Pandemic Preparedness: Maintaining Adequate Immune Fitness by Attaining a Normal, Healthy Body Weight

Sex and age differences in self-reported immune fitness

Studies have reported sex and age differences in self-rated health. On average, women rate their health as being poorer compared to men, and older individuals report poorer health than younger individuals. The current study evaluated sex and age differences for self-reported immune fitness, i.e. the capacity of the body to respond to health challenges (such as infections) by activating an appropriate immune response in order to promote health and prevent and resolve disease. Data from different survey studies (N = 8586) were combined for the current analyses. N = 8064 participants (93.3%) completed the single-item scale to assess momentary immune fitness (mean (Standard deviation, SD) age of 32.4 (16.7) years old, range: 18 to 103, 68.0% women) and N = 4263 participants (49.7%) completed the Immune Status Questionnaire (ISQ) to assess past year's immune fitness (mean (SD) age of 40.9 (17.1) years old, range: 18 to 103, 61.1% women). The analyses revealed that women rated their momentary and past year's immune fitness significantly lower than men (p < 0.001). A small but significant decline in momentary immune fitness when aging was found (r = -0.073, p < 0.001). In contrast, past year's immune fitness steadily improved with progressing age (r = 0.295, p < 0.001), and for each age group the difference from the 18-24 years old group was statistically significant (p < 0.001). When using age as covariate, the sex differences in immune fitness remained significant for both momentary immune fitness (p < 0.001) and past year's immune fitness (p < 0.001). In conclusion, women report a poorer momentary and past year's immune fitness than men. The sex effects in immune fitness are robust and seen across all age groups except the elderly. A relative stable momentary immune fitness was found across the age groups. However, past year's immune fitness (assessments with the ISQ) improved with age. This observation may be related to the fact that the studies comprised convenience samples. Therefore, the observed age effects should be interpreted with caution and require further investigation in nationally representative samples.

An evening of alcohol consumption negatively impacts next-day immune fitness in both hangover-sensitive drinkers and hangover-resistant drinkers

BACKGROUND

Survey research found poorer baseline immune fitness for self-reported hangover-sensitive drinkers compared to hangover-resistant drinkers. However, up to now a limited number of clinical studies revealed mixed results regarding the relationship between the concentrations of biomarkers of systemic inflammation in blood or saliva with hangover severity, and could not differentiate between hangover-sensitive drinkers and hangover-resistant drinkers. The aim of this study was to assess immune fitness and saliva biomarkers of systemic inflammation at multiple timepoints following an alcohol day and alcohol-free control day.

METHODS

The study had a semi-naturalistic design. In the evening before the test days, participants were not supervised. They could drink ad libitum drinking on the alcohol test day and refrained from drinking alcohol on the control day. Activities and behaviors on the alcohol and control day were reported the follow morning. On both test days, from 09:30 to 15:30, hourly assessments of immune fitness (single-item scale) and overall hangover severity (single-item scale) were made and saliva samples were collected for biomarker assessments.

RESULTS

N = 14 hangover-resistant drinkers and n = 15 hangover-sensitive drinkers participated in the study. The amount of alcohol consumed on the alcohol day did not significantly differ between the hangover-resistant group (mean (SD) of 13.5 (7.9) alcoholic drinks) and the hangover-sensitive group (mean (SD) of 12.4 (4.4) alcoholic drinks). All hangover-sensitive drinkers reported having a hangover following the alcohol day (overall hangover severity score 6.1 (on a 0-10 scale) at 09:30, gradually decreasing to 3.3 at 15:30), whereas the hangover-resistant drinkers reported no hangover. On the control day, immune fitness of the hangover-sensitive group was significantly poorer than the hangover-resistant group. On the alcohol day, both groups showed a significant reduction in immune fitness. The effect was evident throughout the day, but significantly more pronounced in the hangover-sensitive group than the hangover-resistant group. No significant differences between the groups were found at any time point on the two test days for saliva concentrations of Interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor (TNF)-α.

CONCLUSIONS

Whereas hangover-sensitive drinkers reported a hangover following an alcohol day and hangover-resistant drinkers did not, both groups reported significantly reduced immune fitness throughout the day. However, the reduction in immune fitness among hangover-sensitive drinkers was significantly more pronounced in comparison to the hangover-resistant group.

Immune Fitness, Migraine, and Headache Complaints in Individuals with Self-Reported Impaired Wound Healing

Background

Having chronic wounds and impaired wound healing are associated with psychological distress. The current study aims to evaluate migraine and headache complaints in young adults with self-reported impaired wound healing.

