A Runner's Guide to a Healthy Immune System: COVID-19 Edition

The truth about the coronavirus pandemic is one that’s hard to believe. While this disease continues to spread, people all around the world are wondering how the massive changes are going to affect their lives. We are already getting a glimpse of the effects on society—closed restaurants, bars, and venues, canceled events, and limited interaction with friends and family. The effects on the economy don’t seem so big now, but as the pandemic continues to spread, the shut down of everything around the globe, including our very own jobs, is going to have a major impact on our individual incomes and economics as a whole. I mean, have you seen the stock market recently?!

As athletes, we should already treat our immune system as a priority to our health for two reasons: 1) We enter an immunocompromised state every time we train intensely, and 2) Getting sick keeps us from our regular training schedules. Most people don’t realize that it takes more than popping a vitamin C supplement every day to keep our immune systems healthy. Our sleep patterns, diet, training regimen, stress levels, and hygiene all play a big role in immune health. During a crisis such as what the world is going through now with COVID-19, we have to pay even more attention to each factor.

Diet

We all know how important a healthy diet is in general but it’s actually specifically linked to our immune function. Our immune system relies on white blood cells to create the antibodies that fight off bacteria and viruses and, believe it or not, certain foods can impair this white blood cell function. Studies have shown that a high fat diet can weaken the immune system. You may have read that a full-on plant-based diet is the way to go, but this is mainly due to the fact that plant-based diets generally have less dietary fat and more fiber—two factors that help improve immunity. You can still eat a high fiber, low fat diet and not specifically be plant-based. Loading up on fruits and veggies is also key to protecting immune health, since they are full of vitamins and minerals.

Sleep

The immune system is pretty complex, and so is the link between its health and our sleep patterns. The basic premise is that with sleep deprivation, our T-cell development is diminished. T-cells are the soldiers of the immune system that attack bacteria and viruses, and help keep us from getting sick. On top of limiting T-cell growth, sleep deprivation increases inflammatory cytokines in the immune system, leading to the development of colds and flus from the viruses that could not be fought off by the T-cells. Sleep is also when we experience our highest fever during illness. We tend to think fevers are a bad part of being sick, but it’s actually our bodies way of fighting off infection. If we don’t get good quality sleep, we can end up with a longer dose of the flu or seasonal cold. Aim for 7-9 hours each night for a stronger immune system.

Supplements

It is not absolutely necessary to take vitamins and other supplements every day in order to be healthy. If you regularly eat a wholesome diet—the right amount from each food group, then you most likely get all of the nutrients your body needs. The problem is the majority of people do not eat a wholesome diet, so taking a daily dose of the right vitamins is essential to good health and organ function. For immune function in particular, a good starting point is adding in vitamin C, zinc, and magnesium. One nutrient that is often overlooked by athletes is glutamine. This vital amino acid works directly with immune cells to fight off infection. Our body naturally produces it already, except that during times of stress, less glutamine is produced. This happens during both physical and emotional stress—intense training, sickness, cancer treatment, or even simply just being mentally stressed on a daily basis from work and family obligations. It can be helpful to add in a glutamine supplement after hard training sessions, especially during cold and flu season.

Training During the Outbreak

How many of us have had to change our training plans because either our local running routes have closed or our cities have gone on lockdown at this time? If the case is that you cannot run outside, then there are other options to get in your endurance training. Of course if you have an at-home treadmill, you are saved—you can keep your same training plan as if there was no crazy outbreak. Most of us, though, don’t have this luxury so we need to find another way. If you live in an apartment building, run laps through the parking garage. It’s not only a way to keep up your training program, but you get the added bonus of working on a hilly route!

