We’ve learned so much about the coronavirus since our last newsletter in early April in terms of the progression of the pandemic and how it individually affects people. Yet, so much about it remains a mystery. Pilots are enduring extreme stress as a result of the pandemic’s impact on the airline industry while also continuing to travel for work to places of high coronavirus incidence. It is imperative to be aware of steps that can be taken to stay healthy based on the information available at this time. While we will hold off on getting into the progress of coronavirus treatment discovery or vaccine development, we can reiterate a few points for maintaining a strong immune system with some greater insight based on current research.
A recent paper published in the Integrative Medicine Journal covered recommendations for each of the four phases of COVID-19, from prevention to recovery. It is important to note that the most severe cases of coronavirus infection are a result of an unregulated inflammatory response by the immune system, leading to cytokine storm and subsequent respiratory distress. While it is crucial to boost the immune system during prevention and in the early stages of COVID-19 symptoms, careful monitoring is required to ensure the inflammatory response is not exaggerated as the disease progresses. For the purposes of article, we will focus on the prevention phase for otherwise healthy adults.
In addition to social distancing and wearing masks, eliminating non-purposeful inflammation is key for fighting infection. The first, and best, thing you can do is to consistently get plenty of high-quality sleep, which supports your anti-viral immune response. Also, work on reducing stress. A high-stress state sends cortisol coursing through your system, which is inherently pro-inflammatory and also reduces your immune response. Reining in stress is easier said than done right now, but you can do a few tangible things that will help. Try to spend time outside every day, maintain connections with friends and family (even if it has to be virtually), and strive to fit in regular exercise. It doesn’t have to be lengthy or strenuous, and in fact, intense exercise can increase stress. Even a quick walk around the block can help.
Aside from these general lifestyle recommendations, eating a diet full of essential nutrients from fruits, vegetables and whole grains is crucial for keeping your immune system healthy and for reducing inflammation. Highly processed foods and foods with chemical additives and/or added sugars promote inflammation and should be avoided. Maintaining a healthy weight through diet and exercise, as well as good glycemic control, are hugely beneficial for fighting infection.
Good nutritional status helps to ensure the body is consuming the vitamins and minerals required for immune system functioning. Perhaps one of the most crucial vitamins for a strong immune system is Vitamin D. It has been well-established that many Americans are unknowingly deficient in this vitamin, and its utility in fighting COVID-19 has been recently reviewed. Considered to be a "low-hanging fruit," physicians believe that, while more research is needed, supplementation with Vitamin D could potentially decrease severity in COVID-19 cases. Spending time outdoors while maintaining social distancing and eating foods rich in Vitamin D, such as fatty fish, are natural ways to boost your Vitamin D level. A supplement of 1000IU to 2000IU daily, under the guidance of a healthcare professional, may be reasonable for many people.
Vitamin A, like Vitamin D, is a fat soluble vitamin that is a major determinant of overall immune status. Deficiency is common, but eating plenty of fatty fish and a variety of fruits and vegetables can help to increase Vitamin A levels. Similarly, Vitamin C has been long recognized as an essential nutrient for the immune system. Supplementation with Vitamin C has shown to both prevent and treat respiratory infections, and preliminary studies have revealed improvement in COVID-19 patients treated with intravenous Vitamin C. This vitamin is found in many fruits and vegetables, such as broccoli, cantaloupe, kale and bell peppers.
Vitamins are not the only key players in immune health. It is well-established that zinc, a mineral, is crucial for the functioning of almost every immune cell. Zinc deficiency has a profound negative impact on the body’s ability to fight off several types of infections. In addition, zinc shows specific anti-viral properties. Foods high in zinc include meat, shellfish, legumes, nuts and seeds. Supplementation with zinc or the previously mentioned vitamins can be considered, in consultation with a healthcare professional, for those concerned about maintaining a healthy immune status.
For pilots who must still report to work and spend time amongst the public, it is now more important than ever to make choices that positively impact health and wellness. This includes taking measures to off-set stress, such as mindfulness, exercise, social connection (from a distance) and getting plenty of sleep. Further protect your health by ensuring your body is getting adequate amounts of nutrients essential for immune system functioning. While the coronavirus pandemic has caused widespread fear and panic for a variety of reasons, several factors remain under our control. Taking the proper health-related preventive measures will help to weather the storm until this crisis is behind us.
[This article was originally published in our newsletter, The Guard Monitor, Volume II. Sign up for our newsletter by clicking on the blue box in the upper right-hand corner to ensure access to helpful information as soon as it is released. We promise not to spam you. You'll receive only 0 to 2 emails per month!]
by Lindsey Palmer, PharmD
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