BALANCING ACT

As COVID-19 rapidly spread around the world, many of us looked for quick fixes to boost our immune systems. But now, new research suggests that we should be aiming to balance, not boost, our immune systems. Immune health should also be part of our long-term healthy lifestyle goals.

There’s nothing like a deadly global pandemic to change the way people think about their body’s defence to the virus – the immune system. In fact, in 2020, when COVID-19 hit the world, immunity became an almost overnight obsession. Understandably, as case numbers increased, we all wanted to boost our immune systems.

The wellness industry responded to this growing demand – immuneboosting foods, supplements and therapies flooded the market. The pivot to focus on immunity was swift, with Instagram posts labelled #immunebooster growing 46 per cent in the weeks following the official start of the pandemic.

But while reaching for a quick fix might have provided some comfort at a time when many of us were worried about the virus, a year on, many experts are urging us to think more broadly about immune health. The common theme is that, rather than boosting our immune systems, immuno-stabilisation or immunobalance should be the goal.

“Immuno-stabilisation means achieving an immune system that works properly,” says Dr Vincent Candrawinata, a health and nutrition researcher. “If this is the case, it is in the most optimised state to protect our body. It’s like cruise control in a Tesla.”

A big misconception about the immune system is that it can be cranked up. But, if the purpose of the immune system is to fight off infection, then why is a ‘hyper’ immune system a bad thing?

“An immune system that overreacts can’t tell the difference between your healthy, normal cells and invaders, which can lead to many autoimmune disorders,” says Dr Candrawinata. “Think of it like your body is having a military coup.”

In other words, having a supercharged immune system could cause the body to attack itself. The pandemic has shown us how dangerous it can be to have an over-boosted immune system: COVID-19 patients who show a particularly robust immune response to the virus often end up in intensive care. When the immune system overreacts, it causes a ‘cytokine storm’. Cytokines are proteins that can trigger an aggressive inflammatory response. Not only does this response attack the virus, it also attacks cells in vital organs and blood vessels – it can lead to organ failure and sometimes death – which shows how illogical the concept of immune boosting is.

BEWARE OF THE JARGON

The downside of the wellness industry’s push for immune boosting solutions is that it can give consumers a false sense of security. This is something that troubled researchers at the University of Alberta, prompting them to investigate the way that misleading information is promoted. They found that the immune-boosting trend on Instagram promotes misleading information about immunity and advances products and services of no proven immunological benefit. “In the case of ‘immune boosting’ in the time of COVID-19, social media is promoting science-free content for commercial ends,” says the paper, published in the journal Allergy, Asthma & Clinical Immunology.

A different study published in the BMJ found that among 227 webpages from Google searches of ‘boost immunity’ and ‘coronavirus’ in Canada and the US, less than 10 per cent provided any critique of the concept of immune boosting. “The spread of misinformation is complex and often more subtle than blatant fraudulent claims,” it concluded.

Given the sheer volume of misinformation out there, how can consumers better understand the difference between evidence-based advice and biomedical jargon?

It’s a topic that frustrates nutritionist Melanie Sinclair. “Always be sceptical of a quick fix, our bodies keep score,” she says.

A GLOBAL PRIORITY

The good news is that immunostabilisation or immune balance has been identified as a key health trend for 2021. The Future of Wellness report, produced after the Global Wellness Summit, notes that COVID-19 has elevated awareness of immune health and caused a ‘profound mindset shake-up’ about its importance. “The goal of this trend is to lay out the evidence for what needs to matter more if we actually want to make a difference in the world’s immune health,” the report says.

In addition to this observation, there is agreement that COVID-19 will not be the last killer virus that the world has to grapple with. The World Health Organization has warned that the world “must prepare for even deadlier pandemics”.

“This pandemic has been very severe. It has affected every corner of this planet. But this is not necessarily the big one,” said WHO emergencies chief Mike Ryan at the global health agency’s virtual media briefing in December 2020.

He added that the coronavirus should serve as a “wake-up call”.

In terms of immune balance though, perhaps the wake-up call needs to be that immune health must be considered as part of a long-term healthy lifestyle. “The immune system works well only if your body is healthy,” notes Dr Candrawinata.

“The immune system is a system, not a single organ. To function well, it requires balance so that it can work in harmony to provide us with the best protection,” he adds.

IMMUNE-BALANCING TRENDS

Over the past decade we’ve seen the practice of intermittent fasting go mainstream. Much of the focus has been on weight loss and weight maintenance, but a new focus is the benefit of fasting on immune health. We’ve known about the benefits of fasting since a groundbreaking 2014 study in the journal Cell Stem Cell

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concluded that fasting for three days can ‘reset’ your immune system. The research, conducted on both mice and humans, found that fasting lowered white blood cell counts, which in turn triggered the immune system to start producing new white blood cells.

