Alzheimer’s disease (AD) is one of the most common neurological disorders that are prevalent worldwide. In the pathogenesis of this disease, complex factors such as environmental factors, biological factors, and mutations in some genes (amyloid β (Aβ), amyloid precursor protein (APP), persinilin 1 and 2 (PS1/2)) are involved (
1,
2). Increased amyloid plaques and hyperphosphorylation of tao protein increase neuroinflammation. This neuroinflammation leads to increased oxidative stress, activated nicotinamide adenine dinucleotide phosphate (NADPH) oxidase, and interactively with increasing inflammation leads to disruption of ATP production in neurons (
1). It is also believed that neuronal loss following AD plays a role in transcriptional dysfunction of metabolic genes and impaired DNA methylation (
3). Thus, disruption of enzymes responsible for DNA splicing, such as O-6-methylguanine DNA methyltransferase (MGMT), inhibits DNA-dependent ATPase-encoding genes (
4,
5).
However, due to the rapid progression of this disease, researchers consider lifestyle changes as effective ways to treat chronic and non-communicable diseases so that researchers have suggested that aerobic and endurance training have beneficial effects on brain function, neuroplasticity, cerebral blood flow, and memory and learning in these patients (
6). Exercise seems to activate some of the DNA splicing enzymes, such as 8-oxoguanine DNA glycosylase-1 (OGG1), and reduces DNA damage in muscle and brain by activating the respiratory nucleus proteins 1 and 2 (NRF1/2) and sirtoin 1 and sometimes modulating cellular redox (
7). Researchers have reported beneficial effects of aerobic exercise on the mental, physical and cognitive health of patients with AD, the intensity, duration of activity, and the most effective duration of exercise, as well as the type of exercise based on differences in contraction and related adaptations, are not yet fully understood (
8). In this regard, the results showed that endurance training reduced C-reactive protein in the muscle tissue of AD rats (
9). In addition, endurance training on different slopes has been one of the challenges in assessing the type of adaptation in the cognitive function of AD animal models. Accordingly, the researchers showed that the positive slope running (ETPS) reduced the pain tolerance threshold, but the negative slope running had no significant effect on it (
10); eight weeks of voluntary and forced training improved avoidance memory and spatial memory in AD rats (
11). Also, the endurance training, resistance training, and combined training have beneficial effects on reducing DNA damage in the brain tissue. Brain-derived neurotrophic factor (BDNF), cAMP-activated protein kinases, and activation of cyclic AMP response element-binding (CREB) protein reduce 8-hydroxy-2-deoxyguanosine and decrease DNA damage (
12); eight weeks of aerobic exercise reduced oxidative stress and increased MGMT expression (
13,
14).
On the other hand, the use of natural antioxidant supplements has been considered by researchers. Among the herbal antioxidant supplements, royal jelly (RJ), due to its anti-inflammatory, antioxidant, anti-diabetic effects, and beneficial impacts on neurotrophins has favorable effects on patients with AD. In this regard, researchers have shown that the use of royal jelly by decreasing oxidative stress, increased neuroplasticity and BDNF in the brain tissue of AD rats (
15). Consumption of honey and its products also improves nerve tone function, reduces oxidative stress, reduces apoptosis, and reduces DNA damage in the brain tissue (
16). In another study, researchers showed that the use of RJ by cAMP/PKA/CREB/BDNF mechanism inhibits nerve cell apoptosis and reduces DNA damage (
17). Although in previous studies, the favorable interactive effects of training and RJ consumption on neurotrophins (
15), cognitive function (
11), and inflammatory factors (
9) have been reported, the exact mechanism of these two interventions on the pathways for DNA repair and transcription of metabolism-related genes (ATPase) are not yet fully understood.