Exercise
It is now common knowledge that to “stay safe” amidst the Covid-19 pandemic, that you should wash your hands, social distance, and wear masks. In our previous blog, we covered the importance of an immune supporting diet as a critical pillar in our health. In this blog, we will look at exercise, another important lifestyle prevention pillar necessary to supporting the optimal functioning of the immune system.
What does Exercise Do?
During this time of pandemic it is common knowledge that a compromised immune system creates not only a risk for infections but also contributes to overall poor health. Researchers have shown that after moderate exercise, all immune cells, particularly natural killer (NK) cells, neutrophils, and macrophages were increased [2]. This benefit was seen even in high-risk populations such as the very old, where after moderate walking of 15-30 minutes, enhanced CD4 and T-cell proliferation was noticed. [3].
These exercise-induced effects on the immune system may act as a natural vaccine against viral infections such as COVID-19. In fact, in a randomized trial of 60 healthy men and women who performed upper body resistant training exercise 6 hours prior to receiving influenza vaccinations, showed after 20 weeks of monitoring that they had immune responses positively associated with the percentage increase in arm circumference.[4]
In a new review of past research, Zhen Yan, a professor of cardiovascular medicine at the University of Virginia Medical School showed that exercise boosted the production of an antioxidant known as “extracellular superoxide dismutase,” or EcSOD, which in turn, protects against acute lung disease and other diseases.
In particular, Yan said, this antioxidant can protect against acute respiratory distress syndrome (ARDS), known to affect up to 85% of patients in the ICU with COVID-191.
What Kind of Exercise is Best?
The exercise does not have to be vigorous or intense. Just 20 minutes of moderate exercise can provide the anti-inflammatory agent.2 In fact, it has been shown that severe exercise, can actually be counter-productive in terms of the susceptibility to infections, since it is linked with higher upper respiratory tract infection rates among elite endurance athletes [5,6].
Researchers found that immediately after a bout of intense exercise in elite swimmers, there was actually a decrease in antibodies such as salivary immunoglobulin A (IgA), and immunoglobin M (IgM) [6]. Higher exercise intensities have also been found to create oxidative stress and muscle damage [7,8].
Individuals at high-risk for COVID-19 such as those who are overweight, insulin resistant, and diabetic all typically have chronic low-grade inflammation. This low grade inflammatory state creates higher levels of pro-inflammatory cytokines and predisposes them to greater risks for infection and more adverse outcomes [37].
Regular, moderate exercise therefore is key to increasing anti-inflammatory effects. A practical method of achieving moderate exercise intensity is 200–400 minutes of aerobic exercise distributed across 5–7 days, with at least 2–3 resistance sessions, at 40–70% of maximum heart rate (HRmax = 220-age). Basic exercising can even be done at home using one’s own body weight i.e. push ups, squats etc, and are enough to counteract sedentary behaviors and reduce sitting times and are particularly recommended for older and high-risk individuals with chronic conditions such as diabetes.
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In summary we have seen that in most individuals with chronic illnesses such as obesity, diabetes, and heart disease, sedentary behavior is present. The consequences of a sedentary lifestyle include a compromised immune system due to systemic inflammation, and oxidative stress [9,10]. Conversely, higher physical activity and fitness levels in adults are associated with an optimized immunity as indicated by reduced white blood cell count, C-reactive protein (CRP), interleukins (IL-6, and IL-18), tumor necrosis factor alpha (TNF-α), and other inflammatory biomarkers [11].
Therefore, beginning any physical activity or exercise program would prove beneficial compared to being sedentary, especially during and after COVID-19 lockdown, social distancing, or quarantine measures.