In 2020, the same researchers, Rafael de Cabo and Mark Mattson, published a new paper in the New England Journal of Medicine. After reviewing multiple fasting strategies, they found that intermittent fasting (also known as ‘time-restricted feeding’) might work in the same way – essentially flipping the switch on immune system regeneration.

There is a lot of interest in the immunity benefits of intermittent fasting. Professor Valter Longo, director of the USC Longevity Institute, is currently researching whether fasting can make a virus less infectious and whether it could impact the effectiveness of the flu and COVID-19 vaccines.

Speaking to the University of Southern California, Longo noted that early findings indicate that fasting could provide mice with more resistance to viral infection itself.

“We want to see if certain dietary interventions can make a virus less infectious or cause fewer negative effects,” he said.

The weight loss associated with intermittent fasting could also impact immune health. Dr Clare Wall, Academic Director at the School of Medical Sciences, University of Auckland, says that changes in body weight resulting from fasting can have positive influences on immunity.

“Obesity and metabolic syndrome can reduce the body’s ability to fight pathogens,” she says. “These conditions alter some of the ways that our bodies respond to pathogens and the coordination of the innate and adaptive immune response.”

Another trend is cold therapy and breath work – something Wim Hof, a extreme athlete known for breaking records related to cold exposure (hence his nickname ‘The Iceman’), has been teaching for years. “The Wim Hof Method is the first method in medical history to have proven we are able to influence our autonomic nervous system and immune system,” says Hof. “Science has shown cold exposure boosts the immune system. It reduces inflammation, which is the cause of nearly all diseases, and also increases your white blood cell count (the ‘soldiers’ of your immune system), while giving you a boost of happy hormones.” A 2020 study investigating the Wim Hof Method published in the journal Metabolites found that the method causes a shift in metabolism, which partly contributes to an anti-inflammatory response.

And in 2014, a study published in the journal PNAS found that Wim Hof practitioners were able to control their sympathetic nervous system and immune response. This suggests that the Wim Hof Method could be an effective tool to battle symptoms of various autoimmune diseases. While the Wim Hof Method isn’t new, the trend has gathered momentum and is becoming much more mainstream.

THE MICROBIOME

It’s a well-established fact that about 70 per cent of the immune system is housed in the gut – so making the link between the microbiome and the immune system is crucial.

“The microbes that live in the gastrointestinal tract play a key role in regulating the immune system by sending signals which prime systemic immune and inflammatory responses,” says Sinclair.

“The microbiome and immune cells are continually working together in this complex system with the same aim; to keep the host (or the individual) healthy.”

A new 2021 study published in the BMJ shows just how vital the link between our immune system and our gut health is. Researchers looking at COVID-19 wanted to know whether the gut microbiome might also affect the immune system response to the virus. They discovered that the gut microorganisms of COVID-19 patients lacked the good bacteria found in uninfected people. On top of this, they found that the microbiome disruption lasted long after they had recovered from COVID-19.

Given the vital role of the gut microbiome, what can we do to prioritise gut health? Sinclair notes that a lot of it comes down to a balanced diet.

“When we eat plant foods such as vegetables, fruit, wholegrains, nuts and seeds, the undigested fibres make their way down to the large bowel which is heavily populated with our beneficial microbes. These microbes ‘feed’ off the fibre now deemed as ‘prebiotics’, consequently supporting a healthy ecosystem.”

“THE MORE REAL, WHOLE PLANT FOODS YOU EAT, THE BETTER.” DR CLARE WALL

And of course, probiotics play an important role, too.

“Probiotics are the actual live microbes that live in the gut and interact with the immune system, and when administered in adequate amounts can provide a health benefit for the host,” says Sinclair. “They are also are found in fermented foods and supplements. We need a balance of both for a healthy microbiome”.

METABOLIC HEALTH

There is another important system that impacts immune balance – metabolic health. “There is a strong connection between our metabolic health and our immune system. One plays a huge role in another and vice versa,” says Dr Candrawinata.

Essentially, Dr Candrawinata notes, our cellular metabolic functions determine the effectiveness of our immune system. “It has a lot to do with all the signalling in our body. Good nutrients, less pollutants in our body such as smoking or alcohol and junk food, adequate sleep and exercising are all factors that contribute to healthy metabolic functions,” he says.

Dr Wall adds that obesity and the metabolic syndrome can reduce the body’s ability to fight pathogens. “These conditions alter some of the ways that our bodies respond to pathogens and the coordination of the innate and adaptive immune response. Weight loss and the loss of adiposity improves immune function.”

SIMPLE STEPS

What can we do on a day-to-day basis to improve the balance of our immune system? Dr Wall says that as well as maintaining a healthy weight, taking regular exercise and getting enough sleep, it’s vital to eat well. “The best evidence we have for maintaining a healthy immune system is eating plenty of vegetables and fruit and minimising the amount of ultra-processed food,” she says.

Sinclair says the best approach is to keep it simple. “The more real, whole plant foods you eat (foods that don’t come with labels) the [better] health outcomes you will have.”