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27 . 03 . 2020

How to Preserve Our Health during the Pandemic?

We are living times of great collective apprehension. Today, we are all aware of the need to slow down the progression of the COVID-19 pandemic, through social isolation and other prophylactic measures. However, there are more behaviors that we can adopt in order to preserve our physical and mental health.

In this atypical era of society, as we know it, we must remember the main pillars of health preservation. They are:

  • Nutrition
  • Physical activity
  • Sleep
  • Stress management

The importance of nutrition and physical activity is often addressed, however the role of sleep and stress management is more “invisible”, but no less important. Let’s explore how we can improve each of these areas.

1. Nutrition

All the structural and cellular components of our body derive, ultimately, from something we eat and absorb. In addition to the structural component, we know today that food has the ability to influence the expression of our genes, through epigenetics.

This is, therefore, a time to ensure an adequate supply of nutrients and to limit food with a potential toxic or disrupting effect on the body. We should follow these principles:

  • prefer fresh over processed foods – the concept of “processed” food should be clarified, as olive oil, for example, can be included in this category, and is a healthy addition to our diet. By processed foods to avoid, we mean those foods with extensive ingredient lists, particularly if they include preservatives, dyes and artificial stabilizers.
  • consume a lot of vegetables – rich in antioxidants and phytonutrients, which are important to the immune system. Prefer cooked over raw if you have digestive problems.
  • eat some fruit – up to 3 pieces a day. Prefer seasonal fruit rich in vitamin C, such as oranges, lemons and kiwis.
  • ensure an adequate supply of protein – about 0.8-1 gram/ kg/ weight. We must choose between fish, lean meats, eggs and legumes.
  • prefer healthy fats – unsaturated fats like olive oil, avocado, nuts and seeds. Some saturated fat from coconut oil and butter can also be included in the diet. Avoid hydrogenated vegetable oils, such as sunflower oil, soy and margarine.
  • moderate intake of unrefined carbohydrates in a moderate way – prefer root vegetables (potatoes, sweet potatoes, manioc, etc.) over cereals.
  • use aromatic herbs and spices – foods such as parsley, coriander, garlic, turmeric, ginger, oregano and cinnamon, have a powerful anti-inflammatory and even anti-viral effect in some cases.
  • drink water and other liquids – we usually don’t drink enough water. On average, a 72 kg man should have about 4 liters of water per day (including the amount present in food). The consumption of teas and soups should be encouraged.
  • don’t overeat! The importance of caloric restriction as a hormetic stimulus of the immune system is well known.

 

manter-saudavel-covid19-fig1

Fig.1 – A diverse diet rich in micronutrients is essential for the immune system.

 

2. Physical activity

Light to moderate physical activity has a positive and tonic effect on the immune system. Concerning this matter, though, more quantity is not necessarily better. In fact, very vigorous physical exercise can cause temporary immunosuppression. This phenomenon is evident in marathons, for example, in which the incidence of respiratory infections is higher in the two following weeks (1).

Another beneficial effect of exercise, especially in this phase of social isolation, stems from the increased blood concentration of endocannabinoids and endogenous opioids (endorphins). These substances have a positive effect on mood and are associated with states of greater satisfaction and resilience to stress (2).

There are several options for exercising, without increasing the risk of contagion:

  • walking or jogging – at least 30 minutes.
  • resistance training with dumbbells, bands, or just your bodyweight.
  • practices that incorporate deep breathing, such as yoga, for example.

It is important to be creative at this stage and try to think of ways to move the body and distract the mind, even within the confines of our homes.

3. Sleep

The effect of sleep on the correct functioning of the human body, in all its complexity, is preponderant, and increasingly recognized. The immune system is no exception, and the importance of good sleep habits in preventing infectious diseases is well documented. In an interesting study, published in 2015, the sleep time of 164 healthy volunteers was recorded (3). Subsequently, nasal drops containing Rhinovirus (the virus responsible for common colds) were administered to each of the volunteers. It was found that volunteers who slept less than 6 hours a night, had a risk about 4 times higher of contracting a respiratory infection.

Now that we will be spending more time indoors, there should be no shortage of sleep. However, the stress tied to this situation can interfere with the quality and pattern of our sleep. Here are some suggestions that we can follow to ensure adequate sleep:

  • Sim for 8 hours of sleep at night.
  • Keep the room dark and silent.
  • avoid watching TV in the bedroom and prefer relaxing activities before bedtime.
  • avoid caffeine comsumption in the afternoon and evening.
  • if necessary, take a nap during the day.

 

Fig. 2 – Sleep is one of the most important factors for health preservation.

 

4. Stress management

Stress is defined as any physical, mental or emotional factor that causes tension. Some stress is necessary and beneficial for us to function, but too much has harmful consequences to the body. This is seldom ignored and underestimated in society, because it is subjective and difficult to measure.

In addition to subjective questionnaires, the measurement of cortisol (the main stress response hormone, produced by the adrenal glands) is used in studies to quantify the effects of stress on individuals. Cortisol is a hormone with an immunosuppressive effect (remember that corticosteroids – analogues of cortisol – are often used in autoimmune diseases, to “calm” the immune system’s response). Therefore, it makes sense that higher levels of cortisol are associated with greater susceptibility to infections. This relationship was proven in a study of 608 healthy adults, in which salivary cortisol was measured. Subsequently, the volunteers were exposed to Rhinovirus, and it was found that those with higher cortisol levels, had a higher rate of respiratory infections and spread the virus for a longer time (4).

The upcoming weeks will bring a lot of stress to all of us, so we need to find ways to reduce it and try to mitigate its effects. Here are some suggestions:

  • reduce exposure to news to the bare minimum – we all know the situation is catastrophic and alarming, but we don’t need to be reminded of that constantly. Let’s keep a period of the day (ideally less than 1 hour) to stay up to date, and try to “disconnect” from the situation for the rest of the day.
  • cultivate optimism. It’s challenging at this point, but let’s try to keep our hopes up.
  • maintain social interaction. Humans are social beings and this forced isolation is another aggravating factor. This is the time to intensify contacts with family, friends and neighbors, by phone, video call or, as we have seen in other countries, from your own balcony.
  • practice active relaxation. There are several modalities with validated results both at a subjective (well-being scores) and biochemical level (cortisol concentration). Examples are meditation (mindfulness), progressive muscle relaxation, visualization exercises, yoga, deep breathing, etc. (5). On YouTube, we can find videos to practice all these modalities.

A long journey is expected, with important limitations to our usual lifestyle. This should be a time to make better choices, and thus preserve our health. Perhaps we can even get out of this pandemic with healthier habits and greater awareness of our role in society and in the world.

 

References:

  1. Cantó E, Roca E, Perea L, et al. Salivary immunity and lower respiratory tract infections in non-elite marathon runners. PLoS One. 2018;13(11)
  2. Basso JC, Suzuki WA. The Effects of Acute Exercise on Mood, Cognition, Neurophysiology, and Neurochemical Pathways: A Review. Brain Plast. 2017;2(2):127–152.
  3. Prather AA, Janicki-Deverts D, Hall MH, Cohen S. Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep. 2015;38(9):1353–1359.
  4. Janicki-Deverts D, Cohen S, Turner RB, Doyle WJ. Basal salivary cortisol secretion and susceptibility to upper respiratory infection. Brain Behav Immun. 2016;53:255–261.
  5. Jones D, Owens M, Kumar M, Cook R, Weiss SM. The effect of relaxation interventions on cortisol levels in HIV-seropositive women. J Int Assoc Provid AIDS Care. 2014;13(4):318–323.
Categories: Exercise, Nutrition, Sleep, Stress

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