Checkmate Stress: How Nutrition, Exercise, and Heart Rate Variability Can Help You Win more at Chess!

As part of my research for my talk at the Global Chess Festival in 2021, I measured my heart rate and calorie burn across various activities – as you see in the below graph, competitive chess was right up there alongside high intensity interval training (walk/run on a treadmill). As Robert Sapolsky mentioned back in 2009, chess players can burn up to 6000 calories per day! The Netflix documentary called Chess Explained goes on to add that during a tournament a chess players blood pressure can be as high as a marathon runner, and they can burn up to 6000 calories a day, more than a World Class Tennis Player!

This is because the brain while being just 2% of the body’s weight, accounts for 20% of the energy use – and up to 50% in case of a six-year-old! Hence, it’s very critical to “eat right” to ensure stable energy levels during a game! 

read that Magnus, for example, switched from orange juice to drinking a combination of chocolate and regular milk to ensure sustained energy levels during long games!

Competition induces a significant amount of pressure to win causing fear, anxiety and stress, temporarily causing heart rate to increase to deal with the situation (“fight/flight”)! To keep our nervous system balanced, we must learn to build resistance to stress and also recover from it! Mental boot camps, where we practice stressful situations via simulation with controlled doses of stress, can help build resistance to stress and increases tolerance to anxiety. Fitness training, physical and mental, are critical as well. Physical fitness enables a stronger heart that is more resilient to very high heart rates!

Breathing helps you relax, lowering stress/anxiety and accelerating recovery, helping balance our nervous system! Vidit, for example, always takes a few moments to breathe before he starts his game – to balance his nervous system by optimizing his heart-brain connection and hence ability to recovery from stressors during the game, switching quickly between alert and calm mental states!

Let’s now discuss a very important concept and tool – Heart Rate Variability. HRV is essentially the time interval between two successive heart beats. And as you can see below, it varies with each Heartbeat, hence called Heart Rate Variability.

“Rhythm of a healthy heart, even under resting conditions, is actually surprisingly irregular, with the time interval between consecutive heartbeats constantly changing! This naturally occurring beat-to-beat variation in heart rate is called Heart Rate Variability (HRV)” – HeartMath.

And HRV reflects our ability to recover from stress – higher the better. It is trainable and a lot of professional athletes are using HRV biofeedback to optimize their training and performance! It is important to understand that the Heart Brain connection is bi-directional – heart signals impact our brain functions like focus, problem-solving and decision making – critical for chess. And positive emotions ensure orderly signals from the heart to brain that enable cognitive functions - critical for high performance!

Essentially HRV is due to the synergistic action of two branches of our nervous system – and much like the accelerator and brake of a car, HRV waveform has a strong connection to our performance and a rhythmic waveform generated by sustained positive emotions lead to optimized performance of our brain and body! HRV Training is essentially resonance breathing (4s inhale, 6s exhale) combined with visualization (positive emotions). Regular training enables quick recovery from a moment of stress as simply breathing the same way would balance your nervous system and help you recover from your stressor, allowing logic to prevail! So, the next time you make a mistake, blunder or even just worried about your position, simply breathe!

I practiced HRV training (using resonance breathing with 4s inhale + 6s exhale and positive emotion visualization) for a month while playing chess. The result? My HRV improved, and my chess skills got better too! Specifically, I improved at converting advantages, handling endgames, and managing time more effectively, according to AimChess analytics!

Coming soon: Closing Thoughts and Advice

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Doctors may use breathing tests like spirometry to confirm an asthma diagnosis. In younger children, an examination of symptoms alone may be enough for a diagnosis.

Asthma is a chronic lung condition affecting nearly 25 million people in the United States, or about 8% of the population.

People with asthma experience repeated flare-ups of wheezing, coughing, and shortness of breath. Every year, this leads to millions of missed school and work days as well as millions of doctor’s office and emergency department visits.

Once you’ve received a diagnosis of asthma, a doctor can help treat and control your symptoms. But although asthma is very common, the diagnosis can be surprisingly challenging, especially in young children.

Keep reading to learn more about how doctors arrive at an asthma diagnosis.

In a diagnostic spirometry test, a healthcare professional will ask you to take a deep breath and blow hard into a large tube. You’ll do this before and after taking a bronchodilator such as albuterol. A machine will then measure your breathing patterns and lung function, determining whether you have the reversible airway obstruction seen in asthma.

Spirometry is the best diagnostic test for asthma. Later, it can also help doctors measure your response to asthma treatment.

But spirometry isn’t perfect. It requires cooperation, coordination, and forceful breathing. Accurate spirometry typically isn’t possible in children under 5 years old. Some healthcare professionals don’t use spirometry to test for asthma in children until they’re age 8 years or older.

Other potential breathing tests for asthma include:

  • Methacholine challenge: In a methacholine challenge test, you’ll inhale another medication before repeating spirometry.
  • Fractional exhaled nitric oxide (FeNO): In FeNO testing, you’ll briefly blow into a tube attached to a small machine. If you have airway inflammation or irritation due to asthma, you’ll exhale slightly higher levels of nitric oxide.
  • Peak flow meter: Peak flow meter testing involves blowing into a small handheld device to move a toggle. This test is most useful for monitoring older children and adults who already have an asthma diagnosis.

Allergy tests can’t diagnose asthma. But they can identify allergies that could be causing or worsening your asthma symptoms.

Researchers estimate that allergies are an asthma trigger in up to 80% of children and more than 50% of adults. If allergies aggravate your asthma, treating them can help get your asthma under better control. Typical allergy tests include skin prick testing and blood testing for allergen-specific antibodies.

Sometimes, exercise triggers asthma symptoms. If initial testing doesn’t reveal symptoms of asthma, a healthcare professional might ask you to perform spirometry after exercising, such as on a treadmill or stationary bike, in the clinic.

Blood tests alone can’t diagnose asthma. But a doctor might order blood allergy testing, an eosinophil count, or additional blood tests to check for different medical conditions that can cause shortness of breath.

During an acute asthma exacerbation, doctors might need other blood tests to monitor your overall condition.

Although asthma symptoms frequently begin in early childhood, asthma is hard to diagnose in young children. This is because wheezing with cold viruses is very common in preschoolers. However, most of these children won’t go on to develop asthma.

More definitive asthma tests, like spirometry or FeNO, aren’t typically useful until the age of 5 years.

If you’re concerned that your young child might have asthma, doctors can often make a clinical diagnosis after talking with you and examining your child.

For older children and adults, doctors can order diagnostic spirometry and additional supporting tests to confirm a suspected asthma diagnosis.

Here are answers to some common questions about asthma diagnosis.

At what age does asthma start?

Asthma usually begins in early childhood, but it’s difficult to diagnose in very young children. In the United States, asthma prevalence is highest among teenagers ages 12–17 years.

But asthma can begin at any age, including during adulthood. Global research shows a second asthma incidence peak around age 65 years.

Does asthma show up on an X-ray?

Some chest X-ray findings, such as lung hyperinflation or bronchial wall thickening, may suggest asthma. However, a chest X-ray alone cannot diagnose asthma, as such findings could indicate other conditions as well.

Still, a doctor may order a chest X-ray, especially during an acute asthma attack. They do this to make sure there’s no other cause for your symptoms, such as a lung infection.

How can I self-diagnose asthma?

If you suspect that you or your child might have asthma, it’s very important to bring the symptoms to the attention of a healthcare professional.

Repeated episodes of wheezing, shortness of breath, or prolonged coughing might indicate asthma.

If you can, make note of when your symptoms started and what seems to trigger them, and review your family’s medical history thoroughly. Then, contact a doctor to discuss evaluation for possible asthma.

Diagnostic breathing tests, like spirometry and FeNO, are common ways for doctors to confirm an asthma diagnosis in older children and adults. Allergy testing may also be helpful.

But asthma often begins in young childhood, and there’s no definite diagnostic test for this age group. Instead, doctors will suspect and treat asthma based on a child’s symptoms and examination, and they’ll continue to monitor the child closely as they grow.

Although asthma is a chronic condition, effective treatment can preserve lung function and control symptoms. Talk with a doctor if you suspect that you or your child have asthma.

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“It’s a great program, and I am enjoying it. The staff is just wonderful, so helpful.”

When it comes to bettering her health, retiree Pamela Ghee is embodying the same traits of resilience and determination she had while serving in the U.S. Army Reserves for 31 years as a comptroller, retiring as a Lieutenant Colonel and as a school counselor for over 30 years.

In particular, Pamela shares that it was years of smoking that has put her in her current predicament, resulting in a variety of health issues.

“I was coughing like crazy, and my excuses were that I had a cold, or that it was my allergies, but I knew it was neither. I knew I had to stop smoking. It was getting ridiculous,” said Pamela. “After quitting, I really started to realize the health effects.”

Over the course of the past few years, Pamela noticed she had severe shortness of breath, which led to requiring a cardiac stent. This stent helped, but Pamela still was feeling short of breath. After undergoing multiple medical evaluations to make sure nothing was wrong, Pamela underwent a pulmonary function test. It turns out the stent was fine, but results showed that her Chronic Obstructive Pulmonary Disease (C.O.P.D.) was going to require her to need pulmonary rehabilitation.

A Pathway to Improved Quality of Life

Pamela taking a photo of herself in a green hat while walking outsideVeterans Affairs (VA) recently set her up with The Pulmonary Rehabilitation Program at Cooperman Barnabas Medical Center (CBMC), accredited by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), which offers patients an educational and supportive program monitored by trained medical professionals.

