TUESDAY, July 18, 2023 (American Heart Association News) — Crystal Cuadra-Cutler lives for soccer. And soccer has added a lot to her life.

The Gilroy, Calif., resident is a chapter president for the American Outlaws, a group known as “U.S. Soccer’s craziest fans.” Whether it’s her local Major League Soccer team or U.S. national team games, you might find Cuadra-Cutler conducting the chants of thousands of spectators. At the 2015 Women’s World Cup final in Vancouver, Canada, she helped lead marchers who filled the streets on the way to the stadium, then cheered the U.S. team to victory.

“Some might consider me a superfan,” she said, ahead of making plans for parties that will begin when the U.S. women open World Cup play in New Zealand on July 21. The monthlong tournament begins the day before in Auckland. Australia also will host matches, including the Aug. 20 final.

For Cuadra-Cutler, the benefits of fandom have been extraordinary. And health experts agree that there’s power in sports passion – some of it positive, some not. Here’s what they say fans of the world’s most popular sport should know before taking in the tournament.

Heart-stopping action?

Dr. Miguel Maturana, chief cardiology fellow at the University of Tennessee Health Science Center in Memphis, understands soccer fandom. He’s a native of Chile, where the sport is often likened to a religion. “My dad used to take me to the stadium when I was 4 years old,” he said. “He would put me his shoulders.”

Maturana also was lead author on a paper, published in 2021 in Current Problems in Cardiology, that reviewed research on heart health among “die-hard” sports fans.

The intense emotions brought on by a big game can trigger a cascade of chemical responses that increase blood pressure and heart rate. “In most people, this is not significant enough to cause any cardiovascular events,” Maturana said. But in some who have a history of cardiovascular disease, and even some who don’t, it can trigger serious problems.

A German study published in the New England Journal of Medicine showed that the incidence of problems such as arrhythmias or cardiac arrest during the 2006 men’s World Cup were more than 2 1/2 times higher on days when Germany played than on days they were off. The number of cardiac events was higher during games that went down to the wire as opposed to easy German victories.

Another study published in The BMJ found that hospital admissions in England for heart attacks increased 25% when Argentina eliminated the English in a penalty shootout at the 1998 World Cup.

Maturana said such reactions are not unique to soccer. But as a fan who flew to Spain this spring to see Real Madrid play English club Liverpool, he’s hardly suggesting people swear off sports.

“These emotions are not negative,” he said, and for many fans, it’s “why we enjoy sports so much.”

But people should be aware that in the right time, and in the right person, intense reactions can cause problems, and “we never know who is going to be the right person or what is going to be the right time.”

His advice: If you experience chest pain, jaw pain or other warning signs of a heart attack, never ignore them – call 911. Learn CPR, and if you’re out in public, know where to find an automated external defibrillator, or AED.

Don’t penalize your sleep

With this year’s tournament taking place on the other side of the globe, Cuadra-Cutler and her fellow fans could end up watching games at all hours. “We have some games that are going to be great for time for us all to get together,” she said. “And some there are going to be a unique challenge.”

Proper sleep is essential for good health, said Girardin Jean-Louis, director of the Center on Translational Sleep and Circadian Sciences at the University of Miami Miller School of Medicine in Florida. Poor sleep health, which includes insufficient and irregular sleep, has been linked to high blood pressure, diabetes, depression and more.

Somebody with such a condition should think carefully about whether to stay up late to watch, he said.

But Jean-Louis, a soccer fan since he was a boy in Haiti, said missing a night or two of sleep may not be a big deal for some people.

“If you miss a couple of nights, and you happen to be in your early 20s and 30s, you can bounce back fairly quickly,” he said. “If you happen to be in your 50s and 60s, you miss a couple of nights, the recovery time is much longer.”

If you’re planning to be staying up late for a week or two, he recommends adjusting your schedule so you sleep during the day and stay awake at night.

