Exercise vs. Meditation? The Winner Is…

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As a trained exercise physiologist, if I were asked the question, “Which would prevent acute respiratory tract infections?” I would have picked exercise over meditation every time. The only reason I would choose meditation is that nagging voice in the back of my brain that says, “If they’re asking the question, maybe there were surprise results.” Science says to ask the question, so the researchers did; let’s take a look at the results.

When Meditation Tops Exercise

There were distinct differences between the exercise and stress-reduction groups versus the controls. When compared to the control group, the exercise group had fewer acute respiratory infections. The mindfulness-based stress reduction program also had fewer acute respiratory infections than did the controls, but when looking at other variables such as absenteeism and lost days of work, the stress-reduction program did slightly better than exercise.

When Exercise Beats Meditation

The researchers also examined the total number of infections, and the exercise group did better. In this study, which was completed well before the current pandemic, the exercise group had no coronavirus infections (the common cold) while the meditation and control groups both did; the difference was that the meditation-trained group handled the infections much better than did the controls.

It would have been great if they had one more group that both exercised and used the stress-reduction techniques. It would have been interesting to see if there were additive or even multiplicative benefits, or maybe there would have been no differences or even negative results. We can’t assume that it would have made the immune system function better; the “stress” of doing both might have compromised immune function.

The Bottom Line

Even though this study was done eight years ago, it’s the only study I could find that examined the benefits of exercise related to any type of upper respiratory infection. That the study also included stress reduction/meditative techniques was a bonus. What we know now, based on this study, is that moderate exercise as well as stress reduction will both reduce our risk of serious infection from many types of virus, and we may have milder symptoms if we do catch one. Whether this will serve us well during this pandemic is uncertain, but even a little protection to reduce the most severe symptoms would be worth the effort. That’s great news for people who don’t have the physical capacity to exercise and for those who don’t have the patience for meditation: either one will work. Just do something.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Fam Med 2012;10:337-346. doi:10.1370/afm.1376.

Immune System Training: Exercise vs. Meditation

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What’s going to work better to prevent acute respiratory infections: moderate exercise training or meditation training? Have you predicted which would be more effective without looking at the article? Or do you not have enough information yet? Let’s take a look at what each group did.

The moderate exercise group met for 2.5 hours each week with personnel trained in exercise physiology. The time was broken up into education about exercise and time practicing on different forms of equipment such as treadmills, exercise bikes, etc. The rest of the week, they exercised for 45 minutes per day. Most subjects used walking or jogging as their home modality of exercise. The subjects were trained to exercise at a moderate level based on the Borg perceived-exertion scale; once trained in assessing exertion, it matches up quite well with the effort people are actually performing during exercise.

The meditation group met with personnel trained in mindfulness-based stress reduction techniques for 2.5 hours a week. This program “is based on the idea that an increased awareness of physical, emotional, and cognitive manifestations of stress may lead to a healthier mind-body response to stress.” The subjects were also to practice the stress reduction techniques for 45 minutes every day at home.

The control group did not do either of the techniques. The training lasted for eight weeks. The variables I mentioned in Tuesday’s memo were collected before, during, and after completion of the eight weeks training. What were the results? I’ll give you a little more time to think about it and give you the answer on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Fam Med 2012;10:337-346. doi:10.1370/afm.1376.

Boosting Immune Function: Exercise vs. Meditation

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Every once in a while, I come across some research that’s just so interesting and unique, I have to share it with you. In this case, it’s directly related to boosting the immune system, which is what a lot of people are trying to do right now. In this case, researchers tested whether an eight-week program of either moderate exercise or meditation would reduce the variables associated with an acute respiratory infection such as time lost from work.

Researchers recruited subjects who did not get a flu vaccination and also did not exercise or meditate; they used just about every survey related to health that was available. They also took samples from nasal rinses after subjects had acquired an acute respiratory infection of any type and tested for markers of immune function in the rinses.

The mean age of the subjects was 59 years old. The subjects were randomly assigned to one of three groups: the control group who agreed to do nothing during the eight weeks; a group who would exercise at a moderate level; and a group who would participate in a specific type of meditation.

