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Nieman DC, Wentz LM. The compelling link between physical activity and the body's defense system. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:201-217. [PMID: 31193280 PMCID: PMC6523821 DOI: 10.1016/j.jshs.2018.09.009] [Citation(s) in RCA: 602] [Impact Index Per Article: 120.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/26/2018] [Accepted: 09/25/2018] [Indexed: 05/05/2023]
Abstract
This review summarizes research discoveries within 4 areas of exercise immunology that have received the most attention from investigators: (1) acute and chronic effects of exercise on the immune system, (2) clinical benefits of the exercise-immune relationship, (3) nutritional influences on the immune response to exercise, and (4) the effect of exercise on immunosenescence. These scientific discoveries can be organized into distinctive time periods: 1900-1979, which focused on exercise-induced changes in basic immune cell counts and function; 1980-1989, during which seminal papers were published with evidence that heavy exertion was associated with transient immune dysfunction, elevated inflammatory biomarkers, and increased risk of upper respiratory tract infections; 1990-2009, when additional focus areas were added to the field of exercise immunology including the interactive effect of nutrition, effects on the aging immune system, and inflammatory cytokines; and 2010 to the present, when technological advances in mass spectrometry allowed system biology approaches (i.e., metabolomics, proteomics, lipidomics, and microbiome characterization) to be applied to exercise immunology studies. The future of exercise immunology will take advantage of these technologies to provide new insights on the interactions between exercise, nutrition, and immune function, with application down to the personalized level. Additionally, these methodologies will improve mechanistic understanding of how exercise-induced immune perturbations reduce the risk of common chronic diseases.
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Affiliation(s)
- David C. Nieman
- Human Performance Laboratory, Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA
- Corresponding author.
| | - Laurel M. Wentz
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC 28608, USA
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Deng Q, Ou C, Shen YM, Xiang Y, Miao Y, Li Y. Health effects of physical activity as predicted by particle deposition in the human respiratory tract. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 657:819-826. [PMID: 30677947 DOI: 10.1016/j.scitotenv.2018.12.067] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 12/05/2018] [Accepted: 12/05/2018] [Indexed: 05/04/2023]
Abstract
Although health benefits of physical activity are well known, the risk of physical activity in polluted air is unclear. Our objective is to investigate health effects resulting from physical activity in polluted air by looking at particle deposition in human tracheobronchial (TB) airways. Airflow and particle deposition in TB airways were investigated using a computational fluid dynamics (CFD) method. We chose three regional airways: upper (G3-G5), central (G9-G11) and lower (G14-G16). Physical activity was described by breathing rate at the mouth, for three levels of activity: sedentary (15 l/min), moderate (30 l/min) and intense (60 l/min). We found that particle deposition was strongly affected by physical activity. Particles are deposited in greater number in the lower airways (G14-G16) during sedentary activity, more in the upper airways (G3-G5) during intense activity, and uniformly in the airways during moderate activity. The difference in the deposition pattern was due to the reason that physical activity increased the airflow which increased inertial impaction. Our modeling of particle deposition in the human respiratory airways shows that there are different health effects for different activity levels: sedentary activity leads to chronic health effects, intense activity results in acute effects, and moderate activity minimizes the adverse health effects of physical activity in polluted air.
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Affiliation(s)
- Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha 410083, China; XiangYa School of Public Health, Central South University, Changsha 410078, China.
