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CHAIM BLOG

Exercise: An Immune Boosting Activity?

5/27/2021

1 Comment

 
PictureOut for a run. PC: Zoë Williams
By Zoë Williams, Carleton University Student-Athlete
​

I tie up my running shoes and head out the door. Gravel crunches underfoot. A song by Taylor Swift plays through my earbuds. Wind brushes against my face as I run. I breathe deeply and look around, enjoying the outdoors on this fresh and sunny spring day. 
​
​Exercise. What comes to mind when you think of the word? With gyms closed and physical distancing rules in place I’d bet your definition has changed and that your daily physical activity levels have changed too. Moving from school or the office to working from home has meant that walking to work, class, or the coffee shop, has been replaced with walking downstairs, to the home office (if you’re lucky enough to not be working in your bedroom!), and into the kitchen. Research findings suggest that COVID-19 has changed our exercise and activity patterns, with some people exercising more, others less, and a worldwide study reporting a decrease in daily step counts that corresponded with the first wave of the pandemic (1). A large survey in the UK also reports that fewer people are staying active in the second lockdown. As we move in and out of various stages of lockdown across the country, Canadians may also be struggling with the motivation to stay active. Yet, exercise may actually be one of the best things a person can be doing for their immune system in the midst of a global pandemic!

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​Hippocrates, a Greek physician who’s considered the father of medicine, is quoted to have said “walking is man’s best medicine”. Based on the evidence, he may have been onto something. Our immune system is comprised of a large array of cells and molecules (check out this video for an immune system refresher) and research findings indicate that moderate intensity exercise can boost our immune system. One of the ways that exercise does this is by increasing the surveillance of our immune cells. When we exercise, our immune cells become mobilized, moving into our bloodstream and then out into tissues where “enemies”, like viruses and bacteria, are more likely to be present (2). If our immune system is our army, you can think of exercise as a signal – moving our army from its barracks and out into the field, telling it to be on high alert for enemies. This means that when we exercise our immune system may be more prepared to detect and respond to potential enemies that enter our body. Although no research has yet examined the effect of exercise on resistance to or severity of COVID-19, studies have reported that exercise can reduce the risk, duration, and symptom intensity of other viral infections. Exercise has also been shown to improve response to vaccinations in older adults by increasing the vaccination effect and reducing side effects (3).

PicturePC: Andrey Armyagov – Shutterstock
However, in these pandemic times we’re not just facing a virus, but many people are also facing confinement and isolation that comes with lockdowns and quarantines. How may exercise interact with that and the immune system? A recent study examining the effects of exercise on astronaut immune health gives us a look at the interaction between exercise, the immune system, and the stress of isolation. Astronauts tend to experience a weakened immune system during space travel, which is thought to be connected to the stress that comes with isolation and confinement. Researchers found that lower cardiorespiratory fitness during space travel was associated with a weakened immune system, but higher levels of fitness were shown to be protective against this weakening. Although most of us are not astronauts, we are facing increased levels of confinement and isolation and this study shows us that exercise may allow our immune system to cope with the added stress (for more information on stress and exercise, check out this blog!). 

PictureWorking out from home. PC: Fottograff iStock Photos
 You may be wondering what types of exercise we should do for these immune boosting effects. More research needs to be done before we know the specifics, but if you’re an elite athlete or a lover of multi-hour high intense exercise then I recommend you check out this podcast. For most of us, simply getting up and moving at a moderate intensity is key. Moderate intensity exercise can be defined as exercise at 60% of heart rate reserve (which is 65-75% of one’s max heart rate) for a max of 60 min. For example, a 30-60 min. brisk walk. The World Health Organization recommends that adults reduce sedentary time, engage in 150-300 minutes of moderate intensity exercise a week and strength training activities at least twice a week, but that this can be adjusted based on fitness level. It may look like a lot, but this is only 20-30 min. of exercise a day! However, if you haven’t exercised before, check out these articles, and make sure to build into it; rapid increases in exercise have been reported to increase the risk of injury (4), but starting at a low intensity and gradually building from there can prevent exercise related injuries, and doing a variety of different types of physical activity may also reduce injury risk (5). For those of us in Ottawa, we are lucky to have the Rideau Canal for skating and a wonderful network of cross country ski, biking, and hiking trails to explore! 

So, lace up your shoes, buckle up your ski boots, roll out your yoga mat, and get moving! Your immune system will thank you.