If you are heading outdoors for your run, do your part and practice social distancing (6 feet apart from anyone!) and good hygiene. Here are some tips to follow to help keep you at low risk of catching and/or spreading any viruses:

✖️RUN SOLO - stay away from group runs, even if you think you are all healthy. Remember you can be carrying the virus around without knowing (zero symptoms!).
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✖️Don’t drink from water fountains - they are rarely cleaned and you can’t count on absolutely no one having put their mouth on the spout, and some people even spit in the fountains too! Just deal with carrying your own bottle for now.
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✖️Keep social distance - 6 feet away from every person! If you have to pass someone, try to hold your breath for a few seconds and look the other way.
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✖️Wash your hands immediately when you get home and get out of your run clothes—you don’t know what has dropped onto you while running.
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✖️Stay hydrated ALL DAY & keep a healthy diet—As stated above, this helps keep a strong immune system!

At-Home Workouts

If you can’t run outside, lack a parking garage, and don’t have enough space to jog around your home, it’s okay ! Don’t worry about losing fitness or getting out of running shape! There are plenty of exercises you can incorporate every day that will keep you in good form. You can make it a goal to maintain your endurance and strength as much as possible by combining a mix of moves. Thankfully you can still place orders online for workout equipment. My go-to tools are resistance bands and medicine balls. Click here to shop these and so many other options! To get the best out of your workouts, make sure to incorporate short rest breaks and keep your heart rate up as if you were running. Explosive moves such as plyometrics are extremely useful for runners and torch more calories than static moves. Try to keep your body moving for the same amount of time you usually run every day.

We are all hoping this virus will get under control within a matter or weeks, so it won’t be long before you can get out for a run again! The positive side of switching up your program for the time being is that you can give your body a break from the constant pounding of running and work different muscle groups. You’ll be surprised how much it will help with your form, strength, and pacing once you’re back out on the road! Endurance may lack bit when getting back into it, but it’s a part of fitness that quickly returns after just a few weeks off. The key is to keep your body moving!

Sources

1. Berenbaum, F.; van den Berg,W.B. Inflammation in osteoarthritis: Changing views. Osteoarthritis Cartilage 2015, 23, 1823–1824. 

2. Rinninella E, Cintoni M, Raoul P, et al. Food Components and Dietary Habits: Keys for a Healthy Gut Microbiota Composition. Nutrients. Published online October 7, 2019

Sick While Tapering? Here’s Why & Ways To Prevent It

Training for a marathon requires several months of hard running, at least decent nutrition, and adequate sleep. The last two to three weeks are extremely important to the training cycle, as it is when the body prepares for race day by enhancing recovery while maintaining the fitness gained throughout the prior months. The goal of this taper period is to get the body to a more relaxed state and fueled for race day. To reach this goal, there should be a gradual drop in mileage and heavy weight lifting, and a focus on proper nutrition. Many runners use this time to lounge on the couch and go overboard on the carb-loading, but it should be more structured than that! A drastic change in routine during the taper is not such a good idea because the body has been used to tackling loads of miles and exercise and a diet to sustain that activity level. It may shock the body and possibly cause illness. The common occurrence of illness during the taper period may be due to other reasons as well.

Overtraining Syndrome

Studies have been done to assess the response of the body’s immune system to physical activity. There is not much evidence to conclude that properly trained and recreational athletes are more susceptible to illness than non-athletes. However, there seems to be an effect on immune function with prolonged intense physical activity. The strongest correlation is the susceptibility to illness and the over-trained athlete. Overtraining syndrome is when there is insufficient rest with a high volume of physical stress, and many times this is combined with other stressors such as emotional, nutritional, and environmental stress. If this pattern continues, after a certain time chronic fatigue will set in along with poor recovery.

Low Plasma Glutamine

Over-trained athletes often present with low levels of glutamine in the body. Glutamine is an amino acid that is responsible for the healthy functioning of lymphocytes, which are the white blood cells that keep our immune systems working properly. With low levels of glutamine, athletes who are undergoing intense physical stress, as in overtraining syndrome, are more susceptible to infections. Although the main focus to prevent a drop in lymphocyte function is to avoid developing overtraining syndrome, glutamine supplementation is an option to keep levels where they need to be.