Methods

A survey was conducted among N=1935 young adults (83.6% women), 18-30 years old, living in the Netherlands. Wound healing status was verified, immune fitness was assessed using a single-item rating scale, and ID Migraine was completed. In addition, several questions were answered on past year's headache experiences (including frequency, quantity, type, location, and severity).

Results

In both the control group (p < 0.001) and the IWH group (p = 0.002) immune fitness was significantly lower among those that reported headaches compared to those that reported no headaches. Individuals with self-reported impaired wound healing (IWH) scored significantly higher on the ID Migraine scale, and individuals of the IWH group scored significantly more often positive for migraine (ie, an ID Migraine score ≥2). They reported a younger age of onset of experiencing headaches, and significantly more often reported having a beating or pounding headache than the control group. Compared to the control group, the IWH group reported being significantly more limited in their daily activities compared to the control group.

Conclusion

Headaches and migraines are more frequently reported by individuals with self-reported impaired wound healing, and their reported immune fitness is significantly poorer compared to healthy controls. These headache and migraine complaints significantly limit them in their daily activities.

Predictors of Hangover Frequency and Severity: The Impact of Alcohol Consumption, Mental Resilience, Personality, Lifestyle, Coping and Mood

Mental resilience is the ability to bounce back from daily life stressors such as divorce or losing a job. Extensive research has demonstrated a negative relationship between mental resilience and alcohol consumption. That is, both the quantity and frequency of alcohol consumption are greater in individuals with lower levels of mental resilience. There has, however, been little scientific attention paid to the relationship between mental resilience and alcohol hangover severity. The objective of this study was to evaluate psychological factors that may impact the frequency and severity of alcohol hangovers, including alcohol intake itself, mental resilience, personality, baseline mood, lifestyle, and coping mechanisms. An online survey was conducted among Dutch adults (N = 153) who had a hangover after their heaviest drinking occasion in the period before the start of the COVID-19 pandemic (15 January to 14 March 2020). Questions were asked about their alcohol consumption and hangover severity on their heaviest drinking occasion. Mental resilience was assessed with the Brief Mental Resilience scale, personality with the Eysenck Personality Questionnaire-Revised Short Scale (EPQ-RSS), mood via single item assessments, and lifestyle and coping with the modified Fantastic Lifestyle Checklist. The partial correlation, corrected for estimated peak blood alcohol concentration (BAC), between mental resilience and hangover severity was not significant (r = 0.010, p = 0.848). Furthermore, no significant correlations were found between hangover severity or frequency and personality and baseline mood. For lifestyle and coping factors, a negative correlation was found between the use of tobacco and toxins (i.e., drugs, medicines, caffeine) and the frequency of experiencing hangovers. Regression analysis revealed that hangover severity after the heaviest drinking occasion (31.2%) was the best predictor of hangover frequency, and that subjective intoxication on the heaviest drinking occasion (38.4%) was the best predictor of next-day hangover severity. Mood, mental resilience, and personality were not relevant predictors of hangover frequency and severity. In conclusion, mental resilience, personality, and baseline mood do not predict hangover frequency and severity.

Emotion Regulation and Mood during the COVID-19 Pandemic

The 2019 coronavirus disease (COVID-19) pandemic has had a significant negative impact on health, mood, and well-being [...].

Reduced Immune Fitness and Job Performance: Absenteeism, Presenteeism, and Associated Costs for the Dutch Economy

Reduced immune fitness can have a significant negative impact on work performance. The aim of the current study was to evaluate the impact of reduced immune fitness on job performance and associated costs for the Dutch economy. Data from n = 425 Dutch working adults (18-65 years old) who completed an online survey were analyzed to evaluate the number of days of absenteeism (not going to work) and presenteeism (working while sick) due to reduced immune fitness, and the performance level on days worked with reduced immune fitness. Data from for the year 2019 were analyzed. Participants reported 2.9 absenteeism days and 19 presenteeism days, with an average performance reduction of 22.8% when working on days with reduced immune fitness. Significantly more days of absenteeism and presenteeism were reported by women, individuals with a poorer immune fitness, and those with underlying disease. Performance impairment on days worked while experiencing reduced immune fitness was significantly greater among individuals with a younger age at the junior career level, those with underlying disease, and among highly educated individuals. The associated costs of reduced immune fitness were estimated at €4.3 billion for absenteeism and €6.4 billion for presenteeism. Together, the costs of reduced immune fitness for the Dutch economy in 2019 were estimated at €10.7 billion. These findings demonstrate that reduced immune fitness has a significant negative impact on the Dutch economy.

