Physical activity and nutrition guidelines to help with the fight against COVID-19

ABSTRACT

As the world is witnessing the epidemic of coronavirus disease 2019, emerging genetics and clinical pieces of evidence suggest a similar immunopathology to those of severe acute respiratory syndrome and Middle East respiratory syndrome. Staying at home to prevent the spread of the virus and consequently being largely inactive is associated with unintended consequences. These can actually enhance the infection risk and exacerbate poor health conditions including impaired immune function. Physical activity is a feasible way of improving health, particularly physical and mental health in a time of social isolation. However, people with certain health conditions in these circumstances may need a special physical activity programme in addition to any exercise they may already be performing via online programmes. This review aims to provide practical guidelines during the COVID-19 quarantine period. We suggest performing aerobic, resistance training, respiratory muscle training and yoga in the healthy, and in those with upper respiratory tract illness, patients with lower respiratory tract illness should be restricted to respiratory muscle training and yoga. In addition, vitamins D and C, omega-3 fatty acids, and regular consumption of fruit and vegetables might be considered as nutritional aids to support the immune system in those affected by COVID-19.     

Physical activity lowers the risk for acute respiratory infections: Time for recognition

Physical inactivity is a well-established risk factor for chronic diseases, such as cardiovascular disease, cancer, and diabetes mellitus. There is a growing awareness that physical inactivity should also be regarded as a risk factor for acute respiratory infections (ARIs). ARIs, such as the common cold, influenza, pneumonia, and coronavirus disease 2019 (COVID-19), are among the most pervasive diseases on earth and cause widespread morbidity and mortality. Evidence in support of the linkage between ARIs and physical inactivity has been strengthened during the COVID-19 pandemic because of increased scientific scrutiny. Large-scale studies have consistently reported that the risk for severe COVID-19 outcomes is elevated in cohorts with low physical activity and/or physical fitness, even after adjusting for other risk factors. The lowered risk for severe COVID-19 and other ARIs in physically active groups is attributed to exercise-induced immunoprotective effects, including enhanced surveillance of key immune cells and reduced chronic inflammation. Scientific consensus groups, including those who submitted the Physical Activity Guidelines for Americans, have not yet given this area of research the respect that is due. It is time to add “reduced risk for ARIs” to the “Exercise is Medicine” list of physical activity-related health benefits.     

COVID-19: Insights into long-term manifestations and lockdown impacts

Coronaviruses are pathogens thought to primarily affect the respiratory tracts of humans. The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 2019 was also marked mainly by its symptoms of respiratory illness, which were named coronavirus disease 2019 (COVID-19). Since its initial discovery, many other symptoms have been linked to acute SARS-CoV-2 infections as well as to the long-term outcomes of COVID-19 patients. Among these symptoms are different categories of cardiovascular diseases (CVDs), which continue to be the main cause of death worldwide. The World Health Organization estimates that 17.9 million people die from CVDs each year, accounting for ∼32% of all deaths globally. Physical inactivity is one of the most important behavioral risk factors for CVDs. The COVID-19 pandemic has affected CVDs as well as the physical activity in different ways. Here, we provide an overview of the current status as well as future challenges and possible solutions.     

太极拳对老年人身心健康影响的研究进展

大量研究表明老年人更易患新型冠状病毒肺炎(COVID-19)在内的呼吸道传染病,新型冠状病毒的爆发对老年人的心理和生理都造成了严重的损害。太极拳刚柔并济,具有独特的呼吸和动作节奏,对老年人的心理、生理健康都有积极的促进作用,相关研究分散于文献中。文章总结分析了太极拳对老年人心理、生理健康的影响及其机制并提供了相应的太极拳练习方式以供老年人练习时参考,为疫情常态化防控状态下老年人的健康促进提供借鉴。     

Physical activity and its relationship with COVID-19 cases and deaths: Analysis of U.S. counties

PurposeThe study was to examine county-level associations of physical activity with coronavirus disease 2019 (COVID-19) cases and deaths, per 100,000 county residents.MethodsData were collected from publicly available data sources for 3142 counties and equivalents, including the District of Columbia. Subjective health ratings, percentage uninsured, percentage unemployed, median household income, percentage female residents, percentage White residents, percentage of residents 65 years of age or older, and rural designation served as controls.ResultsThe two-level random intercept regression showed that physical activity rates at the county level were statistically and negatively associated with COVID-19 cases and deaths. Additional analyses showed that physical activity rates moderated the relationship between cases and deaths, such that the relationship was strongest when physical activity rates were low.ConclusionThe results presented here offer empirical evidence of the benefits of county-level physical activity during a pandemic. Implications for public health and physical activity provision are discussed.     

