Just As Well, The Women's Health Podcast - An Immunologist On The Science Of Staying Well

Episode Date: April 1, 2020

Regular listeners will know that we normally focus on helping you reach a health or wellness goal. But these aren’t normal times. The novel coronavirus, or Covid-19, is now a global pandemic, and in the UK, we’re facing what the Prime Minister has declared ‘the worst public health crisis for a generation’. Right now, all we - like you - want to know, is how to stay as physically and mentally well as possible, and how we can minimise the risk of causing harm to others. So, that’s exactly what we’ll be aiming to find out over the next few episodes, where we’ll be putting your coronavirus questions to scientists, healthcare professionals and fitness experts. In this episode, Senior Editor Roisín Dervish-O’Kane chats to Dr Jenna Macciochi, a lecturer in immunology at the University of Sussex and author of new book Immunity: The Science Of Staying Well. Join Women’s Health on Instagram: @womenshealthuk Join Roisín Dervish-O’Kane on Instagram: @roisin.dervishokane Join Dr Jenna Macciochi on Instagram: @dr_jenna_macciochi Topics:  Why is there so much misinformation around Covid-19? Can ‘boosting your immunity’ protect you from the virus?  Should you forgo alcohol during lockdown? Why is resistance training so good for your immune system? Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

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on Paramount Plus. Hi, everyone. You're listening to Going for Goal, the Women's Health podcast with me, Roshine Devshayne. As you might be able to tell, I sound a little different today, and that's because probably like many of you,

I am working from my living room. So we do apologize for the less than ideal sound quality. Regular listeners will know that we normally focus on how you can hit a health or wellness goal. But these are not normal times. So we're doing things a little bit different. we are putting your questions about how coronavirus affects you to a range of scientists, healthcare professionals and fitness experts.

Today it's Dr Jenna Machoki, a lecturer in immunology at the University of Sussex, and author of the book, Immunity, The Science is Staying Well. Welcome, Jenna. Hi, Christine. Thank you for having me. Great to have you on. It must be really interesting for you over the past few weeks. the immune system and how it works has really been thrust into the spotlight. It is suddenly, immunity's got a place at the table and everybody's sort of the day-to-day conversation, which I've never known it to be the case before in all of the sort of 20 or years

I've been working in this field. But yeah, it's difficult times, it's challenging times. And yeah, there are a better time to start thinking of your immunity. Yeah, absolutely. And is it the case then that when something is suddenly, trust into the sky and everyone's talking about it, that sometimes the understanding and the facts can get a bit lost. Yeah, I mean, my phone hasn't stopped really at the moment because there's a lot of call for information, but at the same time, I've seen growing amounts of misinformation

and, you know, all sorts of snake oils coming out sold as being a way to make yourself invincible from this virus. It's quite sad, really, that this is a time where these opportunists come out. And also, I think, on the other side of it, people are desperate. You know, there's so much uncertainty that we grapple with every day and that can be quite anxiety-inducing, that we look for something that we can cling on to that gives us a sense of agency, a sense that we do have control in what feels like an uncontrollable situation.

So people obviously take on board the government advice, they're looking for the extra things that they can do on top and there you get really into muddy waters, I think. Am I right in thinking there is no one thing, there is no one tincture or food or practice that is going to keep you safe from this virus? Yeah, exactly. There's no way to make yourself invincible. If you come into contact with somebody who's infected and you inhale some particles or somehow that gets into your body, then no matter what health regime and supplements you've been taking, there's an extremely high chance that you will then catch the infection too. So we can't sort of build a wall of invincibility around us through supplementing. But that's not to say that we cannot also take care of ourselves generally

to give us the best chance if we do get sick with this virus or with anything. Okay. Is the, am I right in thinking the ultimate goal then is for that scientists will find a vaccination, Yes, I mean even today, as we're recording, I think, is the first in human vaccine trial is starting. The challenge with vaccines is it could be very straightforward to technically make a vaccine, but to make a vaccine that is safe and we know give long-lasting protection and has little side effects can take quite like a lot of time. So I don't know if we'll see a vaccine anytime soon.

Chances are that most of us will come. contract the virus because it's so transmissible and there's been a lot of travel and people interacting. But what we need to do now is to slow that curve so we don't have a huge peak of people contracting it and perhaps then a subset of them experiencing the very severe issues that would lead to hospital care and may overwhelms our NHS. Sure. So that was, yeah, that was one question that people were intrigued to know about on our Instagram is what is the eventual goal. Another thing that people wanted to know was,

can we make ourselves strong to fight the virus? Or is that a bit too simplistic? Yeah, I mean, as I always say, the immune system is probably the most complex system in the body. I would urge people not to think of it as a binary on and off switch, but more like our whole series of switches, some that fight infection and some that resolve and bring a sense of calm and clear up any damage that could have been caused by the infection.

