Article

Upper respiratory tract infection is reduced in physically fit and active adults

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Limited data imply an inverse relationship between physical activity or fitness level and the rates of upper respiratory tract infection (URTI). The purpose of this study was to monitor URTI symptoms and severity in a heterogeneous group of community adults and contrast across tertiles of physical activity and fitness levels while adjusting for potential confounders. A group of 1002 adults (ages 18-85 years, 60% female, 40% male) were followed for 12 weeks during the winter and fall seasons while monitoring URTI symptoms and severity using the Wisconsin Upper Respiratory Symptom Survey. Subjects reported frequency of aerobic activity, and rated their physical fitness level using a 10-point Likert scale. A general linear model, with adjustment for seven confounders, was used to examine the effect of exercise frequency and fitness level on the number of days with URTI and severity of symptoms. The number of days with URTI during the 12-week period was significantly reduced, 43% in subjects reporting ≥ 5 days/week aerobic exercise compared to those who were largely sedentary (≤ 1 day/week) and 46% when comparing subjects in the high versus low fitness tertile. URTI severity and symptomatology were also reduced 32% to 41% between high and low aerobic activity and physical fitness tertiles. Perceived physical fitness and frequency of aerobic exercise are important correlates of reduced days with URTI and severity of symptoms during the winter and fall common cold seasons.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Some have calculated the overall weekly intensity and activity hours by occupation in the United States, as well as the hours spent and energy consumed in PA domains in Canada (Csizmadi et al., 2011;Steeves et al., 2018). Furthermore, data demonstrated a strong correlation between moderate intensity or high frequency and lower risk of colds (Chubak et al., 2006;Nieman et al., 2011). The survey of the daily PA by different classifications and the link between PA and common colds were of far-reaching influence on public health. ...
... inversely related to the higher number of common colds. Compared with sedentary adults, the high frequency could reduce the severity and number of common cold (Nieman et al., 2011;Zhou et al., 2018). Intensity has a U-shaped doseresponse relationship with colds. ...
... Age, sex, and occupation showed no significant effect on colds in this study (P > 0.05). Some previous studies found a significant effect between age and colds, but the study was limited to 12 weeks (Nieman et al., 2011), whereas this study investigates colds for the past 1 year. When the measurement time was limited to a short range, the individual difference may result in different findings. ...
Article
Full-text available
Background: Physical activity (PA) has a significant health impact worldwide and has been linked to a lower risk of the common cold. Objective: The aim of this study was to estimate the form of PA among Chinese adults and the correlation between PA and number of the common cold in China's eastern, central, and western areas. Design: A cross-sectional study. Setting: China's eastern, central, and western regions from 30 November 2020 to 30 March 2021. Patients: A total of 1,920 healthy participants, who aged over 18 years old, with Internet access, were enrolled, and then self-reported PA behaviors and number of the common cold were collected. Measurements: The authors calculated preference, intensity, frequency, and duration of PA in Chinese based on gender, age, and broad occupational categories and explored the potential effect between these factors and the common cold. Results: Approximately 20.4% of participants reported not participating in sports regularly. Except for gender, there were significant differences in PA preference and intensity among the remaining individuals (P <0.05). Sixteen common exercises were divided into three intensity levels by the Borg CR10 Scale: low- (5), moderate- (8), and high-intensity exercises (3), and the corresponding intensity, frequency, and duration were computed with significant differences (P <0.05). The most popular workouts are "Brisk walking" and "Running." Age, sex, and occupation had no significant effect on colds (P > 0.05). However, intensity shows a U-shaped dose-response relationship with colds, whereas the frequency and duration have an inverse dose-response relationship (P <0.05). High intensity combined with high frequency increased colds the most. Nevertheless, non-exercise groups always have the most colds in each comparison. Limitations: The result may be vulnerable to recall bias. Conclusion: Intensity showed that U-shape, frequency, and duration showed inverse response to the number of colds last year, but age, sex, and occupation had no significant effects. High intensity and high frequency mixed increased colds the most, regardless of duration.
... COVID-19 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which mainly affects the pulmonary and cardiovascular systems [4]. Factors linked with an increased risk of mortality in COVID-19 include comorbidities such as obesity, diabetes, cardiovascular disorders and a lower functional capacity [5][6][7][8]. Poor lifestyles such as physical inactivity could worsen this scenario as it is related to impaired immune function and the increased risk of illness [9][10][11]. ...
... Moreover, moderate levels of physical activity could improve the health status and quality of life and prognosis of patients infected with COVID-19 because it meliorates immunity and health-related physical fitness [5,12]. Nieman et al. [8] showed that higher levels of physical fitness reduced days with an upper respiratory tract infection and the severity of symptoms during the winter and fall, which are common cold seasons. ...
... One possible explanation for the association of COVID-19 symptoms and physical activity level is that the regular practice of physical activity, as well as high levels of physical capacity, are related to an improved immune function and a decrease in immunosuppression and chronic inflammation associated with the aging process and subsequently lower risk of illness and pulmonary infections [8,28,29]. The lack of protection for COVID-19 symptoms in those with higher levels of physical activity might be explained by the J shaped curve that reflects the association between physical activity and immune function and risk of illness, with increased risk for both those who have very low and very high levels of exercise [7]. ...
Article
Full-text available
Corona Virus Disease 2019 (COVID-19) outbreak created an unprecedented impact on global health and further aggravated the physical inactivity pandemic. For this reason, the understanding of sociodemographic variables in the context of physical activity levels are important for the field of public health in order to assist in relevant public health decisions. Our main aim was to characterize sociodemographic variables and physical activity levels and its association in the COVID-19 outbreak. We applied an online Google survey with closed questions in Brazilian people of different age and regions, both sexes, and physical activity levels (n=1,726 respondents). Our main results were that participants who had symptoms of COVID-19 had the highest percentage of level 1 of physical activity (lowest level) and those who showed no symptoms had the highest percentage of levels 2 and 3 of physical activity, that is, close to the moderate levels of physical activity. This cross-sectional study in the Brazilian population provided important sociodemographic data and COVID-19 aspects regarding to the level of physical activity. It is possible to assume that higher levels of physical activity could positively impact individual and collective health and be a tool in the field of public health to cope with disease scenarios that require isolation and social distance. Keywords: Physical activity; COVID-19; Pandemic; Sociodemographic; Online survey
... In fact, the importance of physical activity in decreasing the risk of adverse health conditions, including non-communicable diseases, has been established [6]. Furthermore, physical activity has been shown to reduce the risk of serious community-acquired infections as well as mortality [7]. The Wisconsin Upper Respiratory Symptom Survey revealed that frequent physical activity reduced the risk of upper respiratory infections by 43% [7]. ...
... Furthermore, physical activity has been shown to reduce the risk of serious community-acquired infections as well as mortality [7]. The Wisconsin Upper Respiratory Symptom Survey revealed that frequent physical activity reduced the risk of upper respiratory infections by 43% [7]. Additionally, regular exercise decreases the risk of influenza-associated mortality [8]. ...
... In a recent meta-analysis, higher levels of habitual physical activity lowered the risks of community-acquired infectious disease and mortality [18]. In addition, physically active individuals had a lower risk of infectious diseases, such as community-acquired pneumonia, than their inactive counterparts [19][20][21], and physical activity and regular exercise reduced the risk of upper respiratory infections [7] and influenza-associated mortality [8]. In a Cochran review of a total of 14 trials, although exercise interventions did not reduce the number of acute respiratory infection episodes per person per year, the severity of symptoms measured on the Wisconsin Upper Respiratory Symptoms Survey compared with the controls were reduced [22]. ...
Article
Full-text available
Regular physical activity (PA) is known to reduce the risk of serious community-acquired infections. We examined the association of PA with the morbidity and mortality resulting from coronavirus disease (COVID-19) infection in the South Korean population. Patients who tested positive for severe acute respiratory coronavirus 2 and who underwent public health screening between 2014 and 2017 (n = 6288) were included. Age- and sex-matched controls (n = 125,772) were randomly selected from the Korean National Health Insurance Service database. Leisure-time PA was assessed using a self-reported questionnaire. The mean PA levels were lower in the patient than in the control group (558.2 ± 516.3 vs. 580.2 ± 525.7 metabolic equivalent of task (MET)-min/week, p = 0.001). Patients with moderate to vigorous PA (MVPA) were associated with a lower risk of COVID-19 morbidity (odds ratio (OR), 0.90; 95% confidence interval (CI), 0.86–0.95). In addition, a standard deviation (SD) increment in MET/week (525.3 MET-min/week) was associated with a 4% decrease in the risk of COVID-19 morbidity (OR, 0.96; 95% CI, 0.93–0.99). MVPA and an SD increment in MET/week were associated with lower mortality (MVPA: OR, 0.47; 95% CI, 0.26–0.87; per SD increment: OR, 0.65; 95% CI, 0.48–0.88). Higher levels of regular PA were associated with a lower risk of COVID-19 infection and mortality, highlighting the importance of maintaining appropriate levels of PA along with social distancing amid the COVID-19 pandemic.
... In this context, studies have looked at the effects of exercise on the modulation of the immune response and decreasing rates of infections, such as in viral diseases (133). Whereas few studies have shown that high-intense and prolonged (strenuous) exercise causes the suppression of immune defense and progressively increases the risk of infections ["J-curve", first reported by Nieman (134)], to demonstrate a relationship between physical fitness and immune function (135). Additionally, acute febrile infections have been associated with low performance during exercise due to muscular atrophy, circulatory disturbance, and impaired motor coordination. ...
... In this regard, studies have related a decrease of around 28% in the incidence of URTI rates in people with high fitness and physical activity levels. Moreover, these studies have reported a decrease of symptoms and, mainly, a reduction in the severity of URTI, decreasing the number of days of URTI in 43% and 46% in people who practice moderate and high fitness capacity, respectively (135). Experimental research has shown that higher cardiorespiratory fitness may improve lung function and have anti-inflammatory properties (141). ...
... In parallel, a point to be considered is the season, especially winter, which reverberates in the immune system, increasing the risk of infectious diseases (135,216). As well as the temperature change which affects energy supply to the immune system, decreasing the immune surveillance, and consequently, greater exposure to upper respiratory tract-related diseases (218,219). ...
Article
Full-text available
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a fast spreading virus leading to the development of Coronavirus Disease-2019 (COVID-19). Severe and critical cases are characterized by damage to the respiratory system, endothelial inflammation, and multiple organ failure triggered by an excessive production of proinflammatory cytokines, culminating in the high number of deaths all over the world. Sedentarism induces worse, continuous, and progressive consequences to health. On the other hand, physical activity provides benefits to health and improves low-grade systemic inflammation. The aim of this review is to elucidate the effects of physical activity in physical fitness, immune defense, and its contribution to mitigate the severe inflammatory response mediated by SARS-CoV-2. Physical exercise is an effective therapeutic strategy to mitigate the consequences of SARS-CoV-2 infection. In this sense, studies have shown that acute physical exercise induces the production of myokines that are secreted in tissues and into the bloodstream, supporting its systemic modulatory effect. Therefore, maintaining physical activity influence balance the immune system and increases immune vigilance, and also might promote potent effects against the consequences of infectious diseases and chronic diseases associated with the development of severe forms of COVID-19. Protocols to maintain exercise practice are suggested and have been strongly established, such as home-based exercise (HBE) and outdoor-based exercise (OBE). In this regard, HBE might help to reduce levels of physical inactivity, bed rest, and sitting time, impacting on adherence to physical activity, promoting all the benefits related to exercise, and attracting patients in different stages of treatment for COVID-19. In parallel, OBE must improve health, but also prevent and mitigate COVID-19 severe outcomes in all populations. In conclusion, HBE or OBE models can be a potent strategy to mitigate the progress of infection, and a coadjutant therapy for COVID-19 at all ages and different chronic conditions.
... The WHO state that physical activity is important for health and well-being during self-quarantine [9]. There is no original study or clinical trial on how exercise can protect people with MS against COVID-19, but there are plenty of studies on the effects of exercise on respiratory illness [10,11] and how exercise improves immune system function [12]. ...
... Upper respiratory tract infection (URTI) is caused by various pathogens such as coronavirus and influenza, which involves the nose, sinuses, pharynx, or larynx [13]. It is believed that moderate-intensity exercise such as aerobic activity can help the immune system deal with pathogens to reduce the risk of the infection severity (32-41%), frequency (43-46%), and symptomatology (34-41%) [11]. ...
... It is acknowledged that reducing stress levels, getting adequate sleep, and eating a balanced diet strengthen the immune system. Studies have also shown that exercise makes the body resistant to diseases such as colds and flu [10,11]. The J-shape model describes the relationship between exercise intensity and the risk of catching URTI. ...
Article
Full-text available
Background: COVID-19 seems to have a major impact on physical activity behaviors, especially for people with Multiple Sclerosis (MS) who have health conditions. Methods: This study was a narrative review. Six databases, namely PubMed, ISI Web of Knowledge, Scopus, Google Scholar, Science Direct, and ProQuest, were searched for relevant published studies. Results: Healthcare providers and organizations advise people to stay at home, but this does not mean that they should be inactive. Self-isolation has an adverse effect on behavior activities and mental health in people with MS. Physical activity can act as medicine for people with MS, as it helps reduce stress, anxiety, and fatigue while improving balance, muscle strength, flexibility, and quality of life. Conclusion: People with MS are recommended to perform activities such as whole-body chair exercises with moderate intensity at least 150 minutes per week according to the level of the individual’s ability.
... The relation between physical activity and respiratory tract infections is controversial and it is mostly correlated with exercise intensity (Baik et al. 2000;Chubak et al. 2006;Neuman et al. 2010;Nieman et al. 2011;. ...
... To illustrate, in a randomized controlled study involving 36 women, the risk of upper respiratory tract infections was reduced during moderate exercises (Nieman et al. 1990). Also, in another study that followed 1002 adults for 12 weeks during winter and fall seasons, the level of physical fitness and frequency of aerobic exercise program per week was important and correlated with reduced severity of upper respiratory tract infection (URTI) and the duration of symptoms (Nieman et al. 2011). ...