References:
  1. Reynolds, G. (2020). ‘How the Pandemic Is Changing Our Exercise Habits’, The New York Times, 7 October. https://www.nytimes.com/2020/10/07/well/move/pandemic-exercise-habits-study.html
  2. Simpson, J. (2020). ‘Exercise, Immunity and the COVID-19 Pandemic, American College of Sports Medicine Blog, 30 Marchhttps://www.acsm.org/home/featured-blogs---homepage/acsm-blog/2020/03/30/exercise-immunity-covid-19-pandemic
  3. Edwards K., et al. (2020). ‘Physical Activity, COVID-19 and Older Adults’. Exercise Is Medicine Blog, 6 November. https://www.exerciseismedicine.org/support_page.php/stories/?b=918
  4. Powell K., et al. (2011). ‘Physical Activity for Health: What Kind? How Much? How Intense? On Top of What?’ Annual Review of Public Health. https://www.annualreviews.org/doi/full/10.1146/annurev-publhealth-031210-101151#_i19
  5. Cress M., et al. (2006). ‘Best Practices for Physical Activity and Behavior Counseling in Older Adult Populations’. European Review of Aging and Physical Activity. ​https://link.springer.com/article/10.1007%2Fs11556-006-0003-9   
1 Comment

Are You Really What You Eat?

4/26/2021

0 Comments

 
By Zoë Williams, 4th year Neuroscience and Mental Health Student
We’ve all heard the saying, but how accurate is it? This informative video by Zoë Williams explores how the foods we eat can influence our brain and delves into the mechanics of how diet could impact mood and cognition, particularly highlighting the important role of our microbiota in this gut-brain axis.
Want to learn more?
Food for thought: How your belly controls your brain 
​
TedX talk by Dr.​ 
Ruairi Robertson (2015)
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Picture
Milestones in human microbiota research
​Interactive research timeline  (Nature, 2019)

The role of nutrition in the microbiota-gut–brain axis 
Review article (Oriach et al., 2016)​
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A healthy gut: A promising solution for anxiety
CHAIM blog by Chaya Kandegedara (2019)
0 Comments

Probiotic Potential in a Pandemic

4/1/2021

2 Comments

 
Armoring up against COVID-19 with beneficial bacteria
By Ana Santos, Neuroscience PhD student
Humans are no strangers to microbes and the world is grappling with one that has taken center stage, SARS-CoV-2. Commonly known as COVID-19, this actor is new on the scene and highly viral, making prevention and treatment difficult. COVID-19 is diverse in its acting techniques, a spectrum ranging from mildly cold-like or no symptoms, to
severe organ damage or death, with lots of variation in between. Interestingly, severe cases seem to be associated with more symptoms like diarrhea, vomiting, nausea, loss of appetite, bloody feces, and gut pain[1] and little is known yet about longer term effects.
​
​Most germs we interact with are friends and not foes. The gut microbiota is like a director, staging the immune system to be strong, and managing the good microbes to ward off pathogens. The current theater production is set in the gut and lungs (called the gut-lung axis), which foreshadows how dysfunction in one organ can influence the other. Here, we feature the immune system as the star of the play and cast probiotic microbes as supporting characters.
Terminology
Viral : Ability of a virus to infect, cause disease and spread from host to host.
Microbiota: Collection of microbes: bacteria, viruses, fungi, etc., specific to gut and lungs.
Leaky Gut: Increased permeability of the gut barrier, can contribute to cytokine storm by increasing viral & bacterial invasion into circulation and promoting inflammation.
Dysbiosis: General term for a microbiome characterized by
increases in pathogens and loss of beneficial bacteria. Promotes
inflammation and leaky gut.
Cytokine Storm: Release of many proinflammatory signals (cytokines). When prolonged it causes damage to cells and organs.
Genera, Species, & Strain:
The order that the tree of life categorizes organisms into groups starting from general shared genera to specific unique strains.
Picture
As the lead role, the immune system’s purpose is to kill the virus, but like superheroes who destroy the city in their epic battles, the immune system can leave a wreckage of damaged cells and tissues in its effort to fight off the villain, COVID-19.
This can lead to a sequel of persistent symptoms in the gut and lungs even after the infection has been resolved 
[2]. Early reports have found that COVID-19 infection is linked with a leaky gut and dysbiosis which promote gut inflammation [1]. A gut-lung axis implies signaling goes both ways between the lungs and gut. While the majority of our bodies’ immune cells reside in our gut, they don’t necessarily stay there, so gut inflammation can reach the lungs and vice versa, fueling a fire that is already occurring [3].

Enter left stage, friendly bacteria to help ‘boost’ the immune system. Probiotics are live microorganisms that provide a health benefit when enough are consumed. The most common bacterial genera used in products are Lactobacilli and Bifidobacterium, which are also beneficial members of our normal lung and gut microbiota. The term probiotic is actually very broad. When making conclusions about the influence of these actors, it really comes down to the specific species and strain of the bacteria and the amount needed to induce specific health effects [3].

General mechanisms of probiotics relevant to COVID-19 include [3]:
  • Boosting anti-inflammatory cytokines, like interferons that ‘interfere’ with viruses
  • Producing anti-viral substances to kill and prevent virus infection
  • Supporting the gut barrier, reducing leaky gut
  • Limiting dysbiosis by out-competing pathogens

Probiotic bacteria are dynamic in their actions and mechanisms; they don’t replace our microbes, but interact with the microbes already there to alter their host. It has been shown that certain probiotics influence the gut-lung axis, preventing infection, reducing severity and length of other viral lung infections [3]. Additionally, improving the body’s anti-viral response can reduce the stress of infection and organ damage.

