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Exercise (Prong-5)

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Clinical Autonomic and Mitochondrial Disorders

Abstract

“Exercise” covers a range of activities. However, the essential component is an “active lifestyle.” “Exercise” is not a bad word! It does not have to be drudgery. Exercise should reflect the lifestyles of people before automobiles, elevators, television remotes, and cell phones. It can be a single (preferably daily) acute bout of physical exertion or muscular activity that expends energy above one’s basal or resting level. Exercise can also be a daylong habit of activity, included but not limited to household chores, taking the stairs, shopping, gardening, walking, and playing with children. The physiologic and psychologic benefits of exercise are numerous.

The lack of exercise may place a patient on an accelerated track to autonomic neuropathy, accelerating the aging effect, keeping moving, and helping to keep joints, muscles, and nerves healthy. The Rostral Ventrolateral Medulla (RVLM) is a brain stem nucleus that receives a wide variety of inputs, including cardiovascular and exercise-related inputs from both central and peripheral sources, regulating sympathetic control over baroreceptor reflex and thereby blood pressure and under abnormal conditions, hypertension. Directly and indirectly, through the nervous system, exercise affects sleep, cognition, and memory; immune function; cardiovascular and endothelial function; GI function; endocrine and exocrine function; in fact, all systems of the body are positively impacted by appropriate levels of exercise. Exercise may be the most powerful antioxidant available. Further, it helps to elevate mood and relieve depression and, at the same time, relieve stress and potentially anxiety. Always consult your physician before starting an exercise regimen.

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Notes

  1. 1.

    The most notable exception is hypertrophic cardiomyopathy patients who express the recessive gene, in whom the heart muscle thickens with exercise, reducing stroke volume and ejection fraction, leading to heart attack or sudden death. Normally, the heart muscle does not thicken with exercise or stress, like skeletal muscles, but still gets stronger.

  2. 2.

    The United States, arguably, has the highest incidence of arterial calcification. This is due to ubiquitous pasteurization. Pasteurization, while mainly beneficial, also extracts vitamin K2. Vitamin K2, specifically long-chain vitamin K2, is a cofactor that clears the liver and enters the blood stream with lipoproteins (LDLs, HDLs, and triacylglycerol-rich lipoproteins) where it helps to collect calcium from arteries and other soft tissue and redistribute it to the bones, teeth, and other hard tissue. In western cultures, unpasteurized hard cheeses are the best source of long-chain vitamin K2, but still only provide small amounts. Other unpasteurized dairy products also provide long-chain vitamin K2. Since significant quantities of cheeses are required to provide vitamin K2 benefit, there is a risk of atherosclerosis as well; however, small amounts of red wine (one to two servings) often help to reduce atherosclerotic risk.

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DePace, N.L., Colombo, J. (2019). Exercise (Prong-5). In: Clinical Autonomic and Mitochondrial Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-17016-5_7

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