No independent associations between physical activity and clinical outcomes among hospitalized patients with moderate to severe COVID-19

BackgroundRegular physical activity (PA) has been postulated to improve, or at least maintain, immunity across the life span. However, the link between physical (in)activity and coronavirus disease 2019 (COVID-19) remains to be established. This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19.MethodsHospitalized patients with COVID-19 (mean age: 54.9 years) were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo (a quaternary referral teaching hospital) and from Ibirapuera Field Hospital, both located in Sao Paulo, Brazil. PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity. The primary outcome was hospital length of stay. The secondary outcomes were mortality, admission to the intensive care unit (ICU), and mechanical ventilation requirement.ResultsThe median hospital length of stay was 7.0 ± 4.0 days, median ± IQR; 3.3% of patients died, 13.8% were admitted to the ICU, and 8.6% required mechanical ventilation. Adjusted linear regression models showed that PA indices were not associated with hospital length of stay (work index: β = –0.57 (95% confidence interval (95%CI): –1.80 to 0.65), p = 0.355; sport index: β = 0.43 (95%CI: –0.94 to 1.80), p = 0.536; leisure-time index: β = 1.18 (95%CI: –0.22 to 2.59), p = 0.099; and total activity index: β = 0.20 (95%CI: –0.48 to 0.87), p = 0.563). None of the PA indices were associated with mortality, admission to the ICU, or mechanical ventilation requirement (all p > 0.050).ConclusionAmong hospitalized patients with COVID-19, PA did not independently associate with hospital length of stay or any other clinically relevant outcomes. These findings should be interpreted as meaning that, among already hospitalized patients with more severe forms of COVID-19, being active is a potential protective factor likely outweighed by a cluster of comorbidities (e.g., type 2 diabetes, hypertension, weight excess) and older age, suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease.     

运动性免疫抑制形成的可能负反馈机制及缓解措施的研究进展

目前新型冠状病毒肺炎疫情形势严峻,其传染性极强,能够通过飞沫、接触等途径迅速传播。在此背景下,增强机体免疫系统功能尤为重要。长时间或大强度运动锻炼能够造成运动性免疫抑制,使机体在运动后免疫系统功能大幅下降。因此,缓解或避免运动后的免疫抑制对于防控新冠肺炎疫情具有重要意义。通过分析相关文献,对运动性免疫抑制形成的可能负反馈机制及缓解措施进行综述。研究结果:1)总体而言,中等强度运动能够增强免疫系统功能,且运动性免疫抑制出现的临界强度约为60%V.O2_max强度,而长时间大强度运动能够抑制免疫系统功能。2)运动性免疫抑制形成的负反馈机制包括TCR-P38负反馈机制、MAPK-DUSP负反馈机制、干扰素-STAT1负反馈机制、Foxp3-IL2负反馈机制、低血糖环境-Tregs负反馈机制和CTLA-4-T细胞负反馈机制等。3)缓解运动性免疫抑制值得研究的分子靶点包括DUSP、STAT1、Foxp3、CTLA-4等,且此类分子易受运动、睡眠、饮食等生活行为调节。研究结论:1)运动性免疫抑制的形成可能与免疫系统负反馈调节机制有关;2)除避免长时间大强度运动以外,提高睡眠质量、合理饮食亦能够提高免疫系统功能。     

基于知识图谱的国外身体锻炼与新冠肺炎的相关研究进展分析

该文以SCI、SSCI和A&HCI所收录的国外关于身体锻炼与COVID-19的454篇文献为研究对象,引入CiteSpaceⅤ可视化分析工具,探测国外关于身体锻炼与COVID-19的相关研究热点及主流观点。分析表明：现阶段国外关于身体锻炼与COVID-19的相关研究热点主要集中在身体锻炼与COVID-19的内在关联、身体锻炼适应性、身体锻炼实例等方面。针对处于后防疫时期的中国,提出如下对策：聚焦重点领域技术攻克,强化科技引领;研发多元运动处方库,提高锻炼效应;构建多维保障体系,强化风险防控;打造健康教育新格局,确保长远效应。     