So you kind of have these two arms. Needless to say, if you are, we're talking about healthy adults here, if you're sort of with no underlying health conditions, there are small things you can do to make sure your immune system functions at its best. But I have to caveat that by saying that we are all immunologically unique. There's a really unique process that goes on with your immunity genes. that means that they're even more diverse than those that you've inherited from your parents

through a very special mechanism that I won't go into. And this is a key design of the immune system because, I mean, you might have found that you've got sick once upon a time and other people around you have got sick with that same infection, but you've all fared differently with that. Some people have got it very mildly,

some people have got it quite badly. And there's a reason behind that because if we all responded to an infection the same way, then we would die out as a species if some really severe bug came along. It would wipe us all out. So you always have an inherent diversity in your immune system within a healthy population. So not everyone will respond the same to any given infection.

And that's a deliberate thing on the part of the immune system to make sure we haven't died out. So there is that. But you could be doing everything right and you could still get very sick is what I'm trying to say. But, you know, there are the sort of basics that we can all be. nailing. I don't think right now is a time for extreme changes to your health and well-being routines because that can also upset anything in your body and require a bit of adjustment. So I'd urge people not to do anything extreme. But I think sleep is the bedrock of your immunity. Lots of calibration happens when you're sleeping that allows your immune system to be

working optimally. That's so interesting because we think when there's like all the amazing science has come out between the, about sleep and the brain, that actually better sleep improves your immunity? What's the mechanism behind how that works? Well, I think it's important to say we need enough sleep and enough good quality sleep, which is quite hard to find in today's modern world. There's lots of distractions and things that can keep us going. But if you think about it during the day is when humans are meant to be active, you're, you know, you're more likely to be in contact with people and in contact with germs. So your immune system's ready during the day

for those kind of challenges. During the night, you're sleeping, you're not likely to be in contact with so many germs. That gives your immune system the time to recalibrate, replenish, get itself ready for the day ahead, do lots of healing and repair. So we need kind of the day and night to balance all of the needs of your immune system

to keep it functioning at its best. And you also might notice that if you've ever been sick with, say, like a seasonal flu or something, you might feel exceptionally tired and you might feel socially withdrawn and you want to be at home and you want to sleep and you might not get very good quality sleep but you feel very lethargic and that's because the immune system when it's fighting an infection the chemical that produces act on our brain and tell our behaviour to change to give us the best possible chance to get well so it instructs our brain to be more sleeping and we don't want to go outside we don't want to go to work and do our normal things because that might impair our ability to get well. It also might increase our chance of spreading whatever infection we have. The brain and the immune system are really in close

communication all the time and this is this is called sickness behaviors so they're kind of the immune system instructing our brain to change how we how our bodies and minds are behaving. So right now if people are at home and as people may get this infection let yourself rest. Oh, definitely. I think that's probably something we're all guilty of not doing in the modern world. I think COVID-19 might be a little bit different, but previously I'm sure we've all gone to work when we've had colds. And we could really have been doing with just having one day off, getting lots of rest, letting ourselves recover. But instead, we trundle off to the pharmacy, take all the cold and flu meds that make us feel better by suppressing our symptoms, which is actually your immune system doing its job. And, you know, we continue on regardless because it, it and feels like there's not that chance to stop because life is busy and there's deadlines and those responsibilities and that kind of thing. Okay, so we've talked about sleep being important. What else say someone is working from home now, they are practicing social distancing,

what else is in their control? I'm thinking maybe, should we talk about nutrition? Yes, nutrition's a massive one. And what I would say is that people have to remember that, much of your immunity is built in childhood. So it's really dependent on your microbiome, the microbes that live in your gut, how this develops during childhood, which is influenced by a lot of things beyond our control, like where we're born, how we're born, what we're fed, how many times we had antibiotics,

you know, things that we can't control. And the health of your immune system in relation to diet is really a accumulation of how you eat regularly. So, again, some drastic dietary change today is not going to have a huge change on your immune system tomorrow. It's kind of, you know, eating well most of the time is giving yourself the best chance. Also, the immune system will only work at its best if it has no deficiencies in any of the essential nutrients like vitamins and minerals. So I think in Britain we should be supplementing the vitamin D in the winter because of the, there's less sunshine. Yeah, it's not to say that if we supplement with vitamins, it's going to make it work better than it already does at baseline if you don't have an overt deficiency. So think of it as, you know, some is good, but more is not always better.

Sure. I think we need to take care of our gut health and our gut microbiota. But again, that can be as good many things. Fiber is so essential. And when I say fiber, I mean, just a diversity of plant-based foods, not just thinking in fiber as being one thing. all the beans, pulses, fruits, vegetables, herbs, spices, everything, and going for as much colour and variety as possible. Again, if you do have a digestive issue,

it's not the time to suddenly embark on a dramatic change in your fibre intake because that could upset your digestion. I think there's some utility in taking an amygdra three supplement, especially as often people don't eat so much oily fish or through lifestyle choices like vegetarian or vegan. then they may not get adequate omega-3 oils. And I think then if you do have a particular food that you exclude or a food group that you exclude,

you really have to check that you have got the right supplements to take care of any potential deficiencies from that, like a B-12 if you were vegan, for example. And is that particularly smart to think about supplementing? I think the key thing is that, you know, if you do get sick, whether it be with corona or anything else, and your body is going to mount an inflammatory response. That is a type of oxidative stress on the body.

