Cardiovascular Exercise
- Dr. Brian Abelson
- 4 hours ago
- 9 min read
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.
Trajectory
Many of the principles discussed in this article are explored more fully in my forthcoming book, Trajectory. Chapter 1 examines movement as a foundational pillar of health, encompassing cardiovascular training, strength, mobility, balance, and proprioception. It explores how these elements interact to influence mitochondrial function, inflammatory regulation, vascular integrity, neurological resilience, and long-term independence.
Scheduled for release in late 2026 or early 2027, Trajectory integrates neuroscience, physiology, and practical application into a cohesive, evidence-informed framework. Rather than viewing exercise as a single intervention, the book presents movement as a lifelong strategy, one that shapes energy production, cognitive performance, functional capacity, and biological aging across decades.
References
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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
With over 30 years of clinical experience and more than 25,000 patients treated, Dr. Brian J. Abelson is the creator of Motion Specific Release (MSR), a multidisciplinary assessment and treatment system that integrates biomechanics, fascia science, neurology, manual therapy, exercise rehabilitation, and acupuncture. He is an internationally recognized best-selling author of 10 books and 200+ articles, and has trained healthcare professionals through structured MSR courses and clinical education programs throughout Canada and the United States. Dr. Abelson practices at Kinetic Health in Calgary, Alberta, and continues to develop educational resources focused on long-term function, resilience, and the health trajectory shaped by everyday choices.
For patients, his goal is simple, reduce pain, restore movement, and build long-term independence. For practitioners, MSR provides a practical framework you can integrate directly into daily clinical care.
Why Choose MSR Courses and MSR Pro?
Elevate your clinical practice with Motion Specific Release (MSR) training and MSR Pro, a comprehensive, evidence-informed approach to musculoskeletal assessment and treatment designed to improve diagnostic precision, hands-on skill, and patient outcomes.
MSR proficiency goes far beyond videos and articles. True clinical mastery requires hands-on training, refinement of palpation and force application, and a deeper command of applied anatomy and biomechanics. MSR is a skill-based system built through deliberate practice, real-time feedback, and mentorship, where clinical reasoning and tactile execution come together.
Here’s why practitioners join MSR:
Proven Clinical SystemDeveloped by Dr. Brian J. Abelson, DC, with over 30 years of clinical experience and more than 25,000 patients treated, MSR integrates the most effective components of osseous and myofascial therapies into a cohesive, repeatable framework. The system is grounded in clinical logic and supported by patient outcomes, with a clinic success rate exceeding 90% in decreasing pain and improving function.
Comprehensive, Practical TrainingCourses blend rigorous clinical education with hands-on technique development. You’ll strengthen orthopedic and neurological examination skills while learning targeted myofascial procedures, fascial expansion concepts, and osseous adjusting and mobilization strategies that translate directly into daily practice.
MSR Pro, Your Clinical LibraryAs an MSR Pro subscriber, you gain access to a growing library of 200+ MSR procedures, instructional videos, downloadable and fillable clinical forms, and in-depth practitioner resources that support the full clinical workflow, from intake to reassessment and exercise prescription.
Ongoing Support and UpdatesMSR Pro includes an extensive resource base of 750+ videos, including technique instruction, rehabilitation exercise progression, and clinical application guidance, supported by a large MSK article library and condition-based resources. Content is actively updated and expanded to reflect evolving clinical needs and course development.
A System Built for GrowthMSR is designed to help practitioners think clearly in complex presentations, develop adaptable strategies, and evolve as clinicians. This approach aligns with the broader Trajectory principle, better outcomes are built through the cumulative power of consistent, high-quality clinical decisions.
Unlock your practice’s full potential with MSR Courses and MSR Pro, and join a community of practitioners committed to excellence in musculoskeletal care.
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Explore Dr. Abelson’s YouTube channel, Kinetic Health Online, with 200,000+ subscribers and 37+ million views.
The channel features a large library of evidence-informed musculoskeletal education, including Motion Specific Release (MSR) procedures that integrate fascial-based concepts, manual therapy, movement science, and select Traditional Chinese Medicine (TCM) principles.
You’ll also find:
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Hundreds of mobility, strengthening, and rehab exercise demonstrations
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