In the time of corona: right fit for keeping fit
April 06 2020 01:16 AM
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Everyone is concerned about how the Covid-19 pandemic will affect those around them, especially themselves and their loved ones. Although many may eventually get the virus, the good news is that for most of us there will only be a minimal effect. In fact, for most of us the biggest concern is the effect of the lengthy periods of isolation and reduced activity. Not only will this period of isolation affect us physically, but for many, this period may be stressful and affect our mental health negatively.
Many of us are now confined to our homes and not able to be as physically active as usual. The aim of this piece is to provide you with valuable information to help support you and your loved ones during these uncertain times. The focus is to keep you healthy and provide you with ways in which to support your immune system. 
Your immune system is your bodies’ defence system; it protects you against disease and helps fight it when you become ill. To maximise your immune systems’ response, you need to support it in multiple ways. The great news is that there are many simple ways of keeping yourself strong and healthy. Always remember to wash your hands thoroughly and regularly, wipe down surfaces that these hands have touched, or people have sneezed or coughed over, and physically distance yourself from others.
Other important ways in which you can help support your immune system during this time are as follows. 


SLEEP
Good quality sleep helps support your immune system. You and your family should go to bed at regular times. Don’t stay up late just because you don’t have to go to work or school tomorrow, and keep away from tablets and mobile phones at least an hour before going to sleep. People were found to be 3 to 5 times more likely to get sick with viruses if they slept less than 5-7 hours compared to people who slept 7-8 hours (Prather et al 2012, 2015). Respiratory infections were 4-5 times more common in people who slept less than 6 hours per night compared to people who slept 7-9 hours per night.
Summary: Go to sleep early, keep away from your phones before sleeping and try to sleep at least 8 hours each night.


EXERCISE
Exercise not only reduces the risk of contracting a respiratory infection it also decreases the duration of the illness (Nieman and Weitz 2019). Research has found that the benefit of exercise exceeds the benefit reported for many medications and supplements.
Summary: Exercise is a miracle medicine and can reduce your chances of getting an upper respiratory tract infection. Exercising can also reduce the duration and severity of symptoms should you become ill. (More on exercise will be presented later). 


NUTRITION
Probiotics may reduce the chances of getting a respiratory infection and if you do become ill, may reduce the duration of the illness (Hao 2015). Although there is probably no harm in taking probiotics, it is important for you to know the quality of the research supporting the benefit of probiotics is not strong, and more research is still needed. Vitamin C does not appear to reduce the risk of getting a respiratory infection, but may reduce its duration in people who are exercising and are physically active (Hemile et al 2013, Virilhon et al 2019). However, Vitamin C supplements may not actually help once you have already developed symptoms.
Summary: Ensure you and your family have good nutritional food and avoid unhealthy food and snacks. Consider taking probiotics and Vitamin C supplements if you do not have any respiratory symptoms. For more detailed information on using nutrition to support your immune system please read (x-ref to QU nutrition paper)


STRESS
Stress (short- and long-term) has a very negative effect on your immune system and reduces many of the cells that fight infection (Haywood et al 2020). There are many things you can do to reduce stress, such as cognitive behavioural therapy (https://simple.wikipedia.org/wiki/Cognitive-behavioral_therapy) mindfulness and relaxation exercises. However, another very powerful way of reducing stress is — yes, you guessed it! — exercise.
  Stress increases the risk of infection and makes fighting an infection harder. There are a number of ways to reduce stress such as regular exercise, mindfulness and relaxation activities, etc.
Smoking and being overweight also has a negative effect on our immune systems. Smoking or being overweight may increase our chances of developing respiratory infections and may also decrease our ability to fight infection once the virus has entered our bodies (Sopori  2002; Kalra et al 2004, de Heredia et al 2012). It is advised that you find ways to help you stop smoking or to lose weight in a healthy way. 
MORE ABOUT EXERCISE
Exercise is truly a miracle drug. It can help us sleep better, reduce our stress, improve our mental health, improve our heart and lung function, help our digestion, keep our bones and muscles strong, reduce high blood pressure and help reduce the impact of non-insulin dependent diabetes. It works best when used conjunction with good nutrition, good quality sleep and not smoking. Here are some of the benefits of exercise:


What happens if we don’t exercise?
A lack of normal activity can lead to a very quick and very substantial loss of physical fitness. After 1-2 weeks of inactivity, people can lose 25-50% of their strength and within a week more than 1 kilogram of muscle. Worryingly, it may take up to a year to regain the lost strength and muscle mass (size). For people over the age of 30 years, the loss will be greater and the time to regain muscle size and strength will be much longer. The biggest concern of not exercising is that we don’t get the benefit of all the great positive effects of exercise, including supporting our immune systems (Jiricka 2008, Dirks et al 2016).                     
          
The good news

The good news is that it is relatively easy to maintain and build muscle even in the confines of your home and even without gym equipment. The great news is that no exercise is better than another and all you need do is establish a weekly programme of at least 150 minutes of exercise. This could be 30 minutes a day for 5 days each week or another variation that suits you better. The important issue is that you exercise. You just need to find a level of exercise that you can cope with or tolerate. It is safe to exercise even if you are not feeling 100% well, provided you reduce the intensity of exercising and ensure your level of exercise would allow you to talk to someone during the activity.  Maybe you can exercise with your family at home to support and encourage each other.

Below are some exercises you can do at home without the need for gym equipment.


Sit-to-stand
•Sit on a chair, cross your arms over your chest and stand up and sit.
•Aim for 30 seconds, have a two-minute rest and repeat 3 times.
•Don’t worry if you can’t do 30 seconds the first few times. Just do what you can manage. 
•If you can manage to do 30 seconds comfortably, try to do it a little faster next time. 


Sit-to-stand with shoulder press
•As a progression of the sit-to-stand exercise or as an additional exercise, you could hold a small weight in each hand, such as a 1 litre bottle of water, or a tin can. 
•Once you have stood up, lift the weight up to towards the ceiling as high as you can; first, with one arm and then the other, and then, sit down again.
•Try and get to 20 repetitions. 
•Once you can manage 20 repetitions comfortably, try and progress the exercise with a slightly heavier weight. You can also increase the number of repetitions you are doing.


Bridging
•Lay on your back and lift your pelvis up as high as you can and hold for 3 seconds.
•Slowly lower down again.
•Aim for 30 repetitions. 
•Once you can manage 30 repetitions comfortably, you can progress the exercise in many ways.
•You could place a weight on your stomach such as a 1 litre drinking bottle and lift that up as you do the exercise. You can increase the weight as you become able.
•You can also do one leg bridges
 
Stepping
•Find a stable step and step up and down alternating left and right sides. 
•Aim for 30 seconds, have a two-minute rest and repeat 3 times.
•Don’t worry if you can’t do 30 seconds the first few times. Just do what you can manage. 
•If you can manage to do 30 seconds comfortably, try to do it a little faster next time. 


Exercising outdoors
Engaging in exercise outdoors during Covid-19 is safe provided the exercise is done independently, such as running, cycling or walking and is permitted under the current public health guidance.
If the advice in Qatar allows for exercise with others outdoors, you can exercise with someone else as long as you keep 2 metres apart from your exercise partner at all times. Don’t exercise outdoors by yourself or with anyone else if you are feeling unwell.


Summary
Exercising is one of the most beneficial things you and your family can do at this difficult time. It is something that will benefit you all through your life. Start today, start gently and build up to the recommended level. Do not worry if you feel some pain with exercise, you won’t have done any harm to yourself. If there is some pain afterwards or the next day, then continue but at a slightly reduced level before you build up again.



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