| | - Cuiyun Ou
- School of Energy Science and Engineering, Central South University, Changsha 410083, China; School of Atmospheric Sciences, Sun Yat-sen University, Guangzhou 510275, PR China
| | - Yong-Ming Shen
- Institute of Environmental and Ecological Engineering, Guangdong University of Technology, Guangzhou 510006, China; State Key Laboratory of Coastal and Offshore Engineering, Dalian University of Technology, Dalian 116024, China
| | - Yuguang Xiang
- School of Energy Science and Engineering, Central South University, Changsha 410083, China
| | - Yufeng Miao
- School of Energy Science and Engineering, Central South University, Changsha 410083, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
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A review of the evidence to support influenza vaccine introduction in countries and areas of WHO's Western Pacific Region. PLoS One 2013; 8:e70003. [PMID: 23875015 PMCID: PMC3713047 DOI: 10.1371/journal.pone.0070003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 06/17/2013] [Indexed: 11/24/2022] Open
Abstract
Background Immunization against influenza is considered an essential public health intervention to control both seasonal epidemics and pandemic influenza. According to the World Health Organization (WHO), there are five key policy and three key programmatic issues that decision-makers should consider before introducing a vaccine. These are (a) public health priority, (b) disease burden, (c) efficacy, quality and safety of the vaccine, (d) other inventions, (e) economic and financial issues, (f) vaccine presentation, (g) supply availability and (h) programmatic strength. We analyzed the body of evidence currently available on these eight issues in the WHO Western Pacific Region. Methodology/Principal Findings Studies indexed in PubMed and published in English between 1 January 2000 and 31 December 2010 from the 37 countries and areas of the Western Pacific Region were screened for keywords pertaining to the five policy and three programmatic issues. Studies were grouped according to country income level and vaccine target group. There were 133 articles that met the selection criteria, with most (90%) coming from high-income countries. Disease burden (n = 34), vaccine efficacy, quality and safety (n = 27) and public health priority (n = 27) were most frequently addressed by studies conducted in the Region. Many studies assessed influenza vaccine policy and programmatic issues in the general population (42%), in the elderly (24%) and in children (17%). Few studies (2%) addressed the eight issues relating to pregnant women. Conclusions/Significance The evidence for vaccine introduction in countries and areas in this Region remains limited, particularly in low- and middle-income countries that do not currently have influenza vaccination programmes. Surveillance activities and specialized studies can be used to assess the eight issues including disease burden among vaccine target groups and the cost-effectiveness of influenza vaccine. Multi-country studies should be considered to maximize resource utilization for cross-cutting issues such as vaccine presentation and other inventions.
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Jae SY, Yoon ES, Jung SJ, Jung SG, Park SH, Kim BS, Heffernan KS, Fernhall B. Effect of cardiorespiratory fitness on acute inflammation induced increases in arterial stiffness in older adults. Eur J Appl Physiol 2013; 113:2159-66. [DOI: 10.1007/s00421-013-2648-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 04/09/2013] [Indexed: 12/21/2022]
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Charland KM, Buckeridge DL, Hoen AG, Berry JG, Elixhauser A, Melton F, Brownstein JS. Relationship between community prevalence of obesity and associated behavioral factors and community rates of influenza-related hospitalizations in the United States. Influenza Other Respir Viruses 2012; 7:718-28. [PMID: 23136926 PMCID: PMC5781204 DOI: 10.1111/irv.12019] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Please cite this paper as: Charland et al.(2012) Relationship between community prevalence of obesity and associated behavioral factors and community rates of influenza‐related hospitalizations in the United States. Influenza and Other Respiratory Viruses DOI: 10.1111/irv.12019. Background Findings from studies examining the association between obesity and acute respiratory infection are inconsistent. Few studies have assessed the relationship between obesity‐related behavioral factors, such as diet and exercise, and risk of acute respiratory infection. Objective To determine whether community prevalence of obesity, low fruit/vegetable consumption, and physical inactivity are associated with influenza‐related hospitalization rates. Methods Using data from 274 US counties, from 2002 to 2008, we regressed county influenza‐related hospitalization rates on county prevalence of obesity (BMI ≥ 30), low fruit/vegetable consumption (<5 servings/day), and physical inactivity (<30 minutes/month recreational exercise), while adjusting for community‐level confounders such as insurance coverage and the number of primary care physicians per 100 000 population. Results A 5% increase in obesity prevalence was associated with a 12% increase in influenza‐related hospitalization rates [adjusted rate ratio (ARR) 1·12, 95% confidence interval (CI) 1·07, 1·17]. Similarly, a 5% increase in the prevalence of low fruit/vegetable consumption and physical inactivity was associated with an increase of 12% (ARR 1·12, 95% CI 1·08, 1·17) and 11% (ARR 1·11, 95% CI 1·07, 1·16), respectively. When all three variables were included in the same model, a 5% increase in prevalence of obesity, low fruit/vegetable consumption, and physical inactivity was associated with 6%, 8%, and 7% increases in influenza‐related hospitalization rates, respectively. Conclusions Communities with a greater prevalence of obesity were more likely to have high influenza‐related hospitalization rates. Similarly, less physically active populations, with lower fruit/vegetable consumption, tended to have higher influenza‐related hospitalization rates, even after accounting for obesity.
