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Hypertrophic cardiomyopathy: New rules say you can exercise

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Hypertrophic cardiomyopathy: New rules say you can exercise

About 1 in 500 people have hypertrophic cardiomyopathy (HCM).

It’s a condition where the heart muscle becomes abnormally thick.

HCM is one of the most common causes of sudden death among young athletes and otherwise healthy adults.

In the past, athletes and other patients with hypertrophic cardiomyopathy were told to sit on the sidelines.

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But it may be time to get back into the game.

The American Heart Association and the American College of Cardiology recently released new guidelines on this condition.

The guideline’s writing committee chair and Mayo Clinic Hypertrophic Cardiomyopathy Clinic medical director Dr Steve Ommen says that with exercise and proper medication management, patients can return to their normal daily routines.

“Hypertrophic cardiomyopathy should not be an automatic disqualification from pursuing sports,” he says.

Patients with HCM might benefit from being active, he notes.

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“Our current recommendations are that patients with hypertrophic cardiomyopathy participate in low to moderate intensity exercise as part of a healthy lifestyle, and that it’s reasonable for them to do more vigorous activities as well,” he says.

A new class of medications is on the roster, giving patients more options to manage their disease.

“Usually, there’s some simple medications the patient may try first, and then, if that’s not effective, they will have an option of this medication; an older medication called disopyramide; an operation called surgical myectomy; or a catheter-based solution, alcohol septal ablation,” Dr. Ommen explains.

It’s a good idea to check with your healthcare team before making changes to medications or daily routines.

HCM symptoms include:

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  • Chest pain, especially while exercising.
  • Fainting during or after physical activity.
  • Shortness of breath during exercise.
  • Heart palpitations or rapid heartbeats. – Sonya Goins/Mayo Clinic News Network/Tribune News Service
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Figuring out the best time to exercise

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Figuring out the best time to exercise

It’s a long-standing discussion for all who want to get into shape: When is the best time to exercise?

Based on member data from American fitness company Future, about 41% of workouts take place between 7-9am or 5-7pm.

“The debate is intriguing with proponents of both morning and evening workouts citing various benefits,” says sports medicine research director Dr Andrew Jagim from the Mayo Clinic Health System in Wisconsin, United States.

“From increased energy levels to enhanced performance or greater weight-loss benefits, health experts delve into the science behind exercise timing to shed light on the optimal approach for achieving fitness goals.”

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In the morning

For morning exercisers, the allure of starting the day with a workout is undeniable.

“Getting your workout in and completed before you even begin your day can provide a sense of accomplishment and set a positive tone for the day ahead,” explains Dr Jagim.

“The post-workout release of endorphins and the satisfaction of accomplishing something before 9am can serve as a powerful ego boost.”

Perhaps most importantly, morning workouts eliminate the need to worry about finding time for exercise later in the day.

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This is as it’s often the only time of the day that hasn’t been previously committed to work, social events or family activities.

“By completing your workout in the morning, you free up your afternoons and evenings for other activities, such as cooking dinner, socialising or simply relaxing,” Dr Jagim notes.

“This sense of freedom and flexibility can alleviate stress and enhance overall well- being.”

For people embarking on morning workouts, strategic pre-exercise nutrition can make a significant difference in energy levels and performance.

“Starting the day with a balanced breakfast containing carbohydrates, protein and healthy fats can provide the necessary energy to power through a morning workout,” he advises.

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“Opt for wholegrain cereals, Greek yoghurt with fruit, and allow sufficient time for digestion to prevent discomfort and optimize nutrient absorption.

“Or, if you’re not hungry in the mornings or don’t have time, something simple like an energy bar can suffice.”

In the evening

However, for some people, waking up early to exercise is the last thing they feel like doing, and therefore, the case for evening workouts is more appealing.

“Your body’s ability to perform peaks in the afternoon and early evening, with optimal muscle function, strength and endurance,” states osteopathic medicine practitioner Jake Erickson, who specialises in sports medicine at the Mayo Clinic Health System in Onalaska, Wisconsin.

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“During this time, your body has time to wake up a bit by moving around throughout the day, you’ve likely gotten a meal or two in to ensure adequate energy available to use during the workout, and you may be more mentally alert.”

Additionally, oxygen uptake kinetics are more favourable in the evening, allowing for more efficient utilisation of resources during exercise.

“Your body is primed for performance in the late afternoon and early evening, making it an ideal window for high-intensity activities like interval training or speed work,” he explains.

Conversely, people opting for evening workouts face unique considerations in balancing time commitments and mental energy.

“After a long day at work or shuttling around the kids all day, it can be hard to muster the motivation to go to the gym and put forth a lot of physical effort during a workout,” says osteopathic medicine practitioner Alecia Gende, who specialises in sports medicine and emergency medicine at Onalaska’s Mayo Clinic Health System.

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“Additionally, intense physical activity in the evening may trigger a stress response and cause difficulty falling asleep or waking in the middle of the night if your cortisol is disrupted and released at an inopportune time.

“If you have to get a workout in before sleep, it would be best to be lower intensity, such as a walk or lighter (weight-)lifting session.

“If that’s the case, moving the workout earlier in the day might be more beneficial for them.”

Lastly, if you choose to work out later in the day, it’s important to ensure that you are getting adequate nutrients throughout the day to make sure you have enough fuel available to support the workout, in addition to eating a well-balanced meal after the workout.

“After a long day, it’s essential to refuel the body with carbohydrates and protein,” Dr Jagim says.