... In fact, several physiological processes have been suggested to explain the relationship between physical activity and improved immune and lung function (Barrett et al. 2018;Chubak et al. 2006;Nieman et al. 2011;Obasi et al. 2013). In addition, although lymphocytosis is often associated with acute bouts of exercise, some studies reveal the little effect of training on lymphocyte concentrations . ...
Article
Full-text available
AimThe COVID-19 pandemic is a global health emergency, and therefore the prevention and treatment of this disease is an important priority of world health. In the present study, some risk factors, including unhealthy nutrition, obesity, and physical inactivity, were assessed in patients infected with SARS-CoV-2, and their effects on the severity and duration of disease were evaluated.Subject and methodsThe present study was a cross-sectional study. Data was collected from all patients who visited the respiratory emergency department from March 20, 2020 to April 24, 2020 in the University Hospital. The outcome measures were body mass index, diet quality that was evaluated with a 16-item food intake questionnaire, and physical activity level that was assessed by the global physical activity questionnaire.ResultsTwo hundred and six patients’ data was analyzed. The results investigated that patients with lower levels of physical activity or lower MET.min/week were affected by a more severe form of the disease (p = 0.05 and p = 0.03, respectively). We found that patients with a healthier dietary pattern were affected by lower severity of illness (p < 0.05).Conclusion It seems that increasing levels of physical activity may partly reduce the severity of COVID-19 disease. Some dietary patterns such as increasing fruit and poultry consumption as well as drinking less tea were correlated significantly with a less severe form of the disease. The results did not confirm previous concerns regarding a potentially harmful effect of smoking on the severity or duration of symptoms.
... Physical exercise has been consistently shown to modulate immune function [48][49][50][51]. Higher levels of physical activity [52][53][54] and fitness [54] decrease the risk of respiratory symptoms and illness. In this regard, people involved with strength and power activities [55][56][57][58] usually have a better immunological profile than people involved with long duration aerobic activities [59], which might be a positive point to RT [60,61]. ...
... Physical exercise has been consistently shown to modulate immune function [48][49][50][51]. Higher levels of physical activity [52][53][54] and fitness [54] decrease the risk of respiratory symptoms and illness. In this regard, people involved with strength and power activities [55][56][57][58] usually have a better immunological profile than people involved with long duration aerobic activities [59], which might be a positive point to RT [60,61]. ...
Article
Full-text available
By the end of 2019 a severe acute respiratory syndrome caused by the SARS-CoV-2 started a pandemic, leading to millions of deaths and many important political and social changes. Even in the absence of contamination, the mobility reduction, social distancing and closing of exercise facilities negatively affected physical activity and conditioning, which is associated to muscle atrophy, loss of muscle strength and reductions in functional capacity. In case of infection, it has been shown that increased physical capacity is associated with decreased hospitalization and mortality risk. Although millions of people died from COVID-19, most contaminated individu-als survived from the infection, but carried different sequelae, like severe loss of physical func-tion and reduced quality of life. Among different physical exercise models that might help to prevent and treat COVID-19 outcomes, resistance training (RT) might be particularly relevant. Among its benefits, RT can be adapted to be performed in many different situations, even with limited space and equipment, and it is easily adapted to individual characteristics and health status. The current narrative review aims to provide insights on how RT can be used in different scenarios to counteract the negative effects of COVID-19. By this, the authors expect to provide insights do deal with the current pandemic and also in case the World has to deal with similar events in the future.
... 10 12 18 20-23 Near-daily physical activity compared with inactivity has been linked to reduced incidence rates for influenza, the common cold and severe cases of COVID-19, with diminished mortality rates for pneumonia and other viral and bacterial infections in the general population. [20][21][22][23] Multiple lines of experimental evidence support the hypothesis that moderate exercise may lower risk for respiratory infection in the general population. In a large epidemiological study of 97 844 adults from England and Scotland, exercise training was associated with a lowering of the risk for bacterial and viral infectious disease mortality by more than 50% over a 9-year period 21 (figure 2). ...
... Acute respiratory illness (number of days ill during 12 weeks of the winter and fall seasons) was 43% lower in adults engaging in an average of 5 or more days per week of aerobic exercise compared with those who were largely inactive after accounting for confounders such as age, education level, marital status, gender, body mass index and perceived mental stress (figure 2). 22 Data from the UK Biobank showed that physical inactivity was related to a 32% increased risk for COVID-19 hospitalisations 23 (figure 2). The lifestyle combination of physical inactivity, cigarette smoking and obesity increased the risk of COVID-19 hospitalisation 4.4-fold compared with optimal lifestyles and accounted for up to 51% of the population attributable risk. ...
... Moderate levels of PA are associated with a low risk of URTI, whereas highly active individuals such as elite endurance athletes have an increased frequency of URTI after single bouts of ultra-endurance exercise or during intensive training periods. Inactive individuals are at high risk of URTI as well [16,[23][24][25]. ...
... Moderate levels of PA are associated with a low risk of URTI, whereas highly active individuals such as elite endurance athletes have an increased frequency of URTI after single bouts of ultraendurance exercise or during intensive training periods. Inactive individuals are at high risk of URTI as well [16,[23][24][25]. ...
Article
Full-text available
Age-induced cellular senescence leads to a decline in efficacy of immune response and an increase in morbidity and mortality. Physical activity may be an intervention to slow down or reverse this process for elderly individuals or even delay it via enhanced activity over their lifespan. The aim of this systematic review was to analyze and discuss the current evidence of the effects of physical activity on senescence in leukocyte subpopulations. Two electronic databases (PubMed, Web of Science) were scanned in July 2020. Studies performing endurance or resistance exercise programs and investigating leukocytes of healthy, particularly elderly subjects were included. Nine human studies were identified, including a total of 440 participants, of which two studies examined different types of exercise training retrospectively, three conducted resistance exercise, three endurance exercise, and one endurance vs. resistance training. Results revealed that exercise training increased the naïve subsets of peripheral T-helper cells and cytotoxic T-cells, whereas the senescent and effector memory T-cells re-expresses CD45RA (TEMRA) subsets decreased. Moreover, the percentage of T-helper- compared to cytotoxic T-cells increased. The results suggest that physical activity reduces or slows down cellular immunosenescence. Endurance exercise seems to affect cellular senescence in a more positive way than resistance training. However, training contents and sex also influence senescent cells. Explicit mechanisms need to be clarified.
... Simultaneously, energy, fiber, and macronutrient contents remain unchanged. In part, these effects may contribute to explaining how and to what extent the microbiota reacts to aerobic training in athletes participating in high-intensity competitions [109][110][111][112]. MHC expression is suppressed for several hours during recovery from prolonged endurance exercise. ...
... This condition is opposite to the activation of lymphocytes observed under physical exercise characterized by both moderate intensity/duration or an intense but short duration: only prolonged (greater than 1 h) and/or high-intensity (greater than 70% VO 2 max) efforts can substantially decrease lymphocyte number and activities, thereby eliciting transient immunosuppression in the post-exercise phase [114]. Thus, in an otherwise unexplained performance deterioration in a professional athlete, the evaluation of his/her microbiota (eubiosis or dysbiosis) along with intestinal functions might provide some interesting hints to interpret the general conditions [112][113][114]. In this regard, the use of probiotics (Saccharomyces boulardii, Lactobacillus reuteri, and others) and prebiotics to maintain the eubiosis of the intestinal microbiota may represent an additional support for exercise performance capacity, training adaptations, and recovery from exercise [115,116]. ...
Article
Full-text available
Gut microbiota refers to those microorganisms in the human digestive tract that display activities fundamental in human life. With at least 4 million different bacterial types, the gut microbiota is composed of bacteria that are present at levels sixfold greater than the total number of cells in the entire human body. Among its multiple functions, the microbiota helps promote the bioavailability of some nutrients and the metabolization of food, and protects the intestinal mucosa from the aggression of pathogenic microorganisms. Moreover, by stimulating the production of intestinal mediators able to reach the central nervous system (gut/brain axis), the gut microbiota participates in the modulation of human moods and behaviors. Several endogenous and exogenous factors can cause dysbiosis with important consequences on the composition and functions of the microbiota. Recent research underlines the importance of appropriate physical activity (such as sports), nutrition, and a healthy lifestyle to ensure the presence of a functional physiological microbiota working to maintain the health of the whole human organism. Indeed, in addition to bowel disturbances, variations in the qualitative and quantitative microbial composition of the gastrointestinal tract might have systemic negative effects. Here, we review recent studies on the effects of physical activity on gut microbiota with the aim of identifying potential mechanisms by which exercise could affect gut microbiota composition and function. Whether physical exercise of variable work intensity might reflect changes in intestinal health is analyzed.
... Also, the protective effect of physical activity on physical frailty (i.e., characterized by diminished strength, resilience, and physiologic function) and cardiovascular diseases has been extensively demonstrated [9,10]. Furthermore, physical activity may help strengthening and maintaining the immune system making the individual less susceptible to infections [11]. As COVID-19 affects primarily the cardiopulmonary system; physical function and physical activity are key targets for investigation with important implications for future COVID-19-as well as other respiratory infections-research and public health recommendations. ...
... Previous studies have also shown that cardiovascular fitness and aerobic exercise (e.g., walking) induce a proper cardiorespiratory function and a better immune system [30]. Indeed, physical fitness and levels of aerobic exercise are important correlates of reduced frequency of upper respiratory tract infection and severity of symptoms [11]. Furthermore, previous research has shown that physical activity interventions can delay or prevent frailty progression and age-related decline in immune response [31]. ...
Article
Full-text available
Background One’s physical function and physical activity levels can predispose or protect from the development of respiratory infections. We aimed to explore the associations between pre-pandemic levels of physical function and physical activity and the development of COVID-19-like symptoms in Swedish older adults. Methods We analyzed data from 904 individuals aged ≥ 68 years from the population-based Swedish National study on Aging and Care in Kungsholmen. COVID-19-like symptoms were assessed by phone interview (March–June 2020) and included fever, cough, sore throat and/or a cold, headache, pain in muscles, legs and joints, loss of taste and/or odor, breathing difficulties, chest pain, gastrointestinal symptoms, and eye inflammation. Muscle strength, mobility, and physical activity were examined in 2016–2018 by objective testing. Data were analyzed using logistic regression models in the total sample and stratifying by age. Results During the first outbreak of the pandemic, 325 (36%) individuals from our sample developed COVID-19-like symptoms. Those with slower performance in the chair stand test had an odds ratio (OR) of 1.5 (95% confidence interval [CI] 1.1–2.1) for presenting with COVID-19-like symptoms compared to better performers, after adjusting for potential confounders. The association was even higher among people aged ≥ 80 years (OR 2.6; 95% CI 1.5–4.7). No significant associations were found between walking speed or engagement in moderate-to-vigorous physical activity and the likelihood to develop COVID-19-like symptoms. Conclusion Poor muscle strength, a possible indicator of frailty, may predispose older adults to higher odds of developing COVID-19-like symptoms, especially among the oldest-old.
... An agreement between scientists exists in that moderate exercise enhances the athlete's immunity, but high-intensity prolonged exercise impairs, temporarily, immune competence. In addition, a relationship between immune-depression and risk of upper respiratory tract infection (URTI) has been established following heavy exercise [2]. Therefore, a perception exists that some athletes, especially those engaging in prolonged intensive exercise and competition, such as running, cycling and swimming, may show an increased rate of URTI during intense training periods and competition [2]. ...
... In addition, a relationship between immune-depression and risk of upper respiratory tract infection (URTI) has been established following heavy exercise [2]. Therefore, a perception exists that some athletes, especially those engaging in prolonged intensive exercise and competition, such as running, cycling and swimming, may show an increased rate of URTI during intense training periods and competition [2]. It has been reported that a high percentage of illness occur among elite athletes when training above lactate threshold levels [3]. ...
Article
Full-text available
The rapid spread of the virus that causes COVID-19 (SARS-CoV-2) has sparked alarm worldwide. The way the virus spreads is still unclear; however, it’s known that similar viruses are spread in cough & sneeze droplets. At the time of writing this editorial over 300,000 people worldwide have been infected with over 13,000 deaths (WHO, 2020). The principle measure introduced to stop the spread of infection among the general population is by encouraging the public to undertake specific behaviours related to hygiene, that is useful in stopping the spread amongst family members or close associates for previous outbreaks of virus from the same family. A second measure used widely across the world is social distancing for non-infected members of the public or social isolation for infected families or high-risk individuals. Many sporting events and athletic games have been postponed causing large scale disruption to the global sport industry with millions of dollars lost. Most teams and induvial athletes will continue to train to maintain fitness and be ready for the return to active competition when the pandemic is under control.
... Evidence based studies highlight that physical exercises reduced the number of days subjects suffered from upper respiratory tract infections including the severity of their symptoms [74,75]. As yet common colds cannot be prevented or controlled [76]. ...
Article
Many countries in the world face the new challenge of having human coronavirus infection to manage commendably - the large affliction of human health. Together, each country has modern drugs and a variety of medicinal products developed from their traditional medical practitioners to treat a common cold. In this review, we describe potentially synergistic therapeutics of traditional and complementary medicine available for common cold which might be useful for prevention or for the adjuvant treatment of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Further, we provide a phylogenetic overview of SARSCoV-2 based on a complete genome sequence of common cold viruses. We suggest modern and traditional medicine and preventive strategies which might control the disease to offer more suitable and acceptable common cold management including coronavirus. A substantial proportion of medicinal products developed by traditional medicine against common cold as well as modern medicine mainly focus on symptoms suppression. The recombinant interferon alpha-2b and lactoferrin derived from modern medicine in combination with herbal based products from traditional medicine may support the prevention of novel coronavirus infections. An integrated approach against common cold viruses to establish efficacy and safety through modern and traditional medicine and regular physical exercise along with preventive dietary sources is proposed.
... 21,87 A recent review article by Nieman and Wentz 20 compiled evidence from four recent epidemiological studies with sample sizes of 547 or greater. These studies demonstrated a 29% decreased illness risk when comparing upper versus lowest quartiles of physical activity, 88 an 18% decreased illness risk in high activity versus low activity groups, 9 a 43% decrease in total illness days in high vs lowest fitness tertiles, 89 and a 26% decreased risk of developing the common cold in high activity groups. 90 Epidemiologic evidence to this point supports the consensus belief that physically active individuals are at lower risk of developing respiratory infection. ...