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Affiliation(s)
- Katia M Charland
- Children's Hospital Informatics Program, Children's Hospital Boston, Boston, MA, USA.
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Siu E, Campitelli MA, Kwong JC. Physical activity and influenza-coded outpatient visits, a population-based cohort study. PLoS One 2012; 7:e39518. [PMID: 22737242 PMCID: PMC3380830 DOI: 10.1371/journal.pone.0039518] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 05/26/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although the benefits of physical activity in preventing chronic medical conditions are well established, its impacts on infectious diseases, and seasonal influenza in particular, are less clearly defined. We examined the association between physical activity and influenza-coded outpatient visits, as a proxy for influenza infection. METHODOLOGY/PRINCIPAL FINDINGS We conducted a cohort study of Ontario respondents to Statistics Canada's population health surveys over 12 influenza seasons. We assessed physical activity levels through survey responses, and influenza-coded physician office and emergency department visits through physician billing claims. We used logistic regression to estimate the risk of influenza-coded outpatient visits during influenza seasons. The cohort comprised 114,364 survey respondents who contributed 357,466 person-influenza seasons of observation. Compared to inactive individuals, moderately active (OR 0.83; 95% CI 0.74-0.94) and active (OR 0.87; 95% CI 0.77-0.98) individuals were less likely to experience an influenza-coded visit. Stratifying by age, the protective effect of physical activity remained significant for individuals <65 years (active OR 0.86; 95% CI 0.75-0.98, moderately active: OR 0.85; 95% CI 0.74-0.97) but not for individuals ≥ 65 years. The main limitations of this study were the use of influenza-coded outpatient visits rather than laboratory-confirmed influenza as the outcome measure, the reliance on self-report for assessing physical activity and various covariates, and the observational study design. CONCLUSION/SIGNIFICANCE Moderate to high amounts of physical activity may be associated with reduced risk of influenza for individuals <65 years. Future research should use laboratory-confirmed influenza outcomes to confirm the association between physical activity and influenza.
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Affiliation(s)
- Eric Siu
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | | | - Jeffrey C. Kwong
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
- * E-mail:
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Fondell E, Lagerros YT, Sundberg CJ, Lekander M, Bälter O, Rothman KJ, Bälter K. Physical activity, stress, and self-reported upper respiratory tract infection. Med Sci Sports Exerc 2011; 43:272-9. [PMID: 20581713 DOI: 10.1249/mss.0b013e3181edf108] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE 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. METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Elinor Fondell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SWEDEN.
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Abstract
Prolonged intense exercise causes immunosuppression, whereas moderate-intensity exercise improves immune function and potentially reduces risk and severity of respiratory viral infections. Here, based on available evidence, we present a model whereby moderate exercise-induced increases in stress hormones reduce excessive local inflammation and skew the immune response away from a TH1 and toward a TH2 phenotype, thus improving outcomes after respiratory viral infections.