Probiotics supplementation for athletes – Clinical and physiological effects

Abstract

Probiotic supplementation has traditionally focused on gut health. However, in recent years, the clinical applications of probiotics have broadened to allergic, metabolic, inflammatory, gastrointestinal and respiratory conditions. Gastrointestinal health is important for regulating adaptation to exercise and physical activity. Symptoms such as nausea, bloating, cramping, pain, diarrhoea and bleeding occur in some athletes, particularly during prolonged exhaustive events. Several studies conducted since 2006 examining probiotic supplementation in athletes or highly active individuals indicate modest clinical benefits in terms of reduced frequency, severity and/or duration of respiratory and gastrointestinal illness. The likely mechanisms of action for probiotics include direct interaction with the gut microbiota, interaction with the mucosal immune system and immune signalling to a variety of organs and systems. Practical issues to consider include medical and dietary screening of athletes, sourcing of recommended probiotics and formulations, dose–response requirements for different probiotic strains, storage, handling and transport of supplements and timing of supplementation in relation to travel and competition.     

新型冠状病毒肺炎疫情下学校体育的价值、使命与担当

新型冠状病毒肺炎疫情(下文简称:新冠肺炎疫情)下,如何应对疫情是学校体育面临的重大课题。研究认为,应对新冠肺炎疫情,学校体育具有重要价值:个体层面价值,是保障学生生命安全的物质基础;家庭层面价值,是激活家庭体育发展的重要力量;社会层面价值,是维系国民体质健康的重要基石;国家层面价值,是科学防控新冠疫情的辅助手段。学校体育要发挥特殊使命:重视生命安全价值,为生命安全护航;立足健康本位价值,为全民健康助力;延展医疗辅助价值,为体医融合赋能。学校体育要积极践行担当:完善在线教学模式,提升学生居家体育学习质量;开发疫情体育课程,实行疫情体育长期教育机制;发挥体育教师力量,助力推动国民体质健康促进;发挥体育科研优势,服务国家科学防控疫情需求。     

中老年女性肥胖的危害及防治

肥胖不但影响着人们的生活质量,而且还与许多慢性疾病密切相关。人口的老龄化带来了一系列的社会问题,其中中老年女性肥胖人数日趋增高逐渐成为严重的公共健康问题。通过文献资料法对中老年女性肥胖危害进行了阐述,并有针对性的提出了防治对策,以期提高其的生活质量。     

Projecting the impact of the coronavirus disease-2019 pandemic on childhood obesity in the United States: A microsimulation model

PurposeThe coronavirus disease-2019 (COVID-19) pandemic in the United States led to nationwide stay-at-home orders and school closures. Declines in energy expenditure resulting from canceled physical education classes and reduced physical activity may elevate childhood obesity risk. This study estimated the impact of COVID-19 on childhood obesity.MethodsA microsimulation model simulated the trajectory of a nationally representative kindergarten cohort's body mass index z-scores and childhood obesity prevalence from April 2020 to March 2021 under the control scenario without COVID-19 and under the 4 alternative scenarios with COVID-19—Scenario 1: 2-month nationwide school closure in April and May 2020; Scenario 2: Scenario 1 followed by a 10% reduction in daily physical activity in the summer from June to August; Scenario 3: Scenario 2 followed by 2-month school closure in September and October; and Scenario 4: Scenario 3 followed by an additional 2-month school closure in November and December.ResultsRelative to the control scenario without COVID-19, Scenarios 1, 2, 3, and 4 were associated with an increase in the mean body mass index z-scores by 0.056 (95% confidence interval (95%CI): 0.055–0.056), 0.084 (95%CI: 0.084–0.085), 0.141 (95%CI: 0.140–0.142), and 0.198 (95%CI: 0.197–0.199), respectively, and an increase in childhood obesity prevalence by 0.640 (95%CI: 0.515–0.765), 0.972 (95%CI: 0.819–1.126), 1.676 (95%CI: 1.475–1.877), and 2.373 (95%CI: 2.135–2.612) percentage points, respectively. Compared to girls and non-Hispanic whites and Asians, the impact of COVID-19 on childhood obesity was modestly larger among boys and non-Hispanic blacks and Hispanics, respectively.ConclusionPublic health interventions are urgently called to promote an active lifestyle and engagement in physical activity among children to mitigate the adverse impact of COVID-19 on unhealthy weight gains and childhood obesity.     