Article
Full-text available
The single stranded RNA virus SARS-CoV-2 has caused a massive addition to the already leading global cause of mortality, viral respiratory tract infections. Characterized by and associated with early and deleteriously enhanced production of pro-inflammatory cytokines by respiratory epithelial cells, severe COVID-19 illness has the potential to inflict acute respiratory distress syndrome and even death. Due to the fast spreading nature of COVID-19 and the current lack of a vaccine or specific pharmaceutical treatments, understanding of viral pathogenesis, behavioral prophylaxis, and mitigation tactics are of great public health concern. This review article outlines the immune response to viral pathogens, and due to the novelty of COVID-19 and the large body of evidence suggesting the respiratory and immune benefits from regular moderate intensity exercise, provides observational and mechanistic evidence from research on other viral infections that suggests strategically planned exercise regimens may help reduce susceptibility to infection, while also mitigating severe immune responses to infection commonly associated with poor COVID-19 prognosis. We propose that regular moderate intensity exercise should be considered as part of a combinatorial approach including widespread hygiene initiatives, properly planned and well-executed social distancing policies, and use of efficacious facial coverings like N95 respirators. Studies discerning COVID-19 pathogenesis mechanisms, transfer dynamics, and individual responses to pharmaceutical and adjunct treatments are needed to reduce viral transmission and bring an end to the COVID-19 pandemic.
... Intense training and exercise, especially when recovery is insufficient, can increase risk of immune impairment and URTIs (53)(54)(55). Following recurring periods of physical activity, which can be common in some military personnel, is a period termed the "open window" of immune suppression when it is suggested that pathogens are more likely to invade and establish infection (53). ...
Article
Full-text available
The probiotic industry continues to grow in both usage and the diversity of products available. Scientific evidence supports clinical use of some probiotic strains for certain gastrointestinal indications. Although much less is known about the impact of probiotics in healthy populations, there is increasing consumer and scientific interest in using probiotics to promote physical and psychological health and performance. Military men and women are a unique healthy population that must maintain physical and psychological health in order to ensure mission success. In this narrative review, we examine the evidence regarding probiotics and candidate probiotics for physical and/or cognitive benefits in healthy adults within the context of potential applications for military personnel. The reviewed evidence suggests potential for certain strains to induce biophysiological changes that may offer physical and/or cognitive health and performance benefits in military populations. However, many knowledge gaps exist, effects on health and performance are generally not widespread among the strains examined, and beneficial findings are generally limited to single studies with small sample sizes. Multiple studies with the same strains and using similar endpoints are needed before definitive recommendations for use can be made. We conclude that, at present, there is not compelling scientific evidence to support the use of any particular probiotic(s) to promote physical or psychological performance in healthy military personnel. However, plausibility for physical and psychological health and performance benefits remains, and additional research is warranted. In particular, research in military cohorts would aid in assessing the value of probiotics for supporting physical and psychological health and performance under the unique demands required of these populations.
... Specifically, low-to-moderate intensity exercise provides a hormetic stress stimulus that transiently activates evolutionary conserved cell danger response programs and, when repeated regularly, confers multi-systemic health benefits and protection against a spectrum of diseases [113], including respiratory tract infections and acute respiratory distress syndrome [114,115]. The preservation of SM function in old age is integral since contractile activity mobilizes leukocytes with high cytotoxicity and migratory potential (NK cells and CD8+ T lymphocytes), thus providing exchange between tissues and the circulatory system [116]. ...
Article
Full-text available
Old age is associated with lower physical activity levels, suboptimal protein intake, and desensitization to anabolic stimuli, predisposing for age-related muscle loss (sarcopenia). Although resistance exercise (RE) and protein supplementation partially protect against sarcopenia under controlled conditions, the efficacy of home-based, unsupervised RE (HBRE) and multi-ingredient supplementation (MIS) is largely unknown. In this randomized, placebo-controlled and double-blind trial, we examined the effects of HBRE/MIS on muscle mass, strength, and function in free-living, older men. Thirty-two sedentary men underwent twelve weeks of home-based resistance band training (3 d/week), in combination with daily intake of a novel five-nutrient supplement (‘Muscle5’; M5, n = 16, 77.4 ± 2.8 y) containing whey, micellar casein, creatine, vitamin D, and omega-3 fatty acids, or an isocaloric/isonitrogenous placebo (PLA; n = 16, 74.4 ± 1.3 y), containing collagen and sunflower oil. Appendicular and total lean mass (ASM; +3%, TLM; +2%), lean mass to fat ratios (ASM/% body fat; +6%, TLM/% body fat; +5%), maximal strength (grip; +8%, leg press; +17%), and function (5-Times Sit-to-Stand time; −9%) were significantly improved in the M5 group following HBRE/MIS therapy (pre vs. post tests; p < 0.05). Fast-twitch muscle fiber cross-sectional areas of the quadriceps muscle were also significantly increased in the M5 group post intervention (Type IIa; +30.9%, Type IIx, +28.5%, p < 0.05). Sub-group analysis indicated even greater gains in total lean mass in sarcopenic individuals following HBRE/MIS therapy (TLM; +1.65 kg/+3.4%, p < 0.05). We conclude that the Muscle5 supplement is a safe, well-tolerated, and effective complement to low-intensity, home-based resistance exercise and improves lean mass, strength, and overall muscle quality in old age.
... and regular sports are related to a reduction of infections and other diseases. [10][11][12] It has been hypothesized that the relationship between absolute exercise load and risk of illness is a J-shaped curve, with very low or no training being associated with a higher risk of illness, moderate training associated with low illness risk and very high training associated with the highest risk of acute illness. 13 This suggests that an optimal balance in exercise intensity and duration is essential for a balanced immune system. ...
Article
Full-text available
The amplitude of the innate immune response reflects the degree of physiological stress imposed by exercise load. An optimal balance of exercise intensity and duration is essential for a balanced immune system and reduces the risk of dysfunction of the immune system. Therefore, it is hypothesized that neutrophils, as key players in the innate immune system, can be used as biomarker in detecting overtraining. The aim was to monitor the state of the innate immune system by phenotyping neutrophils during consecutive bouts of prolonged exercise. Study subjects were recruited from a cohort of walkers participating in a walking event on 3 consecutive days. Participants with immune deficiencies were excluded. Questionnaires to determine the physiological status of the participants were completed. Analysis of neutrophil receptor expression was done by a point‐of‐care fully automated flow cytometer. A total of 45 participants were recruited, of whom 39 participants were included for data analysis. Study participants had a median age of 64 (58‐70) years. The absolute numbers CD16dim/CD62Lbright and CD16bright/CD62Ldim neutrophils were increased after the first 2 days of exercise followed by an adaptation/normalization after the third day. Participants with activated neutrophils (high CD11b expression) had an impaired physical feeling indicated by the participant on a lower visual analog scale compared to participants who did not have activated neutrophils (P = 0.017, P = 0.022). Consecutive days of prolonged exercise results in an initial systemic innate immune response, followed by normalization/adaptation. Increased neutrophil activation was associated with impaired physical feeling measured by a validated VAS score indicated by the participant. Fully automated point‐of‐care flow cytometry analysis of neutrophil phenotypes in a field laboratory might be a useful tool to monitor relevant differences in the systemic innate immune response in response to exercise.
... In the study by Nieman et al. a group of 1002 adults were followed for 12 weeks during the winter and fall seasons. In their analysis, the number of days with upper respiratory tract infection was 43% lower in subjects engaging in an average of 5 or more days per week of aerobic exercise compared with those who were largely sedentary [28]. Although there are no specific studies, this could be applicable to COVID-19 infection. ...
Article
Full-text available
IntroductionThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection causes a severe respiratory disease with a 3% global mortality. In the absence of effective treatment, controlling of risk factors that predispose to severe disease is essential to reduce coronavirus disease 2019 (COVID-19) mortality. Large observational studies suggest that exercise can reduce the risk of all-cause and disease-specific mortality. The aim of this study was to analyze the influence of the baseline physical activity level on COVID-19 mortalityMethods This is a retrospective cohort study that included patients between 18 and 70 years old, diagnosed with COVID-19 and hospitalized in our center between February 15 and April 15, 2020. After discharge all the patients included in the study were contacted by telephone. Baseline physical activity level was estimated using the Rapid Assessment of Physical Activity Scale questionnaire and patients were divided into two groups for comparison: sedentary patients (group 1) and active patients (group 2).ResultsDuring the study period 552 patients were admitted to our hospital and met the inclusion criteria. Global mortality in group 1 was significantly higher than in group 2 (13.8% vs 1.8%; p < 0.001). Patients with a sedentary lifestyle had increased COVID-19 mortality independently of other risk factors previously described (hazard ratio 5.91 (1.80–19.41); p = 0.003).ConclusionA baseline sedentary lifestyle increases the mortality of hospitalized patients with COVID-19. This finding may be of great utility in the prevention of severe COVID-19 disease.
... The rapid spread of the corona virus that causes COVID-19 (SARS-CoV-2) has sparked alarm 29 activity such as running, swimming, walking, and dancing (Nieman et al., 2011). The 53 mechanism behind the moderate exercise protection against respiratory infection remain 54 debated. ...
Preprint
Regular exercise is known to boost immunity, increase immune response to fight infection, as well as speeding up recovery times and healing processes. This study seeks to assess if exercising regularly pre- SARS-CoV-2 (COVID-19) and/or BMI status has an effect on recovery time. A total of 215 people infected with COVD-19 from the Kingdom of Saudi Arabia took part in this study (age 36 years, mass 72 kg, stature 166 cm). Only 10 patients were physically active and fulfil WHO physical activity requirement (Age 30 years, Mass 77 kg, Stature 176 cm). There was a significant difference in recovery time between active and inactive patients (P=0.00) with active patients recovery 2.7 times faster than inactive patients. Active patients showed a lower BMI level (p=0.043). Anthropometric measurement characteristics and the fitness level could be used in decision making scenarios for the estimation of the risk of complications in patients with COVID-19.
... Inflammation of respiratory tract is originated by >200 viruses (coronaviruses and rhinoviruses) (Fendrick et al., 2003). Researchers found that duration and symptoms of upper respiratory tract infections (URTIs) was more curtailed in the group 1 (doing aerobic exercise regularly) than the group 2 (sedentary/without exercise) (Nieman et al., 2011). Another controlled mice-based study indicated the increase in survival rate of mice after the exposure to H1N1 (Martin et al., 2009). ...
Article
Full-text available
Emergence of novel coronavirus-2019 has become an international health concern. The objective of this review is to focus on 2019-nCoV emergence, prophylaxis and to predict the treatment approaches. The first case of 2019-nCoV was noted in Wuhan, China. The WHO has announced this epidemic as pandemic. The 2019-nCoV has +ve ssRNA (29903bp), lipid-bilayer envelope spiked with glycoprotein and bears genome sequences similar to bat coronavirus RaTG13. Antiviral agents like Interferon, Darunavir, Ribavirin, Lopinavir, Remdesivir, Chloroquine and Camostat mesylate may be considered for clinical trials. Chinese herbals may be effective against 2019-nCoV. These include Saikosaponins (triterpene glycosides), Amentoflavone, Scutellarein, Myricetin, extracts of Isatis indigotica, and Houttuynia cordata. Another treatment approach is to administer plasma from COVID-19 recovered patients. RNA vaccines, recombinant vector based vaccine and ACE-2 receptor like molecules may be employed for immunization against COVID-19. Moreover, immunity can be boosted against 2019-nCoV by regular exercise. We have checked Thymoquinone as ligand for various targets of 2019-nCoV (receptor binding domain of spike, RNA polymerase, protease, Nsp9 RNA binding protein, nucleocapsid phosphoprotein, endoribonuclease) by protein-ligand docking server SwissDoc. Thymoquinone can bind effectively to the targets of 2019-nCoV. Hence, it may be an effective candidate for the treatment of COVID-19.
... In addition, maintaining high levels of aerobic fitness during aging may help prevent the accumulation of senescent T-cells [252]. While moderate exercise reduces the risk of illness [253], prolonged intense exercise is associated with a transient depression of immune function and can lead to immune impairment in athletes associated with an increased susceptibility to infections (mainly of the upper respiratory tract) [254]. There has been much interest in how dietary strategies can improve immunity in athletes. ...
Article
Full-text available
Regular physical exercise and a healthy diet are major determinants of a healthy lifespan. Although aging is associated with declining endurance performance and muscle function, these components can favorably be modified by regular physical activity and especially by exercise training at all ages in both sexes. In addition, age-related changes in body composition and metabolism, which affect even highly trained masters athletes, can in part be compensated for by higher exercise metabolic efficiency in active individuals. Accordingly, masters athletes are often considered as a role model for healthy aging and their physical capacities are an impressive example of what is possible in aging individuals. In the present review, we first discuss physiological changes, performance and trainability of older athletes with a focus on sex differences. Second, we describe the most important hormonal alterations occurring during aging pertaining regulation of appetite, glucose homeostasis and energy expenditure and the modulatory role of exercise training. The third part highlights nutritional aspects that may support health and physical performance for older athletes. Key nutrition-related concerns include the need for adequate energy and protein intake for preventing low bone and muscle mass and a higher demand for specific nutrients (e.g., vitamin D and probiotics) that may reduce the infection burden in masters athletes. Fourth, we present important research findings on the association between exercise, nutrition and the microbiota, which represents a rapidly developing field in sports nutrition.
... The risk of immune-suppressive effects from an unhealthy 61 lifestyle behaviour, such as physical inactivity, may be amplified by unhealthy sleep habits and 62 high sedentary time. Among the possible consequences is an increased risk of hospitalisations 63 and mortality events caused by respiratory infections (Fletcher et al., 2018;Ibarra-Coronado et 64 al., 2015;Nieman et al., 2011;Opp and Krueger, 2015;Sallis et al., 2020). Studies that have 65 observed inconsistent relationships between inadequate sleep duration and respiratory 66 infections did not consider the role of sleep quality or the influence of combined lifestyle 67 behaviours (Irwin, 2015;Prather and Leung, 2016). ...