On Thursday, I’ll talk about the training programs. Looking ahead, short of looking up the paper itself, what do you think will be more effective: exercise or meditation to boost the immune system?

Insider Conference Call

Tomorrow night is the August Insider conference call. I’m going to do a COVID-19 update focusing on the recent spate of doctors plugging hydroxychloroquine as well as answering Insider questions. If you become an Insider by 8 p.m. ET, you can participate live!

What are you prepared to do today?

        Dr. Chet

Reference: Ann Fam Med 2012;10:337-346. doi:10.1370/afm.1376.

Practice Makes Perfect

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Have you ever looked at new health habits as a series of tasks you need to perfect? There are many different habits that are part of a healthy lifestyle such as eating more vegetables, exercising five days a week, taking your supplements regularly, and dozens more. Losing weight is not just eating fewer calories; it’s a process that involves many different tasks in order for you to be able to do that.

  • What are you going to eat?
  • Who is going to buy the food?
  • Who is going to prepare the food?
  • How are you going to measure the food?
  • When are you going to eat it?

Think about all the decisions that have to be made in order for you to simply eat breakfast—not just any breakfast, but one that fits with your overall meal plan and caloric goal for that particular day.

Let’s say you want to start with a protein smoothie in the morning. Do you have the right kind of blender or juicer to be able to do that? Have you purchased all the fruit, vegetables, and protein powder that you’re going to need? How much time will you need to add to your morning routine in order to do it?

There are probably dozens more nitty-gritty things you need to perfect. The point of this memo is to have you recognize the types of changes that you’re going to have to think about, and remind you that you probably won’t get it right the first time that you try. You’re going to have to practice these new tasks. Hence the title of this memo: Practice Makes Perfect.

Fitness: An Example

If you take any tasks related to the overall goal of getting fit, there are elements of it that you’re going to have to complete. It’s not just the exercise itself. That’s something you can do. Where this idea comes into play is in preparing to exercise.

Are you going to exercise in the morning? Set your alarm at least 15 minutes before you want to begin. For some of you it may have to be an hour earlier because you have certain rituals you perform in the morning before you start your day.

When your alarm rings, get up and get out of bed. You can go back to bed if you want to, but you have to get out of the bed. Do that for one week, weekdays, or weekend. Get good at it. Get used to it. You’re practicing to get up on time in order to be able to exercise. You may find out right then that getting up early is not going to work—maybe mornings just aren’t your time and you’re going to have to figure out some other time to exercise.

Then the following week, the night before you start, lay out your exercise gear. When the alarm goes off, get up get out of bed and put on your workout gear. Do that for a week. Laying out your clothes the night before. Getting up on time. And getting dressed on time. Again, you can go back to bed if you want. When you’ve got that mastered, again weekday or weekend, then you can start your workout routine.

Seems a little silly, I know. But you have to practice being successful at the things that precede exercise before you can be successful at exercising itself. You’re going to run into obstacles, and you don’t yet know what they are. It may be that your wife will want to get up at the same time. It may be that your kids, if you have them, will hear you and want to get up as well. You have to be able to deal with all of those issues and anticipate that they may happen at varying times before your workout. Think of it as getting prepared for a game-time situation. Once you’ve experienced it, you’ll know how to react better than you would if you leave it to chance.

We could do this approach for every task related to any health or fitness goal. The degree to which you have to cut up that elephant to consume the parts depends on you. Some tasks may be easy to manage while others will not. But unless you perfect the component tasks, it will be too easy to quit when an obstacle appears.

The Bottom Line

In this summer of coronavirus, improving everyone’s health has never been more important; if the virus tracks you down six months from now, you can be better prepared to fight it off. This week I’ve written about ways to help you prepare to change your health from where it is to where you want it to be.

  • Setting realistic goals allows you to break up any big goal into manageable parts.
  • Changing directions is critical, or you’ll end up where you don’t want to be.
  • Finally, you have to practice to get the tasks that contribute to your goal just right. You can do it with enough practice. One bite at a time.

