In this worrisome time of a rising third wave of Covid-19 in South Africa, we need to look beyond just vaccinations (because our vaccination rate is lagging far behind the need to gain herd immunity) and non-pharmacological preventive strategies (which people are getting tired of utilising).
I am by no means suggesting that these strategies are not vitally important if we are ever to break the power of Covid in the world today. However there are other important interventions – lifestyle interventions – that enhance our natural immunity, thus reducing both our susceptibility to infection as well as our risk of severe disease.
Last week, we spoke about the benefits of a plant-based diet in boosting our protective immunity, as well as in reducing the risk of excessive response, as with the “cytokine storm”, which has killed many millions of people around the world. There is increasing evidence-based support for this dietary intervention.
Today we will address an equally beneficial approach – the importance of keeping physically active and the effect this behaviour has on our immune response to Covid-19. Much of the information I will present comes from an interview with Prof Sebastien Chastin by Dr Rifai of the True Health Initiative. Dr Chastin is a qualified physiotherapist, but also has a doctorate in Physics, and is Professor of Health Behaviour Dynamics in the School of Health and Life Sciences at Glasgow Caledonian University in Scotland. He is an expert adviser/consultant to the WHO.
He recently headed up a multi-centre study on the effect of physical activity (PA) on firstly resistance to infection, secondly effect on severity if you do contract infection, and thirdly to assess the effect PA has on the efficacy of vaccines. It has long been known that PA has a profound beneficial protective effect on non-communicable diseases (like diabetes, obesity, high blood pressure, cardiovascular diseases, auto-immune diseases, cancer and dementia), but what about infectious diseases.
In a study of around 500,000 individuals, it was found that keeping physically active reduced the risk of becoming infected by an organism like Covid-19 by 31%. Over and above that the risk of death associated with the viral infection was reduced by 37%.
Blood and other samples taken of individuals who exercised and those who did not exercise showed a number of differences. Localised antibodies on mucus membranes, which provide the first barrier to infection, were boosted with regular PA. Secondly, PA increased the CD4 surveillance cells in the body. These enhance the response of the body to the presence of infection.
In those who did regular PA for a minimum of 12 weeks before receiving their vaccination against Covid or in fact any vaccination, their response to the vaccine was significantly enhanced. Most physically active people in the study did around 30 minutes of moderate exertion walking 5 times per week.
Unfortunately 1/3 of the world population does not meet recommendations for adequate PA (150 minutes per week). PA is not only about specific times when one does exercise, but also about being physically active throughout the day. Every move counts. Total inactivity greatly increases risk. As soon as you start to become physically active, benefits start to accrue. A modern scourge has been sitting too much – travel, school, work are all associated with prolonged sitting. This is a dangerous pastime. The more you sit, the greater the risk of premature mortality from any cause. If you can keep physically active – moving in your house or at work, you benefit.
Some of the original research was done by Dr Jerry Morris published in 1953 – the London Bus study – in which he contrasted the cardiovascular health outcomes between bus conductors who walked up and down the buses checking tickets all day, compared to the drivers who were sitting all day. The latter had far higher mortality rates. Dr Rifai coined the term NEAT freaks – Non-Exercise Activity Time – for people who keep physically active throughout the day.
A useful formula: Three minutes of moderate to vigorous activity for every hour of sitting – 3 to 1. So, if you are sitting for 10 hours per day you should complete 30 minutes of PA or, you can replace one of the 3 minutes of moderate to vigorous exercise with a 12 minute gentle walk. So do 27 minutes of moderate/vigorous exercise, and 12 minutes gentle walk. There are many ways to trade off different forms of PA with light exercise using this formula if you don’t like exercising per se.
Here is the interview: Dr. Sebastien Chastin Reviews His Studies on Physical Activity
So what are some practical things we can do to ensure enough movement every day?
- If you are watching TV for hours on end, get up with each of the advert breaks and walk down the passage (not to the fridge or pantry for a snack!!).
- Get some water to drink, which will make your bladder work a bit more frequently
- When you are at work, every 20 minutes or so, get up from behind your computer and walk around the office.
- If you live or work in a multi-storey building, use the stairs rather than the elevator.
- When you go to the shops, park further away from the store entrance and walk with vigour to the shop.
- Don’t expect your spouse or child to do everything for you – get up and do stuff for yourself, especially if it involves some effort on your part – that is what it is all about.
- During your lunch or tea break, go for a little 5-10 minute walk – out in the sunshine and fresh air would be ideal.
- Remember that having a break every 20-30 minutes is not a waste of time, but actually makes you more productive and alert.
- Strength training is particularly important for our senior population – it improves mobility and functionality and independence – but is important as part of our 30 minutes of daily PA for everyone.
In conclusion, a healthy plant-rich diet, together with being physically active are both very important ways of combatting the scourge of Covid, as well as reducing non-communicable diseases, which by the way are co-morbidities with poor outcomes if infected by Covid.
Make some definite plans to incorporate these interventions in your life.
Dr Dave Glass
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