening core muscles, the exercises increase blood flow and strengthen bones and cartilage, and they also improve balance, emdurance, and mood


Pilates can be performed on a mat with the option of using small equipment like blocks and balls, or on various pieces of specialized apparatus on which the level of difficulty car be individually varied by adjusting springs. You can have individual sessions or group classes that take place in person or virtually. ideally participating two or three times weekly in line with the CDC recommended exercise guidelines. Because of its adaptability, this form of exercise has been found to be particularly suitable and safe for older adults, even if they are frail.


Pilates can be preventative medicine and a therapeutic agent. Joseph Pilates developed his technique in the 1920s to train dancers who were prone to injury, and it is frequently recommended by orthopedists for people who are recovering from injuries. But it is also enjoyed by people of all ages who are interested in staying fit and resilient and maintaining a healthy level of self-esteem.


People of any age should be as physically active as their abilities and conditions allow; the goal should be to learn to enjoy what your body can do. As an 82-year-old competitor in the 2022 National Senior Games track-and-field event said, "You got to keep moving."

Pilates Strengthens Your Bones

Carol A. Butler, Ph.D.
February 2023

Bone density diminishes with age, with bones usually at their densest at around age 30. Bones tend to become more fragile and the risk of fractures increases around age 50, due in large part to hormonal changes in both women and men. Appropriate exercise has been shown to play a significant role in both building strong bones when we are young and in keeping bones strong as we age.


"Bone-loading" is weight-bearing activity that stimulates new bone growth. The slow and controlled strength and resistance training and weight bearing exercises that are basic to Pilates provide excellent and safe bone-loading activity. In addition to strengthening bones, Pilates includes static stretching (holding still in a position to lengthen a muscle), and exercises that improve flexibility, coordination, and balance, all of which reduce the likelihood of dangerous falls. Aging and inactivity also typically result in the loss of muscle mass and in the stiffening of tendons. Stretching your joints and muscles combined with resistance training and agility exercises, all of which are typically included in a Pilates session, result in improved range of motion and increased strength and muscle mass.


The author of this article, for example, is a senior who has osteoporosis, osteoarthritis in one hip, and degenerative disc disease in her lumbar spine. She credits her good genes and her three-times-a-week Pilates practice for her ability to remain active and for the improvement in her bone density found in a recent test (a painless, non-invasive scan that measures bone density in several parts of the body).


Any form of moderate exercise can have value, but some common activities are not recommended for building bone because they increase the risk for compression fractures of the fragile vertebrae in the spine. And non weight bearing activities such as swimming and cycling do not contribute significantly to improved bone density.


The CDC recommendation for adults of at least two and a half hours a week of moderate to vigorous physical activity was distilled from a great deal of research that demonstrated the value of exercise in lowering the risk of developing a wide variety of conditions, including cognitive decline, stroke, heart attack, type two diabetes, and cancer of the breast, lung, prostate, endometrium, and colon. Your genes set the tone for your bone density at birth, but your nutritional status, microbiome, hormone levels, chronic illnesses, vitamins, supplements, medications, smoking, and alcohol intake all can impact your bone health. If you choose Pilates as your regular form of exercise you are likely to get many benefits ...including the bonus of stronger bones.

New research discovers a link between gut health and exercise motivation

Carol A. Butler, Ph.D.
January 2023

You are probably somewhat aware that a healthy microbiome (also known as your "gut") is important to your health, but what exactly does that mean? Your unique microbiome consists of trillions of microorganisms that include bacteria, fungi, parasites, and viruses, most of which generally coexist peacefully in your small and large intestines and promote the smooth daily operation of your immune system, your muscles, and other bodily functions. There is a growing area of research on inter-organ communication within the body which focuses on problems that can occur if the microbial equilibrium in the gut is disturbed.


Groundbreaking research on this subject was published in December, 2022 in the journal Nature. It focuses on the link between gut health and exercise motivation. As is often the case with this type of research, the preliminary studies were conducted using mice as subjects, but there is ongoing research on humans which, if it confirms these results, could help to explain why about half of Americans are basically sedentary, unable to find the motivation to engage in even the minimum recommended 150 minutes per week of moderate physical activity.


Gut bacteria normally monitor the contents of the colon and signal the brain whether the body has enough food to fuel a workout. When mice in the recent study were dosed with broad-spectrum antibiotics that killed off some of their gut bacteria, the distance the mice ran dropped by half. When they were taken off the antibiotics, the mice mostly returned to their prior performance levels. While the mice were being treated with antibiotics, the researchers studied the part of the brain responsible for motivation and found reduced cellular activity in the dopamine receptors. Dopamine is what gives you a sense of pleasure and motivates you to repeat the pleasurable activity.