What are you prepared to do today?

        Dr. Chet

Eating the Elephant

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I’m sure you’ve heard the question, “How do you eat an elephant?” The answer: “One bite at a time!”

Paula and I took off last week to try to organize a couple areas of our house. I thought we could get two or three different tasks done. I was wrong; we’re still finishing the very first task. Granted, it’s been at least 10 years, probably more, since we tried to clean out our clothes closet completely, but I felt that it was doable. Turns out it was one enormous elephant, and we didn’t finish. Yet.

When it comes to improving your health, it’s just like eating that elephant: most of us are too optimistic about what we can do within specific periods of time.

  • “Three months until the wedding? I could lose 40 pounds.”
  • “My HbA1c is 6.8? I can get it down to normal in a month or two.”
  • “My blood pressure has sky-rocketed to 195/110? I could handle that in probably a few weeks by getting some exercise and eating better.”

Is it possible to achieve those goals? Maybe. Most likely not, at least not in that time frame, because you’d have to consume too much of the elephant too often. The likelihood is that you’re going to get tired of the taste of elephant and quit before you get there.

Setting realistic goals is difficult when it comes to your health. What’s even more difficult is to understand that you have to make a commitment to take long-term control of your health; short-term plans rarely get the results you want. That means you’re going to have to commit to eating a little better. Eating a little less. And moving a little more.

What are you prepared to do today?

        Dr. Chet

The Magic of Chicory

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Because this is my birthday week, I thought I would indulge myself and talk about some personal research I recently did. Today it’s all about chicory—it’s everywhere. The little purple flowers can be found alongside just about every road in Michigan. I’m pretty sure it’s probably that way across the U.S. where the climate is similar at this latitude. Those little lavender-purple flowers are chicory, officially known as Cichorium intybus, a member of the Aster family. This absolutely phenomenal lavender-flowered plant is one of those plants that are classified as weeds in some areas, but in others are cultivated for their nutritious parts.

Chicory as a Fiber Source

I first became aware of chicory when I found out the root is the source of one of my favorite types of fiber called inulin. The reason that I like that particular type of fiber so much is that it can act as a prebiotic and feed many of the bacteria of the microbiome. But first, it acts like any other type of soluble fiber: it absorbs fluid to help food move through the small intestine. Then when it gets to the large intestine, it can supply the thousands of microbes with food.

Chicory is not the only source of inulin, but it’s the greatest source. Here are some of the other major sources of inulin if you wanted to get it by eating plants; all of these amounts are per 100 grams of a serving; that works out to about 3.3 ounces:

  • Chicory root contains about 40 grams
  • Jerusalem artichoke has 16–20 grams
  • Garlic has 9–16 grams
  • Raw asparagus has 2–3 grams

It might be relatively easy to eat 3.3 ounces of artichokes or asparagus. But I’m not sure many people are going to want to be around you if you eat 3.3 ounces of raw garlic every day, although it could be a big assist in social distancing. Just a thought.

Chicory as Food

I was surprised to find out that almost the entire chicory plant can be eaten; it has been cultivated as food in Europe since the 1600s. Depending on the age of the plant, as well as the time within the growing season, the leaves of the plant can be considered a salad delicacy. I don’t usually stop and eat or even nibble when I’m out for a walk/run, but chicory is in the endive family and the flavor is supposed to be somewhat bitter and crunchy like endive. That’s if eaten raw. When cooked, the flavor mellows out quite a bit, as it does for dandelion greens, another relative. When used in foods, it appears that chicory is often eaten like celery. The leaves, the roots, and the leaf buds are boiled and added to foods. Chicory seems to get more intriguing as a potential food all the time.

Chicory has also been used as an additive to or a substitute for coffee. Evidently when dried and roasted it has a very distinctive flavor that enhances coffee. In fact, after World War II, England and Germany roasted chicory root as a substitute for coffee beans. While I’ve never tasted it, I know that there are several brands of American coffee that contain roasted chicory root. What I don’t know is how that might impact the ability to act as a fiber and prebiotic. Because you’re trying to extract flavor from the root plus roasting the root, there may not be any of the desired digestive qualities available.

