How to maintain immune health and prevent illness in athletes

How to maintain immune health and prevent illness in athletes Your weekly research review Contents of Research Review Background & Objective What They Did What They Found Practical Takeaways Reviewer’s Comments About the Reviewer Comments ... Read more

James Morehen

By Dr. James Morehen
Last updated: March 3rd, 2023
5 min read

How to maintain immune health and prevent illness in athletes

Your weekly research review

James Morehen

By Dr. James Morehen
Last updated: March 3rd, 2023
5 min read

Contents of Research Review

  1. Background & Objective
  2. What They Did
  3. What They Found
  4. Practical Takeaways
  5. Reviewer’s Comments
  6. About the Reviewer
  7. Comments

Background & Objective

Heavy exercise from training and competition combined with life stress such as travelling, emotional status, and pressures to succeed can all have an effect on the innate and acquired immunity in athletes. In this review article, Neil Walsh provides new insights and evidence-based recommendations for coping with the various challenges that athletes encounter on immune health, including: heavy exercise, life stress, sleep disruption, environmental extremes, and nutritional deficits.

What They Did

Neil provides the background and overview of stress-immune interactions, identifying particular key factors that can lower immunity in athletes. Importantly, the common pathways for the immune response to physical and psychological challenges are highlighted, which result in the release of Catecholomines and Glucocorticoids. The innate, mucosal, and acquired immunity are overviewed with both counts and functional aspects related to the influence of prolonged exercise (>90 min); which is a duration many athletes will be exposed to in either training or competition. Additionally, Neil displays values of particular nutritional supplements for reducing the common ‘cold’ and maintaining immunity in various scenarios.

What They Found

In a simple and clear manner, Neil provides some succinct recommendations in relation to how athletes and support practitioners can modify training and recovery activities, optimise psychological well-being, improve sleep strategies, mitigate negative outcomes from those encountering extreme environments, and lastly, how nutritional aids can maintain health in athletes.

Practical Takeaways

Modifying training and recovery activities to maintain immune health in athletes
Manipulate training volume and/or intensity to manage training load; keep the size of increments in volume and intensity to 5–10% per week (particularly during winter); increase the frequency of shorter, so-called “spike” training sessions, rather than enduring fewer but longer sessions; implement recovery activities immediately after the most intensive training sessions; undertake easy-moderate training sessions after each high-intensity session; plan an easier recovery/adaptation week every second or third week of the training cycle; permit athletes at heightened risk of illness several weeks of active recovery after the completion of a season or major competition.

Optimise psychological well-being and maintain immune health in athletes
Keep unnecessary life stress to a minimum; monitor and manage all forms of stress (psychosocial and physical); monitor life demands (e.g. using the DALDA questionnaire); monitor mood, stress, and anxiety; implement stress management interventions where necessary.

Sleep recommendations to maintain immune health in athletes
Aim for 7+ hours of sleep each night; avoid restricting sleep over many days and “catching-up”; monitor morning freshness and vigour; consider monitoring sleep duration and efficiency using a wearable device; daytime naps may be beneficial; optimise sleep hygiene routine in the hour before bedtime (e.g. reduce psychological strain, go “screen-free”, and ensure darkness at bedtime: see attached infographic).

Maintain immune health in athletes encountering extreme environments
Carefully manage training load and recovery when training with additional heat and/ or hypoxia; acclimation to heat and/or hypoxia may limit the influence of environmental extremes on immune health; take extra precautions to avoid prolonged periods of breathing large volumes of cold, dry air (e.g. when training and competing in the winter); personal hygiene, sleep hygiene, proper nutrition, and reducing unnecessary stress become increasingly important during long-haul travel to training camps and competition; short-lasting exposure to environmental extremes may enhance immunity and reduce sickness (e.g. 30-secs hot-to-cold showers).

Nutritional recommendations to maintain immune health in athletes
Match energy intake to expenditure; avoid crash dieting; eat a well-balanced diet; consume >50% daily energy intake as carbohydrate; ensure adequate protein intake (1.2−1.6 g/kg body mass/day); consider 1000 IU/day vitamin D3 from autumn to spring to maintain sufficiency; at the onset of a cold, take zinc acetate lozenges (75 mg/day); consider probiotics (≥1010 live bacteria/day) for illness prone/travelling athlete.

Reviewer’s Comments

“Irrespective of athlete’s playing level, this review touches on many areas that can affect training, competition, and ultimately, the health in those partaking in heavy training periods and competitions. It is important to consider that recommendations should be applied on an individual basis rather than a blanket approach. Indeed, many of them will hold true and important with most athletes, but maybe the biggest wins would come from understanding which areas your athletes already do very well, and therefore, which areas need the most work on to gain the biggest improvements. Lastly, it is important to remember that any supplement being purchased should be from a company that can provide the ‘batch certificate’ with it; this ensures the products/ supplements are clean and contain no WADA banned substances.”

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    James Morehen

    Dr. James Morehen

    Dr. James Morehen is the Lead Performance Nutritionist for England Rugby and previously also worked as the Performance Nutritionist for Bristol Bears Rugby Union. He is a SENr registered performance nutritionist and works privately with both elite athletes and individuals through his business Morehen Performance Ltd.

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    James Morehen

    Dr. James Morehen

    Dr. James Morehen is the Lead Performance Nutritionist for England Rugby and previously also worked as the Performance Nutritionist for Bristol Bears Rugby Union. He is a SENr registered performance nutritionist and works privately with both elite athletes and individuals through his business Morehen Performance Ltd.

    More content by James
    Performance Digest

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