Linda Hardy, BBA, RRT-NPS, RPFT, AE-C, respiratory therapist at The Pulmonary Rehabilitation Program at CBMC explains that the program is designed to aid people with breathing problems maintain and improve the quality of their lives. Through early intervention and individually planned and designed education, therapy, exercise, motivation and lifestyle adjustment programs, patients can once again take control of their daily activities and lives.

“Our program is customized based on the unique needs of the patient,” shares Linda. “Our patients can expect to work one-on-one with a licensed respiratory therapist, who will help them develop their own goals.”

Pamela speaks fondly of her experiences since she started. “Linda Hardy was and is wonderful, everybody I work with is. Linda was my intake person and she was the one that determined my oxygen level was dropping while I was just walking and helped get me all set-up and started with their pulmonary rehabilitation program.”

As for the exercise program, Pamela continues to express her appreciation. “It’s a great program, and I am enjoying it. The staff is just wonderful, so helpful. In addition to Linda, I want to give a special thank you to her teammates, Lilly Earl, BBA, CRT, and Priya Mistry, RRT, as well. They push me to increase my workout, so that I can eventually workout without needing the oxygen.” Pamela says.

For Pamela, her goal is to use the treadmill without the oxygen, “If I can’t do the treadmill for the full 20 minutes at the pace I’m going with the oxygen, but I could do 10 minutes without it, then that would be a goal,” she explains.

Breathing Better, Living Better

Kristin G. Fless, MD
Kristin G. Fless, MD

“Pulmonary rehabilitation is also meant to teach patients various methods of minimizing symptoms of their pulmonary disease and recognizing early symptoms of declining health so they can work with their physicians to get the best treatment,” explains Kristin G. Fless, MD, Medical Director of Pulmonology Services and Chair of the Department of Medicine at CBMC.

“The staff at pulmonary rehab are teaching me really good breathing techniques and tips on how to breathe better and not overexert,” says Pamela. She finds this extremely beneficial because she loves to travel, and is involved in several community groups, church and different events where she is out and about.

“Right now, I have a travel backpack with oxygen and I take it with me regularly no matter where I am going. One of the keys is to walk slow, and if I do pick up pace and need to have the oxygen, then I just put it on and keep going.”

In the future, Pamela hopes to not need her oxygen backpack, and to be fully sufficient on her own from putting in the work at pulmonary rehab. Each session she pushes to get to that next level. If Pamela could share any other recommendation besides considering pulmonary rehabilitation if it might be beneficial, it would be to quit smoking!

“There are people I know with C.O.P.D. that were never smokers, but there are also a lot of people out there with C.O.P.D. as a result of smoking,” Pamela shares. “I know it’s difficult to quit smoking, but it is important to try the best you can, and really work at quitting. The damage shows up later in life, it doesn’t show up in your younger years when you’re having a good time. You get older and the damage is done and it’s irreversible.”

The Benefits of Pulmonary Rehabilitation for Lung Disease

While there is no cure for lung disease, the symptoms can be treated. Lung disorders can make it difficult to breathe, cause chronic coughing and cause persistent stress and anxiety. In the Pulmonary Rehabilitation program at CBMC, patients work to slow down and minimize the debilitating symptoms of lung disease through a combination of exercise, education, breathing retraining and nutritional counseling.

The Pulmonary Rehabilitation Program at Cooperman Barnabas Medical Center strives to help patients:

  • Increase knowledge of your pulmonary disease and self-care management
  • Increase ability to tolerate daily living activities
  • Minimize symptoms associated with your pulmonary disease
  • Recognize early symptoms of declining health
  • Reduce need for hospitalization

For more information, please call our Pulmonary Rehabilitation specialists at Cooperman Barnabas Medical Center, 973-322-8926 or visit The Pulmonary Rehabilitation Program at Cooperman Barnabas Medical Center.

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A personal trainer says she nearly died after a bout of Covid-19 left her with blood clot blockage in her legs, tummy and lungs.

Becky Fanthorpe, 39, from Cambridge, first realised something was wrong when she started feeling pain in one of her hips.

She said doctors initially dismissed it as sciatica, Covid and an autoimmune condition and told her to take paracetamol.

But following advice from 111, Becky made her way to A&E where she collapsed, likely due to the blood clots preventing her blood from flowing to her organs, and tests revealed she actually had blood blots all over her body.

Studies have shown there is an increased risk of clots after contracting Covid, according to the British Medical Journal.

Becky Fanthorpe, 39, was rushed to hospital after advice from 111 where she collapsed likely due to the blood clots

Becky Fanthorpe, 39, was rushed to hospital after advice from 111 where she collapsed likely due to the blood clots

Mother-of-three Becky had to learn to walk again and gave up her job of 16 years as a personal trainer.

A year on, she said falling in love with cooking got her through her darkest days, and she now shares her favourite recipes online to more than 11,000 followers.

Becky, a content creator, said her children and partner helped her get through the difficult times.

'They were there every day. You kind of realise how loved you are when something like this happens,' she explained.

Becky said she first noticed pain in one of her hips in October last year.

She went to the doctor when the pain first appeared, and again when it spread to her groin, but on both occasions her worries were dismissed.

The mum claims her concerns were not taken seriously despite her family history of serious blood clots.

She had Covid in October last year, only a few days after being diagnosed with Graves' disease, an autoimmune condition.

A bout of Covid-19 left Becky with blood clot blockages in her leg

A bout of Covid-19 left Becky with blood clot blockages in her leg

Becky Fanthorpe was admitted to hospital last October

Becky Fanthorpe was admitted to hospital last October

Mum-of-three Becky had to learn to walk again and gave up her job of 16 years as a personal trainer

Mum-of-three Becky had to learn to walk again and gave up her job of 16 years as a personal trainer 

Becky had Covid in October last year, only a few days after being diagnosed with Graves' disease, an autoimmune condition

Becky had Covid in October last year, only a few days after being diagnosed with Graves' disease, an autoimmune condition

The blood clots travelled as far as her stomach and lungs and put Becky in a life-threatening condition

The blood clots travelled as far as her stomach and lungs and put Becky in a life-threatening condition

'The doctor should have picked up on the fact that I should have really got checked out because of all this background, but he didn't,' Becky said.

He sent me home and just said take paracetamol.'

It wasn't until she called 111 a few days later, she was advised to go to the hospital in Harlow, Essex, where she suddenly collapsed.

She explained: 'As I walked through the front door, my leg gave way.

'It was like a lightning bolt through the whole of my body.'

When Becky later woke up in a hospital bed 10 minutes later with a leg infection caused by the clots, she said the doctors did not know if she was going to make it.

'It turned out I had blood clots from the bottom of my leg all the way up through to the top of my groin, all through my arteries,' she said.

The blood clots travelled as far as her stomach and lungs and put her in a life-threatening condition.

She went to the doctor when the pain first appeared, and again when it spread to her groin, but on both occasions her worries were dismissed, she said

She went to the doctor when the pain first appeared, and again when it spread to her groin, but on both occasions her worries were dismissed, she said

Becky's right leg doubled in size due to blood clots and an infection

Becky's right leg doubled in size due to blood clots and an infection 

She was rushed to hospital after dialling 111

Becky 'nearly died' after a bout of Covid-19 left her with blood clot blockage in her legs, tummy and lungs

Becky 'nearly died' after a bout of Covid-19 left her with blood clot blockage in her legs, tummy and lungs

Becky Fanthorpe with her family

Becky Fanthorpe with her family

Becky, previously a personal trainers, as been in recovery since October 2023

Becky, previously a personal trainers, as been in recovery since October 2023

Two weeks later she was released from the hospital, but she was still very unwell and could not walk for eight weeks.

Becky has been in recovery since, but the seriousness of her condition meant that she had to give up her passion for personal training, which she had done as a job for 16 years prior.

'Some days I get really, really down, because exercise was my thing for my mental health,' she said.

'Now as soon as I get out and exercise my legs start swelling again.'

WHAT IS LONG COVID?  

According to the NHS, most people fully recover from a Covid-19 infection after 12 weeks  but some can develop long-term symptoms including:  

  • extreme tiredness (fatigue)
  • problems with memory and concentration ("brain fog")
  • difficulty sleeping (insomnia)
  • feeling sick, diarrhoea, stomach aches, loss of appetite
  • a high temperature, cough, headaches, sore throat, changes to sense of smell or taste

 

She reignited her passion for healthy living by writing about food and sharing healthy recipes on Instagram and Facebook.

She said: 'I nearly died, and I documented my journey on my social media channel on Instagram which has boomed and I now share my love of cooking through it.

'It's like my little escape. For me that's where my heart is now.'

Becky said a check-up has revealed she still has blood clots in her arteries and they might never go away.

But she remains optimistic and feels lucky to be where she is.

'You don't know what's around the corner at all,' she said.

'Always trust your own instinct. Keep thinking that there is always a tomorrow.'

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Muscle and joint pain are frequently reported symptoms of COVID-19. Back pain is the most commonly reported, but many people have pain in other areas, like the neck, shoulders, and elsewhere.

COVID-19 is an infectious disease that results from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. The most common symptoms of COVID-19 include fever, cough, and fatigue.

Another frequently reported symptom is muscle and joint pain, which can affect your neck and other areas of your body.