Chicory as a Nutrient

Because it’s a plant, you know that it must have phytonutrients. I’ve talked about the benefits as it relates to the microbiome, but there may be other benefits from consuming the plant or extracts from the plant. For example, in some of my background research on this, it seems that some people apply a paste of chicory leaves on the skin for swelling and inflammation. In another trial on rodents, chicory was used in combination with a variety of other herbs to see if it would lower blood pressure. It did, but it’s still a long way from a very small study on rats to developing natural ways of dealing with blood pressure.

One thing is for sure: using the parts of the plant that we know are the most effective for the digestive system is probably a good idea. We know that adults should be getting 25 to 30 grams of fiber per day, but most people seem to be able to hit only between 12 and 13 grams. So if taking this type of fiber known as inulin sourced from chicory root or eating more artichokes and asparagus is possible, you’ll get a lot of benefit from this plant. Maybe this will inspire you to taste the leaves of the plant with the little purple flowers on the side of the road in your next salad.

That’s exactly what I did on a trip to the store before writing this Memo. I noticed some chicory growing on the side of the road in an area that had a little bit of parking. So I stopped my car, got out, picked several different sized leaves, and then ate them. The plant had blossoms so that may have made a difference in the flavor. It was extraordinarily bitter but left no aftertaste. It would be interesting to be able to get some chicory that was specifically designed to be used in salads to see if it would taste similar. I would say this: if you can drink an IPA, I think you could eat salad with chicory in it. That’s my experience with eating chicory leaves to date. I’ll stick with inulin from the root for now.

New Info and Some Time Off

There’s a new Basic Health Info posted on the Health Info page at drchet.com about the myths and facts of face masks as described in actual scientific research. If you’re tired of people throwing fantastic tales of masks’ effects at you, here’s where you can go to get the facts: Cloth Masks: What the Research Says

We’re taking next week off to catch up on some big chores around the house, maybe even relax an hour or two, so expect to hear from me again on August 4.

What are you prepared to do today?

        Dr. Chet

Reference: BMC Complement Altern Med. 2017 (3) 7;17(1):142.

Research Update on Probiotics and Adult Allergies

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Researchers recruited a total of 95 adults, ages 19 to 65, with allergic rhinitis for a double blind, randomized, placebo-controlled clinical trial; all the subjects were from two hospitals in South Korea. They were not allowed to take their usual medication to treat seasonal allergies.

In the experimental group, 47 subjects received the probiotics, and 48 subjects were in the placebo group. The probiotics used in the study was a novel blend called NVP-1703. The variables the researchers selected to track were markers associated with the immune response such as IgE and interleukins. They also tracked the symptoms of the subjects by having them complete daily diaries noting responses such as sneezing, itching, nasal congestion, runny nose, etc. The subjects also took standardized written allergy questionnaires.

The researchers found significant positive changes in the questionnaire assessment from baseline through weeks one, three, and four between the probiotic group and the placebo group. The IgE levels and serum IL-10 levels were significantly improved between the probiotic and the placebo group.

The improvement in questionnaire results meant that the subjects that were taking the probiotics saw their allergy symptoms decrease. By assessing the immune responses, they saw that somehow the probiotics stimulated the production of IgE and IL-10. Both of those allow the immune system to control symptoms associated with allergic rhinitis.

The researchers concluded that this blend of probiotics could be beneficial to treat seasonal allergies; I’m not sure I would go that far since the study contained fewer than 100 subjects. I would say that it was nice progress, although there’s still more to do. But if you have allergies, taking your probiotics regularly may be helpful for your allergy symptoms as well as all the other benefits.

What are you prepared to do today?

        Dr. Chet

Reference: Nutrients 2020. 12: 1427-41.; doi:10.3390/nu1205142

Research Update on Probiotics for Infants

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Let’s begin this week’s research review with a study on the potential long-term benefits of probiotic use in infants. Researchers in Slovenia collected data on 316 healthy-weight newborns whose parents had test-confirmed allergies.