Or you can just record the game. “I understand the excitement of, ‘I’ve got to watch it live,'” Jean-Louis said. He’s stayed up late himself to watch critical matches. “But if it’s not one of those, I just catch the highlights, or watch next day.”

A red card for venues

Few people expect healthy food at a stadium or sports bar, but how bad can it be?

Pretty bad, Maturana said. At its worst, watching at one of those places is “like all of the well-known cardiovascular risk factors are all put together.”

In the long term, high-fat foods shoveled out at sports venues or sports-themed restaurants can increase cholesterol and the risk of heart disease. Even in the short term, high levels of salt can raise blood pressure, Maturana said.

A smoky bar is even worse. Secondhand smoke is a serious health hazard. As for alcohol, federal dietary guidelines note potential health risks and that some people shouldn’t be drinking at all.

So, to be clear, Maturana said: “Don’t smoke. Don’t eat anything too salty. If you’re going to drink, drink with moderation.”

Mental health wins

Fandom can boost mental health in individuals and groups, said Lynn Zubernis, a professor and licensed psychologist at West Chester University in West Chester, Pennsylvania.

She studies fandom in pop culture, and particularly in the TV show “Supernatural,” but said that when you get down to the basics, the only difference between someone who dresses up for a “Star Trek” convention and someone who puts on a football jersey for a tailgating party is social acceptance.

“A fan is a fan,” she said, and fandom is a leisure activity. “There’s plenty of research out there on the benefits of leisure, including reducing stress.”

Zubernis said fans often adopt positive attitudes from what they’re following, whether it’s a fictional character’s “never give up” motto or a team that plays hard against the odds.

Maturana has seen this play out in a healthy way in soccer fans who take up the sport themselves and are motivated to stay in shape because of it.

The power of connection

Fandom also protects against loneliness, which has been identified as a major health threat, by helping people forge connections.

Seeing people with a T-shirt or tattoo from your team or TV show signals you’re among your own people. “It feels great to know that you’re part of this group,” Zubernis said, and being part of a group can open people up emotionally.

Even watching a game on TV can help, she said. Human brains have evolved to create an emotional connection with familiar faces but don’t distinguish between a face on a screen or in person. So when we see a member of a favorite team or star of a favorite show, we feel linked to other humans. Although some people can take this too far, she said, “the vast majority of fans are not delusional.”

Fans who feel a connection to a team or celebrity also have higher self-esteem, she said. And fandom can spread emotions among fans. Sometimes, that can play out in ugly ways. But at its best, Zubernis said, a group of people watching a soccer match can share in feelings of joy and achievement if their team wins.

Making it personal

Superfan Cuadra-Cutler hopes to feel some of that joy this year, but she will do it from afar. She and fellow fans will meet at their chapter bar. “The entire place will be decked in red, white and blue,” she said. “Every TV is going to be on the tournament.” There will be singing and possibly drumming.

She’s lived many of the benefits of fandom. Becoming seriously involved in U.S. soccer after the 2006 men’s World Cup transformed her.

“I’ve done a lot of stuff that I never could have envisioned myself doing had I not gotten involved with soccer,” she said. “For example, I was more introverted and didn’t like public speaking. Now, I’m a person that at games is leading the entire chant section.”

She’s also lived the power of connection.

In 2020, Cuadra-Cutler learned she had lung cancer. “My soccer family came together in a way that I couldn’t have imagined,” she said.

The day she began chemotherapy, fellow soccer fans from around the world lined up on video to wish her well. U.S. national team players donated to help cover her expenses. The San Jose Earthquakes of MLS welcomed her to a training session and gave her a signed jersey.

“I had so much help, I didn’t know what to do with it,” she said.

Her cancer can’t be cured, but it has been stable since January 2021, she said. And her fandom, which began “just because I was interested in the sport and I wanted to meet other people who were interested in the sport,” has become something much bigger than she imagined.

“What I get out of it is immense,” she said. “I almost would consider immeasurable.”

American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved.

By Michael Merschel, American Heart Association News