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Flip the Script: How Fitness Professionals Can Overcome Challenging Clients

/24 September 2021/ All MFN blog/

If you are a fitness or medical fitness professional, there is a good chance you have heard one or more of the following statements at least once in your career. In fact, there is also a good chance you have heard these statements on a daily basis. 

1. I am a little tired and my muscles are a little sore from our last session, so I am going to cancel today and rest. 

2. I don’t want to do “that exercise” because I have never done it before.

3. My doctor told me that I should not be squatting, bending, reaching, twisting, etc… 

Many of you reading this article can relate to at least one of the above and may have even let out a slight sigh of frustration when it comes to overcoming challenging clients. Overwhelming amounts of research show that exercise can help to improve your health and fitness without hurting your joints.(1) With your current treatment program, exercise can: 

  • Strengthen the muscles around your joints 
  • Help you maintain bone strength 
  • Give you more energy to get through the day 
  • Make it easier to get a good night’s sleep 
  • Help you control your weight 
  • Enhance your quality of life 
  • Improve your balance 

However, many of our clients still believe that exercise will aggravate their joint pain and stiffness, but that is not the case. Lack of exercise actually can make your joints even more painful and stiff.(2) If the muscles and surrounding tissue are strong, it helps to maintain support for your bones. Choosing not to exercise weakens those supporting muscles, creating more stress on your joints. 

While fitness and medical fitness professionals understand the importance of exercise, the way we translate this to our clients is key. Oftentimes, clients receive misinformation along with mixed messages from doctors, family members, friends, and of course, social media. However, after decades of both academic and professional research working with special demographics, I have discovered a powerful technique to increase clients’ willingness to improve their health through exercise. The answer lies not only in showing the client how each exercise emulates real-life situations, but also how it affects their independence.

For example, telling a client, “Today we will be working on how to safely and effectively execute a squat,” is a lot different than saying, “Today we will be practicing our sit to stand movements so that you have the lower body strength and flexibility to rise from your favorite chair without assistance.” 

Most importantly, it is important to reiterate to your client that their lack of strength, mobility, and balance leads to a more sedentary lifestyle that will decrease their ability to function independently as time progresses. Additionally, muscle atrophy, joint immobility and poor flexibility are key indicators that functional movements, or movements that are required to perform everyday tasks, will soon be a thing of the past.

If a client is unwilling to perform various exercises, here are some conversation starters:

  1. Did you know that this is not just an exercise, but one of the foundational movements to support strength, balance and flexibility in your everyday life?
  2. Do you know the definition of functional fitness?
  3. Do you know that this isn’t just an exercise, but will help you walk up and down the stairs, get up from a seat, carry your groceries, and pick up a grandchild?
  4. Are you ready to give up your independence? 

Christine M. Conti, BA, M.Ed, is an international fitness educator and presenter. She currently serves as the Director of Membership for MedFit Network, sits on the MedFit Education Advisory Board and is a course author for MedFit Classroom. She is also CEO and founder of ContiFit.com and Let’s FACE It Together™ Facial Fitness & Rehabilitation and co-host of Two Fit Crazies & A Microphone Podcast. 

Check out Christine’s online course with MedFit Classroom, Arthritis Fitness Specialist:

References

  1. CDC: Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion. (2021, April 5). Benefits of Physical Activity. Center for Disease Control and Prevention. Retrieved September 10, 2021, from https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm
  2. Mayo Clinic. (2021). Exercising With Arthritis: Improve Your Joint Pain and Stiffness. Mayo Clinic. Retrieved September 9, 2021, from https://www.mayoclinic.org/diseases-conditions/arthritis/in-depth/arthritis/art-20047971
food-and-vegetable-coop-box

Breast Cancer: How To Reduce Your Risk | Fact Sheet from PCRM

/23 September 2021/ All MFN blog/

A healthy diet and lifestyle can lower your risk of getting breast cancer.

These four simple tips can boost your health in other ways, too!

Choose Plant-Based Foods

Healthy foods from plants (vegetables, fruits, whole grains, and beans) can lower your breast cancer risk in several ways. They are often low in calories and high in fiber. This helps you feel full and lose weight if needed.