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“Consuming a nutrient-rich meal within two hours of your workout can facilitate muscle recovery and enhance adaptation to training.

“Consider options such as grilled chicken with quinoa and vegetables, or a protein-packed stir-fry to refuel and replenish after an evening workout.”

For people engaging in prolonged or intense exercise sessions (more than 90 minutes), mid-workout nutrition can play a pivotal role in sustaining energy levels and preventing fatigue.

He recommends incorporating carbohydrate-rich snacks during extended workouts to maintain endurance and performance.

At midday

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Whether working or at home, most people hit the dreaded afternoon slump around 3pm.

A study of more than 90,000 people recently found that working out in the afternoon reduces the risk of heart disease or early death more than physical activity in either the morning or afternoon.

The benefits of afternoon exercise for longevity were most pronounced for men and the elderly.

“Morning workouts may not be ideal for shift workers, or those working late or staying up later in the evening,” says Gende.

“In that case, it may be more prudent to allow more sleep in the morning and perform a mid-day workout or early afternoon workout before your next evening shift or late night.”

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According to a OnePoll survey, the most effective activity for people during an afternoon workout is getting up and going for a walk, which is a great way to perk up both your mind and body.

Find your right time

So, what is the best time to exercise?

For those who just say I don’t have any time available, there’s always time.

“I suggest scheduling a ‘snack competing’ activity,” says Erickson.

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“This can be a good excuse to flip the script, and for people who know they may choose to sit on the couch and snack in the evenings.

“They can use that time to grab a workout of some kind instead.

“This can lead to a big swing in people’s fitness as they consume less calories by avoiding the typical snacking time and burn more calories by the workout.”

There are even benefits to splitting up a workout into short 10-minute mini-sessions throughout the day if you don’t have time to get a full 60-minute session in.

ALSO READ: Always busy? Try stacking short workouts throughout your day

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One thing is clear; even though science may seem contradictory, the importance of regular physical activity cannot be overstated.

“Ultimately, the best time to exercise is the time that fits into your schedule and aligns with your energy levels and preferences,” says Dr Jagim.

“Consistency and adherence to a regular exercise routine are key, and far more important, regardless of the time of day you choose to work out.

“Any time of day is better than no exercise in reducing the risk of death from any cause, including from heart disease and cancer specifically.

“Experimentation and self-awareness are essential in determining the ideal timing toward optimising exercise performance, recovery and overall well-being.” – By Rick Thiesse/Mayo Clinic News Network/Tribune News Service

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Cycle syncing: how tracking your period can help you exercise better

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Cycle syncing: how tracking your period can help you exercise better

Excuses for avoiding exercise aren’t hard to come by. You’ve had a long day; it looks like rain. “Being on my period” might be on that list — but not for much longer. Research is challenging the narrative that fitness and menstruation aren’t compatible.

Instead, according to a new University College London study, women’s reactions and mental agility can improve during their periods. Scientists concluded that “though participants reported feeling worse during menstruation and perceived that this negatively impacted their performance, their reaction times were faster and they made fewer errors”.

This is why “cycle syncing” — tracking the menstrual cycle to dictate how you exercise — could be key to shaping how women approach sport.

As with much related to women’s health, there hasn’t

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The unique exercise this neuroscientist does for optimal brain health: 'Physical activity is so powerful for our brain'

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The unique exercise this neuroscientist does for optimal brain health: 'Physical activity is so powerful for our brain'

To keep your brain health in good shape, you should engage in physical activity as often as you can. 

“Physical activity is so powerful for our brain,” Dr. Wendy Suzuki, neuroscientist and dean of NYU College of Arts and Science, said in an episode of a recent MasterClass series that features neuroscientists and psychiatrists sharing advice for optimal brain health.

Suzuki mentioned how walking 10 minutes a day can do wonders for your mood and that strategic sports like soccer and basketball engage your prefrontal cortex more than other exercises. But the workout in Suzuki’s weekly routine is much different than most others.

“I got pulled back into exercise from couch potato land with this amazing form of workout,” Suzuki said. “It’s called intenSati.”

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The front half of the name “inten” stems from the word “intention,” Suzuki said. “Sati is a Pali word that means mindfulness or awareness.”

Cardio plus mantras is this neuroscientist’s preferred exercise for brain health

IntenSati involves moving your body while speaking affirmations out loud, Suzuki said. It was created by Patricia Moreno in 2002.

“This workout pairs high-energy cardio moves with high-emotion mantras that will leave you uplifted, connected, and strong,” according to the official website for intenSati.

Speaking positive affirmations out loud can strongly impact your outlook on life and your overall mood, Suzuki said.

“If you shout out that you believe you will succeed, you are inspired, you are strong, for a whole hour with a whole bunch of other sweaty, affirmations-shouting people, you come out of that class feeling amazing.”

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A recent study done at the University of California Berkeley encouraged 135 undergraduate students to say compassionate things to themselves for 20 seconds a day, coupled with compassionate touch like placing a hand on their heart. After one month of consistently doing this practice, students reported feeling less stress and seeing improvements in their mental health.

“But whatever the form of workout that you do, any time of day you can work out is the best time of day to workout because our lives are so busy,” Suzuki said.

A 2022 study that examined the health information of more than 500,000 people found that those who regularly engaged in vigorous physical activity like exercise and sports decreased their risk of developing dementia by 35%.

But even doing household chores regularly lowered an individual’s risk by 21%.

“Every single drop of sweat counts for your brain,” she said, “And that’s good news.”

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