Is regular exercise a friend or foe of the aging immune system? A systematic review

Science is slowly uncovering the connection between the immune system and exercise. Below is a great review of the recent science in this area. The short version is that some exercise is a small insult to the body, but the body builds up a resistance to it and is better than before!

Too much of an insult or too much exercise may not be good. No surprise there as anything that can help you, can also hurt you. Heck, you can even die from drinking too much water!

Be sure to check out this post from Dr. Lonnie Lowery HERE on inflammation, as it plays a very key role.

Time to grab that Kettlebell and get to work pumping up your immune system!

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Is regular exercise a friend or foe of the aging immune system? A systematic review.

Haaland DA, Sabljic TF, Baribeau DA, Mukovozov IM, Hart LE.

Clin J Sport Med. 2008 Nov;18(6):539-48

Rheumatology Division, Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. haaland@mcmaster.ca

OBJECTIVE: The purpose of the current review is to synthesize the available evidence from prospective clinical trials that are relevant to the clinical question: "What, if any, are the effects of regular aerobic and/or resistance exercise on the immune system in healthy older adults?"

DATA SOURCES: Electronic databases were searched, using terms pertaining to immunology, exercise, and aging. Using the Ovid interface, the following databases were explored: Allied and Complimentary Medicine (AMED) (1985 to 2008), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 2008), all EBM Reviews (Cochrane DSR, ACP Journal Club, DARE, CCTR, CMR, HTA, and NHSEED), EMBASE (1980 to 2008), and MEDLINE (1950 to 2008). The MEDLINE database was searched a second time through the PubMed interface. STUDY SELECTION: Prospective controlled clinical trials were selected for review if they investigated the effects of an exercise intervention (minimum 4 weeks in duration) on an immune outcome measure in an older but otherwise healthy population. A total of 19 articles representing 17 trials were identified.

DATA EXTRACTION: Quality assessment of the relevant articles was performed using the Jadad et al criteria. Data extraction was performed using a standardized instrument. Data regarding the participants, interventions, and laboratory and clinical immunologic outcomes were synthesized.

DATA SYNTHESIS: Available data provide no clear evidence of acute or chronic effects of exercise on lymphocyte or natural killer (NK) cell numbers or phenotype (ie, surface markers)/activity, with 2 exceptions: (1) strength or endurance exercise may cause an acute transient elevation in circulating CD8+ T cells, and (2) regular aerobic exercise appears to enhance immunologic memory in the context of vaccination. The effects of strength training on NK cell activity are unclear. Furthermore, regular aerobic exercise appears to be associated with a reduction in chronic inflammation. Finally, no prospective controlled trials have clearly documented clinical immunologic benefits of regular exercise, which may well relate to underpowering of these studies.

CONCLUSIONS: Overall, in healthy older adults, regular, particularly aerobic, exercise appears to be a friend of the immune system, helping to offset diminished adaptive responses and chronic inflammation. The possibility exists that particularly strenuous exercise may cause acute immunologic changes, such as diminished NK cell activity, which could predispose to infection in certain individuals. However, given the possible benefits of regular exercise on the immune system and the many definite benefits on other systems, the evidence presented here should not dissuade practitioners from suggesting regular exercise to otherwise healthy older adults.

Muscle soreness, supplementation and inflamation

Here are a few studies looking at ways to decrease muscle soreness and potentially increase perofrmance along with the role of inflammation.
Enjoy!

Do you need to induce muscle damage for growth?


Liquid carbohydrate/essential amino acid ingestion during a short-term bout of resistance exercise suppresses myofibrillar protein degradation.

The effect of a carbohydrate and protein supplement on resistance exercise performance, hormonal response, and muscle damage.

Effect of carbohydrate intake during recovery from eccentric exercise on interleukin-6 and muscle-damage markers.

Changes in inflammatory mediators following eccentric exercise of the elbow flexors.

Systemic inflammatory response to exhaustive exercise. Cytokine kinetics.

Dr. Lonnie Lowery on Nutrition and Inflammation-Special Guest Blog Post

Special Guest Blog Post from Dr. Lonnie Lowery on Nutrition and Inflammation

It is my honor to present some notes that Dr. Lonnie Lowery took from a Feb 2008 research workshop featuring NIH-sponsored list of heavy hitters that occurred in Chicago, IL on Nutrition and Inflammation.

In case you have been living under a rock, Dr. Lonnie Lowery is a nutrition professor, former competitive bodybuilder and Exercise Physiologist living in the Midwest. He is also a writer for www.t-mag.net so go there and check out his excellent articles. The good doctor is a wealth of information and walks the walk.

Dr. Lowery can be contacted through Charles Staley's site. He also does monthly conference calls with a new topic each month. I've been on the calls and they are really well done, so drop Charles Staley a line if you want in on them.

The following is pretty detailed, but excellent, cutting edge information!

Why Should You Care?

Inflammation is proposed to be at the root of many issues from muscle growth (hypertrophy), healing, to cardiac issues. Even most cardiologists I talked to a few years back admit that the main benefit to statin drugs is probably their modification of inflammation in the body and perhaps their effect on cholesterol is more of a "side effect".

So sit back and let Dr. Lowery enlighten us with some brand new research! Take it away Doc!