Here’s what you need to know about COVID-19 and neck pain, including research, treatment, and frequently asked questions.

Muscle pain, also called myalgia, is one of the most frequently reported symptoms of COVID-19 besides fever, cough, and shortness of breath.

As many as 40–60% of people with COVID-19 report muscle aches and pain. Some people report neck pain or head pain, while others report pain in the abdomen, back, pelvis, or joints.

The pain typically appears along with fever, cough, and fatigue and usually resolves on its own after recovery from the disease.

What the research says

A 2024 systematic review examined COVID-19 and neck pain across five studies involving more than 2,600 people. The researchers found evidence that COVID-19 may increase the onset and severity of neck pain, though two studies did not find any increase.

One reason COVID-19 may cause musculoskeletal pain is increased inflammation in the body. Researchers behind a 2022 review believe the virus that causes COVID-19, SARS-CoV-2, may cause the body’s immune system to become overactive. This may lead to widespread inflammation in the body, causing muscle aches and pain.

Some studies have found an association between COVID-19 and an inflammatory condition called subacute thyroiditis. This condition can occur after an upper respiratory tract infection from COVID-19. The main symptoms of subacute thyroiditis are pain and soreness in the neck due to a swollen thyroid gland.

Other studies suggest that the transition to remote working during the pandemic has worsened workers’ musculoskeletal health, leading to increased reports of pain in the neck, back, and shoulders.

More research is needed to clarify the effect of COVID-19 on neck pain.

Is neck and shoulder pain a symptom of COVID-19?

In some cases, people with COVID-19 experience muscle aches and pain, including pain and soreness in the neck, shoulders, and other areas of the upper and lower body.

Neck and shoulder pain alone may not be a symptom of COVID-19. But if you experience neck and shoulder pain along with fever, cough, shortness of breath, or fatigue, those may be symptoms of COVID-19.

Can COVID-19 cause neck and back pain?

The most common musculoskeletal symptoms of COVID-19 include fatigue, muscle pain, joint pain, and back pain, according to the 2022 review.

A 2021 study of musculoskeletal symptoms in people with COVID-19 found that the most common pain region was the back. Most people reported pain in more than one area of the body, including back pain (30.4%), lower back pain (16.1%), and neck pain (11.4%).

Can COVID-19 cause neck pain and headaches?

Headaches are a less common symptom of COVID-19, reported in an estimated 13% of people. This is according to the same 2022 review.

The virus that causes COVID-19 can attack the central nervous system, leading to neurological symptoms like headaches, dizziness, and impaired consciousness.

In some cases, people may experience both neuropathic pain and musculoskeletal pain, which could lead to headaches and neck pain.

Some people experience long-term effects of COVID-19, called “long COVID.” The symptoms of long COVID vary from person to person and may last for weeks, months, or even years.

Common symptoms of long COVID include fatigue, shortness of breath, difficulty concentrating, and stomach pain.

People with long COVID also frequently report muscle and joint pain, which can include pain in the chest, head, and neck.

In many cases, neck pain from COVID-19 may be mild and manageable with at-home treatments.

Home remedies for neck pain include:

  • getting plenty of rest and staying hydrated
  • using a supportive pillow to reduce neck discomfort
  • gently stretching or massaging the neck
  • practicing good posture
  • taking over-the-counter pain relievers

Treatment for more severe or persistent muscle and joint pain from COVID-19 may include medications, exercise therapy, and complementary therapies.

Medications to treat neck pain may include nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.

Stretching exercises for neck pain include neck turns, forward head tilts, and shoulder rolls. These exercises can strengthen the muscles, improve stability, and reduce pain.

Some complementary therapies, like acupuncture, may also provide relief for neck pain, according to emerging research.

Here are the answers to frequently asked questions about COVID-19 and muscle pain.

Is muscle tightness a symptom of COVID-19?

Muscle aches and pains are common symptoms of COVID-19. Some people experience stiffness in the muscles and joints. These symptoms often appear in the shoulders, neck, back, hips, and knees.

How long do COVID-19 muscle aches last?

Symptoms of COVID-19 typically begin 5–6 days after exposure to the virus and last 1–14 days. Most people feel better within a few days or weeks and make a full recovery.

Do muscle relaxers help with COVID-19 muscle aches?

Doctors may prescribe muscle relaxers in addition to NSAIDs to ease muscle pain and swelling due to COVID-19. This is called multimodal pain management, as it targets multiple mechanisms of action for the pain.

Contact a doctor if you experience neck pain that:

  • is persistent or lasts longer than 2 weeks
  • worsens despite self-care
  • radiates down your arms or legs
  • is accompanied by headaches, weakness, numbness, or tingling

A doctor can assess what’s causing your neck pain and develop an effective treatment plan based on your symptoms.

Researchers believe that COVID-19 may cause muscle and joint pain due to increased inflammation from the body’s immune response.

In most cases, neck pain from COVID-19 is mild and manageable with home treatments. If you experience persistent or severe neck pain, contact a doctor.

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HRV, what it can do for anxiety

  1. Introduction
  2. Current Problem
  3. What is Heart Rate Variability?
  4. Low HRV and Anxiety Disorders
  5. Low HRV and Substance Abuse Disorders
  6. How do we track HRV?
  7. Breathing exercises to increase HRV
  8. Zenbeat’s solution
  9. Conclusion

Growing up, I was never shy. I had an extremely bombastic and energetic personality. Most people knew me as the type of kid to go up on stage in front of everyone and give the best wedding speech of all time through improvisation and pure courage at 8 years old (this happened and I was even featured in the wedding video).

Little Theo on the mic

My courage and tenacity came from a huge need for attention. I was an attention seeker and got my daily attention dose from being a cute little showman from the time I was very young.

My anxiety-free living as a kid started to change when I was about 12 or 13. Going into middle school, my courage was replaced by fear and my energetic personality turned into anger against everybody. My attention-seeking outlet used to be with my parents and close family friends but was now replaced with attention-seeking through social media.

My anxiety spiked at 12–14 when I started to get addicted to YouTube, video games and social media. I would stay up all night scrolling meaninglessly through Instagram and posting cringe-worthy stories on my account. This all was accelerated by the COVID-19 pandemic which forced me to stay at home and increased my loneliness and anxiety.

When I finally got out of my dark hole of loneliness, bad habits and anxiety it was through friends, family and mentors who inspired me to be better. Still, even now, all these years later, I go back to those bad habits as an escape from anything that makes me anxious in the real world, escaping to YouTube, social media and video games.

A while back I asked myself, is there any way I could create something that helps me manage my anxiety while also letting me avoid bad habits that make that anxiety worse?

As I started to learn about anxiety, I realized that it was a bigger problem than I thought. Not only is it linked to bad habits but it also contributes to mental health disorders and even addiction relapses.

I was inspired to see if I could build something so I started with a proof of concept and began sharing my idea to help people cope with substance abuse.

As I marketed the solution to experts in the field, I experienced immediate skepticism about the solution because there are still very few studies on the link between an HRV monitoring solution and averting relapses.

I did, on the other hand, receive a lot of interest from people struggling with stress and anxiety disorders. I also found that anxiety and other disorders are linked in many ways, for example:

  • 10 to 40 percent of people with alcohol addiction are also affected by a panic-related anxiety disorder.
  • 10 to 20 percent of people with an anxiety disorder abuse alcohol or other drugs.
  • Most alcoholics also report that their anxiety problems came before their alcohol abuse.

Globally anxiety disorders are the most prevalent mental health disorder, with over 284 million people affected each year. That means that 4% of the world's population has anxiety and this percentage gets worse in the U.S.

33.7 percent of Americans will have an anxiety disorder at some point in their lives

In the United States, anxiety disorders affect over 40 million adults, which is about 19.1% of the population. Among U.S. adolescents aged 13–18, the prevalence of any anxiety disorder is estimated to be 31.9%, with untreated teenagers at higher risk for various challenges.

Lived experience and statistics show that this is a massive problem. Now how do we solve it? Pst… hint *Heart Rate Variability* hint.

Heart rate variability is the measurement of the variation in time between each heartbeat. To be more specific, it’s a measure of how good your nervous system is at adapting: its ability to switch between the parasympathetic and the sympathetic states.

Your heart rate variability is determined by your autonomic nervous system which handles 90% of your body functioning. Our autonomic nervous system constantly reacts to the information our brain processes throughout the day, whether that’s a stressful death in your family or good news about a job promotion.

Our autonomic nervous system is divided into the parasympathetic system (rest and digest) and the sympathetic system (fight or flight). The parasympathetic system is a network of nerves that relax your body after periods of stress or danger. The sympathetic nervous system activates and responds to dangerous or stressful situations.

Persistent negativity in your life such as poor sleep, stress, unhealthy diet, social isolation, and inactivity can disrupt the autonomic nervous system, causing an overactivation of the sympathetic (fight or flight) response.

A high HRV is essentially a numerical measure of how good you are at switching between the sympathetic and the parasympathetic state.

Higher HRV indicates more optimal autonomic nervous system function and can help reduce high blood pressure, depression, and anxiety.

With a low heart rate variability state, the autonomic nervous system is less able to switch from the sympathetic to the parasympathetic nervous system. This can sometimes lead to or is caused by an overactive sympathetic nervous system which is associated with anxiety disorders.

As long as there is a perceived threat, the body’s stress response remains active, releasing cortisol to keep the body amped up, resulting in feelings of being on edge, worried or anxious.

