If you want to avoid getting the flu this winter, follow these proven techniques for boosting your immune system, fighting off germs, and keeping your body healthy.

A few simple recommendations
1. Get enough sleep: Your immune system functions much better when you get enough sleep. Most people really need about 8 hours per night for optimal health. If you’re body is fatigued, it simply won’t be able to fight off the flu virus (or any other infection) very well.

2. Exercise regularly: Exercise helps keep your immune system strong. In fact, a recent study showed that mice who performed mild exercise as soon as they were exposed to the flu virus had much lower death rates.

3. Avoid sugar: Even small amounts of sugar can significantly impair your immune function, making you more susceptible to a flu infection. A large amount of sugar, such as the amount found in a normal can of soda, hurts your immune function for hours.

4. Drink lots of pure water: Keeping your mucous membranes well-hydrated is a key to helping them fight off viruses. Shoot for about eight 8-ounce glasses per day.

5. Reduce stress: Too much stress has a highly negative impact on your overall health and, over time, it will make you much more susceptible to a flu infection. Studies show that prolonged stress is at least partially responsible for 90% of all illness and disease. Regular exercise and sufficient sleep both help reduce stress levels. Also, meditation is a proven stress-buster that is easy, enjoyable and can be used on a daily basis.

6. Wash your hands often: Also, carry a bottle of alcohol-based hand sanitizer with you and use it frequently, especially after you touch anything that others have touched recently (like doorknobs).

7. Eat immune-boosting foods on a daily basis: A healthy diet, including a few proven immune-boosting foods, is one of the best ways to avoid catching the flu. The best flu-fighting foods are:

Fresh, organically grown fruits and vegetables – Brightly colored fruits and vegetables are packed with healthy phytonutrients that can strengthen your immune system, lowering your susceptibility to the flu virus.
Fresh raw or lightly-cooked garlic – Garlic has strong natural antiviral properties that can help to fight off a flu virus. Also, garlic provides a strong boost to your immune system, especially when eaten on a regular basis.
Green Tea – Like garlic, green tea has shown the ability to both kill viruses and to stimulate the immune system to fight off flu infections, especially when used daily. Try to drink 3-6 cups of strong green tea per day during the flu season.
Cayenne Pepper – Cayenne has a long list of health benefits and is believed to be a mild immune-booster. Also, cayenne contains large amounts of natural vitamin A, considered to be an important “anti-infection” nutrient.

8. Keep your hands away from your face and head: The flu virus enters your body through the eyes, nose, mouth, and possibly even the ears.

9. Get fresh air every day: During the winter the dry heat from indoor heating systems dries out your mucous membranes and makes you more susceptible to viruses. If you can, during the day, crack open a window or two to give your body some relief.

10. Drink little or no alcohol during flu season: Too much alcohol impairs liver and immune function, which leaves you open to all kinds of infections. Heavy drinkers are especially susceptible to flu infections. Also, alcohol dehydrates your body which is always bad during flu season.

11. Don’t smoke and avoid smoke-filled places: First and second-hand smoke significantly impairs your immune system. It also dries out your nasal passages and paralyzes cilia, the small hairs in your nose and lungs that help keep out viruses.

12. Take regular saunas: Many experts believe that taking a sauna several times a week can help to keep you from getting the flu. Many people, especially in Europe, takes saunas just for this reason. The air you breath in a sauna is too hot for cold and flu viruses to survive.

I have found this study from 2004. I find it worth reading to understand how stress affects our immune system.

We have known for some time that stress affects our immune systems. Many studies have shown that stress can suppress the immune system, but other studies have shown boosts in the immune system under stress. A July 2004 meta-analysis of 293 studies conducted over the past 30 years puts the pieces of the puzzle together.

Psychologists Suzanne Segerstrom, Ph.D., and Gregory Miller, Ph.D. found the following:
-  Stress does indeed affect the immune system in powerful ways.
-  Short-term stressors boost the immune system. It seems that the “fight or flight” response prompts the immune system to ready itself for infections resulting from bites, punctures, scrapes or other challenges to the integrity of the body.
- Chronic, long-term stress suppresses the immune system. The longer the stress, the more the immune system shifted from they adaptive changes seen in the “fight or flight” response to more negative changes, first at the cellular level and later in broader immune function. The most chronic stressors – stress that seems beyond a person’s control or seems endless – resulted in the most global suppression of immunity. Almost all measures of immune system function dropped across the board.
- The immune systems of the elderly or those already sick are more subject to stress-related changes.

