Cardio Works!
Updated: Oct 13
The Most Powerful Anti-Inflammatory Strategy You’re Not Using Enough
When most people think about cardiovascular exercise, they think about the heart. Perhaps weight loss. Maybe endurance.
But aerobic training is not just about your heart. It is about energy production, inflammation control, vascular integrity, and brain resilience. It is a systems-level intervention that affects nearly every organ in the body.
In clinical practice, I often see patients who describe low energy, brain fog, slow recovery, or persistent inflammation. Many assume these are inevitable parts of aging. They are not. In many cases, they reflect a decline in aerobic capacity and mitochondrial efficiency.
Cardiovascular training is one of the most powerful biological regulators available to us. And it works at any age.
The Energy Story: Why Mitochondria Matter
Every cell in your body depends on structures called mitochondria. These are often referred to as the “power plants” of the cell because they generate ATP, adenosine triphosphate, the molecule that fuels movement, healing, immune function, and cognition.
When aerobic exercise is performed consistently, especially at moderate intensities, it stimulates a process known as mitochondrial biogenesis. This simply means your body builds more mitochondria and improves their efficiency. The molecular driver behind this process includes signaling pathways such as PGC-1α, which regulate energy metabolism.
More mitochondria means:
Improved energy production
Better fat oxidation
Enhanced insulin sensitivity
Reduced fatigue during daily activities
Energy is not just psychological. It is biochemical. When mitochondrial density declines, energy production declines. Aerobic training reverses that trajectory.
This is one reason individuals who begin consistent Zone 2 training often report improved clarity and sustained energy, even before major changes in body composition occur.
Cardiovascular Exercise and Inflammation
One of the most misunderstood aspects of exercise is inflammation.
Acute exercise temporarily increases inflammatory signals. Yet over time, regular aerobic training lowers baseline systemic inflammation. This is one of its most important long-term benefits.
Chronic low-grade inflammation, sometimes referred to as “inflammaging,” is associated with:
Cardiovascular disease
Type 2 diabetes
Sarcopenia, age-related muscle loss
Neurodegenerative disorders
Contracting muscle acts as an endocrine organ, releasing signaling molecules known as myokines. One of these, interleukin-6 (IL-6), behaves differently when released during exercise than during illness. In the context of aerobic training, IL-6 stimulates anti-inflammatory mediators such as IL-10 and IL-1 receptor antagonist, while helping suppress pro-inflammatory cytokines like TNF-α.
In simple terms, regular aerobic exercise shifts the body toward an anti-inflammatory state.
If chronic inflammation drives aging and disease, then aerobic exercise is not optional. It is foundational.
The Vascular System: Protecting the Inner Lining of Your Arteries
The endothelium is the delicate inner lining of blood vessels. It plays a critical role in regulating blood flow, blood pressure, and clotting.
Aerobic exercise improves endothelial function by increasing nitric oxide availability. Nitric oxide is a molecule that allows blood vessels to dilate, improving circulation and reducing vascular stiffness.
The result?
Lower resting blood pressure
Improved arterial compliance
Better oxygen delivery to tissues
Reduced risk of vascular-related cognitive decline
The health of your brain is directly tied to the health of your blood vessels. Compromised vascular function reduces cerebral perfusion, which, over time, contributes to cognitive impairment.
Cardiovascular training protects both the pipeline and the organ it supplies.
The Brain: BDNF and Cognitive Resilience
Aerobic exercise does something remarkable for the brain. It increases levels of brain-derived neurotrophic factor (BDNF), a protein that supports the growth and survival of neurons.
BDNF enhances:
Synaptic plasticity
Learning
Memory
Hippocampal volume
The hippocampus is the brain region central to memory formation. Studies have shown that aerobic exercise can increase hippocampal volume in older adults, counteracting age-related shrinkage.
Meta-analyses have demonstrated that the most physically active individuals have a significantly lower risk of cognitive decline compared to sedentary peers.
While pharmaceutical interventions for dementia offer modest symptomatic improvement for some patients, aerobic exercise influences upstream mechanisms, including vascular health, inflammation, insulin sensitivity, and neurotrophic signaling.
It does not target a single pathway. It regulates the system.
Why Zone 2 Training Deserves Attention
Not all cardio produces the same adaptations.
Zone 2 training refers to moderate-intensity aerobic work performed at approximately 60–70% of your maximum heart rate. At this level, you can speak in short sentences, but sustained conversation becomes difficult.
How to Calculate It
Estimate your maximum heart rate:220 − your ageExample: A 60-year-old → 220 − 60 = 160 bpm
Multiply that number by 0.60 and 0.70.For this example:160 × 0.60 = 96 bpm160 × 0.70 = 112 bpm
So Zone 2 would fall roughly between 95–110 bpm.
A more precise method uses heart rate reserve, but for most people, this estimate is sufficient. If you have cardiovascular disease, metabolic conditions, or other medical concerns, consult your physician before beginning a new exercise program.
