Our immune systems are very finely tuned, experts say. But yes, there are steps you can take to make sure yours is working at its best.
With coronavirus concerns spreading quickly across the globe, claims of what might help individuals avoid catching it are also on the rise. Beyond precautions like hand-washing and avoiding people who are ill, what can you do to make sure your immune system is ready to fight off COVID-19 and other viruses that you may be exposed to?
First of All, How Does Our Immune System Work?
Let’s start at the beginning: The immune system is the network of cells throughout our body (in the skin, the blood, and elsewhere) that work together to prevent or limit infection from potentially harmful pathogens (like bacteria and viruses) and to prevent damage from noninfectious agents (like sunburn and cancer), according to a definition from the National Institutes of Health (NIH).
Scientists categorize the various immune cells in two groups: innate immune cells and adaptive ones, explains Michael N. Starnbach, PhD, a professor of microbiology at Harvard Medical School in Boston.
Innate immune cells are the first line of defense. They identify microbes and other potential threats, triggering a response to get rid of them. Adaptive immune cells are involved in the second part of an immune response. “These are special cells that respond to ‘mop up’ the remainder of the organisms left after the innate immune response,” Dr. Starnbach says.
Here comes the interesting part: The adaptive immune system has what’s known as “immune memory,” meaning that when those cells see a pathogen that has previously entered the body, not only do they help get rid of the invader, they also make more copies of themselves to continue to build a stronger defense in the future so the body is better prepared to fight off the pathogen if and when it reappears, says Starnbach.
In the case of new viruses, such as the novel coronavirus, however, no one has a heightened response to it, because no one’s immune memory has encountered it. No one has been exposed and therefore no one has developed immunity, leaving more of us susceptible, Starnbach explains.
We also don’t have vaccines against the new virus like we have for known viruses.
Vaccines work precisely because of immune memory, Starnbach says. When you get a vaccine, such as for flu, you’re exposing your immune system to a version of the virus that causes the body to enhance the number of immune cells that can respond to and fight off the virus if you get exposed to the real thing. Vaccines are a kind of boost to our immune systems that actually does work, Starnbach says.
But it’s worth noting that a vaccine isn’t a boost to our whole immune system. A flu shot doesn’t make you more resistant to colds and other illness; it boosts your immune response to the specific strains of the flu that the vaccine was designed to protect you from.
“A vaccine is very specific and designed to fight off a particular pathogen such as chicken pox, polio, or the flu,” Starnbach says.
The idea of boosting your immune system globally to make you more resistant to everything or anything that might be out there is really flawed, Starnbach says.
“Our immune systems are very finely tuned,” he explains. The different immune cells are geared to recognize things in our bodies that are potentially harmful and to clear out those things. “If they weren’t, we either wouldn’t be able to respond to the organism that might invade us. Or if our immune systems were too active they would attack our own tissues.”
The immune system attacking our own tissue is what happens in the case of autoimmune diseases such as rheumatoid arthritis or Crohn’s disease. “And we don’t want to globally tune up the immune system to that point,” Starnbach notes.
Some research has investigated whether supplements with specific vitamins and nutrients may help protect against specific colds and viruses, but the data would seem to suggest that if supplements are helpful they may do more in the way of reducing severity of an infection or illness once you catch it rather than fighting it off in the first place.
What’s really important to remember about the novel coronavirus is that scientists hadn’t studied it before the outbreak at the end of 2019 and don’t yet have answers about whether or not certain remedies may or may not help, says Yufang Lin, MD, an internal medicine doctor at the Center for Integrative Medicine at the Lyndhurst Campus of the Cleveland Clinic Health System in Ohio. Vaccines have not yet been developed or tested; there is no data to say that a supplement that may have lessened severity, for instance, of a cold has the same effect when it comes to COVID-19.
What We Do Know: There Are a Lot of Factors That Can Weaken Immune Health
You’ve likely been hearing that people with weakened immune systems should take extra precautions when it comes to avoiding COVID-19 risk. What makes one person’s immune system “weaker” than someone else’s?