Article
In this community-based cohort study, we investigated the relationship between combinations of modifiable lifestyle risk factors and infectious disease mortality. Participants were 468,569 men and women (56.5 ± 8.1, 54.6% women) residing in the United Kingdom. Lifestyle indexes included traditional and emerging lifestyle risk factors based on health guidelines and best practice recommendations for: physical activity, sedentary behaviour, sleep quality, diet quality, alcohol consumption, and smoking status. The main outcome was mortality from infectious diseases, including pneumonia, and coronavirus disease 2019 (COVID-19). Meeting public health guidelines or best practice recommendations among combinations of lifestyle risk factors was inversely associated with mortality. Hazard ratios ranged between 0.26 (0.23-0.30) to 0.69 (0.60-0.79) for infectious disease and pneumonia. Among participants with pre-existing cardiovascular disease or cancer, hazard ratios ranged between 0.30 (0.25-0.34) to 0.73 (0.60-0.89). COVID-19 mortality risk ranged between 0.42 (0.28-0.63) to 0.75 (0.49-1.13). We found a beneficial dose-response association with a higher lifestyle index against mortality that was consistent across sex, age, BMI, and socioeconomic status. There was limited evidence of synergistic interactions between most lifestyle behaviour pairs, suggesting that the dose-response relationship among different lifestyle behaviours is not greater than the sum of the risk induced by each behaviour. Improvements in lifestyle risk factors and meeting public health guidelines or best practice recommendations could be used as an ancillary measure to ameliorate infectious disease mortality.
... Research suggests that physical inactivity is associated with increased COVID-19 severity [3]. Regular physical activity can improve overall health by decreasing the incidence [4][5][6][7][8][9] and morbidity [3,5,10] of chronic and communicable diseases. However, because the greatest gains are from physical activity that was sustained over a period of time [6,10], the assessment of episodic physical activity may not be the best indicator of heath outcomes. ...
Article
Full-text available
Background: It has been suggested that cardiorespiratory fitness (CRF) may be used to identify those at greatest risk for severe COVID-19 illness. However, no study to date has examined the association between CRF and COVID-19. The objectives of this study were to determine whether CRF is independently associated with testing positive with or dying from COVID-19. Methods: This is a prospective cohort study of 2,690 adults from the UK Biobank Study that were followed from March 16th, 2020 to July 26th, 2020. Participants who were tested for COVID-19 and had undergone CRF assessment were examined. CRF was estimated (eCRF) and categorized as low (<20th percentile), moderate (20th to 80th percentile) and high (≥80th percentile) within sex and ten-year age groups (e.g. 50-60 years). Participants were classified as having COVID-19 if they tested positive (primarily PCR tests) at an in-patient or out-patient setting as of July 26, 2020. Participants were classified as having died from COVID-19 if the primary or underlying cause of death was listed ICD-10 codes U071 or U072 by June 30th, 2020. Adjusted risk ratios (aRR) and 95% confidence intervals (CI) were estimated and a forward model building approach used to identify covariates. Findings: There was no significant association between eCRF and testing positive for COVID-19. Conversely, individuals with moderate (aRR = 0.43, 95% CI: 0.25, 0.75) and high fitness (aRR = 0.37, 95% CI: 0.16, 0.85) had a significantly lower risk of dying from COVID-19 than those with low fitness. Conclusions: While eCRF was not significantly associated with testing positive for COVID-19, we observed a significant dose-response between having higher eCRF and a decreased risk of dying from COVID-19. This suggests that prior gains in CRF could be protective against dying from COVID-19 should someone develop the virus.
... We suggest that physical activity and exercise should be recommended to all persons with obesity and malnutrition at risk for SARS-COV-2 infection with poor outcomes, particularly in older adults and in the presence of polymorbidity and metabolic complications, in order to prevent further skeletal muscle loss and promote muscle mass and function [6,7,106]. Besides its beneficial impact on nutritional and metabolic status, regular physical activity is reported to be associated with lower severity and symptomatology of upper respiratory tract infections other than SARS-COV2 when performed at moderate intensity [107] although with higher severity if performed at high intensity and for a prolonged time [108]. By analogy to these findings, we hypothesize that this may be true in case of SARS-COV2 infection. ...
Article
The COVID-19 pandemics has created unprecedented challenges and threats to patients and healthcare systems worldwide. Acute respiratory complications that require intensive care unit (ICU) management are a major cause of morbidity and mortality in COVID-19 patients. Among other important risk factors for severe COVID-19 outcomes, obesity has emerged along with undernutrition-malnutrition as a strong predictor of disease risk and severity. Obesity-related excessive body fat may lead to respiratory, metabolic and immune derangements potentially favoring the onset of COVID-19 complications. In addition, patients with obesity may be at risk for loss of skeletal muscle mass, reflecting a state of hidden malnutrition with a strong negative health impact in all clinical settings. Also importantly, obesity is commonly associated with micronutrient deficiencies that directly influence immune function and infection risk. Finally, the pandemic-related lockdown, deleterious lifestyle changes and other numerous psychosocial consequences may worsen eating behaviors, sedentarity, body weight regulation, ultimately leading to further increments of obesity-associated metabolic complications with loss of skeletal muscle mass and higher non-communicable disease risk. Therefore, prevention, diagnosis and treatment of malnutrition and micronutrient deficiencies should be routinely included in the management of COVID-19 patients in the presence of obesity; lockdown-induced health risks should also be specifically monitored and prevented in this population. In the current document, the European Society for Clinical Nutrition and Metabolism (ESPEN) aims at providing clinical practice guidance for nutritional management of COVID-19 patients with obesity in various clinical settings.
... Inflammation of respiratory tract is originated by >200 viruses (coronaviruses and rhinoviruses) (Fendrick et al., 2003). Researchers found that duration and symptoms of upper respiratory tract infections (URTIs) was more curtailed in the group 1 (doing aerobic exercise regularly) than the group 2 (sedentary/without exercise) (Nieman et al., 2011). Another controlled mice-based study indicated the increase in survival rate of mice after the exposure to H1N1 (Martin et al., 2009). ...
Article
Full-text available
Emergence of novel coronavirus-2019 has become an international health concern. The objective of this review is to focus on 2019-nCoV emergence, prophylaxis and to predict the treatment approaches. The first case of 2019-nCoV was noted in Wuhan, China. The WHO has announced this epidemic as pandemic. The 2019-nCoV has +ve ssRNA (29903bp), lipid-bilayer envelope spiked with glycoprotein and bears genome sequences similar to bat coronavirus RaTG13. Antiviral agents like Interferon, Darunavir, Ribavirin, Lopinavir, Remdesivir, Chloroquine and Camostat mesylate may be considered for clinical trials. Chinese herbals may be effective against 2019-nCoV. These include Saikosaponins (triterpene glycosides), Amentoflavone, Scutellarein, Myricetin, extracts of Isatis indigotica, and Houttuynia cordata. Another treatment approach is to administer plasma from COVID-19 recovered patients. RNA vaccines, recombinant vector based vaccine and ACE-2 receptor like molecules may be employed for immunization against COVID-19. Moreover, immunity can be boosted against 2019-nCoV by regular exercise. We have checked Thymoquinone as ligand for various targets of 2019-nCoV (receptor binding domain of spike, RNA polymerase, protease, Nsp9 RNA binding protein, nucleocapsid phosphoprotein, endoribonuclease) by protein-ligand docking server SwissDoc. Thymoquinone can bind effectively to the targets of 2019-nCoV. Hence, it may be an effective candidate for the treatment of COVID-19.
... This corresponds to a [five-/three-/one-] day decrease per year in the user getting sick." To consider realistic impact levels of the smart assistant, we calculated the impact on the health system according to a person's potential for health improvement, in line withNieman et al. (2011), who reports a negative relationship between regular physical activity and upper respiratory tract infections. To illustrate the potential impact of health improvements to the participants, we reported the equivalent number of days a person would be sick less per year. ...
... Indeed, physical exercise practiced regularly has the ability to change the composition and functionality of various systems, including the immune system, these being phenotypic changes, favorable or unfavorable, dependents on the characteristics of the stimulus received [6][7][8] . The "J curve" model 9 was proposed to describe the changes that occur after physical training with aerobic characteristics, where individuals who regularly practice aerobic exercise of moderate intensity have less risk of getting upper respiratory tract infection (URTI) as they also get less colds compared to sedentary individuals and those who practice high intensity/long duration exercise 10,11 . For example, some professional and recreational athletes are continually affected by deleterious states caused by excessive training, which exceeding the individual's capacity for physiological adaptation, without the necessary adequate rest and recovery periods, contribute to the appearance of signs and symptoms that characterize the overtraining syndrome (OTS) 12 . ...
Article
Aims: Excessively intense physical training can compromise the functionality of the immune system and contribute to the appearance of symptoms associated with overtraining syndrome (OTS). The aim of this study was to analyze the splenic morphological changes in Wistar rats submitted to demanding training. Methods: The animals were randomly assigned to 2 groups; control group (CG) and exercise group (EG), animals in the EG group were sacrificed after 1 (EG1) and 3 weeks (EG3) of training. The animals were stimulated to run on the treadmill (-20º; from 25m/min, with a progressive increase of 1.25m/minute at each session; 1 hour/day) 6 days/ week. Body weight, food intake, appearance of hair, behavior and ability of animals to perform the imposed work were assessed during the protocol. The spleen was collected for histological analysis and immunohistochemical identification of CD4+ T lymphocytes and CD8+ T cells and NF-kB transcription factor. Results: The protocol did not induce OTS, however, decreases were observed in areas of white pulp in EG3 in relation to the other groups. The training induced a decrease in splenic CD4+ T cells with an increase in CD8+T cells. The training increased the expression of NF-κB P65 compared to sedentary animals. Conclusions: In conclusion, even without manifestation of OTS, strenuous physical training, alter the histological and immunological structures of the spleen, suggesting in part a compromise in the functionality of the immune system.
... Regular PA can reduce the days of sickness and also reduces the risk of upper respiratory tract infection. [24] Decrease in PA can affect the physiological systems of the body. It might affect the physiological process of cardiovascular function, insulin sensitivity, cholesterol level, obesity, and hypertension. ...
Article
Background and Aim: Coronavirus disease-19 (COVID-19) is a pandemic disease spreading throughout the world. Lockdown declared by the Indian government to control the spread of this disease leads to change an entire lifestyle of the population. Individual's lives are greater affected due to lockdown which leads to a reduction in their physical activity (PA). It might increase the chance of infection by reducing immunity. How much PA is reduced during this lockdown period among middle adolescence is not known. This study attempts to find out PA level and energy expenditure (EE) among middle adolescence during the lockdown. Materials and Methods: One hundred and twenty-three volunteered students participated in an open e-survey. The survey was carried out by the International PA questionnaire-short form through social networking sites during the COVID-19 lockdown period through the Google Forms link. PA and EE have been measured. Results: Among identified 147 potential survey participants, 123 responded. Total PA during COVID–19 lockdown period was 6262.21 metabolic equivalent task-min/week. While EE during COVID–19 lockdown period was 6009.28 cal/week. Conclusions: A significant reduction in self-report PA and EE levels was observed among middle adolescent students during the COVID–19 lockdown period.
... Physical fitness and frequent aerobic training have been demonstrated to reduce the frequency, severity and symptomatology of upper respiratory tract infections [22]. Although the role of exercise in specific immune mechanism is not well-established, it has been reported that exercise modifies the number of circulating lymphocytes and the release of stress hormones, and in particular, cortisol, which may influence the activity of anti-inflammatory cytokines [23]. ...
Article
Full-text available
Background: Limited evidence exists regarding adverse modifications affecting cardiovascular and pulmonary function in physical active adults affected by COVID-19, especially in athletic populations. We aimed to describe the clinical presentation of COVID-19 in a cohort of competitive athletes, as well as spirometry and echocardiography findings and cardio-respiratory performance during exercise. Methods: Twenty-four competitive athletes with COVID-19 were recruited for this study after ending self-isolation and confirmation of negative laboratory results. All athletes underwent clinical evaluation, spirometry, echocardiography and cardiopulmonary exercise testing (CPET). These data were compared to a group of healthy control athletes. Results: Anosmia was the most frequent symptom present in 70.83% patients, followed by myalgia, fatigue and ageusia. The most frequent persisting symptoms were anosmia 11 (45.83%) and ageusia 8 (33.33%). Compared to controls, COVID-19 patients presented lower FEV1%: 97.5 (91.5-108) vs. 109 (106-116) p = 0.007. Peak Oxygen Uptake (VO2) in COVID-19 patients was 50.1 (47.7-51.65) vs. 49 (44.2-52.6) in controls (p = 0.618). Conclusions: Reduced exercise capacity was not identified and pulmonary and cardiovascular function are not impaired during early recovery phase in a population of physical active adults except FEV1 reduction.
... Moderate Frontiers in Physiology | www.frontiersin.org April 2022 | Volume 13 | Article 783251 level of exercise improves the ability of the immune system to limit viral infections (Nieman et al., 2011). Vigorous exercise improves the anti-inflammatory actions of IL-10 (Wang et al., 2012). ...
Article
Full-text available
Multiple sclerosis (MS) is a demyelinating disease characterized by plaque formation and neuroinflammation. The plaques can present in various locations, causing a variety of clinical symptoms in patients with MS. Coronavirus disease-2019 (COVID-19) is also associated with systemic inflammation and a cytokine storm which can cause plaque formation in several areas of the brain. These concurring events could exacerbate the disease burden of MS. We review the neuro-invasive properties of SARS-CoV-2 and the possible pathways for the entry of the virus into the central nervous system (CNS). Complications due to this viral infection are similar to those occurring in patients with MS. Conditions related to MS which make patients more susceptible to viral infection include inflammatory status, blood-brain barrier (BBB) permeability, function of CNS cells, and plaque formation. There are also psychoneurological and mood disorders associated with both MS and COVID-19 infections. Finally, we discuss the effects of exercise on peripheral and central inflammation, BBB integrity, glia and neural cells, and remyelination. We conclude that moderate exercise training prior or after infection with SARS-CoV-2 can produce health benefits in patients with MS patients, including reduced mortality and improved physical and mental health of patients with MS.