Why It Works
At this intensity, the body primarily relies on oxidative metabolism, meaning:
Greater fat oxidation
Increased mitochondrial density
Improved lactate clearance
Stronger aerobic base without excessive stress hormone response
Many people oscillate between inactivity and overly intense workouts. Zone 2 is neither extreme. It is strategic.
For most adults, this means brisk walking, steady cycling, swimming, or rowing at a consistent, purposeful pace.
Zone 2 is not flashy. It is foundational.
Cardiovascular Fitness Across the Lifespan
Children and Adolescents
Aerobic activity enhances executive function and cognitive development. Movement is a stimulus for brain maturation.
Adults
Cardiorespiratory fitness is strongly associated with reduced risk of metabolic syndrome, cardiovascular disease, and all-cause mortality. It improves stress resilience and autonomic balance.
Older Adults
Declining VO2 max, the maximal capacity to utilize oxygen, is one of the strongest predictors of mortality. Aerobic training slows that decline.
In individuals over 65, moderate aerobic exercise improves cognitive function, preserves independence, and reduces fall risk indirectly by enhancing endurance and confidence in movement.
The recommendation is clear:
150–300 minutes of moderate aerobic activity per week
Or 75–150 minutes of vigorous activity
Ideally distributed across 4–6 days
Consistency matters more than intensity extremes.
Conclusion
Cardiovascular exercise is far more than a strategy for weight control or heart health. It regulates energy production, acts as an anti-inflammatory signal, protects the vascular system, and stimulates brain growth and resilience. It strengthens mitochondria, stabilizes blood vessels, enhances neuroplasticity, and preserves VO₂ max, a strong predictor of longevity.
In a world focused on quick fixes and isolated treatments, aerobic training stands out for its ability to improve the entire system. It is accessible, adaptable at any age, and profoundly protective. The long game of health is not built on extremes. It is built on consistency.
References
Ashor, A. W., Lara, J., Siervo, M., Celis-Morales, C., & Mathers, J. C. (2014). Effects of exercise modalities on arterial stiffness and wave reflection: A systematic review and meta-analysis of randomized controlled trials. PLOS ONE, 9(10), e110034.
Blair, S. N., Kohl, H. W., Paffenbarger, R. S., Clark, D. G., Cooper, K. H., & Gibbons, L. W. (1989). Physical fitness and all-cause mortality: A prospective study of healthy men and women. JAMA, 262(17), 2395–2401.
Cotman, C. W., & Berchtold, N. C. (2002). Exercise: A behavioral intervention to enhance brain health and plasticity. Trends in Neurosciences, 25(6), 295–301.
Egan, B., & Zierath, J. R. (2013). Exercise metabolism and the molecular regulation of skeletal muscle adaptation. Cell Metabolism, 17(2), 162–184.
Erickson, K. I., Voss, M. W., Prakash, R. S., et al. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences, 108(7), 3017–3022.
Gleeson, M., Bishop, N. C., Stensel, D. J., et al. (2011). The anti-inflammatory effects of exercise: Mechanisms and implications for the prevention and treatment of disease. Nature Reviews Immunology, 11(9), 607–615.
Green, D. J., Hopman, M. T., Padilla, J., Laughlin, M. H., & Thijssen, D. H. (2017). Vascular adaptation to exercise in humans: Role of hemodynamic stimuli. Physiological Reviews, 97(2), 495–528.
Hamer, M., & Chida, Y. (2009). Physical activity and risk of neurodegenerative disease: A systematic review of prospective evidence. Psychological Medicine, 39(1), 3–11.
Holloszy, J. O. (1967). Biochemical adaptations in muscle: Effects of exercise on mitochondrial oxygen uptake and respiratory enzyme activity. Journal of Biological Chemistry, 242(9), 2278–2282.
Mandsager, K., Harb, S., Cremer, P., et al. (2018). Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. JAMA Network Open, 1(6), e183605.
Myers, J., Prakash, M., Froelicher, V., et al. (2002). Exercise capacity and mortality among men referred for exercise testing. New England Journal of Medicine, 346(11), 793–801.
Pedersen, B. K., & Febbraio, M. A. (2008). Muscle as an endocrine organ: Focus on muscle-derived interleukin-6. Physiological Reviews, 88(4), 1379–1406.
Peters, R., Beckett, N., Forette, F., et al. (2019). Incident dementia and blood pressure lowering in the HYVET study. Journal of Hypertension, 37(6), 1165–1173.
World Health Organization. (2020). WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization.
DR. BRIAN ABELSON, DC. - The Author
Dr. Brian Abelson is a chiropractor, author, and educator with more than 30 years of clinical experience in musculoskeletal care, rehabilitation, and sports performance. His educational work focuses on musculoskeletal conditions, human movement, sports biomechanics, and evidence-informed approaches to treatment and rehabilitation.
He is the developer of Motion Specific Release (MSR) and Clinical Director of Kinetic Health in Calgary, Alberta, Canada.
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