There are several known factors that make it harder for our bodies’ immune systems to work at their best and fight off potentially harmful pathogens (like the new coronavirus). They include:
Smoking Smoking suppresses your immune systems and weakens your lungs, so people who smoke are more susceptible to having pneumonia or a viral infection, Lin says.
Medications Some drugs can keep your immune system from functioning in the way that a healthy person’s would, says Lin. “Immunomodulators, steroids, or medications for autoimmune conditions can suppress your immune system,” she says.
Age Young children can be more susceptible to catching viruses because their immune systems are still developing; it’s part of the maturation process, Lin says. As they grow older, children’s immune systems are exposed to different viruses, they become accustomed to being exposed to more viruses, and they become much more able to fight those off. “But when they are very young, every time [children] see a new pathogen their body is mounting a significant response,” Lin says. It appears as though children are not at a higher risk for catching the new coronavirus, however, according to the Centers for Disease Control and Prevention (CDC).
Older people, too, tend to have weaker immune systems than other groups. Older people can have multiple chronic medical problems, says Lin. If the body is constantly dealing with a variety of medical conditions that can make it harder to fight off a virus. “Along with that, as we get older our immune system gets a little bit weaker, and it can take longer for our bodies to mount a significant immune response when we get sick. That gives the virus or infection more time to grow or to replicate, which could lead to more severe symptoms,” says Lin.
Underlying medical conditions Preexisting chronic medical conditions, like asthma, diabetes, and heart disease, can affect the immune system and make people with these conditions at higher risk of infections. People with these conditions also do appear to be at a higher risk of becoming severely ill with the new coronavirus than others, according to information from the World Health Organization. Additionally, the CDC advises that older adults are also at heightened risk of COVID-19 (though does not specify an age group).
Pregnancy Pregnant women experience changes in their immune system and body that may place them at higher risk for catching viral infections, including COVID-19, according to the CDC. Just by being pregnant your immune system is somewhat stretched, because it is taking care of two rather than just one, says Lin. “This may put pregnant women at risk for developing a more severe infection,” she explains.
Malnutrition People who are malnourished are more susceptible to viruses and certain diseases, Starnbach says. Deficiency of certain vitamins and minerals in the body keeps the immune system from functioning at its best. Replenishing those missing nutrients with supplements in those cases can help the immune system function in a healthy way and better ward off diseases and infections. (But whether or not supplements help improve immune response generally or in specific ways in people who are not deficient in vitamins and nutrients to begin with is less clear.)
The Bottom Line: What You Can Do Right Now to Keep Your Immune System Healthy
So what can you do to protect yourself against the new coronavirus and other germs? First of all, focus on preventing exposure to and spread of pathogens, Lin says. Wash your hands, and if you cough or sneeze, do so into a tissue and throw that tissue away. (The CDC has published additional guidelines on how to prevent exposure to and spread of the new coronavirus.)
The other part of the equation is practicing the health-promoting behaviors that keep your own immune system functioning at top capacity (and that help prevent underlying chronic health problems that ultimately do make you more susceptible to infections), according to Lin and Starnbach. More specifically:
- Get enough sleep. Healthy sleep supports the immune system in a lot of really critical ways, Lin says. Research finds that there are actually very important parts of the immune response that occur during the different stages of sleep and are regulated by our bodies’ circadian systems.
- Eat healthy foods, including lots of nutrient-rich fruits and vegetables. The vitamins and minerals in our food are the lifelines all the systems in our body rely on to function well (including the immune system); the better you feed the body with the nutrients you need, the better it runs and can avoid chronic and acute disease, according to the Academy of Nutrition and Dietetics. (Also avoid consuming excessive amounts of alcohol, which can interfere with immune functioning, according to an Alcohol Research review paper from 2015.)