... In this study, we performed pooled analyses to estimate the hospi- Previous studies have demonstrated that PA reduces the incidence of non-communicable and chronic diseases and the mortality in infectious diseases. 39,40 The beneficial effects of regular PA on the immune system have been considered one of the main underlying mechanisms in reducing severe outcomes in both chronic and infectious diseases and their subsequent hospitalisation. [41][42][43] Additionally, regular PA has been shown to boost innate immune system responses, including the production of macrophages, natural killer cells, and neutrophils. ...
Article
Full-text available
Among coronavirus disease 2019 (COVID-19) patients, physically active individuals may be at lower risk of fatal outcomes. However, to date, no meta-analysis has been carried out to investigate the relationship between physical activity (PA) and fatal outcomes in patients with COVID-19. Therefore, this meta-analysis aims to explore the hospitalisation, intensive care unit (ICU) admissions, and mortality rates of COVID-19 patients with a history of PA participation before the onset of the pandemic, and to evaluate the reliability of the evidence. A systematic search of MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and medRxiv was conducted for articles published up to January 2022. A random-effects meta-analysis was performed to compare disease severity and mortality rates of COVID-19 patients in physically active and inactive cases. Twelve studies involving 1,256,609 patients (991,268 physically active and 265,341 inactive cases) with COVID-19, were included in the pooled analysis. The overall meta-analysis compared with inactive controls showed significant associations between PA with reduction in COVID-19 hospitalisation (risk ratio (RR) = 0.58, 95% confidence intervals (CI) 0.46–0.73, P = 0.001), ICU admissions (RR = 0.65, 95% CI 0.52–0.81, P = 0.001) and mortality (RR = 0.47, 95% CI 0.38–0.59, P = 0.001). The protective effect of PA on COVID-19 hospitalisation and mortality could be attributable to the types of exercise such as resistance exercise (RR = 0.27, 95% CI 0.15–0.49, P = 0.001) and endurance exercise (RR = 0.41, 95% CI 0.23–0.74, P = 0.003), respectively. Physical activity is associated with decreased hospitalisation, ICU admissions, and mortality rates of patients with COVID-19. Moreover, COVID-19 patients with a history of resistance and endurance exercises experience a lower rate of hospitalisation and mortality, respectively. Further studies are warranted to determine the biological mechanisms underlying these findings.
... Overall, good physical conditioning has been correlated with a reduction in risk of latent viral infections reactivation, characterizing a better immune system dynamic (131). Aerobic activity has been associated with a significant decrease in severity and incidence of symptoms of upper respiratory tract infections (URTI) (134). Importantly, intense physical activity before or during an infection such as COVID-19 and influenza is not recommended, since it can precipitate severe disease (123,135) due to the immunosuppression induced by Th2 anti-inflammatory cytokines aimed at reducing muscle tissue damage (122,135). ...
Article
Full-text available
COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been considered a public health emergency, extensively investigated by researchers. Accordingly, the respiratory tract has been the main research focus, with some other studies outlining the effects on the neurological, cardiovascular, and renal systems. However, concerning SARS-CoV-2 outcomes on skeletal muscle, scientific evidence is still not sufficiently strong to trace, treat and prevent possible muscle impairment due to the COVID-19. Simultaneously, there has been a considerable amount of studies reporting skeletal muscle damage in the context of COVID-19. Among the detrimental musculoskeletal conditions associated with the viral infection, the most commonly described are sarcopenia, cachexia, myalgia, myositis, rhabdomyolysis, atrophy, peripheral neuropathy, and Guillain-Barré Syndrome. Of note, the risk of developing sarcopenia during or after COVID-19 is relatively high, which poses special importance to the condition amid the SARS-CoV-2 infection. The yet uncovered mechanisms by which musculoskeletal injury takes place in COVID-19 and the lack of published methods tailored to study the correlation between COVID-19 and skeletal muscle hinder the ability of healthcare professionals to provide SARS-CoV-2 infected patients with an adequate treatment plan. The present review aims to minimize this burden by both thoroughly exploring the interaction between COVID-19 and the musculoskeletal system and examining the cutting-edge 3D cell culture techniques capable of revolutionizing the study of muscle dynamics.
... Regular, long-term exercise training is a major geroprotective intervention as it ameliorates immune function, whereas a prolonged period of sedentary lifestyle accumulated over weeks, months or years (activities that require low energy expenditure, e.g., sitting: <1.5 METsmetabolic equivalents; 1 MET = 3.5 mL O2· kg −1 · BM· min −1 ) leads to immune supression [113] and hyper-inflammation state [106,114]. The study on exceptional longevity in men provided information that vigorous exercise was associated with approx. ...
Article
Full-text available
Aging is a complex, multietiological process and a major risk factor for most non-genetic, chronic diseases including geriatric syndromes that negatively affect healthspan and longevity. In the scenario of "healthy or good aging", especially during the COVID-19 era, the proper implementation of exercise as "adjuvant" or "polypill" to improve disease-related symptoms and comorbidities in the general population is a top priority. However, there is still a gap concerning studies analyzing influence of exercise training to immune system in older people. Therefore, the aim of this review is to provide a brief summary of well-established findings in exercise immunology and immunogerontology, but with a focus on the main exercise-induced mechanisms associated with aging of the immune system (immunosenescence). The scientific data strongly supports the notion that regular exercise as a low-cost and non-pharmacological treatment approach, when adjusted on an individual basis in elderly, induce multiple rejuvenating mechanisms: (1) affects the telomere-length dynamics (a "telo-protective" effect), (2) promote short- and long-term anti-inflammatory effects (via e.g., triggering the anti-inflammatory phenotype), 3) stimulates the adaptive immune system (e.g., helps to offset diminished adaptive responses) and in parallel inhibits the accelerated immunosenescence process, (4) increases post-vaccination immune responses, and (5) possibly extends both healthspan and lifespan.
... Numerous studies point to the benefits of physical activity also in the psychosocial domain (Klaperski et al., 2014;von Haaren et al., 2016), namely as a stressregulating effect. At the same time, they effectively influence the health of the immune system (Nieman et al., 2011), which is of particular importance in a coronavirus epidemic. ...
Article
p style="text-align: justify;">The purpose of this paper is to determine the relevance of turning the camera on or off during distance learning as an argument for active or passive student participation. Seventy-five (75) students participated in the study and were divided into five groups (1-5) according to teaching method (i.e., synchronous instruction online with camera (1) and without camera (2), synchronous transmission of the recording online with camera (3) and without camera (4) and received the online instruction (5)) only. In the beginning and at the end, all students were tested with the same adapted test to determine general physical and motor status. All groups had the same training program twice a week for 45 minutes for 7 weeks. The first training of the week was dedicated to strength development, the second to endurance. In the end, all participants completed a questionnaire to determine their additional physical activity and how they felt about using a camera. The camera being turned on was identified as a factor that made participants uncomfortable but contributed significantly to the effectiveness of the course. However, 94.6 % of all participants cited non-camera methods as their favourite.</p
... A high level of cardiorespiratory fitness (CRF), which can be achieved through regular exercise practice, has been associated with fewer days (−46%) of illness from acute respiratory infections as compared with a low level of CRF [39]. A high CRF has also been reported to positively impact the expression of immune markers that could theoretically reduce the risk of COVID-19 complications [40], particularly the so-called cytokine storm syndrome [40]; that is, the excessive, uncontrolled release of proinflammatory cytokines (e.g., interferon-γ, IL-1, IL-6, IL-18, tumor necrosis factor [TNF]-α) to the bloodstream that is frequently found in patients with severe disease, including COVID-19 [41]. ...
Article
Full-text available
Growing evidence supports the importance of lifestyle and environmental exposures—collectively referred to as the ‘exposome’—for ensuring immune health. In this narrative review, we summarize and discuss the effects of the different exposome components (physical activity, body weight management, diet, sun exposure, stress, sleep and circadian rhythms, pollution, smoking, and gut microbiome) on immune function and inflammation, particularly in the context of the current coronavirus disease 2019 (COVID-19) pandemic. We highlight the potential role of ‘exposome improvements’ in the prevention—or amelioration, once established—of this disease as well as their effect on the response to vaccination. In light of the existing evidence, the promotion of a healthy exposome should be a cornerstone in the prevention and management of the COVID-19 pandemic and other eventual pandemics.
... Besides from athletic populations, regular PE is a key protective factor to improve immune function, while inactivity weakens immunity (Nieman et al., 2011). In a study on 48,440 adult patients with COVID-19, self-reported physical activity level was used to categorize them in three groups (consistently inactive = 0-10 min/week, some activity = 11-149 min/week, and consistently active ≥150 + min/week). ...
Article
Full-text available
The coronavirus disease (COVID-19) pandemic is caused by a novel coronavirus (CoV) named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As the angiotensin converting enzyme 2 (ACE2) is the cellular receptor of SARS-CoV-2, it has a strong interaction with the renin angiotensin system (RAS). Experimental studies have shown that the higher levels of ACE2 or increasing ACE2/ACE1 ratio improve COVID-19 outcomes through lowering inflammation and death. Aerobic moderate intensity physical exercise fights off infections by two mechanisms, the inhibition of ACE/Ang II/AT1-R pathway and the stimulation of ACE2/Ang-(1–7)/MasR axis. Exercise can also activate the anti-inflammatory response so that it can be a potential therapeutic strategy against COVID-19. Here, we summarize and focus the relation among COVID-19, RAS, and immune system and describe the potential effect of aerobic moderate intensity physical exercise against CoV as a useful complementary tool for providing immune protection against SARS-CoV-2 virus infection, which is a novel intervention that requires further investigation.
... The main finding from this study was that moderate-intensity PA may decrease COVID-19 symptoms, and this was not seen with higher intensity PA levels. Our findings align with past work that reports that PA and respiratory tract infection mainly correlate with exercise intensity [36,37]. ...
Article
Full-text available
Statistical modeling indicated that COVID-19 would have afflicted more than 60% of the US population. Social distancing, self-quarantine, and widespread shutdowns were imposed. The push to stay at home and the decreased availability of exercise facilities have potentially reduced physical activity (PA). The purpose of this observational, correlational study was to determine if there is a relationship between PA level and symptoms of COVID-19. Subjects were asked to complete a single Survey Monkey questionnaire. The survey asked demographic questions, PA behaviors, and questions relating to COVID-19 symptoms. Chi-square analysis was run to determine frequency differences within the PA group and specific COVID-19 symptoms. Hierarchical regression analysis was run to determine if PA was a unique predictor of the number COVID-19 symptoms experienced. Sixty male and 85 female (n = 145) subjects completed this study.
... There is compelling evidence that cardiorespiratory fitness is closely associated or can modulate immune functioning [28,41,[79][80][81][82][83], such that improved cardiorespiratory fitness might decrease the risk of illness. Therefore, a proper IT prescription might provide a time-efficient strategy to increase cardiorespiratory fitness while preserve or improve immunological function. ...
Article
Full-text available
Purpose: To summarize the evidence regarding the acute and chronic effects of interval training (IT) in the immune system through a systematic review with meta-analysis. Design: Systematic review with meta-analysis. Data source: English, Portuguese and Spanish languages search of the electronic databases Pubmed/Medline, Scopus, and SciELO. Eligibility criteria: Studies such as clinical trials, randomized cross-over trials and randomized clinical trials, investigating the acute and chronic effects of IT on the immune outcomes in humans. Results: Of the 175 studies retrieved, 35 were included in the qualitative analysis and 18 in a meta-analysis. Within-group analysis detected significant acute decrease after IT on immunoglobulin A (IgA) secretory rate (n = 115; MD = -15.46 µg·min-1; 95%CI, -28.3 to 2.66; p = 0.02), total leucocyte count increase (n = 137; MD = 2.58 × 103 µL-1; 95%CI, 1.79 to 3.38; p < 0.001), increase in lymphocyte count immediately after exercise (n = 125; MD = 1.3 × 103 µL-1; 95%CI, 0.86 to 1.75; p < 0.001), and decrease during recovery (30 to 180 min post-exercise) (n = 125; MD = -0.36 × 103 µL-1;-0.57 to -0.15; p < 0.001). No effect was detected on absolute IgA (n = 127; MD = 47.5 µg·mL-1; 95%CI, -10.6 to 105.6; p = 0.11). Overall, IT might acutely reduce leucocyte function. Regarding chronic effects IT improved immune function without change leucocyte count. Conclusion: IT might provide a transient disturbance on the immune system, followed by reduced immune function. However, regular IT performance induces favorable adaptations on immune function.
... lower blood pressure, higher cardiorespiratory fitness, enhanced sleep quality) and mental (e.g. lower levels of anxiety and depression) health benefits among adults with CVD. 17 18 Moderate intensity aerobic exercise is associated with a reduction in respiratory infection rates, respiratory symptom burden, and mortality, [19][20][21] underscoring the importance of maintaining an active lifestyle during the COVID-19 pandemic. Those infected with COVID-19 and consistently inactive have been shown to be at an increased risk of hospitalization, admission to the intensive care unit, and death as a result of the virus in comparison to counterparts who participated in some physical activity and those who met the physical activity guidelines (150 minutes of moderate-vigorous physical activity per week) 22 Aerobic and resistance training exercise have additional benefits that aid in reducing the severity and burden of CVD including: improvements in cardiorespiratory and functional fitness and mental health; minimized age-related decline in muscle mass; reduced risk of experiencing a second cardiac event; and, mortality. ...
Article
Full-text available
The novel coronavirus disease 2019 (COVID-19) is a global public health crisis that disproportionately affects those with pre-existing conditions. Cardiovascular disease (CVD) is the leading cause of death worldwide and many key CVD risk factors are modifiable (e.g., physical inactivity, sedentary behavior, obesity). To limit the spread of COVID-19 most governments have implemented restrictions and recommended staying at home, reducing social contact to a select and exclusive few, and limiting large gatherings. Such public health constraints may have unintended, negative health consequences on 24-hour movement behaviour. The primary purpose of this review is to provide practical at-home recommendations for sedentary time, sleep, and physical activity in those living with CVD. Those with CVD will benefit from practical recommendations to reduce sedentary time, increase purposeful exercise, and obtain optimal sleep patterns while at-home and adhering to public health restrictions. Our recommendations include the following: (i) self-monitoring sitting time; (ii) engaging in 2-3 days per week of purposeful exercise for those with low exercise capacity and >3 days per week for those with moderate-to-high exercise capacity; (iii) self-monitoring exercise intensity through the use of scales or wearable devices; (iv) maintaining a regular sleep schedule; and, (v) moving daily. Clinicians should be particularly aware that clear communication of the importance of limiting prolonged sedentary time, regular physical activity and exercise, and ensuring good quality sleep in association with the provision of clear, comprehensible and practical advice is fundamental to ensuring that those living with CVD respond optimally to the challenges posed by the pandemic.