Source

Controlled studies show that high HRV results in improvements in:

  • Anxiety
  • Depression
  • Asthma
  • Fibromyalgia
  • Chronic pain
  • Sleep problems

People with high HRV are better at regulating their emotions. They’re better at controlling their impulses and they’re better at processing information. If your heart rate variability is constantly low, it means that your body is probably stuck in alert mode or stress mode.

An example of when you’re HRV Stressed and your HRV when you’re Relaxed

Biofeedback exercises, which sync respiratory and heart rate patterns, can increase heart rate variability. This eventually can lead to the person becoming more coherent and more resilient to stimuli.

To better understand why HRV impacts anxiety, we must understand the vagus nerve. The vagus nerve mobilizes bodily responses by scanning for safety or danger in a situation.

The vagus nerve is why our breathing slows and our body relaxes when we are comfortable. It’s also why our heart rate jumps and our stomach turns when we sense danger. It plays a central role in alerting the autonomic nervous system on whether it should be in a state of calm or alarm.

For the past few decades, the research has highlighted the link between low heart rate variability and mental health. A meta-analysis of 36 studies found anxiety disorders (e.g. PTSD, generalized anxiety disorder, panic disorder, social anxiety disorder) are associated with significant reductions in heart rate variability.

The reason for this is that anxiety in all its forms ultimately creates a reduced ability to rest. Over time this negatively affects people’s cognitive, behavioural and psychological responses.

A reduced capacity to regulate negative stimuli leads to reduced vagal flow, lowering HRV and increasing feelings of anxiety.

“The significant reductions in heart rate variability found in the meta-analysis echoed previous theoretical models, indicating that the prefrontal cortex’s ability to regulate processes that contribute to the experience of anxiety are mediated by the vagus nerve, which is reflected in heart rate variability.” Source

Heart rate variability (HRV) is an indicator of autonomic abnormalities. Little is known about the role of HRV related to substance use disorder. However, some studies show that higher HRV can help addicts through their cravings.

A total of 14 studies were reviewed. Studies included outpatients with a prescription or nonprescription opioid misuse behavior with a primary diagnosis being chronic pain or substance use disorder (SUD). Significantly decreased resting HRV was found in substance users compared to healthy controls. Lower resting HRV has been significantly associated with stress, craving, and greater symptom severities in individuals with SUD and other substance dependence. HRV indices can be potential measures of homeostatic imbalance and self-regulation flexibility.

HRV may be a useful tool for monitoring early indication of relapse so that relapse prevention measures can be implemented in a timely manner. Future studies in substance use may benefit from examining HRV in relations to substance use and relapse signs and symptoms in a larger population to guide future relapse prevention strategies.

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Based on some new studies, increasing HRV through biofeedback may be an accessible, cost-effective intervention solution.

ECG (electrocardiogram) and PPG (photoplethysmography) are the most common ways of recording HRV data.

ECG measures the electrical activity of the heart over a period of time through electrodes that are attached to the skin. ECG essentially records the electrical activity of the heart muscle.

PPG is a very simple optical technique for measuring HRV. Unlike ECG, which uses electrodes, PPG applies light reflection to detect the blood volume changes in peripheral arteries which occur with each heartbeat. Recordings are usually measured on parts of the body where blood vessels are close to the skin, like fingertips or earlobes.

The advantage of the ECG method is that it has been proven to be more accurate and comprehensive than those obtained through PPG. This is mainly because ECG reads the electrical signals produced by the heart activity directly, while PPG provides a more indirect measurement, using light reflection to detect the pulsating activity of the heart.

PPG measurements are influenced by the proximity of the blood vessels present in the particular spot you placed it, this makes the accuracy of PPG change according to the body position. The accuracy also can vary depending on other factors, for example, the effect of ambient lighting or even motion factors.

ECG, on the other hand, even though it presents many advantages it also has problems such as it relies on a physician to collect and interpret the data. This greatly limits access to this tool for diagnosis, care, prevention, or general HRV tracking.

For my project, PPG seemed like the most accessible and easiest way to collect data so I decided to move forward with this technology.

What’s a good HRV?

Heart rate variability is very personal. What’s considered a good HRV will vary from person to person. Multiple formulas are used to calculate this metric. Two of the most common are the root mean square of successive differences between normal heartbeats (RMSSD) and the standard deviation of normal intervals.

Wearable devices use these formulas to compute HRV, and current data shows that the desirable range may be as broad as 20 to 150 milliseconds, depending on the individual.

Resonance breathing has consistently been shown to increase HRV, mood, and adaptability. Resonance breathing is a technique that involves deepening and slowing down your breathing to a specific pace, typically around 6 breaths per minute.

This breathing technique synchronizes your parasympathetic nervous system, promoting calmness and improving the balance in the nervous system.

Studies have shown that regular resonance breathing can significantly improve HRV parameters such as SDNN, pNN50, and total power.

I named my solution: Zenbeat! Zen refers to a perpetual state of calmness and Beat refers to our heartbeat.

V1 of Zenbeat

My first iteration of Zenbeat was to help substance abuse disorder patients manage their cravings. The idea behind this was that heart rate variability which was correlated to stress, was potentially able to detect cravings. This made sense because HRV biofeedback has been proven to help addiction patients lower their cravings, especially opioid cravings.

However, over long research hours, I realized that there were not enough studies yet to say that HRV could be directly correlated to craving. Most studies alluded to it being either indirect or addiction-producing low HRV.

I used Oura ring to create a prototype version to prove that it could be possible in time to make something like this.

Prototype using Oura Ring

V2 of Zenbeat

As I continued down this path of addiction recovery research, I started building a prototype of a full-stack application that could detect and prevent cravings in real-time. This prototype application taught me a lot about what features I wanted to integrate into the app.

This included a resonance breathing exercise feature, a calendar, graphs of your progress and other interesting ideas that came to mind… It also taught me a lot about full-stack development, react, javascript and other coding stuff.

Presentation on Zenbeat

But I ran into one pretty big roadblock, most of the wearable technology on the market did not provide real-time HRV data which would be necessary if we wanted to intervene in real time.

I realized I probably needed to build my own sensor so I applied for a grant from an amazing team at 1517 who generously awarded me enough funds to buy my own sensor.

Full-stack prototype

V3 of Zenbeat

V3 of Zenbeat aims to utilize real-time HRV data from the PPG sensor built into the small Emotibit. This sensor can easily be placed on you’re finger or arm and immediately starts streaming data to the app.

The idea for the app in the future is that every time your heart rate variability lowers based on the readings from the PPG sensor, it will automatically notify you and it will help you calm yourself down using resonance breathing techniques.

Tracking biometrics with a sensor

There are already apps on the Apple watch that do what Zenbeat aims to do like the Breathe app and other stress trackers. These stress tracker solutions work very well and beat Zenbeats in terms of convenience for the user (using Apple infrastructure). This is why V4 creates a new application for PPG sensors and evolves Zenbeats further.

V4 of Zenbeat

The objective of V4 is to use a PPG sensor (already used in sensor infrastructure such as Apple Watch and Oura ring) that accurately monitors and displays the breathing cycle and rate in real time. By providing immediate feedback on breathing cycles wearable devices enable individuals to engage in mindful breathing exercises and help to reduce stress.

In conclusion, the monitoring of patients both in hospital settings and at home, has significantly benefited from the advancements in wearable devices. These devices provide the ability to continuously and non-invasively track various physiological parameters, enabling timely interventions and improving patient care.

Zenbeat aims to help use novel ways of detecting and preventing stress using a PPG sensor to track HRV. The stretch goal with Zenbeat is to eventually be able to use AI to analyze PPG data to track breathing rates and cycles in real-time.

This is the first article in a series of Zenbeat articles that take you through the process of solving anxiety and stress for millions of people across the world.

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According to the Lancet report, the total number of children, adolescents and adults across the world living with obesity has crossed one billion. The numbers seem concerning because there has been a declining prevalence of individuals who are underweight since 1990, making obesity the most common form of malnutrition in most countries. 

Obesity is associated with numerous health risks and complications, both physical and psychological. (Image: Freepik)

New Delhi: Obesity among children in India has shot up with nearly 12.5 million of those between the ages of five and 19 years in 2022 compared to 0.4 million in 1990, revealed a global analysis published in the Lancet journal. The report noted that out of 12.5, 7.3 million were boys and 5.2. million girls. Additionally, the total number of children, adolescents and adults across the world living with obesity has crossed one billion. The numbers seem concerning because there has been a declining prevalence of individuals who are underweight since 1990, making obesity the most common form of malnutrition in most countries.

According to an earlier report released by the Lancet, the link between abdominal obesity in females is stronger in older age groups, people from urban residents, non-vegetarians and people from the wealthier sections. Further, the report also noted that for people practising the Sikh religion, the rate is higher in both men and women.

Dr Prashant Patil, Consultant Paediatric Endocrinology, NHSRCC Children’s Hospital, Mumbai told News9, Obesity is associated with numerous health risks and complications, both physical and psychological.

Some of the primary risks associated with obesity include:

Cardiovascular Disease: Obesity increases the risk of heart disease and stroke due to factors such as high blood pressure, high cholesterol levels, and insulin resistance.

Type 2 Diabetes: Obesity is a major risk factor for developing type 2 diabetes, as excess body fat can lead to insulin resistance, where the body’s cells do not respond properly to insulin.

