We all have been discussing exercise as medicine, highlighting its role in managing chronic conditions like hypertension, hyperglycemia, etc. However, some debate that exercise is not medicine, often due to concerns about incidents like sudden cardiac death or heart attacks during fitness and sporting events. Reports of athletes collapsing during a triathlon in British and marathons and fitness class in Malaysia fuel this skepticism.

In 2024, I consulted with a client who, after blacking out during a fitness class, stopped exercising due to safety concerns. Additionally, two trainers in our mentorship program shared similar stories of friends collapsing during fitness class, marathon and pickleball events.

These cases contribute to the debate on exercise as medicine. As an exercise physiologist, I believe it's vital to address these concerns by promoting safe exercise practices. While this discussion won't delve deeply into sudden cardiac death, it's important to encourage and promote the concept of “Exercise Right and Safe Sport” to minimize risks and maximize health benefits.

Misconceptions About Exercise

Many people understand that exercise improves fitness and can help prevent chronic diseases. However, misconceptions persist. For example, some believe that high-intensity exercise burns more fat, directly aiding weight loss. This myth is reflected in comments I’ve heard during consultations and mentorship sessions, where clients and trainers often equate HIIT (High-Intensity Interval Training) with instant fat loss: "HIIT = Use Fat = Lose Fat" 

From an exercise energy system perspective, high-intensity workouts primarily use glucose as fuel due to the immediate energy demands. So, how does HIIT help with fat loss? Research shows that HIIT supports weight management by reducing body fat, not because it burns fat during the exercise but due to Excess Post-Exercise Oxygen Consumption (EPOC), commonly known as the “afterburn effect.” Post-HIIT, the body’s core temperature, heart rate, and metabolic rate remain elevated, contributing to fat loss over time.

However, people may stop exercising during or after a HIIT session or even collapse for several reasons:

1. The intensity exceeds their current fitness level, leading to feelings of anxiety and demotivation.

2. Physiologically, the excessive strain places undue stress on the heart, increasing the risk of cardiac distress events.

Exercise Right, Safe Sport

Negative news and experiences around exercise shouldn’t overshadow its benefits. To promote safe and effective exercise practices, consider the following steps:

1. Medical Checkups: Before starting an exercise program, undergo a medical assessment to check heart health (e.g., ECG tests) and blood biomarkers (e.g., lipid profiles). If results indicate risks like elevated blood pressure, abnormal ECG waveforms, or an unhealthy lipid profile, consult a medical doctor before starting exercise or refer to an Exercise Physiologist (EP).

2. Seek Professional Guidance: Even if you are healthy but new to exercise or struggling to increase physical activity levels, consult an EP. They will: (1) Analyze your medical reports. (2) Conduct exercise testing to identify baseline fitness, strengths, and weaknesses. (3) Prescribe the right exercise dosage tailored to your needs.

3. Work With Certified Trainers: If you’re already active and have a normal medical profile, consider hiring a qualified personal trainer or fitness coach to improve fitness levels while minimizing injury risks. Verify their academic background and certifications to ensure they are qualified.

4. Practice Recovery and Moderation: Avoid high-intensity workouts daily. Alternate high-intensity days with recovery days to allow your body to rest and adapt, reducing the risk of adverse events.

#To better understand the role between Exercise Physiologist and Fitness Trainers, kindly check our last article HERE.