Researching COVID-19 for my Pathophysiology & Exercise course has been like going down the rabbit hole—with all the increasing depth and complexity but without the chaos. It is a fascinating journey. It has also been quite comforting in light of the fear and confusion that the pandemic has been generating.
I have added a new word to my (exercise) physiology vocabulary: “inflamm-aging”. Inflamm-aging was first defined by Franceschi and colleagues1 as “a global reduction in the capability to cope with a variety of stressors and a concomitant progressive increase in the proinflammatory status” (p. 246). My doctoral professor, Michael Flynn and colleagues2 introduced “inflamm-inactivity” to describe the “portion of age-associated hyper-inflammatory state that occurs due to a sedentary lifestyle” (p. 152). A healthy immune response involves a delicate balance between the pro-inflammatory and anti-inflammatory responses. When one is out of whack, so goes the immune defenses.
AARP (AARP.org) recently shared “25 Tips for Reducing Your Risk of Contracting COVID-19”. Not on the list were: exercise, lose weight (i.e., body fat), eat a healthy diet, and get adequate sleep. Clearly, age is a factor in the severity of COVID-19—i.e., the “cytokine storm”—and the elderly are at greatest risk of death or complications from the virus. Those with underlying health conditions—e.g., hypertension, diabetes, heart disease, etc.—are also at greater risk. At the center of these health conditions is obesity and inactivity. Interestingly, one question that lead me to explore inflamm-aging was one of vitamin D deficiency. The complexity of the “cytokine storm” and the specifics of the immune system response to COVID-19 are beyond the scope of this blog post, however, Meftahi and colleagues3 offer a thorough review of the pathophysiology. Important for us is to understand to role that lifestyle has to play in our immune system as we age.
Obesity is a central factor in metabolic syndrome (hyperinsulinemia, hypertriglyceridemia, and hypertension) which leads to diabetes and vascular/heart disease. Obesity has a genetic component, but it is also a symptom of poor diet and inactivity. It is a treatable risk factor in countless diseases, including COVID-19.
As medical science searches for a cure and/or vaccine for COVID-19, we must be looking beyond the current pandemic and to the inevitable future viruses that are in our future. The best treatment for any disease is prevention. The best-known prevention against any disease is diet and exercise. To a certain degree, inflamm-aging is unavoidable; however, there is ample evidence that longevity is dependent upon anti-inflammaging. It is not too late to protect oneself against COVID-19, especially as we prepare to begin to open our communities back up. Masks and social distancing work in the present, but these are not sustainable. Standard operating practices will have to change in our schools, gyms, and workplaces; however, we will need to strengthen our personal defenses. The anti-infammaging things that we can do to immediately is 1) increase our physical activity, 2) exercise, 3) lose body fat, 4) eat a balanced diet that is nutrient-dense and restricts sugars and excessive processing, 5) establish a regular sleep-wake cycle, 6) get outdoors (moderate sun exposure will boost one’s vitamin D, as well as spirits), and moderate our stress levels. Additionally, we cannot succumb to fear. Fear fuels the “fight-or-flight” response that drives up cortisol and weakens the immune system. Take the proactive approach to health. Be determined to age well. Be active. Be grateful. Laugh. Smile. And, of course, wash your hands.
Be your beat today; be better tomorrow.
Carpe momento!!
1Franceschi, C., Bonafe, M., Valensin S., et al. (2000). Inflamm-aging. An evolutionary perspective on immunosenescence. Annals of the New York Academy of Sciences, 908:244–254.
2Flynn, M.G., Markofski, M.M., & Carrillo, A.E. (2019). Elevated inflammatory status and increased risk of Chronic disease in chronological aging: inflamm-aging or inflamm-inactivity? Aging and Disease, 10(1):147-156. http://dx.doi.org/10.14336/AD.2018.0326
3Meftahi, G.H., Jangravi, Z., Sahraei, H., & Bahari, Z. (2020). The possible pathophysiology mechanism of cytokine storm in elderly adults with COVID-19 infection: the contribution of inflame-aging. Inflammation Research. https://doi.org/10.1007/s00011-020-01372-8