Post-Exercise Immunosuppression

There is a drop in some aspects of immune system functioning following exercise, especially intense exercise, such as a long cycle or run. This window of opportunity for infections can last between 3 to 72 hours. Some studies have shown that over-trained athletes who have a combination of stressors may extend this window even longer than a three-day period. This may be a reason why illness arises during the taper period. Our hardest training is performed right before the taper begins and with a window of opportunity extending to three or more days, we are more susceptible to falling ill. This is where proper nutrition is key. It is beneficial to have a wholesome diet full of the essential vitamins and minerals the body needs to lower our risk of developing infections.

Tissue Damage

Intense exercise causes tissue trauma that triggers higher levels of cytokines in the blood due to chronic inflammation. Elevated cytokines will causes a suppression of certain lymphocytes that are responsible for immunity. This occurs mostly in over-trained athletes who do not recover properly. A protective response of the body is automatic behaviors that will lead the athlete to decrease training intensity. This is due to the communication of cytokines with the brain to induce mood changes and fatigue.

Taper Illness Recovery & Prevention

The first plan of action to prevent taper sickness is to avoid falling into overtraining syndrome. Throughout the several months of training it is vital to incorporate enough rest time. Not every body is the same. Some tolerate less recovery than others. It is important to keep in mind that without proper recovery, our bodies cannot perform at their best. As mentioned above, good nutrition should also be a top priority every day during training. A diet full of essential nutrients and vitamins is key to keep our bodies working properly, as well as maintaining a low risk of acquiring infections.

If you are reading this while you are already sick and in the midst of your race taper, then the best action to take is to get plenty of rest during this time and drink a good amount of fluids. Nutrition is extremely important during illness, as our bodies require more energy to assist in the healing process. Appetite may be low or nonexistent during sickness, but it is vital to make sure to eat enough calories and make sure it is all from high-quality foods! The taper will require continued training runs at a lower intensity and volume, but if your illness consists of fever, body aches, and chest symptoms, it is best to take a few days off from physical activity. If symptoms are from the neck and above, such as a runny or stuffy nose and headache, it is usually safe to head out for easy runs. Remember, the taper period is not meant to improve performance and taking a few days off will not lower your fitness levels. Forcing running during this time while you are sick may only prolong your illness and negatively affect your race day outcomes.

Sources

Elena Papacosta and Michael Gleeson, Effects of Intensified Training and Taper on Immune Function, Journal, Jan 31, 2020.

Vitamins: Do Athletes Really Need More?

Diet and exercise go hand in hand these days. Most people change their diets when they begin an exercise program, or at the least, they become more mindful of what they eat and drink. Whether you are exercising to lose weight, gain muscle, train for a marathon, or simply to maintain a healthy heart, diet will play a big role in the outcomes. Many active people include supplements in their diet to get more nutrients that may be missing in their regular diets or for the sake of enhancing their performance or recovery. The best approach to nutrition is to eat a well-balanced diet from every food group, making sure to include all vitamins and minerals your body needs. For the majority of people who live a busy lifestyle, this may not always be possible.

In any popluation many factors can affect what the body needs such as illness and disease, regular diet, activity level, genetics, and even the amount of time we spend indoors versus outdoors! People who lower their food intake to lose weight end up lacking necessary nutrients the body needs. On the other spectrum, high intensity athletes, especially marathoners, tend to lose nutrients and not replace them sufficiently due to their higher metabolic rates. Both of these categories require a certain amount of nutrients, including vitamins and minerals in order for the body to perform at any state and maintain proper organ function.

Since many vitamin and mineral supplement bottles are labeled with a notice that states they are not FDA approved, many people are opposed to taking them. It isn’t until they develop a symptom or certain results from routine blood work that they pay more attention to taking the essential missing nutrients. It would be helpful to get evaluated by your doctor and get routine blood work done before any negative symptoms or illness develop, since it is possible that a body can naturally not produce or absorb certain nutrients even when given a wholesome diet. If you are trying to lose weight and know that you are cutting out certain food groups, or are an athlete performing at higher intensity levels or for long durations, you may want to consider including proper supplementation to keep your body going.

