有沒有免費幾乎可防治百病的處方呢？
有，那就是運動(Exercise)。
Imagine your doctor offers you something that will cut your risk of heart attack, stroke, diabetes, obesity, cancer and Alzheimer’s disease. It’s free, there are few side effects and it’s up to you when you take it. Even better, the more you take the healthier you will get. Would you go for it?
(運動)可以降低罹患心臟病、中風、肥胖、阿茲海默症等等的風險，問題在於當事人願不願意起而行。
…the US government’s advice on physical activity. That prescribes 150 minutes per week of moderate aerobic activity, such as brisk walking, ballroom dancing or gardening, or 75 minutes of more vigorous cycling, running or swimming.
美國政府部門對國民運動量的建議是：
1. 每星期至少有150分鐘以上的中強度有氧運動，譬如快走、跳舞或從事園藝活動，或者
2. 每星期至少有75分鐘以上的強度運動，如騎自行車、跑步或游泳。
Physical activity works by stimulating the circulation, flushing out fatty deposits in blood-vessel walls and dilating small veins and arteries that could otherwise cause a heart attack or stroke. It also helps to destroy dangerous forms of fat: it alters the structure of triglyceride particles in the bloodstream, for example, making them easier for enzymes to destroy.
運動促進血液循環，清理血管壁上沈積物，擴張小靜脈及動脈，有助預防心臟病或中風。
運動有助於減少低密度膽固醇，它改變了三酸甘油脂的結構，使其容易被酶分解。
(三酸甘油酯是極低密度脂蛋白和乳糜微粒的主要組成部分，在新陳代謝過程中它作為能源和食物中的脂肪的運輸工具起……。其能量密度為醣類和蛋白質的兩倍（9大卡每克）。在小腸內，三酸甘油酯在脂肪酶和膽汁的作用下被分解為甘油和脂肪酸後進入血管。在血液內它重組，形成脂蛋白的組成部分。它的作用包括向細胞運輸脂肪酸。不同的組織可以釋放脂肪酸或者吸收脂肪酸作為能源。脂肪細胞可以產生和儲藏三酸甘油酯。假如身體需要脂肪酸作為能源時升糖素會促使脂肪酶分解三酸甘油酯，釋放自由脂肪酸。由於腦無法使用脂肪酸作為能源，三酸甘油酯中的丙三醇會被轉化為葡萄糖供腦作為能源使用，而脂肪酸也可在肝中轉化為大腦可利用的酮體。假如腦對葡萄糖的需要大於身體內的含量時，脂肪細胞也會將三酸甘油酯分解。……三酸甘油酯一旦過度增加，良性的高密度脂蛋白膽固醇會減少；而惡性的低密度脂蛋白膽固醇可能在血管壁內堆積，導致通道變窄。有時可能形成凝塊。….~維基百科)
Exercise rouses cells to become more responsive to insulin, so they remove more glucose from the blood. Muscle contractions activate a protein in muscle and fat cells called AS160, which improves glucose absorption. Once activated, AS160 spurs the cells to send ‘transporter molecules’ to their outer surface to draw glucose inside. Without those transporters, glucose can’t pass through the cell membrane.
運動增強了細胞對胰島素的敏感度，可以把更多的葡萄糖(血糖)從血液中移出。肌肉的收縮，會驅動肌肉和脂肪細胞中AS160蛋白質，促進葡萄糖的吸收。AS160一旦開始運作，傳輸分子就會分佈在細胞外側來吸收葡萄糖。沒有那些傳輸分子，葡萄糖是無法穿過細胞膜而被吸收的。
This isn’t the only beneficial effect of exercise. Active muscles use up lots of adenosine triphosphate, the molecule (ATP) that fuels most living cells. As ATP dwindles, an enzyme called AMPK triggers cells to generate ATP by absorbing and burning more fatty acids and glucose. Muscle contractions activate AMPK, encouraging this process.
肌肉會用三磷酸腺苷(ATP)來產生能量。當三磷酸腺苷(ATP)不足的時候，收縮的肌肉會促使AMPK這種酶的分泌。AMPK則吸收、燃燒脂肪酸及葡萄醣來產生肌肉需要的三磷酸腺苷(ATP).
(所以，運動的人不會肥胖)
Added protection against cancer might also come from exercise’s ability to activate AMPK. Another of this enzyme’s jobs is to dispose of unwanted cell detritus, including faulty or mutated DNA that might trigger cancer if it stayed around. The same process also works in brain cells, suggesting that exercise might help to stave off neuro-degeneration.
運動產生的AMPK酶，也有助於清理細胞廢棄殘渣，包括有問題的細胞或DNA變異的細胞，可以防癌。同一個道理，運動也有助於清理我們的腦，避免神經細胞退化。
Since then, more evidence has stacked up, especially for elderly people. Over-fifty-fives who do not exercise tend to have poorer cognitive functions – such as memory and learning skills – than contemporaries who swim, garden or cycle a few times a week. Such activities also appear to have lasting benefits: middle-aged people who exercise at least twice a week cut their risk of developing dementia in their sixties and seventies..
規律的運動(游泳、園藝、騎自行車等等)有助於促進記憶及學習等認知能力，這對上了年紀的人(55歲以上的人)益形重要。從中年開始有運動習慣的人，到了六、七十歲患失智症的風險將大幅降低。
…The brain needs a large supply of oxygen and nutrients via an intricate network of capillaries. Exercise encourages growth of these supply lines.…
腦的運作有賴健全的毛細微血管把氧和養料送達。運動可以促進毛細微血管的健全。
Exercise keeps the brain running smoothly, too. It stimulates the release of neurotransmitters, such as dopamine, serotonin and noradrenaline, which regulate signalling in the brain. These are the same compounds that drugs for attention-deficit hyperactivity disorder and depression are designed to increase. Physical activity also triggers the release of compounds, such as “insulin-like growth factor-1‘ and ’brain-derived neurotrophic factor, that encourage the growth of new neurons and connections between them.
運動刺激神經傳輸物質的分泌：多巴胺、血清素、正腎上腺素。治療注意力不足過動症及憂鬱症的藥物中，就有一樣的物質。
運動也會促進「類胰島素生長因子-1」、「腦源性神經營養因子」的分泌，這些會促進神經元及神經傳導的生長。
結論：要運動，而且要規律的運動，那樣有益身心(腦)的健康。
根據更新的研究顯示，運動不是促進腦的認知能力的充分條件，而是必要條件。運動不必然腦袋一定更靈光，但是腦袋要更靈光、認知能力要更好，不運動是不行的。
找一種強度與時間足夠，而且對自己方便易行喜歡的運動方式，然後持之以恆，就是身心健康之道。
*：New Scientist, How to be human, 2019, New Scientist
2024/11/16 運動 Damakey