Joint Problems: Excess weight puts additional pressure on joints, leading to conditions such as osteoarthritis, which can cause pain, stiffness, and reduced mobility.

Sleep Apnea: Obesity is a leading cause of sleep apnea, a condition characterized by pauses in breathing during sleep, which can lead to daytime fatigue and an increased risk of cardiovascular problems.

Certain Cancers: Obesity has been linked to an increased risk of certain types of cancer, including breast, colon, endometrial, and kidney cancer.

Respiratory Issues: Obesity can restrict lung function and lead to conditions. obstructive sleep apnea and central hypoventilation syndrome, where inadequate breathing results in low oxygen levels and high carbon dioxide levels in the blood which can be life-threatening situations.

Digestive Disorders: Obesity is associated with an increased risk of digestive disorders such as gallbladder disease, fatty liver disease, and gastroesophageal reflux disease (GERD).

Mental Health Issues: Obesity can have significant psychological effects, including low self-esteem, depression, and anxiety, often stemming from societal stigma and discrimination

Prevention methods

According to Dr Patil, “Preventing obesity involves adopting a combination of healthy lifestyle habits. The importance of a balanced diet rich in fruits, vegetables, and lean proteins, coupled with portion control and regular exercise is paramount. Mindfulness of sedentary behaviour, hydration, sleep, and stress management are pivotal. Limiting screen time to < 2 hours/day and seeking support from loved ones or healthcare professionals are also essential. Education on nutrition and avoiding crash diets are paramount. Regular health check-ups aid in monitoring progress. By integrating these strategies, individuals can mitigate the risk of obesity and enhance overall health.

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Initiating outpatient pulmonary rehabilitation within 3 weeks post hospital discharge for chronic obstructive pulmonary disease (COPD) exacerbations can cut hospital readmissions by nearly half, according to findings from a systematic review and meta-analysis published in Thorax.

Researchers updated previously published Cochrane reviews that have assessed the efficacy of pulmonary rehabilitation programs after hospital discharge for COPD exacerbation on clinical outcomes. Notably, the 2016 Cochrane review included evidence that “reduced confidence in the observed benefits of pulmonary rehabilitation in the context of an acute exacerbation of COPD,” noted researchers for the current review. The current review, which was used to inform an American Thoracic Society guideline on pulmonary rehabilitation, therefore focused on outpatient rehabilitation programs started within 3 weeks of patient discharge for exacerbation of COPD.

The reviewers identified 17 studies from October 2015 to August 2023, which in total included 1724 patients enrolled in pulmonary rehab programs following hospital discharge for exacerbation of COPD symptoms. Study sample sizes varied between 26 and 389 participants. Of the studies, 6 involved a rehabilitation program initiated during inpatient acute care and continued as outpatient rehabilitation post-discharge; in the remaining studies, outpatient rehabilitation began within 4 weeks post-discharge. The control group constituted 4 studies involving ‘delayed’ pulmonary rehabilitation.

Inclusion/exclusion criteria did not specify a minimum number of exercise sessions. Some of the pulmonary rehabilitation programs studied offered additional components like self-management education, dietary guidance, breathing exercises, and psychological support. For studies that included patients with mixed diagnoses, the results were included if more than 90% of participants had COPD.

[T]hese findings support the need to develop strategies to ensure that people with COPD are
offered pulmonary rehabilitation following hospital discharge for an exacerbation.

The meta-analysis found that pulmonary rehabilitation significantly reduced hospital readmissions by nearly half for patients with COPD (OR, 0.48, 95% CI, 0.30-0.77; I2=67%). In addition, pulmonary rehabilitation programs led to other quality of life improvements, including increased exercise capacity, as evidenced by the ability to walk longer distances in both the 6-minute walk test (mean difference [MD], 57 m; 95% CI, 29-86; I2=89%) and an incremental shuttle walk test (MD, 43 m; 95% CI, 6-79; I2=81%).

Pulmonary rehabilitation was also linked to notable improvements related to respiratory health, as measured by the St. George’s Respiratory Questionnaire (MD, −8.7 points; 95% CI, −12.5 to −4.9; I2=59%) and specific aspects of the Chronic Respiratory Disease Questionnaire (CRQ; emotion: MD, 1.0 points; 95% CI, 0.4-1.6; I2=74).

Moreover, rehabilitation programs led to reductions in dyspnea, as noted by improvements in the CRQ and the modified Medical Research Council Dyspnea Scale (CRQ dyspnea scale MD, 1.0 points; 95% CI, 0.3-1.7; I2=87%; modified Medical Research Council Dyspnea Scale MD, −0.3 points; 95% CI, −0.5 to −0.1; I2=60%).

The analysis did not note that pulmonary rehabilitation had any significant effects on self-efficacy, overall COPD assessment, general quality of life, or mortality rates. No adverse events were reported by those participating in rehabilitation programs.

Limitations of this analysis include the risk for bias in all 17 studies used in the meta-analysis; 12 studies were identified as having a high risk of bias and 5 had a moderate risk of bias. The 2 main issues contributing to bias were the inability to blind participants to the exercise training, which introduced performance bias, and inadequate reporting of methods and outcomes in some studies.

The study authors concluded that “Improvements in key clinical outcomes such as hospital re-admission, exercise capacity and health-related quality of life in the absence of adverse events support the use of pulmonary rehabilitation in the postacute exacerbation phase.” As they further noted, “[T]hese findings support the need to develop strategies to ensure that people with COPD are offered pulmonary rehabilitation following hospital discharge for an exacerbation.”

Disclosures: This research was funded by the American Thoracic Society. Please see original reference for more information.

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New Delhi: Indians suffer high rates of lung function damage after acute COVID-19 with about half reporting shortness of breath, according to a recent study, a worrying finding that experts attribute to various reasons, including co-morbidities and pollution.

The study by the Christian Medical College, Vellore, is the largest from India to investigate the impact of COVID-19 on lung function.

It examined 207 individuals, showcasing substantial impairment in lung function, exercise capacity, and quality of life among recovered individuals.

The study revealed a high prevalence of respiratory symptoms among Indians who recovered, even after a mean of over two months following acute illness, with shortness of breath reported in 49.3 per cent and cough in 27.1 per cent of the cohort.

In people recovering from COVID-19, there is evidence of potential long-term pulmonary sequelae and associated lung function impairment. The most severe illness in the context of SARS-CoV-2 infection is acute respiratory distress syndrome (ARDS). In some, the ARDS may result in fibrotic interstitial lung disease.

Signs and Symptoms of Post-Covid Lung Damage:

1. Shortness of breath: Difficulty in breathing or shortness of breath, particularly during physical activity, can persist long after the acute phase of the infection has passed.

2. Persistent cough: A lingering cough that lasts for weeks or months after the initial infection is common in individuals with post-Covid lung damage.

3. Chest pain or tightness: Some individuals may experience chest pain or tightness, which can be exacerbated by deep breathing or exertion.

4. Fatigue: Chronic fatigue is a common symptom of post-Covid lung damage, often accompanied by reduced exercise tolerance.

5. Decreased exercise tolerance: Individuals may notice a reduced ability to engage in physical activities they once tolerated, due to persistent shortness of breath or fatigue.

6. Frequent respiratory infections: Vulnerability to respiratory infections may increase following COVID-19, as lung damage can weaken the immune system’s ability to fend off pathogens.

Treatment:

Pulmonary rehabilitation: Structured exercise programs supervised by healthcare professionals can help improve lung function, endurance, and overall physical health.

Medications: Bronchodilators and anti-inflammatory medications may be prescribed to alleviate symptoms such as shortness of breath and inflammation in the airways.

Oxygen therapy: In cases of severe lung damage, supplemental oxygen therapy may be necessary to ensure adequate oxygen levels in the bloodstream.

Nutritional support: A balanced diet rich in nutrients and hydration is essential for supporting overall health and aiding in recovery.

Psychological support: Dealing with chronic symptoms can take a toll on mental health. Counselling or support groups may be beneficial in coping with the emotional impact of post-Covid lung damage.

Regular monitoring: Close monitoring by healthcare providers is crucial to track progress, adjust treatment plans as needed, and address any emerging complications.

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Whether you’ve spent the week at your desk, on your feet in a store, or with little time to spare, you may be after an effective, efficient way to move your body over the weekend. Fortunately, you don’t need to spend hours searching YouTube, as we’ve found five great routines for you to try.

Plus, you don’t need the gym to get started! All you need is a few weights, like adjustable dumbbells or kettlebells, and maybe a yoga mat for floor-based exercises. But don’t worry if you don’t have any equipment, as we’ve also included a bodyweight-only option for you.

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Life is not measured by the number of breaths we take, but by the moments that take our breath away, said Maya Angelou. It is easy to read this and think of awe-inspiring breathtaking moments, but what about that moment that will take your breath away, forever? Could your last breath be stolen by lung cancer, South Africa’s greatest cancer killer?

Did you know that cancer affects one in four South Africans, through the diagnosis of family, friends, colleagues or self?

Angie Oeh and Mark Pilgrim are two South African celebrities who don’t seem to have a lot in common, when in fact, they share their final breath being taken by cancer’s greatest killer, lung cancer. We live in a world where celebrities are considered ‘untouchable’. We often don’t pause to think about how they are regular people, proving that lung cancer can happen to anybody, no matter your societal status.

According to the World Health Organisation, 8950 lung cancer cases were reported in South Africa in 2020, of these reported cases, 69% occurred in males, and 31% occurred in females, making it the second most common cancer in men and fourth most common cancer in women in South Africa.