Calcium and Vitamin D

Bone health is a popular topic throughout life. Most children are brought up learning to drink calcium-rich milk every day to make and keep bones strong. Besides being a bone-strengthener, calcium is also in charge of other vital roles in our bodies such as nerve conduction, muscle contraction, and aiding in blood clotting. Many food sources are rich in calcium besides milk, including almonds, kale, broccoli, yogurt, and most other dairy products. Sufficient amounts of Vitamin D should also be included as it is responsible for the calcium absorption, as well as other functions such as helping reduce inflammation in the body and for immune health. More recent studies have shown that insufficient Vitamin D intake may lead to more incidences of stress fractures and decreased performance levels. Foods high in Vitamin D include milk, mushrooms, eggs, and most seafood. The easiest way to increase vitamin D intake is to spend an extra ten minutes in the sunlight!

Iron and Vitamin C

The most important role iron plays in the body is to transport oxygen in the blood to the tissues, basically ensuring proper muscle function. This is a major factor for athletes who want to perform at their best. During recovery from strenuous exercise, such as long distance running, iron helps produce new cells and repair our damaged muscles. It is important for high intensity and endurance athletes to include the recommended amount of iron in their diets. Women in particular should be aware that their requirements are higher than for men. Iron deficiency can be caused by blood loss, poor absorption, or inadequate intake through diet. The antioxidant Vitamin C plays a role in the proper absorption of iron, as long as it is ingested at the same time. Vitamin C is also vital for the repair of damaged tissue and immune health.

B Vitamins

For active individuals who train at high intensities or for prolonged periods, it is essential to include the recommended amount of B-vitamins in order to be able to perform at their best. This important group of substances is in charge of the proper metabolism of macronutrients—carbohydrates, proteins, and fats. Some B-vitamins help our bodies rely on carbohydrates for energy, which may assist in delaying the glycogen depletion process. This is desirable for a marathon runner who wants sustained energy for as long as possible. These vitamins are abundant in many food sources, so it is not difficult to ensure adequate intake. Fortified cereals, vegetables, lentils, animal products, and nuts are all rich in most B-vitamins.

Magnesium

Many vitamins, minerals, and antioxidants aide in the metabolism of macronutrients, including magnesium, which is essential for muscle health. Its role in protein synthesis is especially important for the recovery process when muscle tissue is broken down during exercise. Magnesium also plays a role in oxygen uptake, therefore making it beneficial for high intensity and prolonged exercise, since there is a need for higher oxygen requirements. During activities that result in increased sweat loss, magnesium is known to be one of the electrolytes lost during the process, which will decline exercise performance if not replaced. Good high-magnesium food sources include seeds, legumes, bananas, avocados, and dark chocolate.

Upper Intake Level

Although dietary requirements of vitamins and minerals vary from one individual to another, it is important to note that there is a maximum. Many studies have shown there are benefits to including the proper amount of vitamins in an athlete’s diet, but going beyond the maximum level will not enhance performance further. There are harmful effects of ingesting too much of any nutrient, such as increased risk of toxicity, interference in absorption of other medications and nutrients, immunosuppression and oxidative damage. As mentioned earlier, it is best to include a balanced diet of all food groups in your daily diet with plenty of fruits, vegetables, and other fortified sources before opting for supplementation. If your diet is lacking in a particular food group, such as in a vegan or vegetarian diet, or a low calorie diet used for weight loss, and it is difficult to include a variety of vitamin-rich food sources, supplementation may be necessary. Many health conditions and diseases can alter the amount of nutrients and vitamins our bodies require, which is why it is always best to consult a medical professional before modifying your diet.

Sources

Melvin H. Williams, Dietary Supplements and Sports Performance: Introduction and Vitamins, Journal, Nov 03, 2017

John Eric W. Smith, Megan E. Holmes, Matthew J. McAllister, Nutritional Considerations for Performance in Young Athletes, Journal, Nov 03, 2017

Kathleen Woolf, Melinda M. Manore, B-vitamins and Exercise: Does Exercise Alter Requirements?, Journal, Nov 03, 2017

Forrest H. Nielsen and Henry C. Lukaski, Update on the Relationship Between Magnesium and Exercise, Journal, Nov 03, 2017