High-fiber, low-fat diets can also help reduce estrogen levels. Lower estrogen levels can lower your risk of breast cancer. A recent study showed that eating less fat and more fruits, vegetables, and grains could help protect breast cancer survivors, too. Packed with nutrition, plant-based diets can also reduce the risk of other diseases, like diabetes and heart disease. For the best nutrition, eat a variety of plant foods each day. Be sure to include a good source of vitamin B12, too, such as a supplement. Keep salt intake low, but when you do use salt, choose the iodized kind.

Fill up on veggies.
Not only are they healthy, but some have cancer-fighting nutrients. Try adding broccoli, collard greens, or cabbage to meals.

Eat more soy.
Tofu, soy milk, and edamame may help protect against breast cancer. Studies show that women who eat more soy have a lower risk of breast cancer. Soy foods may help protect women who’ve already had breast cancer, too.

Avoid processed meats.
Hot dogs, bacon, sausage, and lunch meats have been linked to a higher risk of breast cancer. Swap in healthy plant-based proteins like beans, tofu, or nuts instead.

Download the Physicians Committee for Responsible Medicine’s Fact Sheet, Breast Cancer: How To Reduce Your Risk, to read the remaining 3 tips! Feel free to download and share this free resource.

The Physicians Committee for Responsible Medicine is a 501(c)(3) nonprofit organization, headquartered in Washington, DC. Our efforts are dramatically changing the way doctors treat chronic diseases such as diabetes, heart disease, obesity, and cancer. By putting prevention over pills, doctors are empowering their patients to take control of their own health.

Fact sheet shared with permission from PCRM. Click here to view other PCRM Fact Sheets.

diabetes-exercise-feature

How Exercise May Be the Only Way to Curb the Diabetes Epidemic

/23 August 2021/ All MFN blog/

The incidence rate of type 2 diabetes has been increasing in the United States for the past 40 years.  In fact, the American Diabetes Association estimates that at least half of all US adults (over 65 million people) have pre-diabetes or full-blown diabetes.  It is often underreported on death certificates, and is probably the third leading cause of premature death in the US.

So why is there such an increase in diabetes in this country?  The biggest reason is diet.

From a young age, children are eating processed food. When they enter school – lunchrooms in many school districts are sponsored with food from McDonald’s, Pizza Hut, and Coca Cola.  In college – most dorm food is also like fast food, and they can eat as much as they want. That and their foray into alcohol, and we have the beginnings of obesity, insulin resistance, and pancreatic damage. The very concept of type 2 diabetes used to be called “adult diabetes”.  Since many teenagers are now diagnosed, it’s now time to change the name.

One would say that if diabetes is a disease of the foods that you eat, then simply change the foods you eat. Not that simple. Once you’re diagnosed with diabetes, you become a ward of the medical system. Doctors will perform a lot of tests, take blood, and prescribe both insulin and drugs to mimic the glucose-lowering effects of the body, and many spend a minimal amount of time counseling on the right type of diet for your needs.

There are, in fact, many good diets to lower blood sugar, like the well-known Keto diet, which emphasizes higher fats and low carbohydrates. This is something that doctors have been prescribing in one form or another since the Atkins diet in the 1960s. What about vegetarian and vegan diets?  If you ask Dr. John McDougall, one of the nation’s leading plant-based doctors, he would advocate that a diet higher in plant-based carbohydrates is better for the body than high amounts of meat and cooking oils.

Both may have a point, but if you look at the food choices that most Americans have, they walk into a grocery store, and if they’re not savvy enough to shop on the outside isles (fruits, vegetables, meats, cheeses), they are trapped in an endless cycle of boxed cereals, candy bars, frozen foods, soft drinks and alcohol. It is almost impossible to go to a store and not pick up about 50-75% of food from a box, bucket or bottle.  Many still haven’t put two and two together — that the foods they eat now will have an effect on their physiology and medical status in 5-20 years.

So what’s missing? I have been in an interesting position of working in diabetes research in the 1980s, and watching from the sidelines the work, research, and policy in this area of medical care for the past 30 years. Here are my thoughts.  

First, although exercise is touted as part of the trilogy of treatment for diabetes (along with diet and insulin), it is the first to be discarded for another type of treatment that is expedient and profitable.  