Lung cancer has one of the lowest survival outcomes of any cancer because more than two-thirds of patients receive a diagnosis too late or lack access to innovative therapies for curative treatment, proving a need to raise awareness to encourage early screening measures in patients.

The impact of this disease goes far beyond the statistics, leaving many families grieving for their loved ones often while they have to carry the financial burden the disease brings with it.

Already feeling the pinch? Consider the colossal cost associated with cancer

The second annual Money Stress Tracker (July 2023), which polled subscribers to debt counselling company DebtBusters' website and platform found that 3 out of 4 South Africans already feel the pinch when it comes to money stress. It is no secret that any medical expenses incurred by any illness take a huge financial toll - now, consider the stress and cost of cancer on top of your current financial struggles. 

Unfortunately, the financial effects of cancer, including lung cancer, are a factor many do not consider.

According to the Lung Ambition Alliance’s Lung Cancer Screening: the Cost of Inaction report, lung cancer has the highest economic toll of all cancers on patients as most people who are diagnosed with lung cancer do not return to work at all which results in a ‘significant cost to early retirement to individuals, their families as well as the economy.’

Efforts must be put into prevention and early detection by going for lung screenings. The benefits of lung screenings go far beyond lung cancer detection and can detect other Noncommunicable diseases (NCDs) at an early stage. Lung cancer prevention does not only include screening, it can also include things such as increasing your exercise regimen, quitting smoking, bettering your diet and becoming more informed.

Smoke and mirrors - lung cancer goes beyond smoking

Smoking is still a very common pastime for many individuals around the world. In South Africa, 33.4% of males and 8.3% of females above the age of 15 are consumers of tobacco.

Although it is worth noting that the most important risk factor for lung cancer remains tobacco smoking, it is not the only cause of lung cancer. We are seeing more and more people living healthy lifestyles with no history of smoking also being diagnosed with the disease.

Other risk factors that can potentially contribute to the deterioration of your health and lead to lung cancer include a poor diet, family history, air pollution, HIV, and ionising radiation.

What about e-cigarettes?

E-cigarettes do not contain tobacco, but many of them contain nicotine, which comes from tobacco. Because of this, the Food and Drug Administration (FDA) classifies them as "tobacco products." A survey conducted by The University of Cape Town, funded by the Bill and Melinda Gates Foundation as part of the Tobacco Control Data Initiative (TCDI), found that 4% of urban South Africans were regularly using e-cigarettes (used an e-cigarette at least once a week), Further the survey found that among people who regularly used e-cigarettes before ever regularly smoking combustible cigarettes, the survey found that one in five (19%) were “on-rampers” (had since started smoking combustible cigarettes and were still smoking at the time of the survey), while people who started using e-cigarettes after regularly smoking combustible cigarettes, one in eight (13%) were “off-rampers" (had since stopped smoking combustible cigarettes).

Although there isn't enough research to indicate the relationship between the use of e-cigarettes (vaping) and lung cancer diagnoses as yet, it is important to note the relationship between vaping and the use of combustible cigarettes and to remember that tobacco remains an important risk factor for lung cancer.

Support structures are key

One of the ways you can become informed is by engaging in conversation with community groups like Campaigning for Cancer (C4C). C4C hosts several campaigns and projects aimed at informing communities about cancer and how to take preventative measures against it.

While many people who have been diagnosed with lung cancer lead very healthy lives, there are many whose actions have led to an undesirable cancer diagnosis.

You have the chance to take preventative measures to stay healthy for yourself and your loved ones by going for lung screenings to ensure early detection and to be able to take full advantage of the life you’ve been given. Spend your last breath knowing you did everything you could to live a life that took your breath away, in the best possible way.

This post and content is sponsored, written and produced by Campaigning for Cancer.

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Even after your other symptoms from COVID-19 have gone away, you might experience sadness, fatigue, and other signs of depression. Scientists are still studying how COVID can affect the brain in some people and why this may put them at greater risk of depression. 

Depression is one of the most common issues some people experience after a COVID infection, as part of long COVID—sometimes referred to as PASC (post-acute sequelae of COVID-19). According to one analysis, roughly 10% to 30% of people may still experience depression symptoms three months later, which may be severe in 3% to 12% of people.

This article explains more about the link between depression and COVID. It discusses how the virus that causes COVID directly affects the brain, other mental health effects of the pandemic, and tips on how to cope with depression after COVID.  

FG Trade / Getty Images


Is There a Link Between COVID-19 and Depression?

Although scientists were initially most concerned about COVID-19 symptoms such as shortness of breath from lung infection, the virus causing COVID-19 (SARS-CoV-2) can also affect other body systems, including your brain. 

People who have COVID have a higher rate of depression than people in the general population. You might be more prone to getting depression even after your other symptoms from COVID, like sore throat, are gone, and you no longer have an active viral infection.

People with severe COVID symptoms seem to have a greater risk of initial depressive symptoms. However, some studies have shown that people with mild COVID symptoms have a similar risk of post-COVID depression as people who had more severe infections that required hospitalization.

What’s the Link Between Long COVID and Depression? 

Long COVID broadly refers to symptoms still present at least three months after a COVID-19 infection. 

Not everyone with long COVID has the same symptoms. Some people have shortness of breath, dizziness, or pain without a clear cause. However, others have symptoms that are very common in clinical depression. Others might have mild depressive symptoms.

For example, many people with long COVID have fatigue, apathy (lack of interest), sleep problems (too much or too little), or decreased mental sharpness (brain fog). Many people also experience increased anxiety or sadness. In some cases, depression might be part of a long COVID syndrome, with or without additional symptoms. 

What Causes Depression in People Who Have Had COVID-19?

Scientists are still learning about what causes depression in people who’ve had COVID-19. They do know that circumstances contribute to COVID-related depression. For example, if you’ve lost income or have to cancel plans due to a COVID infection, you may naturally feel some sadness.

However, the virus that causes COVID also seems to directly affect the brain in ways scientists don’t fully understand. Other infections may also trigger syndromes that can cause symptoms like depression, like the original SARS virus or Lyme disease.

Scientists theorize that inflammation plays a role in the development of depression with COVID-19. The virus that causes COVID can trigger immune-signaling molecules that can enter the brain and affect your mood, sleep, sense of motivation, and enjoyment. Scientists think inflammation plays a role in depression, even in people who have never had COVID.

However, the link between COVID and depression is complex. The virus that causes COVID binds to specific receptors in your brain, which might worsen depression. Some scientists speculate that low levels of the virus might be present in some people with long COVID, which could contribute to depression symptoms.

Alterations in the normal immune response (autoimmune disease) may also play a role, but more research on the relationship between autoimmune disease, COVID, and depression is needed. 

Risk Factors

Some people seem to be at greater risk of depression after COVID. For example, women have an increased risk compared to men—which is true for depression in general, as well. People with a history of depression or other mental health issues also have an increased risk.  

Other Mental Health Effects of the Pandemic

The pandemic significantly increased rates of anxiety and depression overall, even in people who didn’t have the COVID-19. This was especially true early in the pandemic before vaccines and targeted treatments were available. Uncertainty about the virus was particularly stressful and profoundly affected people’s lives. 

The pandemic also had broader effects, which varied based on individual circumstances. Some people were grieving from losing a loved one or managing the physical challenges of regaining their health, including from long COVID.

People were also dealing with the indirect impacts of the virus, such as job and income loss, social isolation, and burnout from increased responsibilities at home and/or work. Alcohol-related deaths and rates of suicide also increased. 

Many of these trends improved as the impact of COVID lessened and disease outcomes became more predictable. Some scientists believe the overall effects on people’s mental health have been overestimated.

However, some people are still struggling with mental health issues that might have been triggered or worsened by circumstances related to the pandemic. 

How to Cope With Depression After COVID-19

Depression after COVID-19 is relatively common, and symptoms decrease with time in most people. 

If your depression is severely interfering with your life, reach out to a healthcare provider or mental health professional. It’s especially critical to do so if you are having thoughts of self-harm or suicide. They can help you determine how to best navigate this time.

Even if your symptoms are less severe, getting some input from a mental health provider is often helpful. Depending on your situation and personal preferences, you might consider drug treatments for depression or therapy such as cognitive behavioral therapy (CBT).

Many people benefit from a holistic, multifaceted approach to depression treatment. Some considerations to help you cope include the following:

  • Decrease stressors: Scale back responsibilities in a way that’s practical for you (when possible).
  • Lean on your personal support network: Find ways to connect with others, even if you mostly feel like withdrawing.
  • Exercise regularly: Try to exercise in ways you enjoy, but pace yourself and don’t overdo it. It can be beneficial to get out in nature. 
  • Pay attention to your diet: Make sure you are eating enough. Try to emphasize whole foods with protein, fiber, vitamins, and minerals over heavily processed foods with lots of sugar. 
  • Prioritize sleep: If you are sleeping too much, make small goals to help get you out of bed and engaged in a task.
  • Find time for your favorite activities: Even if you don’t feel like pursuing your hobbies, sometimes the enjoyment comes back once you get started. 
  • Try mind-body or stress-reduction techniques: Approaches like tai chi, yoga, meditation, massage, guided imagery, or prayer may help. Some people report improvement from alternative approaches like acupuncture.
  • Be kind to yourself: Practice self-compassion and remind yourself that it isn’t your fault you are having a tough time. 

