Mar 30

Guide to Staying Healthy During Cold and Flu Season – Part 2

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This is the second part of the February Newsletter and “Tip of the Week.” The information was previously forwarded from SIRC (Sport Research Intelligence Sportive, Canada). The article is by Sheila Kealey: (http://www.sheilakealey.com), and is modified. Even though the Flu season may slowly be disappearing the 2-part series is still valid for the so-called Summer Flu, which can actually be nastier. Temperature changes (hot outside, air conditioned homes, malls, restaurants, hotel rooms) can set off sore throat, colds, fever, and Flu-like symptoms.


Guide to Staying Healthy During Cold and Flu Season – Part 2

Strengthen Your Immune System

Some Tips for the Immune System to Perform at its Best


5. About Supplements

In general, there is no convincing evidence to suggest that supplements boost immunity or prevent colds in healthy individuals, although they may help malnourished or some individuals deficient in critical nutrients (e.g., vitamin C, certain B vitamins, iron, and zinc). And despite being disproven by countless studies, many people believe high doses of Vitamin C will help prevent the common cold. However, inconsistent evidence suggests that low-dose (250 mg – 1000 mg/day) supplementation with vitamin C might reduce the duration of a cold, and 5 studies in people exposed to severe physical exercise (including marathon runners and skiers) suggest that vitamin C might cut the risk of getting a cold in half (though 2 studies in competitive swimmers and marine recruits showed no effect).  It’s important to consider research showing that mega doses of certain vitamins can actually suppress the immune system; for example, zinc is important for immune function, but high dose supplements may actually suppress immune response.

Also, athletes should keep in mind the emerging evidence showing that antioxidant supplements might actually hurt performance by reducing the health-promoting effects of training.

“Immune boosting supplements” are a waste of money. And you may see lists of “immune-boosting” foods, but your best bet is to consume a healthy diet that includes a variety of fruits and vegetables.  In case you’re compelled to take Vitamin C based on the research noted above, here’s a list of foods rich in vitamin C (and many other protective compounds).

6. Get the Flu Shot

Even healthy people can get pretty sick from inFluenza and spread it to others. Some experts believe athletes might be at higher risk of becoming infected if they have a high training load that compromises immunity. If infected with the Flu, athletes may be at higher risk for complications like myocarditis.

A seasonal Flu shot helps to develop antibodies against the viruses contained in the vaccine, greatly reducing the chance of getting infected with the Flu. If infected, it reduces the severity of the illness. Importantly, protecting oneself from Flu will also help protect those around, who may be more vulnerable if they become infected because of a weaker immune system.

7. Time it Right

Elite athletes may have concerns about the timing of the shot and other vaccinations. This recent article outlines vaccination guidelines for elite athletes. It is a great resource and discusses vaccines recommended for athletes, and optimal timing to minimize interference with training and racing, and other issues specific to athletes.

8. Learn How to Respond to Respect Rest and Recovery Days
9. Limit the Invaders

While a strong immune system will improve your odds of staying healthy, we can also reduce our risk of infection by limiting your exposure to cold and Flu causing germs.


Hand-washing is an effective way to reduce the risk of infections. Many viruses are easily spread by direct contact. Unwashed hands are a terrific vehicle for germs. The eyes, nose, and mouth are the route that most cold and Flu viruses enter the body; most people touch these areas many times throughout the day, often without realizing it.

So keep those hands away from the face, and wash them, especially after being in contact with someone who has a cold and other obvious times (e.g., preparing food, after using the toilet, playing with pets, etc.).

Most people could use a refresher in hand-washing: a recent study found that only 5% of people wash hands the right way.

Here’s how to do it correctly:

  • Wash all surfaces of the hands with plain soap and hot water for about 20 seconds (about the time it takes to sing Happy Birthday twice – or if you prefer One Republic check out the video below!). Hand-washing reduces the risk of getting sick by creating a slippery environment that causes microorganisms to slip off the hands.
  • Use a hand sanitizer (alcohol gels and wipes with at least 60% alcohol) when not having access to soap and water (generally hand-washing is preferable and just as effective at reducing the spread of germs).
  • Skip antibacterial soaps and antiseptic products. Research shows they have no benefit over regular soap and water, can cause skin irritation, and promote drug-resistant bacteria.
Limit Exposure

Keep distance and limit the exposure to infected people, and be sure to wash the hands after coming into contact. If facilities are available, coaches might consider giving a sick athlete their own sleeping quarters.

Got Sick! Now What?
  • Try not to expose others. Limit contact with others, and cover the mouth and nose with a tissue when coughing or sneezing to prevent the spread of germs. If no tissues are available cough or sneeze into the upper sleeve or elbow, not the hands.
  • Get plenty of sleep and stay hydrated. Warm liquids may feel soothing to a sore throat, ease congestion, and increase the flow of mucus.
  • Over the counter products won’t cure the cold but can help ease symptoms. Keep in mind that they aren’t without side effects: some can cause drowsiness or disrupt sleep. Also, some contain a stimulant (pseudoephedrine) that is banned during competition (WADA advises athletes to avoid pseudoephedrine-containing cold and Flu products for several days in advance of competition).
  • Although marketing efforts will lead one to think otherwise. The evidence that supplements, pharmaceuticals, or products shorten the duration of the cold is nonexistent or weak. Although some evidence suggests that zinc lozenges taken at the first symptoms may help a cold, this remains controversial. Cold-FX is a popular remedy boasting questionable claims, but there’s no evidence of benefit at symptom onset (and very weak evidence as a cold preventative). Sorry, if I’ve ruined any placebo effect these supplements might have!
  • If suspecting the Flu, see the doctor. Ask about antiviral drugs that can shorten the duration of the Flu, and possibly reduce its intensity.