Second, there are little, if any, referrals to the health club sector in order to work on basic exercise programs for persons with diabetes. Even moderate types of programming will results in dramatic drops in body weight (and fat), daily blood sugars, and A1c levels. It simply is not being done. Many in allied health scream that personal trainers and fitness instructors are not qualified to teach exercise programs for diabetes. With the advent of medical fitness over the past 20 years, this simply isn’t the case today. I would think that having a mechanism to get patients into health clubs through their health plan, or Medicare, or a revolving door policy with their physician group, would be an outstanding way to get more patients into the exercise routine.  

Third, people who work in the fitness industry should be looking very carefully in getting diabetic persons into their facilities in their communities. This takes an effort with health club trainers, club managers and company owners to reach out to the medical community through health programs, lectures, fairs and membership discounts in order to get patients in the door.  It may even entail home exercise visits, or online coaching where patients are taught programs, and keep their exercise routines times and exercise notes. 

Lastly, the fitness industry needs to move into the technology realm and look at the effects of exercise on patients both over 3-4 weeks, but also 3-4 years. This will be done through outcomes-based software programs that can be detailed to physicians, health plans, and sports medicine journals. Once the majority of medical fitness centers and health clubs are on board, we will see a changing of the guard in terms of what Americans think is the best type of treatment program to reduce diabetes symptoms, and look at the data of how people exercise, and how many of their health risks are being reduced by a challenging and consistent exercise program. This can be done at any age, and at almost every state of diabetes — whether they are newly diagnosed, or have basic complications that they are dealing with regarding long-standing diabetes. 

It is time to embrace exercise as part of a diabetes prevention and reduction strategy.  If not, in 20 years we will probably see the epidemic at such a high level, that a good portion of Americans will not be able to work due to their complications.  The costs to society will be even higher than they are now. It’s a risk we don’t need to take, because of the untapped market of over 31,000 health clubs in the US, there is virtually no reason not to engage in exercise. It would seem that our nation’s health depends on our next steps – literally. 

Eric Durak is President of MedHealthFit – a health care education and consulting company in Santa Barbara, CA. A 25 year veteran of the health and fitness industry, he has worked in health clubs, medical research, continuing education, and business development. Among his programs include The Cancer Fit-CARE Program, Exercise Medicine, The Insurance Reimbursement Guide, and Wellness @ Home Series for home care wellness.

Lori M Self Evaluation

A Self-Evaluation To Do at Home

/12 August 2021/ All MFN blog/

Take notice before your muscles begin to evaporate, and you need someone else to take charge.

Here are some questions, allowing you to make a self-evaluation, which can help you decide if you need assistance.

  1. Can you walk 50 feet in 12 seconds? This benchmark is a good indicator of the ability to walk for exercise. If you can’t, it’s time to think about ways to get moving.
  2. Can you walk 400 meters (a little less than a quarter mile) in just over five minutes? For endurance, the threshold is walking 400 meters or about one lap around a high-school track.
  3. Can you stand up from a chair five times in 11 seconds or less? This is a way to assess lower body strength needed for numerous tasks climbing stairs, walking, getting out of a chair or car, picking something up off the floor, getting off the toilet, or stepping out of a tub.
  4. Can you walk 10,000 steps a day? If you can achieve this benchmark, good for you. Studies have shown that it can help protect people from osteoarthritis and from developing mobility problems.
  5. Can you stand still with one foot directly in front of the other for 10 seconds without tipping over? If you didn’t sway or step out, great. Practice more complicated moves by continuing to take ten steps in a straight line without losing your balance. (Click here to take my Balance Quiz.)

Exercise is for everyone. But the truth is, some people, especially seniors, lack the range of motion, strength and flexibility to exercise. That’s especially true for those just starting out.

Assessment tools used by personal trainers are designed to meet the basic criteria that helps to measure physical fitness parameters and functions needed to accomplish activities of daily living.

Reprinted with permission from Lori Michiel. 

Lori Michiel, NASM, has been assisting seniors in their homes since 2006 with customized exercise programs including those designed to address Parkinson’s, metabolic disorders, arthritis and diabetes. These adaptive programs are specifically designed to improve balance, circulation, flexibility, mobility and promote independence. Lori Michiel Fitness has over 40 certified trainers who are matched with clients in Los Angeles, Ventura and Orange Counties. Connect with Lori at www.LoriMichielFitness.com.

fitness-exercise-at-home

Exercise is great, but it shouldn’t injure you!