A holistic approach may also work best if you have depression in the context of other symptoms from long COVID. You may want to connect with a long COVID clinic (facilities specializing in long COVID care), where they can provide additional expertise and treatment approaches. 

Summary

COVID-19 causes an increased risk of depression, both during active infection and for months following. Sometimes, this is part of a broader long COVID syndrome, which might include additional symptoms like pain, light-headedness, brain fog, and fatigue. 

Social isolation and other factors surrounding COVID negatively affect many people’s mental health. But infection with the virus itself also seems to leave you more prone to depression, whether by inflammation or other unclear brain changes.

A holistic approach may work best in managing symptoms of depression related to COVID. Often, a combination of psychological therapy, medication, mind/body approaches, solid nutrition, and other lifestyle changes are needed. 

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On February 23, Bancroft Fitness celebrated their receipt of an Ontario Trillium Foundation grant of over $70,000, which will allow for building upgrades at their gym space in Bancroft.  

The date also happened to be the two-year anniversary of Bancroft Fitness at its current downtown location. 

The gym was started over 20 years ago by Dr Carolyn Brown, who had a vision for exercise and rehabilitation that was accessible for everyone. To this day it remains not for profit. 

Dr Brown spoke about how they got started, when many years ago her and a colleague wanted to find a way to help people get better after injuries: 

“At that point Angela Perreira was a kinesiologist in a tiny little spot in the bottom of Billa St.” said Dr. Brown, “And we got together and said, ‘let’s make a clinic’. It took quite a while to get there but you just keep working away a bit more, a bit more, a bit more. And then it happens”  

The gym has expanded into cardiac and pulmonary rehab, and will be expanding into a ‘lower limb preservation project’. On top of a wide array of gym equipment it also offers a variety of classes from chair yoga to HiiT training. 

They say that, thanks in part to the grant which allowed them to update their HVAC system, they hope to have a new hydrotherapy pool up and running by May. 

MPP Ric Bresee was at the event, along with Mayor Paul Jenkins. Dr Brown and members of the Family Health team acknowledged their gratitude to the province and the town of Bancroft, saying without them they couldn’t have made such accessible fitness and rehabilitation happen.  

For more information, check out Bancroft Fitness online. 

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This risk is high for indians after severe COVID-19 infection..!?

Indians face a higher risk of lung damage after severe Covid exposure, a new study reveals. A recent study revealed that people who recovered from severe coronavirus infection faced impaired lung function. It was also revealed that half of the participants in the study suffered from shortness of breath. A study was conducted by Vellore Christian Medical college to investigate the impact of corona infection on lung function. 207 people participated in this study. The lung function and exercise capacity of people who recovered from Corona were studied. The study found that among indians recovering from severe COVID-19 for more than two months, respiratory symptoms were more common, with 49.3% having shortness of breath and 27.1% having cough.
TJ Christopher, professor of Pulmonary Medicine at CMC Vellore, said, "The study clearly shows that lung function is more affected in the indian population compared to data from other countries at every level of disease severity." He said it could be due to a person having more than one disease or co-morbidity at the same time. Published in the journal PLOS Global Public Health, researchers compared data from europe and China.For example, a study based in italy found that 43% had shortness of breath or shortness of breath and less than 20% had a cough. Corresponding figures in the Chinese study were lower than those observed in the indian study. However, the Vellore Medical college study did not cite any specific data from china or european countries other than Italy. Although the exact cause of the poor condition among indians is unknown, co-morbidities are said to be a factor. The researchers concluded that post-coronavirus lung damage has a significant impact on lung function, quality of life, and exercise tolerance.



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Saharan DustSaharan Dust
Public advisory issued, as Saint Lucia again faces challenges Saharan Dust

The Minister of Health- Moses Jn Baptiste in Saint Lucia has issued a public advisory as the nation is grappling with a significant Saharan dust outbreak. The people with respiratory issues are advised to take necessary medications and be prepared for emergencies.

The health minister urged the residents to wear dust masks or face masks when going outside amidst the haze of dust particles, present in the air. Due to such condition, the air quality reaches to ‘unhealthy’ level.

“It is paramount to protect ourselves from the potential health effects of Saharan dust. We urge citizens to wear face masks to prevent inhaling dust particles and take precautions when engaging in outdoor activities”, said Minister Jeanne Baptiste.

Such circumstances built due to a movement of strong winds which have carried dust from the Sahara Desert in North Africa, across the Atlantic and moves towards the Caribbean region.

Individuals suffering from respiratory illnesses such as asthma or sinuses are urged to remain vigilant as they are on the high risk to get sick. The authorities will continue to work on the progression of the dust plume and has warned of limited visibility.

Noting this, the primary concern lies in the potential health effects associated with inhalation of airborne dust particles due to reduced visibility. The authorities have introduced some measures and expected people to exercise them and avoid getting sick.

  • Use a clean face mask while venturing outside their homes
  • Close windows and doors to minimize dust entry into the home
  • One should drink plenty of water and stay hydrated
  • Individual should seek medical assistance when experience worsening respiratory symptoms, such as difficulty in breathing or continuous coughing
  • The asthma patients should consult their doctors for personalized advice
  • Cover water sources such as wells, water storage ponds and containers to avoid contamination

The high levels of Saharan Dust may cause dry cough, itchy and watery eyes, sore throat, sneezing and a runny nose. Considerably, the advisory has also been issued in the country associated with the health and safety risks.

Therefore, the Minister of Health- Baptiste advised citizens to exercise caution and citizens should keep antihistamines and steroid nasal sprays with themselves in case of standard allergy medications for less severe symptoms.

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By Shayna Kaufmann

Shayna Kaufmann

SAN DIEGO — Last Saturday night, I had the pleasure of co-chairing Tifereth Israel Synagogue’s annual Sisterhood Shabbat – an entirely female led event that honors and celebrates sisterhood members. In a shift from past years, our event started with the evening service of Minchah and culminated with a Mindful Havdalah. Sisterhood women, including our new “Tifereket Quartet” singers, led the service, chanted Torah, facilitated a “speed schmoozing” activity, and served a delicious meal, hosted by Olga Worm and Bekker’s Catering.

In preparation for the mindful Havdalah, I led the room of 80+ attendees in a mindful breathing exercise. “We can talk about mindfulness – intentionally paying attention to the present moment – conceptually for days but you have to experience it to really understand its essence,” I explained. I was stunned when the room, which was loud with chatter moments before, became completely silent – a rare moment for a social hall packed with people. With our focus on counting through our inhalation, holding our breaths, and counting through our exhalation, it was a collective moment of presence, of mindfulness.

I explained that there are other means to practice mindfulness, aside from focusing on our breath. We can also use anchors such as our senses, bodily sensations, or words, to help us remain aware of the present moment. Havdalah is a beautiful and perfect opportunity to do this. “During the service, pretend as if you are a curious Martian, watching Havdalah for the very first time. Give your full attention to the beautiful sounds of the melodies, intently watch the flickering of the candlelight, feel your arms around each other, and breathe in the aromatic scents of the spices. You may just experience Havdalah in a new light,” I explained.

My co-chairs, Cailin Acosta, Isabel Shechter, and Olga Worm, and I were thrilled with the response. Attendees raved about the entire event. It was a beautiful, women-led experience of joy and connection. Many remarked that they indeed experienced Havdalah in a fresh, brighter light.

*

Dr. Shayna Kaufmann, a psychologist, received her mindfulness teacher training through Dharma Moon and Tibet House US. She leads meditation workshops and retreats and teaches mindfulness individually.

 

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INDIANAPOLIS (WISH) — To pump every healthy drop out of February’s American Heart Month, WISH-TV Medical Expert Dr. Janel Gordon joined Daybreak for some Leap Day wisdom.

She started with a hard truth: by the numbers, nothing is deadlier than heart disease.

“It’s still America’s leading killer,” Dr. Gordon told our viewers. She says it’s true of both men and women, though not at the same stage of life. “Men are usually presenting with heart disease at an earlier age than women do. Unfortunately, that has led to some disparities when it comes to researching cardiovascular disease or heart disease in women – as well as some discrepancy in care that is received or given to women.”

Gordon points out that heart health disparities show up across racial and ethnic groups. The American Heart Association says Black, Hispanic, American Indian, Asian, and other groups face increased rates of cardiovascular disease.

While some factors may be beyond the control of an individual, Dr. Gordon says there are plenty of areas we can improve to keep hearts as healthy as possible.

She’s a big believer in exercise – both cardio and weights. Each week, she says, “The American College of Lifestyle Medicine recommends that you do 150 minutes of cardio activity… Additionally, you want to do at least two days of resistance training.”

Sleep is a major factor, too. Dr. Gordon says she asks all of her patients about it, every time they visit.

“People are now saying sleep should be an additional vital sign – in addition to measuring someone’s heart rate, their blood pressure, their respiratory rate or breathing rate.”

Heart-healthy breakfast ‘heart bars’ in chocolate treat with berries (WISH PHOTO)

Dr. Gordon is also a passionate advocate for a healthy diet, especially as it relates to heart health. She brought breakfast hearts, a dinner plate, and a dessert for viewers to try at home.

To see how to prepare them, watch the video above.