Flu shot

Coach Monika’s German Sense of Humor!

“Please! Oh, Please! No Shot!…Terrible Pricking!”


Chicken Soup for a Cold?

 A handful of studies have looked into this folk remedy, but the benefits aren’t clear. In 1978, Mount Sinai researchers conducted a study and found that a classic chicken soup was more effective at fighting congestion than hot or cold water. A more recent study found that a traditional  “Grandma’s” chicken soup with onions, sweet potatoes, parsnips, turnips, carrots, celery, parsley, might ease cold symptoms, possibly due to mild anti-inflammatory effect (although researchers could not isolate which soup ingredients were protective). Generally the evidence for chicken soup helping colds is weak, but it seems that any nourishing hot soup might have some benefits, due to their nutrition-filled broth that rehydrates, easy feeding for a sore throat or poor appetite, or hot vapors to help clear nasal passages.

Exercising When You’re Sick?

Low intensity exercise can sometimes be helpful, but high intensity workouts or long training sessions aren’t a good idea; let the severity of your symptoms and how you feel guide you.

Some exercise physiologists encourage low to moderate exercise, especially for head colds where symptoms are above the neck (runny noses and sneezing), but advise more caution for colds that produce fevers or chest congestion.

Although this hasn’t been studied extensively, research has found that exercising with a cold didn’t affect lung function or exercise capacity, cold symptoms, or recovery time, and this study (in mice) found that moderate exercise lessened Flu symptoms in mice infected with the virus.

You might consider illness a good time to focus on other sports-related activities (stretching, recovery techniques, mental training) or activities that don’t elevate heart too much or require strenuous breathing (skills and technique training).


Beyond the stress of intense exercise sessions, athletes may have stress related to school work/exams, job responsibilities, family obligations, and social interactions. High academic stress can increase illness and injuries in athletes. Athletes are more than three times more likely to get injured during times of high academic stress compared to periods of low academic stress, according to a recent study by researchers at the University of Missouri.




Strategies to help Cope with Stress

Avoiding stressful situations isn’t always possible or practical. In fact, it’s likely how we respond to stress and not the stressor itself that contributes to illness. One study found that collegiate athletes (rowers) assigned to a group that learned strategies to cope with stress (Cognitive Behavioral Stress Management – CBSM) experienced significant reductions in the number of illness and injury days and reported half the number of health services visits compared to athletes who didn’t learn these strategies.

Mindfulness training is an additional strategy that is gaining popularity among athletes. A study of elite junior athletes in Norway found that 12 weeks of mindfulness training had a positive impact on the athletes’ recovery and prevention of burnout, and a study in BMX riders found that a 7-week mindfulness training course improved several measures of self-awareness and stress response.

It might be helpful to keep in mind that stress isn’t necessarily a bad thing. As athletes, stress allows us to get stronger, fitter, and faster: hard workouts stress our body’s systems and they respond by adapting to handle the stress. Mental stresses allow us to figure things out, become more resilient, and learn to adapt to difficult situations.

That said, sometimes life throws us more stressors than we are primed to deal with. Try to anticipate periods of added stress (e.g., exam period) and adjust the workouts accordingly.

Don’t worry too much!

Worrying is a form of stress and can affect health — and that includes worrying too much about getting sick!  At least we can put the fears of sickness caused by airplane air, germs in gyms, and necessity of wearing face masks aside, according to UC Berkeley Wellness.

The Bottom Line

Strengthening your immune system and limiting invaders will help keep you healthy. A bonus is that beyond reducing illness, many of these strategies (getting more sleep, eating a healthy diet, reducing stress) will benefit other areas of health and athletic performance.

Additional Information

This information is helpful for those living in states or countries where winter months and lack of sunshine may contribute to immune health issues.

A new review paper (http://www.ncbi.nlm.nih.gov/pubmed/26853300) in the Journal Exercise Immunology Review, from Neil Walsh at the University of Bangor, along with Michael Gleeson of Loughborough University and colleagues, examines the ‘Vitamin D sweet spot’ for athletes in order to optimize immunity. Vitamin D plays a bunch of different roles in the body-bone health, cancer prevention, blood pressure, muscle function, etc., BUT one of its key contributions is to the immune system. One theory is that the reason colds and flu spike during the winter months is because that’s when we tend to be low in vitamin D. So what is the optimal level? The authors cite evidence that those with at least 75 nmol/liter seem have to markers of stronger immune function and are less likely to contract respiratory infections. Perhaps most interesting to me was this infographic included in the paper, which tries to summarize some of the practical recommendations for maintaining good vitamin D levels: https://twitter.com/ProfNeilWalsh/status/698173217861664768


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