/26 July 2021/ All MFN blog/

“Many people trying online routines during the coronavirus pandemic are finding it’s not so easy to do them right.” A recent article in the Wall Street Journal, titled “New Home Workouts Come With New Aches and Pains”, has pointed out an unfortunate side effect of folks exercising at home during the pandemic shelter-in-place order.

They are getting injured.

Social media has been saturated with home-based exercise programs as the fitness industry works hard to get, and keep, individuals exercising during this intense, but temporary, period of partial social isolation and staying at home.

We wish we could tell you that under any and all conditions you should always be pursuing exercise because it is always good for you…

It’s not!

“This is chess, not checkers” —Alonzo Harris: Denzel Washington’s Character in the movie, Training Day

Of course, we commend everyone who has made the wise choice to begin and sustain a regular routine of physical exercise.

Exercise is simple, right?

It looks so easy when the trainer and therapists are doing it on the video.

There is a name for the exercise, there is a way it is supposed to be done, you do it, and it helps you!

Right?

Apparently not.

Physical exercise is certainly presented like checkers: a relatively simple and easy game that doesn’t require a lot of skill and deep thinking… some quick fun for the family.

But physical exercise is really more like chess. Chess is a complex game that requires deeper thinking, patience, and skill. So is physical exercise.

Why?

Because the human body is really complicated!

Because exercise places stress on your body.

There are hundreds of muscles, joints, tendons, ligaments, nerves, bones, and on and on.

These structures and tissues have varying properties and tolerances for handling stress.

Some are better at it than others. If you haven’t exposed some of them to the demands of the physical stress of exercise in awhile, or you have had surgeries, previous injuries, or diseases that negatively affect some of your body’s tissues then they just might not be ready.

Instead of being a great thing to do to promote health and wellness, physical exercise becomes a process that degrades it.

But there is a solution.

1 Take honest stock of your own body. Ask yourself some questions:

  • How long has it been since I really exercised and moved the way that an exercise is “supposed” to be done?
  • Have I had injuries or surgeries that could have compromised parts of my system

2. Put the ego aside. Expediency is the wrong mindset for exercise. Physical exercise is a long game.

3. Start slowly and do not assume that because an exercise looks easy it will be.

4. Pay attention to body signals. You’re the expert on your bodily experience. Trust that. If it doesn’t feel right to you stop or modify.

5. Take on the perspective of what is the least amount of exercise I need to do to reach my goal, not the most. Overdosing exercise is the problem.

6. Seek professional guidance and support from a qualified healthcare professional and trainer.

  • Get a thorough pre-exercise assessment to identify any areas of your body that need to be shored up prior to engaging in unrestricted physical exercise.

7. Take Dr. Nicholas DiNubile’s Advice: “The managed dose of exercise that will do the most for you – without harming you – needs to be measured out for you alone.” (1)

If you have been injured while exercising, see your physician to make sure nothing really serious has happened that will require medical attention. When the doctor gets done, and there is no serious problem, seek out an Exercise Professional from the MedFit Network to discuss how we can help measure out the right dose of exercise – just for you – so you can exercise safely and effectively for life.

Co-written by Charlie Rowe and Greg Mack.

Charlie Rowe, CMSS joined Physicians Fitness in the fall of 2007 after spending 9 years as the Senior Personal Trainer at Oak Hill Country Club in Rochester, New York. He has also worked within an outpatient Physical Therapy Clinic coordinating care with the Physical Therapist since joining Physicians Fitness. Charlie has earned the Cooper Clinic’s Certified Personal Trainer, the NSCA’s Certified Strength and Conditioning Specialist, the American College of Sports Medicine Certified Health Fitness Specialist, Resistance Training Specialist Master Level, and American Council on Exercise Certified Orthopedic Exercise Specialist Certifications. 

Greg Mack is a gold-certified ACE Medical Exercise Specialist and an ACE Certified Personal Trainer. He is the founder and CEO of the corporation Fitness Opportunities. Inc. dba as Physicians Fitness and Exercise Professional Education. He is also a founding partner in the Muscle System Consortia. Greg has operated out of chiropractic clinics, outpatient physical therapy clinics, a community hospital, large gyms, and health clubs, as well operating private studios. His experience in working in such diverse venues enhanced his awareness of the wide gulf that exists between the medical community and fitness facilities, particularly for those individuals trying to recover from, and manage, a diagnosed disease. 