... People eating a high-salt diet excrete more sodium in sweat than people eating a low-salt diet [211]. Near-daily aerobic activity that increases heart rate, breathing, and sweating for at least 20 min, such as playing basketball, is correlated with reduced frequency, severity, and symptomology of upper respiratory tract infections [212]. Of relevance, no professional basketball players tested positive for COVID-19 during the first five weeks of the 2020 National Basketball Association playoffs during the pandemic [213], which may be related to the athletes' profuse sweating of up to more than four liters during each game [214]. ...
Article
Full-text available
Dietary factors in the etiology of COVID-19 are understudied. High dietary sodium intake leading to sodium toxicity is associated with comorbid conditions of COVID-19 such as hypertension, kidney disease, stroke, pneumonia, obesity, diabetes, hepatic disease, cardiac arrhythmias, thrombosis, migraine, tinnitus, Bell’s palsy, multiple sclerosis, systemic sclerosis, and polycystic ovary syndrome. This article synthesizes evidence from epidemiology, pathophysiology, immunology, and virology literature linking sodium toxicological mechanisms to COVID-19 and SARS-CoV-2 infection. Sodium toxicity is a modifiable disease determinant that impairs the mucociliary clearance of virion aggregates in nasal sinuses of the mucosal immune system, which may lead to SARS-CoV-2 infection and viral sepsis. In addition, sodium toxicity causes pulmonary edema associated with severe acute respiratory syndrome, as well as inflammatory immune responses and other symptoms of COVID-19 such as fever and nasal sinus congestion. Consequently, sodium toxicity potentially mediates the association of COVID-19 pathophysiology with SARS-CoV-2 infection. Sodium dietary intake also increases in the winter, when sodium losses through sweating are reduced, correlating with influenza-like illness outbreaks. Increased SARS-CoV-2 infections in lower socioeconomic classes and among people in government institutions are linked to the consumption of foods highly processed with sodium. Interventions to reduce COVID-19 morbidity and mortality through reduced-sodium diets should be explored further.
Article
The paper reviews the current data on the effect and role of varying intensity physical activity in the prevention of various respiratory virus infections, including influenza virus and SARS-CoV-2 coronavirus. The paper discusses the effect of varying intensity physical activity on antiviral immunity, cellular and cytokine responses to respiratory virus infections, physical activity influence on vaccination effectiveness and the role of regular moderate intensity physical activity in the prevention of viral infection in patients with obesity, overweight, diabetes and other metabolic disorders. The paper analyzes physical activity role in the prevention of SARS-CoV-2 infection, as well as in the conditions of self-isolation and quarantine.
Article
Full-text available
Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.
Article
Full-text available
Novel Coronavirus (Covid-19), an infectious disease, a nightmare, scourge confronting humanity and economies. Pandemic has fuelled the fire in turbulent economies. Mankind especially under privileged deserve to be safe from health hazards and timely relief. Modern scientists and researchers are working tirelessly to find remedy and vaccine for the virus. Traditional Ayurveda acquaintance its repository for treating many diseases. This turbulent time we need an amalgamation of modern medicine and Ayurveda. In some cases, Ayurveda have initiated intricacies with modern molecular medicine. Immunity being back bone to absorb any shock on human system, and Ayurveda extends its long-studied support in boosting human immune support system. This study is an exploratory and secondary data-based study, where traditional resources has been explored. Author has proposed a model to fetch a relationship among traditional with modern in a systemic way, in an anticipation of ray of hope for mankind.
Article
Full-text available
The COVID-19 pandemic has had a wide range of negative physical and mental impacts. This review begins with a theoretical explanation of the psychological defense mechanisms used to deal with the pandemic. It then discusses different categories of defense mechanisms and their roles in managing the impacts of psychological distress. The aim of this review is to highlight the various psychological defense mechanisms individuals use to deal with the pandemic and to discuss how adjustment mechanisms can protect individuals from internal and external threats by shielding the integrity of the ego (the mind) and helping individuals maintain their self-schema.
Article
This review supports that physical activity improves immunosurveillance and has the potential to counter COVID-19 infection and symptomatology at three prevention levels. At the primary prevention level, several lines of evidence support that physical activity is an immune system adjuvant in combating infectious diseases. Recent epidemiological studies indicate that regular physical activity is associated with a reduced risk for COVID-19, similar to what has been reported for other respiratory infections. Although specific COVID-19-related studies are needed, data from investigations with other types of infectious agents, such as influenza, support the potential role of physical activity in augmenting COVID-19 vaccine efficacy (secondary prevention level). There is a growing awareness that COVID-19 can cause sustained morbidity in some patients, and physical training and rehabilitation (tertiary prevention level) can be directed toward improvement in physical fitness, quality of life, and immune health.
Chapter
The emerging research field of exercise immunology is becoming an essential sub-discipline of exercise medicine. Many studies have revealed a strong association between physical exercise and human immune system function. Moderate daily exercise can enhance general immunity whereas individuals deficient in exercise or engaged in heavy training tend to be more liable to infection. This review summarizes the effects of long-term moderate and heavy exercise on the immune system, and the general mechanisms of the immune response to physical activity and the biomedical changes of the exercise–immune relationship are illustrated in detail. Nutritional influences on exercise and exercise-induced immune dysfunction are also summarized. Together with advanced informatics technologies, the challenges and future directions of exercise immunology are also discussed.
Article
Regular exercise is beneficial to health. This study evaluated the effects of moderate and intense physical exercise modalities on intradermal infection by Staphylococcus aureus in a murine model. Mice that practiced moderate exercise had lower bacterial load on lymph nodes and less inflammatory infiltrate in dermis. They presented greater weight, however, less amount of epididymal fat: the weight was increased while they had fat diminished. A positive correlation was observed between lipid content and bacterial load in mice trained at moderate intensity. Animals that were under high intensity exercises presented superior bacterial load on the lymph nodes, increased neutrophil count and circulating lymphocytes, and had leukocyte recruitment to the dermis augmented, when compared to the ones in moderate exercise. These findings suggest that moderate physical activity modulates the immune response in dermal infection caused by S. aureus in a murine model.
Article
Full-text available
Introduction: This article summaries key exercise immunology findings from five years of research on 350 athletes in the 60-km Western States Endurance Run (WSER), a point-to-point trail run in the Sierra Nevada Mountains of northern California. Methods: WSER athletes provided pre-and post-race blood, urine, and saliva samples, and these were assayed for immune function, inflammation, and oxidative stress outcome measures. Subjects also provided upper respiratory tract infection (URTI), training, and demographic data. Results: Several key findings from an analysis of the entire 5-year dataset revealed the following:. One out of four runners reported sickness during the 2-week period after the 60-km race. Post-race values for granulocyte oxidative burst activity were reduced 50% compared to pre-race. Of all outcome measures, only low post-race sIgA secretion rate was significantly linked to URTI. 2. Variance in plasma cytokine changes during the race was large between WSER finishers, with no male-to-female differences. The cytokine profile measured indicates a strong anti-inflammatory response. 3. Plasma cytokine perturbations were linked to muscle damage and inflammation. Unexpectedly, cytokine variance was unrelated to oxidative stress. 4). Despite the widespread use of ibuprofen by WSER athletes, no beneficial effects were measured for reducing RPE, muscle damage, or DOMS. To the contrary, ibuprofen use was linked to mild endotoxemia, kidney dysfunction, and systemic inflammation. Conclusions: In general, the WSER data indicate that competitors experience significant immune system stress, reflecting the physiological trauma experienced by the athletes. Long term effects on health have not yet been ascertained.
Article
Full-text available
Quercetin supplementation results in a variable plasma quercetin response in humans. The purpose of this study was to determine whether this variance is related to gender, age, body mass index (BMI), and other demographic and lifestyle factors. Subjects (N=1002, ages 18-85 years, 60% female and 40% male) were recruited from the community and randomized to one of three groups, with supplements administered using double-blinded procedures: Q-500 (500 mg/day), Q-1000 (1000 mg/day), or placebo. Subjects ingested two soft chew supplements twice daily during the 12-week study. Fasting blood samples were obtained pre- and post-study, analyzed for plasma quercetin, and then compared between and within groups by gender, age group (<40, 40-59, and >or=60 years), BMI (<25, 25-29.9, and >or=30 kg/m(2)), self-reported physical fitness level, and diet intake (food group servings). Quercetin supplementation over 12 weeks caused a significant increase in overnight-fasted plasma quercetin, with a net increase of 332+/-21.0 and 516+/-30.8 microg/l for Q-500 and Q-1000 compared with 53.6+/-6.4 microg/l for placebo (interaction effect, P<0.001). The increase in plasma quercetin was highly variable within each quercetin supplementation group, but was unrelated to age, gender, BMI, fitness levels, or diet intake. In summary, quercetin supplementation in doses of 500 and 1000 mg/day caused large but highly variable increases in plasma quercetin that were unrelated to demographic or lifestyle factors.
Article
Full-text available
Quercetin, a flavonoid found in fruits and vegetables, is a strong antioxidant with anti-inflammatory, antimicrobial and immune-modulating properties. The purpose of the present study was to investigate the effects of long-term quercetin supplementation on innate immune function and inflammation in human subjects. Female subjects (n 120; aged 30-79 years) were recruited from the community and randomised to one of three groups, with supplements administered using double-blinded procedures: 500 mg quercetin/d (n 38), 1000 mg quercetin/d (n 40) or placebo (n 42). Subjects ingested two soft chew supplements twice daily during the 12-week study period. Fasting blood samples were obtained pre- and post-study and were analysed for plasma quercetin, IL-6, TNF-alpha and leucocyte subset cell counts. Natural killer cell activity (NKCA) and lymphocyte subsets were assessed in a subset of seventy-four subjects. Granulocyte oxidative burst activity (GOBA) and phagocytosis were assessed in sixty-four subjects. Eighteen subjects had overlapping data. Quercetin supplementation at two doses compared with placebo increased plasma quercetin (interaction effect; P < 0.001) but had no significant influence on blood leucocyte subsets, plasma IL-6 or TNF-alpha concentration, NKCA, GOBA or phagocytosis. NKCA was inversely correlated with BMI (r - 0.25; P = 0.035) and body fat percentage (r - 0.38; P = 0.001), and positively correlated with self-reported physical fitness level (r 0.24; P = 0.032). In summary, results from the present double-blinded, placebo-controlled, randomised trial indicated that quercetin supplementation at 500 and 1000 mg/d for 12 weeks significantly increased plasma quercetin levels but had no influence on measures of innate immune function or inflammation in community-dwelling adult females.
Article
Full-text available
This study measured the influence of ingesting quercetin on plasma measures for oxidative stress and antioxidant capacity. Male and female subjects (n = 1002) varying in age (18-85 years) and body mass index (BMI) (16.7-52.7 kg/m(2)) were studied. Subjects were randomized to one of three groups using double-blinded methods: placebo, 500 mg or 1000 mg quercetin/day with 125 mg or 250 mg vitamin C/day, respectively. Pre- and post-study fasting blood samples show that plasma quercetin increased in a dose-responsive manner. The pattern of change in plasma F(2)-isoprostanes, oxidized low density lipoprotein, reduced glutathione, ferric reducing ability of plasma (FRAP) and oxygen radical absorbance capacity (ORAC) did not differ between supplementation groups or after adjustment for gender, age, BMI and disease status. In summary, quercetin supplementation over 12 weeks in doses of 500 mg or 1000 mg/day significantly increased plasma quercetin levels, but had no influence on several measures of oxidative stress and antioxidant capacity.
Article
Full-text available
The present study evaluated the association between fruit and vegetable intake and the incidence of upper respiratory tract infection (URTI) during pregnancy. In a cohort of 1034 North American women, each subject was asked retrospectively about their fruit and vegetable intake during the six months before the pregnancy and their occurrences of URTI during the first half of pregnancy. Multivariable-adjusted hazard ratios (HR) were calculated with Cox proportional hazards models. The adjusted HR of URTI for women in the highest quartile (median 8.54 servings/d) v. the lowest quartile (median 1.91 servings/d) of total fruit and vegetable intake was 0.74 (95 % CI 0.53, 1.05) for the 5-month follow-up period and 0.61 (95 % CI 0.39, 0.97) for the 3-month follow-up period, respectively. A dose-related reduction of URTI risk according to quartile of intake was found in the 3-month (P for trend = 0.03) but not the 5-month follow-up. No association was found between either fruit or vegetable intake alone in relation to the 5-month or the 3-month risk of URTI. Women who consume more fruits and vegetables have a moderate reduction in risk of URTI during pregnancy, and this benefit appears to be derived from both fruits and vegetables instead of either alone.
Article
Full-text available
Sleep quality is thought to be an important predictor of immunity and, in turn, susceptibility to the common cold. This article examines whether sleep duration and efficiency in the weeks preceding viral exposure are associated with cold susceptibility. A total of 153 healthy men and women (age range, 21-55 years) volunteered to participate in the study. For 14 consecutive days, they reported their sleep duration and sleep efficiency (percentage of time in bed actually asleep) for the previous night and whether they felt rested. Average scores for each sleep variable were calculated over the 14-day baseline. Subsequently, participants were quarantined, administered nasal drops containing a rhinovirus, and monitored for the development of a clinical cold (infection in the presence of objective signs of illness) on the day before and for 5 days after exposure. There was a graded association with average sleep duration: participants with less than 7 hours of sleep were 2.94 times (95% confidence interval [CI], 1.18-7.30) more likely to develop a cold than those with 8 hours or more of sleep. The association with sleep efficiency was also graded: participants with less than 92% efficiency were 5.50 times (95% CI, 2.08-14.48) more likely to develop a cold than those with 98% or more efficiency. These relationships could not be explained by differences in prechallenge virus-specific antibody titers, demographics, season of the year, body mass, socioeconomic status, psychological variables, or health practices. The percentage of days feeling rested was not associated with colds. Poorer sleep efficiency and shorter sleep duration in the weeks preceding exposure to a rhinovirus were associated with lower resistance to illness.