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Woods JA, Keylock KT, Lowder T, Vieira VJ, Zelkovich W, Dumich S, Colantuano K, Lyons K, Leifheit K, Cook M, Chapman-Novakofski K, McAuley E. Cardiovascular exercise training extends influenza vaccine seroprotection in sedentary older adults: the immune function intervention trial. J Am Geriatr Soc 2010; 57:2183-91. [PMID: 20121985 DOI: 10.1111/j.1532-5415.2009.02563.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To determine whether cardiovascular exercise training resulted in improved antibody responses to influenza vaccination in sedentary elderly people who exhibited poor vaccine responses. DESIGN Single-site randomized parallel-arm 10-month controlled trial. SETTING University of Illinois at Urbana-Champaign. PARTICIPANTS One hundred forty-four sedentary, healthy older (69.9 +/- 0.4) adults. INTERVENTIONS Moderate (60-70% maximal oxygen uptake) cardiovascular exercise was compared with flexibility and balance training. MEASUREMENTS The primary outcome was influenza vaccine response, as measured according to hemagglutination inhibition (HI) anti-influenza antibody titer and seroprotective responses (HI titer > or =40). Secondary measures included cardiovascular fitness and body composition. RESULTS Of the 160 participants enrolled, 144 (90%) completed the 10-month intervention with excellent compliance ( approximately 83%). Cardiovascular, but not flexibility, exercise intervention resulted in improvements in indices of cardiovascular fitness, including maximal oxygen uptake. Although not affecting peak (e.g., 3 and 6 weeks) postvaccine anti-influenza HI titers, cardiovascular exercise resulted in a significant increase in seroprotection 24 weeks after vaccination (30-100% dependent on vaccine variant), whereas flexibility training did not. CONCLUSION Participants randomized to cardiovascular exercise experienced improvements in influenza seroprotection throughout the entire influenza season, whereas those in the balance and flexibility intervention did not. Although there were no differences in reported respiratory tract infections, the exercise group exhibited reduced overall illness severity and sleep disturbance. These data support the hypothesis that regular endurance exercise improves influenza vaccine responses.
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Affiliation(s)
- Jeffrey A Woods
- Department of Kinesiology and Community Health, University of Illinois, Urbana-Champaign, IL 61801, USA.
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Sim YJ, Yu S, Yoon KJ, Yoon KJ, Loiacono CM, Kohut ML. Chronic exercise reduces illness severity, decreases viral load, and results in greater anti-inflammatory effects than acute exercise during influenza infection. J Infect Dis 2009; 200:1434-42. [PMID: 19811098 DOI: 10.1086/606014] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND It is assumed that moderate exercise may improve resistance to infection and reduce inflammation, but there are limited data to support this assumption in an infection model. METHODS BALB/cJ mice were assigned to the following groups: no exercise (NON-EX), 1 session of acute exercise (A-EX), or chronic exercise for approximately 3.5 months (C-EX). Mice were infected with influenza (C-EX mice infected at rest; A-EX mice infected 15 min after exercise). RESULTS C-EX mice demonstrated the lowest severity of infection, assessed by body weight loss and food intake. There was less virus in the lungs at day 5 after infection in C-EX and A-EX mice compared with NON-EX mice (P = .02) and less virus at day 2 after infection only in C-EX mice (P = .07). Soon after infection (day 2), interleukin 6 (IL-6), monocyte chemoattractant protein 1 (MCP-1), macrophage inflammatory protein 1beta, and tumor necrosis factor alpha in the bronchoalveolar lavage (BAL) fluid were lower in C-EX and A-EX than in NON-EX mice. At day 5 after infection, the BAL fluid from C-EX (but not A-EX) mice had less IL-6, interleukin 12p40, granulocyte colony-stimulating factor, keratinococyte-derived chemokine, and MCP-1 than that from NON-EX mice. A trend toward reduced immunopathologic response was found in C-EX mice. CONCLUSIONS Chronic exercise resulted in reduced symptoms, virus load, and levels of inflammatory cytokine and chemokines. Acute exercise also showed some benefit, which was limited to the early phase of infection.
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Affiliation(s)
- Young-Je Sim
- Department of Immunobiology, College of Human Sciences, Iowa State University, Ames, Iowa 50011-1160, USA.
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Chan KL, Tong KY, Yip SP. Relationship of serum brain-derived neurotrophic factor (BDNF) and health-related lifestyle in healthy human subjects. Neurosci Lett 2008; 447:124-8. [DOI: 10.1016/j.neulet.2008.10.013] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 10/03/2008] [Accepted: 10/03/2008] [Indexed: 10/21/2022]
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