The families were divided into two groups: 115 infants were placed into a probiotic group and received probiotics every day between the ages of four weeks to twelve weeks while breastfeeding. The remaining 201 infants were put in the control group and breastfed without any supplements.

All children were followed by the same pediatrician through nine years of age to assess the children over the years to see who developed allergic rhinitis or allergic rhino conjunctivitis at some point. The results showed during the follow-up that 19.6% of the children had developed either form of allergy. They confirmed the diagnosis by examining the children for levels of IgE and skin prick tests.

Children in the probiotic group were three times less likely to develop allergic rhinitis than those in the control group, 4.3% versus 13.9%. When examining allergic rhinoconjunctivitis, the difference between the probiotic group and the control group was much lower although still statistically significant at 8.7% versus 9.5%.

I like this study because the children were tracked for an extended period of time. It may be that if the infants were tracked only through one year of age or if the study were terminated when they were four or five, there might not have been the same significant differences. Sometimes seeing the benefits can take longer than we expect.

You have to wonder what the results would be if the children were given probiotics beyond twelve weeks (some may have been; probiotics weren’t prohibited beyond the study.) We make sure Riley, who’s five, gets his probiotics every day.

Is that reduction in allergies worth the effort? Paula says any lessening of allergies is worth doing. Next month will be the 57th anniversary of her first allergy shots, and she’s been getting shots nearly continuously ever since—three at a time these days. If probiotics will spare some children years of shots or medications, let’s go for it.

What are you prepared to do today?

        Dr. Chet

Reference: EAACI Digital Congress 2020. Besednjak-Kocijančič, L. et al.

COVID-19: What We Don’t Know

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I’m sure you’ve heard the expression “What we don’t know could kill us” and that’s truer today than at any other time. While we may argue about masks and social distancing, there’s just still too much we don’t know about the novel coronavirus. The critical factor is that because of what we don’t know, we aren’t able to work on treatments that can be administered to more people sooner once they’ve been diagnosed.

The Microbiome

You’ve heard me repeatedly say that the immune system starts in the gut; I don’t think many healthcare professionals would debate that anymore. That’s why knowing how the microbiome deals with COVID-19 is critical to establishing prevention and treatment programs. I don’t mean preventing people from catching the virus—I mean preventing them from getting a very serious form of the infection that results in hospitalization and severe treatments such as intubation and respirators.

We know that the digestive system is full of ACE2 receptors as I’ve written about before. What we don’t know is how to specifically make the microbiome more robust. What specific foods should we eat? What specific strains of microbes should we ingest to help immune function?

If we should eat more vegetables, should they be raw or can they be cooked? There are 6,500 different microbes that we know of at this point with multiple strains; if we’re supposed to take specific microbes, which strains are the most effective? We just don’t know enough to make our personal immune system stronger. We should still do the things that we’re doing by eating more vegetables, taking fiber and probiotics, but we could do better if we had more specific information.

Genotype and Phenotype

We know that age is a risk factor for a serious case of COVID-19; we also know that conditions such as heart disease, hypertension, and type 2 diabetes are also associated with a serious COVID-19 infection. And that’s about it for right now. Let me give you three questions that may or may not be important but certainly have to be checked out.

Does race have an effect? In addition to the observations about co-morbidities and healthcare opportunities, there may be some impact related to race that hasn’t been examined yet. Or instead of race, maybe it’s ethnicity. Think about it; from an ethnic perspective, what was different between the people of Italy and Spain, where there were significant deaths, from those who lived in Norway and Denmark? What about male pattern baldness? What about familial hypercholesterolemia? Could either of those be a genetic risk factor?

What about phenotype? Are people who are ex-smokers at greater risk than those who never smoked? We would think so, but nobody’s studied it. What about people who’ve lost a significant amount of weight and maintained it? What about people who exercise regularly compared to those who never exercise? All those traits would be associated with a healthier lifestyle, but we haven’t tested their impact of the risk of COVID-19. Lifestyle can impact the expression of your genes. And in some ways, once genes are expressed or turned on, they may not be downregulated or turned off. That could be important.