特殊人群的运动、感染风险和免疫机能

有关运动与免疫的研究,大都集中在研究运动对普通人群和运动员上呼吸道感染的影响以及免疫机能的影响,这些研究的大部分案例都是针对年轻人和健康人群的。那么,运动免疫学领域还很大,尤其是对那些疾病、亚健康和特殊年龄段的人群的研究仍是相对薄弱的地方。对特殊人群(HIV感染人群、老年人、儿童、肥胖和糖尿病)的运动、感染风险和免疫机能进行综述。     

体医融合视阈下体育助力疫情防控的价值意蕴与实然路径

在抗击新冠肺炎疫情的关键时刻,厘清疫情防控、体育助力、健康中国行动三者内在的逻辑机理,重点对体育在疫情防控中的功能价值进行梳理与分析,结合运动促进健康的治理效能,提出构建健康中国建设的体医融合治理方案。研究表明,体育健身价值是助力全民体质健康的必由之路,体育文化功能是促进全民健康素养提升的现实使然,体育场馆服务功能是创新方舱医院建设的应然之举,体育经济价值是打赢疫情防控阻击战的强大支撑。体育助力疫情防控的实然路径体现在:优化慢性病防治与健康促进的体医深度融合路径;健康知识普及行动纳入到社会生态模型中构建和推广;创新建成环境与健康环境的有机耦合模式;扩宽全民健身战略内涵,引领体育产业高质量发展。在坚持"以人民为中心"的发展理念下,迫切需要建立稳健可持续的体医融合运行机制。体医深度融合是搭建运动促进健康服务治理体系形成的有效进路。     

The BASES expert statement on exercise therapy for people with chronic kidney disease

Chronic kidney disease (CKD) is becoming a serious health problem throughout the world and is one of the most potent known risk factors for cardiovascular disease, which is the leading cause of morbidity and mortality in this patient population. Physical inactivity has emerged as a significant and independent risk factor for accelerated deterioration of kidney function, physical function, cardiovascular function and quality of life in people in all stages of CKD. CKD specific research evidence, combined with the strong evidence on the multiple health benefits of regular and adequate amounts of PA in other cardiometabolic conditions, has resulted in physical inactivity being identified by national and international CKD clinical practice guidelines as one of the multiple risk factors that require simultaneous and early intervention for optimum prevention/management of CKD. Despite this realisation, physical inactivity is not systematically addressed by renal care teams. The purpose of this expert statement is therefore to inform exercise and renal care specialists about the clinical value of exercise therapy in CKD, as well as to provide some practical recommendations on how to more effectively translate the existing evidence into effective clinical practice.     

Exercise immunology: Future directions

Several decades of research in the area of exercise immunology have shown that the immune system is highly responsive to acute and chronic exercise training. Moderate exercise bouts enhance immunosurveillance and when repeated over time mediate multiple health benefits. Most of the studies prior to 2010 relied on a few targeted outcomes related to immune function. During the past decade, technologic advances have created opportunities for a multi-omics and systems biology approach to exercise immunology. This article provides an overview of metabolomics, lipidomics, and proteomics as they pertain to exercise immunology, with a focus on immunometabolism. This review also summarizes how the composition and diversity of the gut microbiota can be influenced by exercise, with applications to human health and immunity. Exercise-induced improvements in immune function may play a critical role in countering immunosenescence and the development of chronic diseases, and emerging omics technologies will more clearly define the underlying mechanisms. This review summarizes what is currently known regarding a multi-omics approach to exercise immunology and provides future directions for investigators.     

新冠肺炎疫情下我国体育旅游产业困境应对与高质量发展前瞻

新冠肺炎疫情对我国体育旅游产业造成严重冲击。站在推动体育产业高质量发展的角度,在分析新冠肺炎疫情对我国体育旅游产业影响的基础上,提出体育旅游行业的应对之策,洞察后疫情时代我国体育旅游产业的发展趋势。研究认为:疫情在检验体育旅游行业免疫力的同时,亦在重塑人们对运动增强免疫力在抗"疫"中关乎健康和生命质量的深刻认知,并由此触发体育旅游消费新升级,引致体育旅游行业蝶变。后疫情时代,体育旅游线上线下融合发展、智慧基因植入、健康生态内核深度表达、精众品牌塑造、危机管理体系构建、产业深度融合、区域一体化加速推进等一系列措施都将为体育旅游产业高质量的复苏和振兴注入强劲动能。     