References

(1) DiNubile, MD, Nicholas A. Framework: Your 7-Step program for healthy muscles, bones, and joints, 2005, Page xix.

Smiling elderly woman training in a group

It’s time to play!

/7 July 2021/ All MFN blog/

I had just returned home from an amazing educational conference in Arizona. Some of the most educated and credentialed humans in the fitness world had come together to share and learn the most up-to-date and evidenced-based systems in the fitness world. My thoughts felt like a bag of ping pong balls had been dropped, bouncing in many directions at once.

I was getting out of my car on the way to get groceries. All the lessons, lectures, and workouts swirling in my mind. I was looking for a common thread. What was the connection to all that I have learned?  Then, I hear this clippity clack clippity clack! I look over my shoulder in the parking lot of a Publix. There was this young girl holding her mother’s hand. She had her princess outfit on, crooked crown, fake jewels and plastic shoes. The shoes skipping on the pavement was the clippity clack sound that made me look. I giggled at the difference between mom’s face, stress, deep thought and worry, and the young girl’s free and happy smile. Then I see them in the store. The young princess was leaping from colored tile to colored tile. I could see the imaginary moat she might be trying to cross while being chased by the creatures below.

I flashback to a seminar and one of the drills I just experienced with Master Instructor, Andy Hainey. Bounding in multiple planes of motion to challenge the athlete’s ability to accelerate and decelerate force efficiently. This beautiful happy princess was naturally doing some of the most advanced programming I flew thousands of miles to study.

BOOM! It hit me. PLAY…. she was PLAYING! The sessions and lessons that shone brightest and stayed with me from the workshops, were those that felt like play. They were technical and evidence-based, and they were fun! No one used jargon or spoke of the sagittal plane or the eccentric phase.  They made it fun.

Benefits of Incorporating “Play” into Your Programming for All Ages

The are many studies of the benefits of play and physical relation between activity in youth populations. The evidence shows a positive relation between physically active youth, and seven areas of cognitive performance (perceptual skills, intelligence quotient, achievement, verbal tests, mathematics tests, developmental level/ academic readiness, and other). Sibley et al., 2003

Playing increases enjoyment and adherence at all ages. It creates a positive reaffirming cycle of success. The more you enjoy something, the more time spent doing it. The more time spent doing an activity, the more skilled you become. The greater the skill level you achieve or the higher the achievement, the more you will enjoy doing the activity. 

We forget what it was like to play as we age with all the responsibilities and stresses we have We are told to put childish things aside. As a “fitness professional” we are blessed to keep playing in many senses of the word. I have spent many hours of my life educating myself and gaining certifications. While I believe that time has been well spent, my clients continually tell me their favorite aspect of our time together is the fun factor.  

Many feel as though they haven’t repeated a workout ever. This is not the case. I do follow the NASM OPT model. It is a progressive system that can be applied to every aspect of fitness training. Our body has a miraculous ability to adapt to specific demands placed on it. That is my primary guide to programming for my clients. Once we establish their baseline abilities through comprehensive assessments, and what goals they want. Then we create the program based on the S.A.I.D. principle (Specific Adaptation to Imposed Demands). The assessments many times feel intimidating and clinical and set that as the tone for you and your client.  If we as trainers and coaches make the assessments fun and non-intimidating games (I use the term drills in place of games for my adults many times) or play, we can start creating a positive nurturing environment for our clients.  Don’t just show them where they are deficient. Let them show and celebrate what they are capable of.

Bottom line is, have fun and play! You will enjoy every session. Your clients will look forward to each session. They will give their all and get better results.  Keeping clients training is one of the most challenging parts of what we do.  Embrace your inner child, and theirs. Get them to hop from stone to stone in monster infested waters or bring out the agility ladder. Either way just play!

Coach Pete Guzman is a NASM Master Trainer with CES, PES, YES, CNC, SGPT MMACS and 4th degree Black Belt. Look for his upcoming seminar in June to find out more about youth programming and adding fun to your clients’ journeys.