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In a world that often feels like it's moving at lightning speed, finding moments of tranquility can seem like a Herculean task. Yet, a simple breathing technique, backed by experts like Kianoush Sheykholeslami, M.D., is gaining attention for its promise to not only quiet the mind but also usher in a restful night's sleep. Known as the 4-7-8 breathing exercise, this method hinges on the rhythmic pattern of inhaling, holding, and exhaling breaths, a practice deeply rooted in the ancient art of yoga's pranayama.

The Science Behind the Breath

The principle of the 4-7-8 breathing exercise is straightforward: inhale through the nose for four counts, hold that breath for seven counts, and exhale through the mouth for eight counts. This pattern is not arbitrary; it's a deliberate orchestration of time and rhythm designed to bring about physiological changes within the body. Dr. Alex Dimitriu suggests that initiating at least four cycles of this breathing technique can start to dial down the day's stress, with the option to increase to eight cycles for those particularly tense moments or as a prelude to sleep.

It's the shift in focus to the act of breathing, a move away from stressors, that lends the 4-7-8 method its power. This focus not only helps to distract the mind but also facilitates a physiological response that counters the stress-induced cortisol surge, effectively hitting the body's 'pause' button on anxiety and tension. A 2022 study in Physiological Reports highlighted its potential to lower blood pressure and heart rates, underscoring the health benefits of this seemingly simple exercise.

Embracing the Practice

Yet, as with any practice that involves the body's delicate balance of oxygen and carbon dioxide, newcomers to the 4-7-8 breathing technique might experience initial lightheadedness. This sensation is typically a result of increased carbon dioxide levels from the extended breath holding. Caution is advised, particularly for those with cardiovascular or respiratory conditions, with a strong recommendation to consult a doctor before embarking on this or any new wellness practice.

Despite these considerations, the accessibility of the 4-7-8 technique is undeniable. It requires no special equipment, can be practiced virtually anywhere, and, perhaps most appealingly, fits seamlessly into a nightly routine. Anecdotal evidence, bolstered by personal testimonies on platforms like TikTok from users such as Emilie Leyes and The Sleep Doctor, paints a vivid picture of its effectiveness in managing anxiety and improving sleep quality. Dr. Mamina Turegano, MD, also points to its roots in pranayama, advocating for its role in a healthy lifestyle that prioritizes mental wellness.

A Balanced View

While the benefits of the 4-7-8 breathing technique are compelling, it's important to approach it as part of a broader stress management and sleep hygiene strategy. Regular practice, coupled with other healthy lifestyle choices, can enhance its effectiveness. However, it's not a panacea; individual experiences may vary, and it's essential to maintain realistic expectations about the results.

Ultimately, the 4-7-8 breathing exercise offers a bridge to tranquility in the tumult of daily life, a tool that, when used with mindfulness and consistency, can significantly improve one's quality of life. By turning our focus inward, to the simple act of breathing, we unlock a powerful ally in the quest for calm and restful nights.



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TAKE A DEEP BREATH. That’s good advice for when you feel overwhelmed, stressed, or anxious. It helps you center yourself and relax. Ad taking it a step further to focus on a pattern of inhaling and exhaling could heighten the calming effects.

The 4-7-8 breathing exercise is one technique that can cultivate “body, soul, spirit connections,” says Kianoush Sheykholeslami, M.D., F.A.C.S., chief of ENT and head and neck surgery at Saint Peter’s University Hospital. “Doing certain exercises with the rhythm, rate, and duration of your breathing” relaxes your body.

Basically, it involves inhaling through your nose for four counts, holding that breath for seven counts, and exhaling through your mouth for eight counts.

4-7-8 breathing can help release stress and calm your anxiety, Dr. Sheykholeslami says. The technique has also been shown to help you doze off if you struggle to fall asleep and improve your quality of sleep.

“When you’re stressed out, you want to take your brain off that stressor,” he says. “It brings your attention to your breathing.”

The breathing exercise is based on a yoga principle called pranayama breathing, or slow exhale, explains Alex Dimitriu, M.D., a double board-certified physician in sleep medicine and psychiatry and founder of Menlo Park Psychiatry and Sleep Medicine. It’s become more popular recently, but integrative medicine expert Andrew Weil, M.D. has been teaching the method for decades.

While experts say 4-7-8 breathing brings many benefits, it can take a little practice to perfect. Here’s exactly how to do it, how it can improve your stress levels, and tips for getting the most out of the technique.

What is 4-7-8 breathing—and, how to do it?

You can do 4-7-8 breathing anywhere and in any position, according to Dr. Weil. But he suggests sitting with your back straight until you get the hang of it.

the single man meditating alone at home while listening to meditation music through wireless headphones, doing breathing exercises

Halfpoint Images//Getty Images

Place the tip of your tongue on the tissue behind your top teeth and keep it there as you do the breathing exercise, he suggests. Next, follow these steps:

  • Exhale fully through your mouth, making a whoosh sound
  • Inhale quietly through your nose with your mouth closed for a count of four seconds
  • Hold your breath for a count of seven
  • Exhale through your mouth, making a whoosh sound again, for a count of eight

This is one cycle. “It is advised to do at least four cycles of this type of breathing per round, and it can be done several times a day, as well as before sleep,” Dr. Dimitriu says. As you practice it more, you can do it for up to eight cycles.

How often you do 4-7-8 breathing and when you do it is up to you. People often use the breathing pattern just before bedtime or a nap to help them fall asleep, Dr. Sheykholeslami says.

It could also be used to relax throughout the day, as a kind of meditation. If you go that route, he suggests finding a quiet place to practice the breathing.

The Benefits of 4-7-8 Breathing

Taking steps to reduce stress and sleep better is good for your overall health. Here are some of the main benefits of 4-7-8 breathing:

It has a calming effect.

When you’re upset or overwhelmed, it can be tough to focus. Dr. Sheykholeslami says 4-7-8 breathing can help you distract yourself, calm down, and let go of the stress. Incorporating it into your daily routine gives you an effective coping strategy when stressors arise.

shot of a young man experiencing chest pains at home

Moyo Studio//Getty Images

It reduces stress and anxiety.

The body goes into fight-or-flight mode when you’re stressed, which triggers the release of cortisol, also known as the stress hormone. Focusing on your breathing, such as the 4-7-8 technique, releases subcortical hormones, which Dr. Sheykholeslami says can have an “anti-cortisol effect.”

“It relaxes your brain and relaxes your body,” he adds.

Research shows that 4-7-8 breathing may be beneficial in reducing anxiety for people after they had bariatric surgery and improving their quality of life, Dr. Dimitriu says.

It helps you sleep.

Most people don’t get enough sleep or sleep well, Dr. Sheykholeslami says. It’s often because they don’t practice good “sleep hygiene,” he says, meaning they stare at their phones right before falling asleep, their bedrooms aren’t at a comfortable temperature, or they don’t have a relaxing bedtime routine.

Practicing a few rounds of 4-7-8 breathing before falling asleep can reduce anxiety and calm your mind, helping you drift off, says Dr. Sheykholeslami, who recommends 4-7-8 breathing to his patients.

A 2022 study published in Physiological Reports found that 4-7-8 breathing helped lower blood pressure and heart rates for people with and without sleep deprivation. That’s crucial, as lack of sleep can increase your risk for high blood pressure, which can also affect sleep.

It helps you control stress long term.

Learning to relax your body on cue is an effective way to manage stress. Once you get into the habit of regularly practicing 4-7-8 breathing, even when you’re not stressed, Dr. Sheykholeslami says you “could control your mind better.” In other words, you train your nervous system to better respond to its fight-or-flight response, according to the Cleveland Clinic. Then, the breathing technique becomes a natural part of your stress response that you automatically turn to when stressors come up.

Are there any downsides to 4-7-8 breathing?

There are really no drawbacks to 4-7-8 breathing, Dr. Sheykholeslami says. You just have to devote time and energy to practicing it, which could take time.

However, some people might experience lightheadedness when they first start, he says. Holding your breath for seven seconds causes carbon dioxide to build up, and some people might feel a little dizzy as a result. Usually, this effect will go away once you practice the breathing exercise more.

If you have cardiovascular disease or respiratory problems, it’s best to talk to your doctor before trying 4-7-8 breathing, just to be safe.

How to Get the Most Out of 4-7-8 Breathing

The more you practice 4-7-8 breathing, the more of a habit it'll become, and you’ll keep seeing the benefits.

The technique works best when it’s incorporated into a healthy lifestyle that includes healthy eating, exercising, limiting alcohol, and getting enough sleep, Dr. Sheykholeslami says. You can also combine it with other meditation practices.

“It becomes a powerful tool,” he says.

Headshot of Erica Sweeney

Erica Sweeney is a writer who mostly covers health, wellness and careers. She has written for The New York Times, HuffPost, Teen Vogue, Parade, Money, Business Insider and many more.

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A trigger is anything that can cause you to have asthma symptoms. This might include trouble breathing, wheezing, tightness in the chest or coughing.  

When you have asthma your airways are more sensitive. Your airways get swollen, red (inflamed) and become narrow when exposed to your triggers.  

Asthma triggers can come from your environment, lifestyle or the quality of the air you breathe. Cold and flu viruses, smoke, exercise or allergies to pollen or dust mites are all types of triggers.  

Asthma triggers are different for different people. Each person (both adults and kids) can have different reactions to different triggers. Some triggers are avoidable (like cigarette smoke or perfumes), while others are more difficult to avoid (such as weather changes and pollen). 

Knowing your asthma triggers and understanding how to avoid them can help lower your chance of having asthma symptoms.

 

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