6周有氧运动改善不同程度肥胖青少年体质健康的研究

目的:研究有氧运动对不同程度肥胖青少年形态、机能、糖脂代谢及身体素质的影响,探索非医疗运动手段治疗青少年肥胖的可行性方法。方法:招募50名13~19岁肥胖青少年,依据BMI值分别纳入中度或重度肥胖组,每组25人。两组受试者进行6周有氧运动(5days/week,50min/day),在运动前、运动3周和6周后分别测试受试者的身体形态、基础生理机能、糖脂代谢和身体素质等指标,并对以上数据进行统计学分析。结果:3周和6周运动均显著降低两肥胖组的体重、BMI、腰围、臀围、脂肪量、体脂率、血脂、甘油三酷、血清胰岛素水平和胰岛素抵抗指数(P＜0.05或P＜0.01),下调重度肥胖组的低密度脂蛋白水平(P＜ 0.01),提高两组肺活量、肺活量指数和50 m跑、俯卧撑、坐位体前屈成绩(P＜ 0.05);6周运动还能进一步提高两组的1 000 m跑、平衡能力以及重度肥胖组的瘦体重和高密度脂蛋白水平(P＜0.05或P＜0.01),下调两组的基础代谢率(P＜0.05)。结论:3周有氧运动就能有效改善肥胖青少年的体质健康,运动改善体质健康的效应呈时间依赖性增加的模式,并且重度肥胖者相比中度肥胖者对有氧运动更加敏感。     

Canadian children's and youth's adherence to the 24-h movement guidelines during the COVID-19 pandemic: A decision tree analysis

PurposeThe purpose of this study was to use decision tree modeling to generate profiles of children and youth who were more and less likely to meet the Canadian 24-h movement guidelines during the coronavirus disease-2019 (COVID-19) outbreak.MethodsData for this study were from a nationally representative sample of 1472 Canadian parents (Mean_age = 45.12, SD = 7.55) of children (5–11 years old) or youth (12–17 years old). Data were collected in April 2020 via an online survey. Survey items assessed demographic, behavioral, social, micro-environmental, and macro-environmental characteristics. Four decision trees of adherence and non-adherence to all movement recommendations combined and each individual movement recommendation (physical activity (PA), screen time, and sleep) were generated.ResultsResults revealed specific combinations of adherence and non-adherence characteristics. Characteristics associated with adherence to the recommendation(s) included high parental perceived capability to restrict screen time, annual household income of ≥ CAD 100,000, increases in children's and youth's outdoor PA/sport since the COVID-19 outbreak began, being a boy, having parents younger than 43 years old, and small increases in children's and youth's sleep duration since the COVID-19 outbreak began. Characteristics associated with non-adherence to the recommendation(s) included low parental perceived capability to restrict screen time, youth aged 12–17 years, decreases in children's and youth's outdoor PA/sport since the COVID-19 outbreak began, primary residences located in all provinces except Quebec, low parental perceived capability to support children's and youth's sleep and PA, and annual household income of ≤ CAD 99,999.ConclusionOur results show that specific characteristics interact to contribute to (non)adherence to the movement behavior recommendations. Results highlight the importance of targeting parents’ perceived capability for the promotion of children's and youth's movement behaviors during challenging times of the COVID-19 pandemic, paying particular attention to enhancing parental perceived capability to restrict screen time.     

Physical fitness before and during the COVID-19 pandemic: Results of annual national physical fitness surveillance among 16,647,699 Japanese children and adolescents between 2013 and 2021

BackgroundLimited nationally representative evidence is available on temporal trends in physical fitness (PF) for children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic. The primary aim was to examine the temporal trends in PF for Japanese children and adolescents before and during the COVID-19 pandemic. The secondary aim was to estimate the concurrent trends in body size (measured as body mass and height) and movement behaviors (exercise, screen, and sleep time).MethodsCensus PF data for children in Grade 5 (aged 10–11 years) and adolescents in Grade 8 (aged 13–14 years) were obtained for the years 2013–2021 from the National Survey of Physical Fitness, Athletic Performance, and Exercise Habits in Japan (n = 16,647,699). PF and body size were objectively measured, and movement behaviors were self-reported. Using sample-weighted linear regression, temporal trends in mean PF were calculated before the pandemic (2013–2019) and during the pandemic (2019–2021) with adjustments for age, sex, body size, and exercise time.ResultsWhen adjusted for age, sex, body size, and exercise time, there were significant declines in PF during the pandemic, with the largest declines observed in 20-m shuttle run (standardized (Cohen's) effect size (ES) = −0.109 per annum (p.a.)) and sit-ups performance (ES = −0.133 p.a.). The magnitude of the declines in 20-m shuttle run and sit-ups performances were 18- and 15-fold larger, respectively, than the improvements seen before the pandemic (2013–2019), after adjusting for age, sex, body size, and exercise time. During the pandemic, both body mass and screen time significantly increased, and exercise time decreased.ConclusionDeclines in 20-m shuttle run and sit-ups performances suggest corresponding declines in population health during the COVID-19 pandemic.