Earlier research has established that if an activity is repeated with the dopamine function blocked, the motivation to repeat the activity will progressively weaken. This is what appears to have happened to the mice in the present study; their microbiome was disturbed by the antibiotics with the result that their brain's dopamine receptors were temporarily impaired. Even though they had enough food, the mice were apparently less motivated to be active.


How can you keep your microbiome healthy?


The scientific literature has recognized that fermented foods generally are "gut-friendly" because they contain beneficial live microorganisms. If you incorporate into your diet fermented foods like yogurt, kefir, pickled vegetables, tempeh, kombucha tea, kimchi, miso, and sauerkraut, it should improve the health of your microbiome and it might have an impact on your motivation to exercise. In addition, eating a plant-based diet, eliminating or minimizing sugar and processed foods, minimizing the use of antibiotics, getting a good night's sleep, and minimizing stress are known to be favorable to the health of the gut.


As part of the current research into human exercise motivation, one group of researchers is analyzing the gut microbiomes of people with varying levels of exercise motivation, and another group is analyzing the microbiome's impact on high-intensity interval training. This type of research can take years to complete, so while we wait for the results why don't you experiment to try to improve the health of your microbiome-- and see if you find yourself wanting to do more Pilates?

Use it or lose it? Get it back with Pilates

Carol A. Butler, Ph.D.
August 2023

          The author is a psychoanalyst and a senior citizen who has almost unfailingly attended Pilates classes three times a week for the past eight years. Pilates was prescribed by her orthopedist, himself a Pilates devotee, when she consulted him because of pain from sciatica. She personally vouches for its physical, psychological, and social benefits.

You already know that smoking is bad for your health, but did you know that the benefits of switching from a sedentary lifestyle to a moderate workout schedule compare to the health benefits that result from stopping smoking? Is this enough motivation for you to get moving?

Strength, endurance, agility, flexibility, balance, reaction time, speed, coordination, range of motion-- these qualities all diminish to some degree as we age, and they are all associated with the natural decline of muscle mass that increases as you pass age 40. In order to preserve functional fitness and retard the loss of muscle mass, it is vital for each individual to be as physically active as they can manage. You (like the author) might be concerned with being able to lift your suitcase into the overhead compartment on an airplane. Or you may want to be able to walk up subway steps without getting too winded, or to carry groceries or a toddler more comfortably. What are the activities of daily living that are important for you to manage?

People stop being active for a variety of reasons, including physical or emotional illness, injury, pain, fear of falling, family obligations, work demands, travel, and even because of harsh weather. Extended breaks from being active can significantly reduce fitness, but the good news is that if you were physically active and then became sedentary, you should be able to regain fitness more quickly than someone who has always been sedentary. Your recovery will be facilitated by “muscle memory”, the long-lasting structural changes that occur in muscles and brain that enable you to repeat familiar movements with a minimum of conscious thought, like brushing your teeth or walking-- or regular exercise.

How you lose it

  • Aerobic capacity gained through exercise is mostly lost within two to four weeks of inactivity. As the size and strength of muscles decreases, exercise becomes more tiring and muscle soreness becomes increasingly likely.

  • VO2 max measures the capacity of the heart and lungs to take in oxygen and convert it into energy. VO2 max decreases naturally with age, and that decline is steeper if you are not active. Most studies indicate a complete reversal of VO2 max after long-term inactivity when regular workouts are resumed.

  • Bones are most dense at around age 30. Density declines with age and the risk of fractures increases significantly by age 50. If you sit for most of the day, your bone density will decline faster than if you move around regularly. Weight-bearing exercise has been shown to play a significant role in both building strong bones when we are young and in stimulating bone growth as we age.

  • Blood volume: Exercise increases the heart’s ability to pump blood. Blood carries oxygen and glucose, the main sources of energy, so more blood flowing to the cells in your brain and body gives you more energy. And as a bonus, blood also carries the materials to produce proteins that build new muscle cells.

  • Blood glucose: Your blood glucose level typically rises after a meal. If blood glucose levels remain elevated you have an increased risk of heart disease, diabetes, and weight gain, but physical activity converts glucose in the blood into energy, and the amount of glucose that remains is reduced. A study that followed adults on an eight-month-long regimen of strength and aerobic training confirmed that regular exercise lowered their blood glucose levels, but about half of the subjects lost that benefit within 14 days of quitting exercise.