Article
Full-text available
A randomly controlled 15-wk exercise training (ET) study (five 45-min sessions/wk, brisk walking at 60% heart rate reserve) with a group of 36 mildly obese, sedentary women was conducted to investigate the relationship between improvement in cardiorespiratory fitness, changes in natural killer (NK) cell number and activity, and acute upper respiratory tract infection (URI) symptomatology. The study was conducted using a 2 (exercise and nonexercise groups) x 3 (baseline, 6-, and 15-wk testing sessions) factorial design, with data analyzed using repeated measures ANOVA. No significant change in NK cell number occurred as a result of ET as measured by the CD16 and Leu-19 monoclonal antibodies. ET did have a significant effect on NK cell activity (E:T 50:1) especially during the initial 6-wk period [F(2.68) = 12.34, p less than 0.001]. Using data from daily logs kept by each subject, the exercise group was found to have significantly fewer URI symptom days/incident than the nonexercise group (3.6 +/- 0.7 vs 7.0 +/- 1.4 days, respectively, p = 0.049). Improvement in cardiorespiratory fitness was correlated significantly with a reduction in URI symptom days/incident (r = 0.37, p = 0.025) and a change in NK cell activity from baseline to six but not 15 wks (r = 0.35, p = 0.036). In summary, moderate ET is associated with elevated NK cell activity after six but not 15 weeks, and reduced URI symptomatology in comparison to a randomized, sedentary control group.
Article
Full-text available
Questionnaires (750 respondents, 44.4% response rate) examined the long-term health value of endurance exercise training in older age-classed competitors ('Masters Athletes', 551 men and 199 women) over a 7-year period (1985-1992). The majority had initially completed maximal exercise tests. The weekly time devoted to training, competition and exercise-related travel was 10 to 30 h, and the annual expenditure on clothing, equipment and entrance fees was typically in the range Canadian $500-1500. Despite their age (mean(s.d.) 58(10), current range 40-81 years), only 1.4% reported sustaining a non-fatal heart attack and 0.6% had required bypass surgery over the 7-year interval. The majority (90%) were very interested in good health; 76% considered themselves as less vulnerable to viral illnesses than their peers, and 68% regarded their quality of life as much better than that of their sedentary friends. The majority of former smokers had stopped smoking before they began training, but 37% indicated that exercise had helped them in smoking withdrawal. In keeping with their health-conscious attitude, 59% had regular medical check-ups, and 86% obeyed legislation requiring use of a seat-belt when driving. In contrast with many older people, 88% slept well or very well. Slightly over half of the sample (57%) had sustained some injury which had limited their training for one or more weeks over the 7-year study. Although participation in Masters competition appears to carry considerable health benefits, gains may in part reflect an overall healthy lifestyle.
Article
Full-text available
Respiratory viral infections, also known as the common cold, are the most common infections in humans. Despite their benign nature, they are a major cause of morbidity and mortality on a worldwide basis. Several viruses have been associated with such illness, of which rhinovirus is the most common. Symptom production is a combination of viral cytopathic effect and the activation of inflammatory pathways. Therefore, antiviral treatment alone may not be able to prevent these events. The optimal use of such agents also requires earlier initiation; therefore, it is important to develop accurate and rapid diagnostic techniques for respiratory viruses. Before any reliable and effective treatment is available, symptomatic therapies may remain the only possible choice of management.
Article
Full-text available
Moderate exercise training is associated with a decreased risk for upper respiratory tract infection in human and animal studies, but the mechanisms have not been elucidated. Lung macrophages play an important role in resistance to respiratory infection, and moderate exercise can enhance macrophage antiviral resistance, but no studies have directly tested the role of lung macrophages in this response. This study tested the effect of lung macrophage depletion on susceptibility to infection following short-term moderate exercise training. Mice were assigned to one of four groups: exercise (Ex) and resting controls (Con) with and without clodronate encapsulated liposomes (CL(2)MDP-lip). Ex mice ran for 1 h on a treadmill for 6 days at 36 m/min, 8% grade. Fifteen minutes following exercise or rest on the last day of training, mice were intranasally inoculated with a standardized dose of herpes simplex virus type 1. Clodronate (Ex-CL(2)MDP-lip and Con-CL(2)MDP-lip) or PBS liposomes (Ex-PBS-lip and Con-PBS-lip) (100 microl) were intranasally administered following exercise or rest on the 4th day of training and again on the 4th day postinfection. Morbidity, mortality, and symptom severity were monitored for 21 days. Exercise decreased morbidity by 36%, mortality by 61%, and symptom severity score on days 5-7 (P < 0.05). Depletion of lung macrophages negated the beneficial effects of moderate exercise. This was indicated by no differences between Ex-CL(2)MDP-lip and Con-PBS-lip in morbidity (89 vs. 95%), mortality (79 vs. 95%), or symptom severity. Results indicate that lung macrophages play an important role in mediating the beneficial effects of moderate exercise on susceptibility to respiratory infection.
Article
Full-text available
Viral respiratory tract infection (VRTI) is the most common illness in humans. Despite the high incidence, the economic impact of non-influenza-related VRTI has not been rigorously explored. Our objectives were to obtain an updated incidence of non-influenza-related VRTI in the United States and to quantify the health care resource use (direct costs) and productivity losses (indirect costs) associated with these infections. A nationwide telephone survey of US households (N = 4051) was conducted between November 3, 2000, and February 12, 2001 to obtain a representative estimate of the self-reported incidence of non-influenza-related VRTI and related treatment patterns. Direct treatment costs measured included outpatient clinician encounters, use of over-the-counter and prescription drugs, and associated infectious complications of non-influenza-related VRTI. Absenteeism estimates for infected individuals and parents of infected children were extrapolated from National Health Interview Survey data. Of survey respondents, 72% reported a non-influenza-related VRTI within the past year. Respondents who experienced a self-reported non-influenza-related VRTI averaged 2.5 episodes annually. When these rates are extrapolated to the entire US population, approximately 500 million non-influenza-related VRTI episodes occur per year. Similarly, if the treatment patterns reported by the respondents are extended to the population, the total economic impact of non-influenza-related VRTI approaches $40 billion annually (direct costs, $17 billion per year; and indirect costs, $22.5 billion per year). Largely because of the high attack rate, non-influenza-related VRTI imposes a greater economic burden than many other clinical conditions. The pending availability of effective antiviral therapies warrants increased attention be paid to this common and expensive illness.
Article
Full-text available
This article provides a selected overview of 20 years of research on the role of psychosocial factors in susceptibility to upper respiratory infections. We present evidence from our laboratory that psychological stress is associated with increased risk for developing respiratory illness for persons intentionally exposed to a common cold virus, that the longer the duration of the stressor the greater the risk, and that stress association with susceptibility may be mediated by stress-induced disruption of the regulation of proinflammatory cytokines. We further provide evidence that social relationships (social integration and social support) are also associated with risk for respiratory illness: Social integration is associated with reduced risk irrespective of stress level and social support protects persons from the pathogenic influences of stress. Finally, we report recent evidence that lower levels of early childhood socioeconomic status (SES) are associated with greater risk of viral-induced illness during adulthood, independent of adult SES.
Article
Full-text available
Supplementation of nutritional deficiencies helps to improve immune function and resistance to infections in malnourished subjects. However, the suggested benefits of dietary supplementation for immune function in healthy well nourished subjects is less clear. Among the food constituents frequently associated with beneficial effects on immune function are micronutrients such as vitamin C, vitamin E, beta-carotene and zinc, and colostrum. This study was designed to investigate the effects these ingredients on immune function markers in healthy volunteers. In a double-blind, randomized, parallel, 2*2, placebo-controlled intervention study one hundred thirty-eight healthy volunteers aged 40-80 y (average 57 +/- 10 y) received one of the following treatments: (1) bovine colostrum concentrate 1.2 g/d (equivalent to approximately 500 mg/d immunoglobulins), (2) micronutrient mix of 288 mg vitamin E, 375 mg vitamin C, 12 mg beta-carotene and 15 mg zinc/day, (3) combination of colostrum and micronutrient mix, or (4) placebo. Several immune function parameters were assessed after 6 and 10 weeks. Data were analyzed by analysis of variance. Groups were combined to test micronutrient treatment versus no micronutrient treatment, and colostrum treatment versus no colostrum treatment. Overall, consumption of the micronutrient mix significantly enhanced delayed-type hypersensitivity (DTH) responses (p < 0.05). Adjusted covariance analysis showed a positive association between DTH and age. Separate analysis of younger and older age groups indicated that it was the older population that benefited from micronutrient consumption. The other immune function parameters including responses to systemic tetanus and oral typhoid vaccination, phagocytosis, oxidative burst, lymphocyte proliferation and lymphocyte subset distribution were neither affected by the consumption of micronutrients nor by the consumption of bovine colostrum concentrate. Consumption of bovine colostrum had no effect on any of the immune parameters assessed. The micronutrient mix enhanced cellular immunity as measured by DTH, with an increased effect by incremental age, but did not affect any of the other immune parameters measured. Although correlations between decreased DTH and enhanced risk of certain infection have been reported, it remains unclear whether and enhanced DTH response actually improves immune defense. The present data suggests that improvement of immune parameters in a population with a generally good immune and nutritional status is limited and that improvement of immune function in this population may be difficult.
Article
This study sought to evaluate the association between perceived and aerobic physical fitness and both psychological functioning and physiological stress responsivity. Sixty nonsymptomatic participants (30 males, 30 females) participated in the experiment. Participants completed a series of personality and mood questionnaires as well as a laboratory procedure measuring cardiovascular responses (i.e., heart rate and blood pressure) while performing stressful laboratory tasks (i.e., the Stroop Color Naming Test and a sham IQ test). Aerobic fitness (i.e., VO 2 max using the Bruce protocol) as well as perceived fitness were also determined. Results suggest that perceived fitness was generally associated with positive personality and mood variables while aerobic fitness was not. Overall results support the view that perception of fitness may be as important or perhaps even more important than aerobic fitness in its association with psychological but perhaps not physical functioning.
Article
upper respiratory tract infection (URTI) is the most common reason for seeking primary care in many countries. Still, little is known about potential strategies to reduce susceptibility. We investigated the relationships between physical activity level, perceived stress, and incidence of self-reported URTI. we conducted a population-based prospective cohort study of 1509 Swedish men and women aged 20-60 yr with a follow-up period of 4 months. We used a Web-based questionnaire to assess disease status and lifestyle factors at the start of the study. We assessed physical activity and inactivity as total MET-hours (MET task) per day and perceived stress by the 14-item Perceived Stress Scale. Participants were contacted every 3 wk via e-mail to assess incidence of URTI. They reported a total of 1181 occurrences of URTI. We used Poisson regression models to control for age, sex, and other potential confounding factors. we found that high levels of physical activity (≥ 55 MET·h·d) were associated with an 18% reduced risk (incidence rate ratio (IRR) = 0.82, 95% confidence interval (CI) = 0.69-0.98) of self-reporting URTI compared with low levels of physical activity (<45 MET·h·d). This association was stronger among those reporting high levels of stress (IRR = 0.58, 95% CI = 0.43-0.78), especially among men (IRR = 0.37, 95% CI = 0.24-0.59), but absent in the group with low levels of stress. we found that high physical activity was associated with a lower risk of contracting URTI for both men and women. In addition, we found that highly stressed people, particularly men, appear to benefit more from physical activity than those with lower stress levels.
Article
Quercetin in culture with target cells and pathogens exerts anti-pathogenic activities against a wide variety of viruses and bacteria. A few small-scale human quercetin supplementation studies have produced conflicting results regarding quercetin's effects on upper respiratory tract infection rates, and little is known regarding the appropriate human dose. The purpose of this randomized, double-blinded, placebo-controlled trial was to measure the influence of two quercetin doses (500 and 1000 mg/day) compared to placebo on upper respiratory tract infection (URTI) rates in a large community group (N=1002) of subjects varying widely in age (18-85 years). Subjects ingested supplements for 12 weeks and logged URTI symptoms on a daily basis using the Wisconsin Upper Respiratory Symptom Survey (WURSS). No significant group differences were measured for URTI outcomes for all subjects combined, or when analyzing separately by gender, body mass index, and age categories. Regression analysis revealed that the strongest interaction effect with group status was self-reported fitness level. A separate analysis of subjects 40 years of age and older rating themselves in the top half of the entire group for fitness level (N=325) showed lower URTI severity (36% reduction, P=0.020) and URTI total sick days (31% reduction, P=0.048) for the Q-1000 group compared to placebo. In summary, for all subjects combined, quercetin supplementation over 12 weeks had no significant influence on URTI rates or symptomatology compared to placebo. A reduction in URTI total sick days and severity was noted in middle aged and older subjects ingesting 1000 mg quercetin/day for 12 weeks who rated themselves as physically fit.
Article
Restoring sleep is associated with psychological well-being. In contrast, poor sleep leads to impaired daily cognitive, emotional, and social functioning. Both commonplace and expert opinion hold that exercise has a favorable impact on preventing poor sleep and improving its quality. However, the scientific basis for this opinion remains limited, and results are mixed. The aim of the present study, therefore, was to explore the impact of perceived physical fitness, exercise, and a perceived lack of activity on sleep in early adulthood. Gender-related patterns were also examined. A total of 862 participants (639 females and 223 males; mean +/- SD = 24.67 +/- 5.91 yr) took part in the study. Respondents completed a series of self-report questionnaires assessing perceived physical fitness, exercise, perceived lack of physical activity, insomnia (Insomnia Severity Index), dysfunctional sleep-related thoughts (Fragebogen zur Erfassung allgemeiner Persönlichkeitsmerkmale Schlafgestörter), and quality of sleep (Pittsburgh Sleep Quality Index). High perceived physical fitness, but not exercise, was associated with favorable scores for various sleep indicators. A perceived lack of physical activity was associated with poor sleep. Perceived physical fitness and exercise were moderately correlated. Compared with males, females reported more sleep difficulties and also more dysfunctional sleep-related thoughts. For early adulthood, findings did not support commonplace or expert opinion that exercise behavior has a favorable influence on sleep. Rather, the findings lend support to the importance of cognitive processes in the onset and maintenance of sleep complaints.