Dr. Lonnie Lowery on Nutrition and Inflammation

Talk #1: Nutrition and Age-Associated Inflammation: Implications for Disease

The first talk was done by a legend in the field of inflammation and nutrition: Simin Meydani. As a DVM, PhD, perhaps I should refer to her as "doctor, doctor" Medydani. (And I thought I spent too much time in school!) You may not find the title of her talk especially exciting (unless you're middle-aged like me, with a growing interest in overall health) so I'll serve up a whole bunch of key points and spike it with some data of my own:

• Excessive macrophage (an aggressive white blood cell type) activity and decreased T-cell (a different white cell type) activity leads to more and more inflammation and less resistance to infection as we age. An increase in prostaglandin E2 (PGE2) is obvious in old versus young rodents, for example. I sometimes think of PGE2 as inflammation itself. The end result is increased risk of coronary heart disease, Alzheimer's, osteoporosis, increased infections and even cancer. Ugh.
• Inflammatory cytokines like interleukin-6 and TNF-alpha increase the enzyme that makes more prostaglandin E2. You might care because exercise, especially the eccentric type, is known to be a consistent, albeit brief, inducer of IL-6.

• We'll see more on exercise in the next talk.
• Low antioxidant status (low glutathione presence) leads to more ceramide in the body. Ceramide leads to more creation of prostaglandin E2, so this is not good. Strength athletes enduring hard training don't need to struggle with excess inflammation. Keep up your antioxidant defenses.
• Vitamin E corrects and decreases PGE2 levels in old mice by interfering with the enzyme that makes it.
• 200 I.U. of vitamin E is better than either 60 I.U. or 800 I.U. among human elderly. Their antibody response to an immune challenge is improved at this dose. Some minor effect among the young was also noted.
• A huge variability in subject responses to vitamin E is due to genetic differences. (Intellectual people have loved to say "gene polymorphisms" for years… say it with me: "g-e-n-e p-o-l-y-m-o-r-p-h-i-s-m-s". Don't you feel smarter?
• Calorie restriction of 30% below needs but not 10% below needs results in lower PGE2, which appears to be one mechanism by which lifespan is lengthened. Interestingly, both levels of restriction improve clinical responses to immune challenge (in this case a delayed-type hypersensitivity reaction).
• Low-fat, high fish (oil) intakes lead to lower interleukin-6 production. That could lead to less inflammation and less catabolism in the body. Low-fat, low-fish intakes do not offer the same benefits.
• Over a three month period, 1.5g EPA combined with 1.0g DHA and a couple hundred I.U. of vitamin E strengthened immune response to a skin challenge as noted above. This is interesting since adding vitamin E interferes rather than helps in some studies investigating fish oil.
• Aggressive macrophages infiltrate fatty tissue, leading to inflammation via interleukin-6, interleukin-1 beta and TNF alpha. And I thought these little guys were a pain regarding muscle recovery! More on this later.

Talk #2: Molecular Basis of Inflammation: Relationships between Catabolic Cytokines, Hormones, and Energy Balance

As a weight lifter and not just a person looking for healthy aging, this lecture rocked. Here are the goods:
• A 154 pound (70 kg) man will eat 50 tons of food in his lifetime. He'll use 10 million liters of oxygen to burn it and he'll regulate his day-to-day intake to within one percent. (That's great but it's still plus or minus 10,000 kcal per year, or about three pounds of fat, which could explain the slow creep of body weight many guys experience as they age.)
• Depending on race, 16-28% of men in the U.S. have metabolic syndrome (high blood pressure, insulin resistance, central obesity, low HDL cholesterol and high blood triglycerides). Inflammation is an underlying factor. Imagine, one of the next four guys you meet is an inflamed metabolic train wreck!
• The biochemical pathways of leptin and insulin interact to help determine how fat you are, among other things.
• The mechanism linking energy balance and muscle size has been described/ explained in more detail in a 2007 paper by Nader and colleagues (Nature Medicine 13: 1016-19). This finally gives key insights as to why eating extra kcal and not just protein is so important to muscle size.
• Individuals with rheumatoid arthritis have faster metabolic rates, 25% lower muscle protein synthesis, less body cell mass and 36% less strength thanks to pro-inflammatory tumor necrosis factor (TNF-alpha) and friends. Further, their physical activity levels drop as they unconsciously compensate for the hyped metabolism. Harsh.
• The immune system is a huge player in muscle mass. Just as IL-1, IL-6, and TNF are catabolic, conversely IL-15 and IGF-1/ MGF are anabolic. ('Course you may already know this.)
• In the aged, inflammatory IL-6 actually predicts all-cause mortality. If you think inflammation is no big deal, I hope you learn better before you're old!
• Young or old, IL-6 rises by six hours after exercise (confirms my data in graph above)
• Blockade of the "marijuana receptor" has received attention as a potential way to give obese subjects the "un-munchies". Unfortunately for hopeful dieters, this approach also leads to anti-euphoric effects like nightmares and depression.
• As I understand it, a company named Acceleron is making a drug called Activin that blocks myostatin. The speaker said human trials begin next year. Whoa.
• Combined testosterone plus GH replacement is getting some spanking new 2008 attention. In truth, many competitive bodybuilders could've told these researchers how this works 20 years ago.
• The immune system can determine energy and protein balance. Resistance exercise is the "natural way to entrain these pathways" while pharmaceutical approaches to harnessing the benefits of exercise are still in their infancy.
---Dr. Lonnie Lowery

Lonnie Lowery is a nutrition professor, former competitive bodybuilder and Exercise Physiologist living in the Midwest