Fitness parners in sportswear doing exercises at gym. Fitness sp

The Perils of Taking the Easy Way Out When It Comes to Fitness

/24 June 2021/ All MFN blog/

We are by nature lazy creatures. We try to get by with as little effort as possible; we love to minimize work but maximize enjoyment. Sadly, this concept applied to exercise can have severe consequences to our bodies. 

Weak links, in essence, are parts of our bodies that are not as strong as the others. Logically, it would make sense for us to strengthen these weak links in order to build our bodies as a whole. 

However, our bodies usually choose to perform a movement with the least amount of effort and resistance. If one of our muscles is weak, instead of activating it, our body will compensate or cheat by making the other muscles around it work harder to complete the movement. 

This results in strong muscles growing stronger, and weak links growing weaker. The only way to overcome our cheating tendency is to consciously activate our weak links and establish proper movements. 

Once fundamental movements are established, only then can you add in other factors such as strength, endurance, speed, agility and athletic skills, which will help play a big role in improving performance and injury prevention.

A chain is only as strong as its weakest link

There’s no point building big muscles if your joints, tendons, and bones can’t stand the strain. Instead, it is wiser to first build your foundation — and for many people, that means revisiting the weakest parts of your body. 

Perhaps it came from a previous injury, or maybe it’s just a muscle you didn’t pay attention to previously. Whatever the case, tending to your weakest link will lay the necessary groundwork for true fitness. Skip this step, and you may end up doing yourself more harm than good. 

It’s not just limited to gym-goers who overload their muscles by lifting too much weight. In fact, women who are supposedly “flexible” and great at yoga can get into trouble too. On one hand, the gym-goers are building strength without flexibility; on the other hand, yoga enthusiasts are pushing the limits of their stretches without increasing their strength. This can result in joint laxity (looseness of joints) that makes them vulnerable to injury. 

Weak links due to injuries

Some of you reading this right now may have suffered injuries before, whether major or minor. And most of you would be able to relate to the fact that you never feel the same after an injury. The weak links caused by injury are often hard to repair and can lie dormant for a long time before resurfacing to cause discomfort and pain. 

That’s why it is important to identify your weak links. Even if you’ve never been injured, there are other factors that may cause weak links: 

  • old injuries that you were unaware of
  • surgery
  • poor movement
  • incomplete rehabilitation
  • alignment issues
  • muscle imbalances
  • aging
  • mindset
  • genetics 

As you may realize, weak links are not always caused by outward injuries, but may also develop due to intangible factors like age, mentality and physical habits. 

Nevertheless, many people suffer because they do not rehabilitate completely from an injury. A lot of people go through physio and recovery program, but stop once they reach 80% wellness. However, it’s at this stage where it’s the easiest to experience re-injury. Instead, it’s always better to achieve 110% fitness before you go back to your usual workout or sports routine. This ensures your weak link has been strengthened and prevents injury from occurring easily. 

Getting fit the right way

Ultimately, your body is unique. Although most of us want to go straight to training like Arnold, or run like Usain Bolt, our body has its own sets of strengths and weak links that need to be addressed individually first. And the best way to do that is through a personally tailored corrective exercise program, measured out specifically for you. 

The shortcut to fitness is doing it right in the first place.

Ke Wynn Lee, author and an international award-winning corrective exercise specialist, currently owns and operates a private Medical Fitness Center in Malaysia. Apart from coaching, he also conducts workshops and actively contributes articles related to corrective exercise, fitness & health to online media and local magazines.

seniors-biking-in-gym-group

Be Physically Active to Boost Your Immune Response

/16 June 2021/ All MFN blog/

In these challenging times, if we only could get a medication that would boost our immune system and response to viruses, lower all stress associated with still being in a pandemic, and treat most of the pre-existing health conditions that are associated with a higher risk of dying from COVID-19, we would all be lined up for it! Guess what? We already have something that does all these things already—and that is physical activity.

Let’s consider its impact on how well your immune system works. While physical activity can boost your immune function, here’s what else we know about the immune system and all the lifestyles factors we can manage:

Exercise: A single workout may temporarily suppress your immune system, but chronic training (assuming it is not excessive) boosts immunity to the common cold, other viruses, and a whole host of pathogens (1). Being regularly active generally makes you less likely to get sick.