In reaching these conclusions the authors looked at the effects of the various stressors on different immune responses, such as “natural” and “specific” immunity. They summarized the results of the studies that looked at each of these types of stress:
- Natural immunity produces quick-acting, all-purpose cells that can attack many pathogens; they bring fever and inflammation.
- The body takes a few days to mount a more specific attack on particular invaders with specific immunity. This response includes lymphocytes (T-cells and B cells). Specific immunity has both cellular responses, which fight pathogens that get inside cells (such as viruses), and humoral responses, which fight pathogens that stay outside cells, such as bacteria and parasites. Segerstrom and Miller were able to assess how different types of immune response correlated with different types of stress because researchers have identified the blood markers of these different immune responses.

They divided stressors into different types:
- Acute time-limited stressors: lab challenges such as public speaking or mental math.
- Brief naturalistic stressors: real-world challenges such as academic tests.
- Stressful event sequences: a focal event such as loss of a spouse or major natural disaster gives rise to a series of related challenges that people know at some point will end.
- Chronic stressors: pervasive demands that force people to restructure their identity or social roles, without any clear end point – such as injury resulting in permanent disability, caring for a spouse with severe dementia, or being a refugee forced from one’s native country by war.
- Distant stressors: traumatic experiences that occurred in the distant past yet can continue modifying the immune system because of their long-lasting emotional and cognitive consequences, such as child abuse, combat trauma or having been a prisoner of war. Much of their analysis goes on to review the similarities and differences among the 293 studies that they examined. These studies included a total of 18,941 subjects. “Stressful event sequences” appeared to be weakly associated with different immune consequences, depending on the type of event. There appeared to be different patterns for grief than for trauma, for example, but the associations weren’t strong enough for the authors to make new claims. They recommended further study.

The authors did find that the most chronic stressors – those which change people’s identities or social roles, are more beyond their control and seem endless – were associated with the most global suppression of immunity. In such situations almost all measures of immune function dropped across the board. The longer the stress, the more the immune system shifted from potentially adaptive changes (such as those in the acute “fight or flight” response) to potentially detrimental changes, at first in cellular immunity and then in broader immune function. This analysis suggests that stressors that turn a person’s world upside down and appear to offer no hope for the future probably have the greatest psychological and physiological impact.

The authors also found that age and disease status affected a person’s vulnerability to stress-related decreases in immune function. It seems that illness and age make it harder for the body to regulate itself.

This is a ground-breaking meta-analysis that helps us understand the complex relationship between stress and the immune system. It should lead to new treatments and to better stress management programs, especially for patients with HIV or other disorders that compromise immunity.

I read an article published in the New York times and published yesterday. In the article a doctor named Colin Fernandes tells of the inadequacy of drugs offered to treat some diseases notably trauma and back pain.

As an example, the author describe the case of young veterans, frequently in their 20s, coming back from combat. They mostly have chronic pain and traumatic brain injury, untreated post-traumatic stress disorder, and sleep and mood disorders.

The challenge he faces if to find a balance between pain relief and side effects; For example the only treatment available for these problems is giving opioid painkillers (Percocet or Vicodin). But these drugs affect mood and sleep and he finds himself in the unenviable position of limiting access to pain medications if their use will lead to functional decline.

He he is sobered by the fact that the only study of efficacy of these drugs is a 16 weeks test where in practice the use of these drugs are often maintained on opioids for years or decades.

Colin Fernandes also note that trials suggest that on average, patients given opioids experience an improvement of only 2 to 3 points on a pain scale of 0 to 10 [=not much compared to the side effects]. Side effects and risks are many: chronic constipation, sedation and somnolence, a worsening of mood, opioid-induced hyperalgesia (a paradoxical phenomenon in which pain medications actually increase pain), hypogonadism (impaired endocrine function) and addiction [sic]. Recent studies also suggest an adverse effect on immune function.

Colin concludes that the guiding principle learned in medical school “First do no harm” is easy to understand but as a doctor saying to your patient “There is nothing more I can offer you” is very hard.

Feel free to tell me of your experiences in comments below..