Stress is a catch-all term, including emotional or social stress like isolation, and physical stressors such as infection or disrupted sleep. Extreme and/or accumulating stressors, like many have experienced through the pandemic, can significantly impact our health and also induce dysbiosis, making us more susceptible to infection. This highlights another role probiotics may play, as certain probiotics help buffer the effects of stress and reduce symptoms of anxiety and depression [4]. This is especially important for an aging population who are the most vulnerable to severe COVID-19 infections and the negative effects of stress. Except in certain cases (like severely immunocompromised patients), probiotics are generally safe and well tolerated even in intensive care settings (ICU) and vulnerable populations, like the elderly. Probiotics have been shown to prevent ventilator-associated pneumonia in patients in the ICU, and ventilator support is necessary when individuals with COVID-19 have severe respiratory distress [3]. Therefore, the idea of preventatively boosting our defenses to help reduce the severity of COVID-19 infection is highly attractive.

The virality of COVID-19 requires researchers to be creative in their treatment methods. However, a script for treatment and prevention may not lie in killing the virus. Remembering that COVID-19 enters our cells by binding spike proteins at our ACE2 receptors, blocking this mechanism may essentially stop the virus from entering cells and replicating in the first place. 
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There are drugs that bind to this receptor and block COVID-19 from doing so; however, blocking the ACE2 receptor can also lead to a pro-inflammatory response [2]. So what is to be done about this paradox? Well, microbes are not easily outshined. One specific cast member, Lactobacillus plantarum, produces chemicals called plantaricins. These products can actually bind to COVID-19’s spike proteins, preventing the virus from binding to ACE2 without blocking the receptor and negatively impacting the immune system [5], an exciting twist in this story! When we understand probiotic mechanisms, it highlights the potential for more bacteria to be screened for the production of substances that could neutralize COVID-19 and combat infection.

Stagehands are often overlooked, like the natural probiotics occurring in fermented foods. Common ferments include yogurt, fermented vegetables, sour cream, some cheeses, kefir, kombucha, sourdough bread and of course, beer and wine. Lactobacillus plantarum is even found in cabbage ferments like sauerkraut and kimchi. There are many species of microbes in varying amounts within these products, but they are readily accessible and when eaten regularly are believed to promote a healthy gut. You can hear more about fermented foods and health here [3].
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There are still gaps in our knowledge about probiotics, and it is strongly encouraged that individuals listen to their gut (pun intended). Some symptoms are mild (and gassy) but tend to go away with continued use. However, if a probiotic causes an adverse reaction, like significant gut distress, know that personal response trumps any other suggestions. 
In addition, the market for probiotics is admittedly a mixed bag; some products are properly evaluated in controlled human studies, while others have unsubstantiated claims or are poorly manufactured. Others are simply too expensive, costing from $0.50 - $4/dose. While people can review online whether specific brands test their product’s quality in a lab, there are also websites to help consumers make informed choices by performing independent lab-based evaluation of products on the market such as: Lab Door, Consumer Health Report, and Consumer Lab Report (not free).

A housekeeping note: while probiotic therapies may contribute to viral protection, the suggestions in this post draw from currently available clinical studies on probiotic bacteria and other viral respiratory tract infections, not COVID-19. This information is in no way meant to replace advice or treatments from medical doctors.

Although the curtains have closed on this post, the potential of probiotics to boost our health is information we can use in this pandemic and beyond. But as we continue to deal with COVID-19 and the accompanying isolation, at least with trillions of microbes we are never truly alone.
 
Podcast link on the science of fermented food

References:
  1. Zuo T, Liu Q, Zhang F, et al. Depicting SARS-CoV-2 faecal viral activity in association with gut microbiota composition in patients with COVID-19. Gut. 2021; 70(2):276-284. doi:10.1136/gutjnl-2020-322294 
  2. Behl T, Kaur I, Bungau S, et al. The dual impact of ACE2 in COVID-19 and ironical actions in geriatrics and pediatrics with possible therapeutic solutions. Life Sci. 2020; 257:118075. doi:10.1016/j.lfs.2020.118075 
  3. Olaimat AN, Aolymat I, Al-Holy M, et al. The potential application of probiotics and prebiotics for the prevention and treatment of COVID-19. Nat Part J Sci Food. 2020; 4:17. doi:10.1038/s41538-020-00078-9 
  4. Liu RT, Walsh RFL, Sheehan AE. Prebiotics and probiotics for depression and anxiety: A systematic review and meta-analysis of controlled clinical trials. Neurosci Biobehav Rev. 2019; 102:13-23. doi:10.1016/j.neubiorev.2019.03.023. 
  5. Anwar F, Altayb HN, Al-Abbasi FA, Al-Malki AL, Kamal MA, Kumar V. Antiviral effects of probiotic metabolites on COVID-19. J Biomol Struct Dyn. 2020; 1-10. doi:10.1080/07391102.2020.1775123 
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