- Stay active. Researchers haven’t yet pinpointed the mechanism through which staying active keeps the immune system functioning best, but they do know exercise helps keep other systems in the body functioning properly, so they suspect there’s a link, according to NIH. (There’s even evidence that older adults who exercise regularly can keep their immune systems functioning similarly to people decades younger, according to a study published in April 2018 in Aging Cell.) Note: There is evidence you can overdo it. High-intensity or extreme training can actually harm immune functioning. For optimal immune functioning, stick with moderate activity levels.
- Manage your stress. Stress can actually suppress the immune system, keeping it from working at 100 percent. “Try to take time to relax and do something fun,” Lin says. “Make sure you take care of yourself.”
Get Your Gut Back On Track!
An estimated 110,000 people consume antibiotics daily in Ireland, between December/March. (Source: Health Protection Surveillance Centre).
We asked Nutritional Therapist Rosanna Davison for her Top Tips to get your gut back on track after an illness.
1. Take time out
Don’t push yourself too quickly. Remember your body needs time to rebuild its reserves and regain strength.
Take more rest than usual. If you need to sleep longer, go to bed earlier.
Cut back on non-essential activities; they can wait until you are feeling 100%.
- Embrace fibre-rich foods full of protective nutrients
Fresh vegetables and fruits are rich in dietary fibre, vitamins and antioxidants. Try eating seven to nine portions over the course of each day. Choose different colours so that you nourish your body with a variety of phytonutrients.
Eat a portion of complete protein at each meal, such as poultry, fish, eggs, beans, pulses or tofu.
Consume essential omega-3 fatty acids daily. Avocados, seeds (flax, chia) and oily fish (mackerel, wild and organic salmon), are naturally rich in anti-inflammatory fats.
- Go ‘fermented’
Fermented foods are rich in ‘friendly’ bacteria. Sauerkraut is simple to make at home or buy kefir or kimchi in your local health store.
- Reduce or eliminate sugary foods
Processed foods often contain refined sugars to enhance taste. Excess refined sugar and processed foods may encourage the growth of ‘unfriendly’ bacteria, so aim to buy and eat fresh food.
If you have a sweet tooth, try eating berries (strawberries, blackberries, blueberries, raspberries). They are rich in antioxidants and naturally low in sugar.
If you need a sweetener, try Stevia which is extracted from plant leaves and doesn’t impact blood sugar levels.
Do vegans need to take supplements?
A varied, wholesome vegan diet provides almost all essential nutrients in sufficient quantities. I hear you shouting ‘Noooo! It provides absolutely everything we need!’ and you may be right, but only if you regularly eat certain fortified foods. The sad truth is that modern food production systems and lifestyles make it more difficult for everyone – vegans or not – to get all they need from diet alone. It doesn’t mean a vegan diet is unnatural or unhealthy, in fact the opposite is true. It means that how we grow, produce and consume food has changed and, with an ever-growing population, the demands on the systems that produce our food are so high that certain nutrients become harder to obtain.
I get a lot of questions about supplements and understand why people are confused. Over the years, I’ve worked on many vegan research projects and as science and population studies reveal ever more data, the guidelines and recommendations change and evolve. Hence, what we were told 10 years ago may no longer be up-to-date and that’s why different opinions arise, depending on where and when we got our information. It’s my job to keep up-to-date, so hopefully I can bring some clarity to the supplement discussion!
So what’s needed? The trio of nutrients to keep a close eye on are vitamin B12, vitamin D and iodine. You may not need to supplement with all these, all year long, but it depends on several factors. Read on…
Vitamin B12 naturally comes from bacteria in the soil and both people and animals would traditionally have got it from eating unwashed plants. However, we not only wash vegetables before we eat them (and for good reasons), but food production is now so sanitised that most vegetables are washed in chlorine, or other sterilising solutions, so there’s not a trace of B12 left.
People are not generally aware that most farmed animals are given B12 supplements and this is how the vitamin eventually ends up in their flesh. So, the argument that meat is a natural source of B12 doesn’t really stack up as meat-eaters essentially consume B12 supplements recycled by the animals that were given them!
