Background

I have many people reaching out to me asking about what supplements they should be taking to combat Covid-19, but they are not fully taking advantage of what is arguably the single most important intervention that can reduce your risk of a serious Covid-19 infection, other than social distancing, and that’s exercise.

There is no supplement that comes even close to the immune boosting effects of exercise, along with providing the heart and lung fitness necessary to deal with serious infections.

Covid has a susceptibility to damage the heart and lungs in particular, so we have to keep these organs in prime shape.  Unfortunately many of my patients already started off the year in poorer cardiovascular shape due to winter holiday and hibernating patterns. Many rebound back around this time, but now due to the lockdown, they are once again indoors. We are literally seeing an extension of winter sedentary activity due to this virus.  In addition, for those of us used to exercising in a gym, the gym closures have been an additional barrier that have led to many individuals quitting exercise altogether.

Friends…we are in this for the long haul. Even if we flatten the curve and miraculously turn it downward in a few short months, this virus has the potential to keep coming back over the next 12-18 months or longer. You might have experience training for running events like a 5K or half marathon or some other sporting event.

I recommend applying that same focus and discipline now and have yourself and your loved ones train for the Covid-19 like it’s the most important race of your life.

Our seniors are especially susceptible to remaining sedentary during this sheltering time.  Aerobic fitness and strength decreases rapidly in seniors from sedentary activity, and this significantly reduces their risk of surviving infections like flu and Covid.  I have beloved family members and family members of friends and colleagues who have stopped exercising completely due to Covid, and they are putting themselves at very high risk of developing a devastating infection.

To avoid Covid or any serious lung infection you need to ensure a few key things, and exercise addresses each of these better than virtually any single food or supplement I’m aware of.  Let’s explore the 3 key factors below.

3 Key Factors

1. YOUR GENERAL IMMUNE SYSTEM IS INTACT
There is a field called exercise immunology where studies like this repeatedly show the incredible immune-boosting effects of regular exercise.  All components of your immune system are benefited by regular exercise and there is a clear inverse relationship between moderate exercise and illness risk.  There are a lot of posts out there on the benefits of nutrition on immunity and food is definitely a key factor, but do not underestimate the power of exercise in optimizing immunity to fight off infections.

2. YOUR RESPIRATORY IMMUNE SYSTEM IS INTACT
In addition to optimizing overall immunity, you want to make sure the immune system that specifically resides in your sinuses and respiratory tract are in good working order since this is the entry point for infections like Covid-19.  Breathing a little heavier while you exercise helps your nose, sinuses and lungs clear debris so infectious particles don’t linger and cause damage. The air you rapidly inhale and exhale during exercise is heated, humidified and enhances your own internal respiratory filtration system better than any air purifier.

Think of regular exercise and daily physical activity as turning on and keeping on this critical respiratory filter, especially as viral loads in the environment escalate.

3. YOU HAVE SUFFICIENT AEROBIC FITNESS
I have noticed in my own practice that patients who are aerobically fit get sick less often and when they do get sick, they tend to get minor colds and less bronchitis or shortness of breath. With Covid you are likely aware of the significant number of individuals requiring a breathing machine (mechanical ventilator) to provide support for several weeks.

Again, if you are aerobically fit, there is less chance of you having to be on a ventilator and also a higher chance that you would get off the ventilator sooner.

This study in Taiwan actually split patients on ventilators into an exercise vs no exercise group and the exercised group had far better functional outcomes in terms of coming off the ventilator and being discharged from the respiratory care center.

When you regularly engage in aerobic exercise, you not only condition your heart and lungs, but you also train your accessory breathing muscles pictured below.  I cannot overemphasize how important these muscles are in preventing severe complications from infections.

Accessory Breathing Muscles
Accessory breathing muscles

One of the reasons the elderly (or anyone who is deconditioned) end up on ventilators is because these accessory muscles are already so weak, and then deteriorate even more rapidly after hospitalization, preventing individuals from being able to naturally move air in and out of their lungs.  The mechanical ventilator is then used as an artificial supplementary device to do the work of breathing for you.

My recommendations are as follows:

  • Get a minimum of 60 minutes of aerobic activity daily. Most of you have extra time on your hands now that you are likely not commuting to work and overall workloads are lower.  It’s fine to split this 30-30 between morning and evening, and I especially recommend getting some exercise in the morning since it also helps manage stress.  Please be sure to read my post here on how to get the right dose of exercise to optimize immune system function while also lowering heart disease, cancer and overall chronic disease risk.  Overdosing on intensive exercise can actually stress your immune system, so be sure you understand the limits outlined in my exercise post.
  • Dust off your Fitbit, pedometer or Apple watch and pay attention to your daily steps. Do not be a Covid couch potato glued to your screen all day watching the news, obsessively tracking your investments, or trying to be the first to provide family and friends with the most dramatic news updates or the funniest Covid jokes.  Pick a single walking partner if you’d like to make this social and adhere to social distancing rules or just pop in your earpiece and make a social call while walking alone. You might have family or friends who are experiencing loneliness or other stressors…brighten their day while you walk
  • Use Fitness Apps and Exercise channels on Youtube to keep you motivated.  Some good Youtube channels to try out are Fitness Blender, HASfit, and Pop SugarWarning: some of the workouts on these channels are tough.  Go at your own pace and shorten the duration as needed.  You don’t want to get injured.  Again, the foundation of your exercise program should be longer sessions of moderate intensity cardio which I discussed in the first bullet.

Finally I’m sure you are aware by now that cardiovascular risk factors like diabetes and high blood pressure make you high risk for Covid complications, even if you are taking medications. Exercise has the potential to stabilize, partially reverse, or fully reverse many of these risk conditions, so this is one more important reason to stay active in addition to eating healthy.

Summary

You have likely heard of some of the key factors the health care system is relying on to prevent and manage Covid-19.  These include masks like the N95, ventilators to keep complicated patients alive, and the development of vaccines to trigger your body to boost your immune system to combat Covid-19.

What I’ve hopefully made clear to you in this post is that your own body can provide some similar functions enabled by exercise.  Breathing heavier during sustained exercise is your own internal N95 mask, helping to filter and sweep away viral particles so they have less chance of attacking your cells.  Obviously the proper mask, when indicated, helps prevent viral particles from entering your body in the first place.

The use and development of your accessory muscles during exercise serve as your body’s own natural mechanical ventilator, allowing air to move vigorously in and out of your body, reducing your risk of relying on an artificial machine if you do develop a significant infection requiring hospitalization.  This by the way does not just benefit your health, but makes more mechanical ventilators available to those in need.

Finally, while we wait anxiously for the development of a safe, effective and easily deployable vaccine to prime our immune system against Covid, use exercise as a natural supplement that has been proven to boost every major arm of your immune system against Covid and other infections.  I truly hope we can use Covid as an opportunity to motivate individuals of all ages to improve their overall fitness and health, which will continue to serve them even after we are over this pandemic.