Do supplements help? It’s easy to say massive amounts of vitamin C and vitamin D and turmeric will help, but do they help everyone? What if you already have adequate vitamin D levels? Could adding even more be counterproductive? The same is true for vitamin C. We know that vitamin C is an antioxidant, but in high quantities, it may act as a pro-oxidant and increase free radical damage. How much is the right amount? Think of all of the supplements that we all take. It would be nice to know which are the key supplements to help our immune function against this virus and which ones just help our bodies in our day-to-day activities. At this point, we don’t have enough information.

Better Treatments

The whole point of treatments for COVID-19 is to force the virus to back off long enough to allow the immune system to do its job. There are no medications that I’m aware of that can target the virus and kill it; that means it’s up to the body to do the killing, and even after a vaccine is available, that will still be the case. We need better treatments that can neutralize the impact the virus has on the body so that the immune system can, in effect, clean up the mess.

There have been a lot of debates about some medications such as hydroxychloroquine. There are hopeful additions that include steroids, although they have issues as well. We may even find out that specific types of diets including fasting may be beneficial. Or they may be disastrous. We need more research to find better treatments, and we need that research now.

As it relates to a vaccine, we really don’t know if there ever will be one or how effective it will be. Even if one is developed, the logistics are just incredible. How are we going to get 330 million doses of a vaccine ready for administration when we still don’t have enough tests available or enough gloves and masks for healthcare workers? Early testing means early treatment. But if you can’t test people to begin with, and you can’t get the results to them quickly, using better treatments could end up being too little too late for any given individual.

The Bottom Line

The novel coronavirus will be with us for a while longer. Maybe indefinitely. As I wrote a couple months ago, we don’t have to fear it; we have to respect it. Your job is simple: take care of your body the best that you can with diet, exercise, supplements, and reducing stress. If you’re going to venture out of your home, wear a mask, social distance, and wash your hands frequently. That’s our job. And know that there are people who will keep trying to find the answers we need and still more people who will help us if we get sick. We can give them time to work and lighten their load if we do our part.

What are you prepared to do today?

        Dr. Chet

COVID-19 and Obesity

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Obesity may be a contributing factor to the severity of symptoms for those who get COVID-19. The best explanation I’ve found why that may be true is in a paper in Nature Reviews Endocrinology published in April. There are several reasons in addition to the cardiovascular and endocrinological co-morbidities associated with obesity.

Just a reminder, by definition obesity is a Body Mass Index (BMI) greater than or equal to 30.0 kg/meters squared; it’s a measure of surface area. You can check yours at the Health Info page on the Dr. Chet website; it also includes the info to determine if you’re really big boned, because that has an impact.

The increased risks associated with obesity are driven by the respiratory system:

  • Impaired respiratory mechanisms
  • Increased airway resistance
  • Impaired gas exchange
  • Low lung volume
  • Low muscle strength

In effect, the greater the obesity, the more difficult it is to breathe deeply and when deep breaths are taken, the resistance within the airway and the actual exchange of oxygen and carbon dioxide are impaired. If required, intubation is more difficult. The greater the degree of obesity, the more difficult it is to provide regular patient care if someone is hospitalized with the virus. Add to all that the co-morbidities of the cardiovascular and endocrinological systems, and it makes recovery very difficult. More research is needed, but it’s a serious issue in a country where over 40% of all adults are obese.

I’ll wrap this up on Saturday with some thoughts about what we don’t know that could be impacting the development of treatments for the COVID-19 virus.

Facebook Messenger

I try to make myself as accessible as possible, and Insiders and Members have quicker access. My website contains a way to email me if you have a question. One way I’m no longer going to accept questions is via Facebook Messenger, so please use one of the other avenues.

What are you prepared to do today?

        Dr. Chet

Reference: Nature Reviews Endocrinology volume 16, pages341–342. (2020)