Stress: Any type of stressor, be it physical or mental, can weaken your immune system, most commonly through increases in levels of the hormone cortisol and other factors (2). Exercise overtraining raises cortisol levels and can make you more likely to catch a cold or the flu.

Sleep: Lack of sleep—particularly deep REM sleep—and short sleep duration cause a rise in cortisol levels that can dampen immune function (3). Many people with type 2 diabetes and overweight/obesity also have sleep apnea that interferes with getting quality sleep, making them more susceptible to getting sick. Better management of all of these conditions helps.

Nutrition: Chronic malnutrition lowers the ability of the immune system to function optimally. Low levels of vitamin D (which acts as a prohormone) in the bloodstream has also been tied with lower immunity, and many people with diabetes and older adults have low vitamin D status. Getting adequate vitamins, minerals, and calories in your diet can boost your immunity.

Alcohol: While a moderate intake of alcohol may give you some health benefits, abuse of alcohol suppresses your immune system (4). “Moderate” is one drink per day for females, two for males—and there is no rollover from one day to the next if you miss one!

Smoking: Tobacco smoking increases inflammation and lowers immune function, and it may also lower your immune response to certain vaccines. Quitting smoking can help restore immune function.

We also need to discuss how our bodies react to vaccinations. All of us are facing possible vaccination for COVID-19 once we all can get access to the many safe and effective vaccines that are now slowly being distributed around the US and the world. You may be, like I was previously, assuming that vaccines work the same for everyone. In reality, there is no guarantee of a universal and equally protective response, and a whole host of factors (inside your body and out) can impact how well a vaccine actually works for you (5). Not surprisingly, all of the lifestyle factors listed above can impact the strength of your immunity post-vaccination, and making improvements in any/all of them can help. But your age can also have a negative effect.

COVID-19 is unlikely to be the last threat to our collective health, so it is worth discussing why we are more vulnerable to threats to our immune system as we get older. For starters, older adults have a less robust immune response to everything, including strains of influenza, and they suffer from a more rapid waning of antibodies. Basically, our immune systems are getting less robust and effective as we age—and that potentially impacts our response to vaccines. 

Generally, older adults have a lesser immunity to any virus that they have been vaccinated against, and that will likely include the current global coronavirus once a vaccine is available. However, engaging in regular aerobic training improved flu vaccine responses in a group of older adults who had been previously sedentary (6): participants who did a regular moderate-intensity physical activity like brisk walking were 30 to 100 percent more likely to have an antibody response sufficient to keep them from getting the flu. Although research on this topic remains limited, exercise is likely to help boost the immune systems in people who are currently sedentary and start being active.

Other confounding health issues may make immune responses weaker when you are exposed to a virus or vaccinated. For instance, many seniors with diabetes develop kidney disease requiring dialysis. In these individuals, many fail to have an adequate immune response when given a vaccine for hepatitis B; how well it works depends on their age, how long they have been on dialysis, their diet, and other factors (7). In children (and adults) with type 1 diabetes, certain vaccines have been shown to be less effective, particularly when they also have celiac disease and consume gluten (8).

So, what can you do? Fight back by adopting the healthiest lifestyle that you can—one that includes being regularly moderately active—and stay as healthy as you can for when the next virus comes along. Protect yourself with a daily dose of exercise!

Sheri R. Colberg, PhD, is the author of The Athlete’s Guide to Diabetes: Expert Advice for 165 Sports and Activities (the newest edition of Diabetic Athlete’s Handbook). She is also the author of Diabetes & Keeping Fit for Dummies, co-published by Wiley and the ADA. A professor emerita of exercise science from Old Dominion University and an internationally recognized diabetes motion expert, she is the author of 12 books, 30 book chapters, and over 420 articles. She was honored with the 2016 American Diabetes Association Outstanding Educator in Diabetes Award. Contact her via her websites (SheriColberg.com and DiabetesMotion.com).

 

References

  1. Cerqueira É, Marinho DA, Neiva HP, Lourenço O. Inflammatory Effects of High and Moderate Intensity Exercise-A Systematic Review. Front Physiol. 2020 Jan 9;10:1550. doi: 10.3389/fphys.2019.01550. PMID: 31992987.
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