I am a 35-year-old woman who is busy at work and with my family all day and through the early evening. I want to exercise on my stationary bicycle and elliptical machine at home, but I have time only around 7 p.m. or 8 p.m. . A doctor friend of mine told me that exercising so late could make it difficult for me to go to sleep. Are there any health problems posed by exercising at night? E.P., Montreal, Canada

Judy Siegel-Itzkovich replies:

The common belief that high-intensity exercise should be avoided in the evening due to its effect on sleep only serves to act as another barrier to exercise at this time. But new research recently published in Experimental Physiology suggests that 30 minutes of high-intensity exercise performed in the early evening does not negatively affect subsequent sleep, and it may also have the beneficial effect of reducing hunger pangs.

Researchers at Charles Sturt University in Australia recruited 11 middle-aged men to complete three experimental trials to investigate sleep and appetite responses to exercise performed in the morning (6 a.m. to 7 a.m.), afternoon (2 p.m. to 4 pm) and evening (7 p.m. to 9 p.m.). Participants were required to perform high-intensity cycling involving six one-minute, maximal intensity sprints interspersed by four minutes of rest. Blood collections were taken prior to exercise and following exercise to examine appetite-related hormones, and multiple tests were performed during sleep to assess sleep stages.

The results showed not only that evening exercise did not have a detrimental impact on subsequent sleep, but that afternoon and evening high-intensity exercise were also associated with greater reductions of the hunger stimulating hormone, ghrelin. It is important to note that a single bout of exercise was not linked to reduced hunger, but nevertheless, the observations from this study support high-intensity exercise early in the evening as a viable time-of day for exercise.

As this study’s sample size was relatively small, the findings extrapolated to other population groups beyond middle-aged men may be limited, given that sleep and appetite regulation are influenced by gender and age.

Dr. Penelope Larsen, lead author of the study, commented that “in the future, we hope to conduct similar studies recruiting women, to determine whether sleep and appetite responses may be different depending on gender. Also, this study only considered a single bout of exercise; therefore, it would be beneficial to investigate long-term sleep and appetite adaptations to high-intensity exercise training performed either in the morning, afternoon or evening.”

Interestingly, power output during the sprint efforts was higher for the afternoon and evening trials compared to the morning trial, indicating that participants were able to perform better during latter parts of the day. Therefore, time-of-day may also need to be considered when planning training schedules.”

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I am 28 years old, the mother of twins. I developed varicose veins in my legs during that pregnancy, but they went away. Now I am pregnant again, in the fifth month. I have painful varicose veins again, and it is hard to walk and to work. Is there any way to treat them conservatively, make them shrink and reduce the pain. And how does one prevent them in the first place? S.I., Baltimore, Maryland

Prof. Arnon Samuelof, head of obstetrics at Jerusalem’s Shaare Zedek Medical Center, answers:  

Thanks for the question! The best way to treat painful varicose veins that do not have thrombosis (clots) is to rest and wear good elastic stockings. It’s difficult to shrink them during pregnancy because pregnancy usually makes them worse.


Has Israel progressed with stem cell treatment for multiple sclerosis beyond giving a patient chemo to turn off the immune system and then using stem cells extracted from the patient’s own bone marrow to infuse back into the patient? I am 88 and don’t have MS but my sonm 58, was diagnosed in 2018 with secondary progressive MS. I will take him anywhere in the world where he can get help. M.S.R., Piano, Texas, US.

Prof. Anat Achiron, head of the MS center at Sheba Medical Center at Tel Hashomer in Israel gave the name of a senior neurologist at Hadassah Medical Center in Jerusalem who is involved in such clinical trials. His e-mail address was forwarded to M.S.R. in Texas.


My husband Darrell had his prostrate removed in August 2000 at the age of 52. The continued prostate-specific antigen (PSA) tests consistently were 0.05. In October 2017, the test came back at 2.4; in May 2018, it was 3.5; this past December it has risen to 5.6. The urologist ordered bone scans and CT scans of the lower abdomen. Those results were negative, so a radiologist/oncologist has ordered a PET scan which is scheduled soon. He is also suggesting my husband start eight weeks of radiation therapy five days a week along with hormone shots for six months.

If there is no sign of cancer, why would we consent to the radiation treatments? Also, we have already said no to the hormone shots due to the side effects. Thanks for your input. God bless you and your research. L.M, Branson, Missouri, US

Prof. Raphael Catane, a veteran oncologist at Jerusalem’s Shaare Zedek Medical Center, comments:

The rising of the PSA suggests that there are still viable cancer cells that might spread and affect the skeleton and other organs. To prevent this from occurring, we give radiation therapy to the prostate accompanied by hormonal therapy. Every treatment – and particularly cancer treatments – has its downsides, such as side-effect or toxicity. The art of medicine is to balance the positive effects of the treatment with the toxicity. A careful appraisal of the situation is probably in favor of the combined radiotherapy and hormones; however, I have to agree that the situation is not critical and a delay in starting therapy could be done without too much harm.

If you want an Israeli expert to answer your medical questions, write to Breaking Israel News health and science senior reporter Judy Siegel-Itzkovich at judy@israel365.com with your initials, age, gender and place of residence and details of the medical condition, if any.

Source: Israel in the News