It is absolutely necessary that we have a reliable source of vitamin B12 for our bodies. We need it to make red blood cells, for a healthy heart and circulation, and it’s essential for the nervous system. It takes years to develop a B12 deficiency, so on one hand, you don’t need to worry about not having taken B12 for a while. On the other hand, you do need to pay attention, as when symptoms develop, it’s usually serious.
To ensure adequate intake, you should have at least 5µg (micrograms) daily from supplements or fortified foods. The B12 used in both foods and supplements is produced commercially by growing bacterial cultures in large vats – and it’s always suitable for vegans.
There are two forms of B12 in supplements – cyanocobalamin (cheap) and methylcobalamin (expensive). Cyanocobalamin is the stable ‘inactive,’ form of B12 and is used in supplements and to fortify foods and drinks. Once ingested, it’s activated by your body so it can be used. Methylcobalamin is the ‘active’ form of vitamin B12 as it does not require any metabolic reactions to be activated. It costs more and is not so stable.
So which one to choose? Unless you’re a heavy smoker, have kidney failure or any other serious condition affecting your metabolism, cyanocobalamin – the cheap form of B12 – is perfectly fine. Intakes up to 2,000µg a day are safe and you can take either a lower dose daily or a higher dose a couple of times a week.
We need vitamin D for healthy bones, teeth and muscles and it also performs other essential functions in our metabolism. It is produced in the skin when exposed to sunlight and this is the main source of vitamin D for most people. However, if you always use sun-block, cover most of your skin or live in a country, like the UK, where we don’t get enough sunlight over the winter, you need a supplement, whether you’re vegan or not.
The UK Government now recommends that we all take a supplement from October to April and, if you protect your skin ferociously over the sunnier spring and summer months, you should take a supplement all year long. Otherwise, just 20 minutes of sunlight on the face and arms is all that is required by the body to manufacture sufficient vitamin D.
Fortified breakfast cereals, bread, plant milks and vegan margarines can be useful sources if exposure to sunlight is not practicable, but may not be enough. When it comes to supplements, there are two types and your body can use both, but it’s advisable to check the source – vitamin D2 is always vegan, but vitamin D3 can be of animal origin. Many vegan foods are fortified with vitamin D2 and labelled so, but if not specified, especially on cereal products, vitamin D tends to be of animal origin. If you choose to supplement your diet, there’s a range of quality and affordable vegan supplements with vitamin D2. There are also those made from algae or mushrooms that contain D3 and these are recommended if you need a higher dose. When deciding on your dosage, 10µg per day is enough and you shouldn’t go above 25µg.
Iodine has been a hot topic lately, especially with plenty of tabloid ‘experts’ warning that vegans are missing out. This mineral is necessary for thyroid function and helps to regulate how energy is produced and used in the body.
The amount of iodine in plants depends upon the iodine content of the soil in/on which they are grown. The closer to the sea, the more iodine and therefore vegans can get enough from plant foods, but there’s no guarantee. Seaweed, which of course grows in seawater, is always a good source and includes nori, laver, dulse and the kelp family (kombu, arame, wakame). But be warned – kelp absorbs far more than other seaweeds and you can get too much iodine from it. So, while seaweed consumption is encouraged, kelp should be used only sparingly.
It’s best to use a kelp supplement so you know exactly how much iodine you’re taking – it’s cheap, reliable and you don’t have to worry about taking too much. The recommended daily intake is 140µg and intakes up to 500µg are considered safe. In many countries, iodised salt is commonly used to ensure iodine intake, but it’s not the norm in the UK.
The dairy industry has been boasting about the iodine content of cow’s milk. What they don’t tell you is that it’s not a natural component of milk, but comes from iodinated cattle feed, supplements, iodophor medication, iodine-containing sterilisers of milking equipment, teat dips and udder washes. Cow’s milk is neither a natural nor the best source of iodine, so we can happily leave all that dairy out of our diet.
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