  • Blood pressure: Elevated blood pressure is commonly a result of stiffening of the blood vessels. A recent study found a healthy decrease in participants’ blood pressure during a six-month period of training, but after just two weeks of inactivity their blood pressure rose as the total amount of blood circulating in the body decreased and blood vessels began to stiffen. After three sedentary months, even endurance athletes experience increased arterial stiffness that becomes progressively worse if they remain inactive.


How you get it back

”Start where you are. Use what you have. Do what you can.”

Arthur Ashe

Can you walk four city blocks (400 meters) in less than 15 minutes? If you are a healthy adult under age 40, that should be easy for you. But that was the working definition of mobility used in a study of older adults who were dealing with physical frailty and disability. It is important for you to evaluate your individual fitness level appropriately so that you can set reasonable goals that allow you to measure your improvement. This link contains several easy ways to evaluate your fitness level: Mayo Clinic- Healthy Lifestyle

Benefits and a reduced risk of illness will follow from even small amounts of exercise. A recent article in the journal Sports Medicine reported that as little as a two-to five-minute walk after a meal had a positive effect on heart health and a significant impact on insulin and blood sugar levels. And a recent study in the journal Circulation reported that adding just 500 steps a day resulted in a 14 percent reduction in the risk of heart disease, stroke, and heart failure. Although more exercise generally yields greater benefits, when the long-term health of “weekend warriors” (people who only exercised on weekends) was compared with the long-term health of people who had higher levels of activity spread over more days, there were substantial and comparable health benefits that resulted even from being moderately active on only a couple of days a week.

Pilates exercises are an excellent way to maintain strength, balance, range of motion, and flexibility- and to maximize fitness at any age. Pilates is recommended by many orthopedists for people who are resuming activity after recovering from an injury, and it’s a good way for anyone to get in shape because of its many options that adapt the movements to your ability level.

The general rule is to start resuming activity slowly, and gradually build up towards your fitness goal. Always tweak your routine based on how your body feels. Always make sure you perform any movement safely and correctly. Your strength will increase first, and it will take a bit longer to regain your endurance. Scheduling your activity is a good way to start. Make an appointment with yourself to take a walk or sign up for a Pilates session, and then keep that appointment.

Keep in mind that regular exercise makes you feel good. When you exert the effort to exercise, chemical messengers in the brain reward you with a good feeling and a sense of accomplishment, and those feelings will motivate you to repeat the pleasurable activity. So just get moving; you will feel good, and your health will improve.

How Does Exercise Lower the Risk of Getting Cancer?

Carol A. Butler, Ph.D.

October 2023

There is strong evidence that regular exercise can reduce the risk of getting bladder, breast, colorectal, and gastric cancers by as much as 20 percent. A 2019 review found more than 45 studies involving several million people that reached this conclusion. This is great news, of course, especially for those of us who are committed to an exercise routine. But, until recently, it was a mystery as to how exercise could possibly reduce that risk. 


The solution to this mystery is suggested by the results of a small study conducted at Texas MD Anderson Cancer Center that was just published in the journal Clinical Cancer Research. The subjects in this research were adults between 18 and 50 who have Lynch syndrome, an inherited genetic mutation that can lead to cancer at a young age. Half of the group were enrolled in a 12-month exercise program and the other half were simply told about the benefits of working out. The exercise prescribed consisted of 45 minutes of high intensity cycling 3 days a week, and both groups of participants were given activity trackers; the exercise group recorded a median of 164 weekly exercise minutes, while the other group recorded a median of 14 weekly exercise minutes. 


The researchers found that 13 genes became more active in the people who exercised regularly. These activated genes were involved in immune signaling pathways involving “natural killer” cells (CD8 and T cells) that attack foreign entities like cancer cells. People in the exercise group also demonstrated a drop in the levels of the inflammatory marker prostaglandin E2 and an increased ability to use oxygen, and both are factors involved in regulating the immune system.  


These changes suggest that regular exercise strengthens the body’s immune response and improves its capacity to detect and remove cells that would otherwise become cancerous. Eduardo Vilar-Sanchez, the lead author of the study, said, “It was mind-blowing to me that exercise induced such a strong and durable change.”  

This was the first study that found a link between relatively vigorous exercise and changes in immune biomarkers, and it is an important foundation for future research. This link may have been discovered because the researchers used next-generation genetic sequencing that permitted more sensitive measurements than the tools used in earlier research. If the preventative benefits of this type of exercise prescription are validated and generalized, it will offer a new way for people to lower their cancer risk over time. 


These results give you one more reason to exercise as much as is appropriate for your physical condition and lifestyle. In addition to the possibility of lowering your risk of several cancers, exercise has been shown to lower the risk of cognitive decline, dementia, dangerous falls and broken bones, stroke, cardiovascular disease, and type two diabetes. So… what are you waiting for?? 

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