Article
The extent and duration of changes on lymphocyte function and serum immunoglobulin (Ig) levels were examined in 12 women who walked 45 min at 60% VO2 max in a laboratory setting. A 2-factor, 2 x 6 design with repeated measures on both factors was utilized. The first factor was condition (exercise and rest), and the second factor was time (six times of measurement over a 24-h period), with treatment order counterbalanced. The 45-min walk, in comparison to rest in a seated position, was not associated with significant changes in circulating numbers of interleukin-2-activated T cells (CD5 and CD25) or on spontaneous or concanavalin-A-stimulated lymphocyte proliferation. A trend for decreased phytohemagglutinin-stimulated lymphocyte proliferation in comparison to the rest condition, however, was seen 1.5 h following the exercise bout (p = 0.047). The patterns of change for serum IgG, IgA, and IgM were significantly different (p = 0.001, p less than 0.001, p = 0.010, respectively) between conditions. IgG rose 7.2% immediately following exercise, and then returned to baseline 1.5 h later, which contrasted significantly with changes in the rest condition. These same patterns of change occurred also with IgA and IgM, but increases immediately following exercise were not significant, although a trend was seen for IgA (p = 0.03). The 45-min walk had no effect on plasma cortisol and epinephrine levels relative to the rest condition, but was associated with a significant 89% increase in norepinephrine.(ABSTRACT TRUNCATED AT 250 WORDS)
Article
The relationship between cardiorespiratory exercise, immune function, and upper respiratory tract infection (URTI) was studied in elderly women utilizing a randomized controlled experimental design with a follow-up of 12 wk. Thirty-two sedentary, elderly Caucasian women, 67-85 yr of age, who met specific selection criteria, were randomized to either a walking or calisthenic group; 30 completed the study. Twelve highly conditioned elderly women, 65-84 yr of age, who were active in endurance competitions, were recruited at baseline for cross-sectional comparisons. Intervention groups exercised 30-40 min, 5 d.wk-1, for 12 wk, with the walking group training at 60% heart rate reserve and the calisthenic group engaging in mild range-of-motion and flexibility movements that kept their heart rates close to resting levels. At baseline, the highly conditioned subjects exhibited superior NK (119 +/- 13 vs 77 +/- 8 lytic units, P < 0.01) and T (33.3 +/- 4.9 vs 21.4 +/- 2.1 cpm x 10(-3) using PHA, P < 0.05) cell function, despite no differences in circulating levels of lymphocyte subpopulations. Twelve weeks of moderate cardiorespiratory exercise improved the VO2max of the sedentary subjects 12.6%, but did not result in any improvement in NK cell activity or T cell function. Incidence of URTI was lowest in the highly conditioned group and highest in the calisthenic control group during the 12-wk study, with the walkers in an intermediate position (chi-square = 6.36, P = 0.042). In conclusion, the highly conditioned elderly women in this study had superior NK and T cell function when compared with their sedentary counterparts.(ABSTRACT TRUNCATED AT 250 WORDS)
Article
The effects of exercise on susceptibility to respiratory infection were determined by using a murine model of intranasal challenge with herpes simplex type 1 virus (HSV-1). Two doses of treadmill exercise were assessed: moderate short-term (30 min) exercise and prolonged strenuous exercise to voluntary fatigue (2.5-3.5 h). Morbidity and mortality among exercised and control mice were compared after intranasal challenge with HSV-1. We also assessed the ability of alveolar macrophages to restrict HSV-1 viral replication (intrinsic resistance) among exercise and control groups of mice at several time points postexercise. Exercise to fatigue followed by exposure to viral infection resulted in greater morbidity and mortality than either no exercise or short-term moderate exercise. In addition, antiviral resistance of macrophages obtained from the lungs of both exercised groups was suppressed, albeit for a longer duration in the fatigued group. These data are particularly important in that they identify an exercise-induced decrease in antiviral resistance of a specific component of the immune system within the lungs, in conjunction with increased susceptibility to respiratory infection in vivo. The specific mechanism of decreased antiviral resistance of alveolar macrophages and its role in respiratory infection after exercise remains to be determined.
Article
The effect of exercise training (five 45-min walking sessions/wk at 60-75% maximum heart rate) and/or moderate energy restriction (4.19-5.44 MJ or 1,200-1,300 kcal x d(-1)) on innate and adaptive immunity (including mitogen-stimulated lymphocyte proliferation (MSLP), natural killer cell activity (NKCA), and monocyte and granulocyte phagocytosis and oxidative burst (MGPOB) was studied in obese women (N = 91, age 45.6 +/- 1.1 yr, body mass index 33.1 +/- 0.6 kg x m(-2)) randomized to one of four groups: control (C), exercise (E), diet (D), exercise, and diet (ED). Aerobic power, body composition, and immune function were measured in all subjects before and after a 12-wk diet intervention period, with data analyzed using a 4 x 2 repeated measures design. All subjects self-reported symptoms of sickness in health logs using a precoded checklist. Statistical significance was set at P < or = 0.05. Data from this study indicate that although exercise training was unrelated to any significant changes in resting immune function, the number of days with symptoms of upper respiratory tract infection (URTI) was reduced relative to subjects in the nonexercise groups (5.6 +/- 0.9 and 9.4 +/- 1.1 sickness days, respectively, P < 0.05). Energy restriction and weight loss (7.9 +/- 0.7 kg) was associated with a significant decrease in MSLP, but no change in NKCA, MGPOB, or URTI. The data are consistent the viewpoint that weight loss, even at a moderate rate, is associated with a decrease in mitogen-stimulated lymphocyte proliferation without a change in various measures of innate immunity of the blood compartment.
Article
To analyze, both by a retrospective and prospective study design, the relationship of maximal oxygen consumption (VO2max) and physical activity (PA) to upper respiratory tract infections (URTI) symptomatology in elderly subjects. 61 (33 men and 28 women) healthy and weight-stable active elderly volunteers aged 66-84 yr participated in the study. PA was evaluated by a questionnaire QAPSE (Questionnaire d'Activite Physique Saint-Etienne) and expressed by two QAPSE activity indices: MHDEE (mean habitual daily energy expenditure) and sports activity (daily energy expenditure corresponding to leisure time sports activities). Log books for daily recording of URTI symptomatology were used in prospective design. In a 1-yr retrospective study a significant correlation was found between number of weeks with URTI per year and Sports activity index (r = -0.27, P = 0.037). In a prospective 12-month follow-up, the number of episodes per year and number of days with URTI per year were significantly negatively associated with sports activity index (r = -0.29, P = 0.022 and r = -0.26, P = 0.041, respectively). In healthy active elderly subjects the symptomatology of URTI over long periods of time is inversly related to energy expenditure utilized during moderately intensive physical exercise.
Article
Acute respiratory tract infections are the most common illnesses in all individuals, regardless of age or gender. Epidemiologic surveys and community-based studies conducted since the beginning of the 20th century have determined the rates of illness and the pathogens involved in such infections. These studies have shown that rhinoviruses cause the great majority of these respiratory illnesses, and their findings have examined the means of transmission of respiratory illness. More recently, advances in diagnostic techniques have enabled more complete identification of the viruses involved in respiratory infections, which has aided in the ability to direct specific therapeutic agents at the causative pathogens.
Article
To develop a sensitive, reliable, responsive, easy-to-use instrument for assessing the severity and functional impact of the common cold. We created an illness-specific health-related quality-of-life outcomes instrument. This original questionnaire was used in a 1999 randomized trial of echinacea for the common cold. In 2000 we used cognitive interview and focus group qualitative methods to further develop the instrument. Semistructured interviews used open-ended questions to elicit symptoms, terminology, and perceived functional impact. Responses were used to improve the instrument. The randomized trial watched 142 University of Wisconsin students for a total of 953 days of illness. The subsequent qualitative instrument development project recruited 74 adults with self-diagnosed colds for 56 in-person interviews and 3 focus groups. We measured specific symptoms, symptom clusters (dimensions), functional impact, and global severity. The original questionnaire included 20 questions: a global severity indicator, 15 symptom-severity items using 9-point severity scales, and 4 yes/no functional assessments. Data from the trial provided evidence of 4 underlying dimensions: nasal, throat, cough, and fever and aches, with reliability coefficients of 0.663, 0.668, 0.794, and 0.753, respectively. Qualitative assessments from the interviews and focus groups led us to expand from 15 to 32 symptom-specific items and from 4 to 10 functional impairment items. The original 9-point severity scale was revised to 7 points. Two global severity questions bring the item count to 44. The instrument fits comfortably on the front and back of a single sheet of paper. The Wisconsin Upper Respiratory Symptom Survey (WURSS) is ready for formal validity testing or practical use in common cold research.
Article
A "J"-shaped model has been proposed to describe the relationship between physical activity and risk of upper-respiratory tract infection (URTI). However, little epidemiologic evidence is available to support the contention that moderately active individuals are at lowest risk of URTI. This investigation examined differences in URTI risk between physically inactive and moderately active adults. Observational study of 547 healthy adults (49% women) aged 20-70 yr reported URTI events at 90-d intervals over 12-month of follow-up (5 evaluations). Three 24-h physical activity recalls per evaluation were obtained and averaged to quantify total moderate-vigorous activity (> or =3.0 metabolic equivalents [MET]). Associations between URTI and physical activity levels were estimated using incidence rate ratios (IRR) derived using Poisson regression while adjusting for a number of potential confounders including age, education, anxiety, cynicism, and selected dietary factors. Men and women reported 1.2 (1.4) and 1.2 (1.2) URTI events per year, respectively (mean [(SD]). Adjusting for gender and potential confounders, the IRR for less than 3.93, 3.94-7.15, 7.16-11.95, and > or = 11.96 MET-h.d(-1) among men, and less than 2.38, 2.39-4.09, 4.10-6.24, and > or = 6.25 MET-h.d(-1) among women, were 1.00 (referent), 0.87 (95% confidence interval [CI], 0.70-1.07), 0.88 (95% CI, 0.71-1.09), and 0.77 (95% CI, 0.62-0.95), respectively (P(trend) = 0.03). This effect was stronger in men (P(trend) = 0.03) than women (P(trend) = 0.17), although at similar expenditure levels (6-7 MET-h.d-1), risk was reduced by about 20% in men and women. Risk reduction was most pronounced in the fall of the year (P(trend) = 0.02). These data support the hypothesis that moderate levels of physical activity are associated with a reduced risk for URTI.
Article
Despite great advances in medicine, the common cold continues to be a great burden on society in terms of human suffering and economic losses. Of the several viruses that cause the disease, the role of rhinoviruses is most prominent. About a quarter of all colds are still without proven cause, and the recent discovery of human metapneumovirus suggests that other viruses could remain undiscovered. Research into the inflammatory mechanisms of the common cold has elucidated the complexity of the virus-host relation. Increasing evidence is also available for the central role of viruses in predisposing to complications. New antivirals for the treatment of colds are being developed, but optimum use of these agents would require rapid detection of the specific virus causing the infection. Although vaccines against many respiratory viruses could also become available, the ultimate prevention of the common cold seems to remain a distant aim.
Article
To measure several components of immune changes related to walking 30 min with or without an exercise assist device compared with sitting. Fifteen healthy and nonobese female subjects (37.5 +/- 3.1 yr of age) accustomed to regular walking were recruited and tested for aerobic power (VO(2max) 34.4 +/- 1.4 mL.kg(-1).min(-1)). During three randomly assigned 30-min test sessions, subjects functioned as their own controls and either sat in the laboratory, walked at approximately 60% VO(2max), or walked at the same treadmill speed using the BODY BAT Aerobic Exerciser. This exercise assist device resembles a pair of baseball bats seamlessly joined together and is held with both hands and swung to shoulder height across the body in a natural side to side pendulum motion. Saliva and blood samples were collected pre- and postexercise, and 1 h postexercise, with the data statistically analyzed using a 3 x 3 repeated measures ANOVA. Walking with the exercise assist device increased oxygen consumption 11 +/- 2% and heart rate 8 +/- 2 beats.min(-1). The pattern of increase in blood counts for neutrophils, lymphocytes, monocytes, and natural killer cells, plasma interleukin-6 concentration, and PHA-induced lymphocyte proliferation differed significantly when comparing walking with sitting, but no differences were found between walking with or without the exercise assist device. No significant increases over time or interaction effects were measured for plasma cortisol concentration, salivary IgA output, or plasma interleukin-1 receptor antagonist concentration. The use of an exercise assist device increased oxygen consumption 11% during walking, but did not alter the pattern of change in several components of immunity measured during walking alone in comparison to sitting. Walking caused modest and short-lived changes in immune parameters, most notably for neutrophil and natural killer blood cell counts.
Article
To assess reliability, responsiveness, importance to patients, and convergent validity for the Wisconsin Upper Respiratory Symptom Survey (WURSS-44) and to develop a short-form WURSS. Community-based recruitment of participants with colds. Prospective monitoring from within 48 hours of first symptom until 2 days after end of cold. The WURSS-44 includes 1 global illness severity item, 32 symptom-based items, 10 functional quality-of-life items, and 1 item assessing global change. The SF-36, SF-8, and the Jackson cold scale were used as external comparators. Participants included 104 women and 45 men, aged 18 to 80 years, self-reporting on 1,681 person-days of illness. Factor analysis suggested 10 dimensions, with reliability coefficients from 0.62 to 0.93. Comparing daily WURSS-44 to Jackson and SF-8 yielded Pearson correlation coefficients from 0.73 to 0.93, and from -0.60 to -0.84, respectively. Importance to patients and responsiveness assessment yielded a short version, the WURSS-21. Guyatt's responsiveness index was 0.54 for the SF-8, 0.61 for the Jackson, 0.71 for the WURSS-44, and 0.80 for the WURSS-21, suggesting that a two-armed trial would require 74 participants for the WURSS-21, 92 for the WURSS-44, 124 for the Jackson scale, and 156 for the SF-8. The construct validity of WURSS-44 is supported by measures of reliability, responsiveness, importance to patients, and convergence. A shorter version, the WURSS-21, may be even more responsive.