Interplay Between Sociodemographic Variables, Physical Activity, Sleep, Dietary Habits, and Immune Health Status: A Cross-Sectional Study From Saudi Arabia's Western Province

BACKGROUND

In addition to developing effective therapeutic approaches, the maintenance of health also constitutes lifestyle and behavioral aspects related to being more resilient in the event of future illness. Reduced immune health has been linked to reports of more frequent and severe infections as well as a variety of non-communicable diseases, both of which may eventually place a significant burden on the healthcare system. Several lifestyles and behaviors can influence immune health, both positively and negatively. Accordingly, this study aimed to evaluate the immune health status and investigate its relationship with widely practiced lifestyle behaviors that are thought to affect immunological functioning.

DESIGN AND METHOD

Saudi Arabian citizens and international residents of the Western Province were invited to participate in this cross-sectional web-based survey through an online advertisement. The integrated questionnaire on lifestyle (Arab Teens Lifestyle Study) and immune health status (Immune Status Questionnaire (ISQ)) was completed in November 2022 by 1230 participants. Descriptive analysis, Mann-Whitney U test, chi-square, or Fisher's exact test was utilized to investigate the relationships between study variables and immune health status groups. Spearman's or Pearson's correlation coefficients were used to determine correlations between the overall ISQ scores and study variables.

RESULTS

Of the 925 study participants, 34.7% scored below 6 on the ISQ. Of the respondents, 50% had a body mass index of 25 or higher, and 46.3% reported sleeping less than four hours each night. Of the participants, 62-82% did not engage in any form of physical activity. The associations between the ISQ score and weight (p = 0.006), total sleep time per night (p = 0.001), duration of household activities (p < 0.001), and smoking status (p = 0.001) were statistically significant.

CONCLUSIONS

According to the data presented here, reduced immune health as measured by ISQ < 6 was prevalent among residents of Saudi Arabia's Western Province and correlated significantly with obesity, sleep duration, and smoking status. Various measures to mitigate the negative impact of an unhealthy lifestyle on public health and to reverse the observed poor immune health and their economic consequences are highly required.

The Assessment of Immune Fitness

Immune fitness (i.e., adequate functioning of the immune system) is essential to maintain health, prevent and resolve disease, and improve quality of life. This article provides an overview of how to assess immune fitness. It discusses how a single-item rating scale can be used to assess immune fitness. The scale can be used in conjunction with a single "yes" or "no" question asking whether the individual is experiencing reduced immune fitness. Retrospective assessments can be complemented with the Immune Status Questionnaire (ISQ) to provide more insight into the type and frequency of experiencing specific immune-related complaints. Momentary assessments of immune fitness can be complemented with biomarker measurements in body fluids. As individuals may be unaware of systemic inflammation (e.g., biomarker concentrations outside the normal range), it remains critical to combine immune fitness assessments with biomarker measurements of immune functioning.

COVID-19 Lockdown Effects on Mood, Alcohol Consumption, Academic Functioning, and Perceived Immune Fitness: Data from Young Adults in Germany

Recently, a study was conducted in the Netherlands to evaluate the impact of the coronavirus disease (COVID-19) pandemic and its associated lockdown periods on academic functioning, mood, and health correlates, such as alcohol consumption. The Dutch study revealed that lockdowns were associated with significantly poorer mood and reductions in perceived immune fitness. Overall, a reduction in alcohol consumption during lockdown periods was shown. Academic functioning in terms of self-reported performance was unaffected. However, a significant reduction in interactions with other students and teachers was reported. However, there was considerable variability among students; both increases and reductions in alcohol consumption were reported, as well as both improvements and poorer academic functioning during periods of lockdown. The aim of the current online study was to replicate these findings in Germany. To achieve this, a slightly modified version of the survey was administered among young adults (aged 18 to 35 years old) in Germany. The survey assessed possible changes in self-reported academic functioning, mood, and health correlates, such as smoking and alcohol consumption, perceived immune functioning, and sleep quality during periods of lockdown as compared to periods with no lockdowns. Retrospective assessments were made for five periods, including (1) ‘BP’ (the period before the COVID-19 pandemic), (2) ‘L1’ (the first lockdown period, March–May 2020), (3) ‘NL1’ (the first no-lockdown period, summer 2020), (4) ‘L2’ (the second lockdown, November 2020 to May 2021), and (5) ‘NL2’ (the second no-lockdown period, summer 2021). This article describes the content of the survey and the corresponding dataset. The survey was completed by 371 participants.