So it's good to have a diet that's rich in fruit and vegetables, which contain lots of antioxidants that can help take the edge off that. But it's not to say that we should be consuming lots of supplements because these may be in extremely high doses that actually would affect the immune system's ability to do its job properly. And it's interesting. It's such a complex system that, you know, it needs to be balanced correctly. It needs inflammation, but it also needs resolution.

There's also supplements that have been shown to improve the ability of immune cells to do their job, like echinacea. But in the case of COVID-19, do we know that that might actually lead to a worse situation? Because if your immune system is overly aggressive towards the virus, it would damage your delicate lung tissues even more in its quest to get rid of the virus. and that then could actually lead you with more severe a more severe disease. Really important that people err on the side of caution and don't go towards all these weird and wonderful immune boosting supplements that are touted. In fact, Brighton the Sussex Medical School at the University of Sussex where I worked did a study

a few months ago where they showed that the majority of Google searches for immune boosting came back with products and information that was based on wrong information. Basically, there was no evidence to support the majority of the claims that they found when they explored all these Google searches. So I know people are worried. I know they want to have some control over their health. I think the ones with the least risk are things like vitamin C, which our needs do go up when we're fighting an infection.

So again, it's not going to make you invincible. It's not going to stop you getting infected. but the immune system needs to increase quite dramatically when it's fighting in infection. So it can be a useful one to have in if people want to buy something. And zinc also is really important when the immune system is fighting an infection. But it's not a supplement that we should all be taking all the time. It can be problematic if you over-consume it for a long period of time. So again, always check an error on the side of caution.

Think of a food-first approach. Food is also packaged conveniently with cyber, which is one of the best immune-nourishing things I can think of in the diet. So I would always prioritize that. And then like you say, if you cannot get certain food items, then you might have to think about other safety net. You know what's better than the one big thing? Two big things.

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And you talked there early about inflammation. So we're thinking of what is in a good diet that people can have them at. Plenty of fruit and vegetables. Oily fish, if not possibly supplementing. And then so I'm guessing then is it true that people need to think about cutting back on inflammatory food? I'm thinking if someone is feeling the COVID symptoms. So I'm thinking things maybe like coffee, like alcohol, like sugar. Where do you stand on that?

Yeah, I mean, coffee I think it depends how much you're drinking. I certainly enjoy a coffee in the morning. It's one of the little luxuries that are left when you're going to be inside, doesn't it? Exactly. It doesn't seem to play such a huge role in the functioning of our immune system per se. but if you were over-consuming coffee and it was affecting your sleep, then indirectly that would affect your immune system. Alcohol, again, it's a sleep disruptor.

So I think now is not the time to be smashing two bottles of wine every night, but maybe enjoying a drink as part of a way to relax or unwinds, but probably avoid, you know, binge drinking or, you know, several big nights in a row. We also know that it can affect the ability of the immune system. cells to do their job properly and also the production of new immune cells. So we're always replacing old with new. So yeah, alcohol, maybe the odd glass of wine to relax, but not the time to really be going for it hard.

And then inflammatory food, I mean, I think it's very difficult to demonise foods like sugar. I think, you know, we also have to find a bit of joy in our diet, especially when times are hard and we've, you know, people might be disappointed because events have been cancelled. They can't see family. We need to have that joy. And I think food can be part of that. Food is community.

If you're self-isolating with friends or family and you're there together, then cooking meals together and enjoying food is a really nice thing to do. We do know that people with uncontrolled blood sugar, so diabetics, pre-diabetes, metabolic conditions, tend to fight infections worse. So, you know, we're thinking about those people who can't control their blood sugar as well or they have these huge excursions and blood sugar. And there's a lot of test tube studies that show that glucose and sugar can make immune cells maybe more aggressive in the inflammatory response.

But it's hard to say how this would work in a human because we're much more complex and we don't just eat sugar, we eat food and we eat that in the context of different meals. So probably don't be afraid of things like that. and I think if you do get sick, often our appetite is one of the first things to go when we have a fever. I don't know if anyone's ever experienced that, but you often lose your appetite when you have a fever, and this is supposed to be a safety mechanism by the immune system. It instructs their brain to not want to eat, to lose their appetite, and by not ingesting any food, there's less sort of fuel available for the immune system, and it almost helps with the off switch to switch inflammation off when it's finished doing its job.

and help with the clear-up and the resolution. So we have to think of fighting an infection as the inflammatory part, which is killing the infection, and then the resolution, which is just as important. It's actually a very active phase. It's not just a passive thing that happens once the germ has been eliminated. So we have to support this resolution part as well. And it's got to be a delicate balance,

and it's very hard to say how that will pan out in a given individual. That's so helpful. and it's really helping me understand it more as well. So basically, top lines of nutrition, eat as much fiber as possible, as much fruit and vegetables, drink as much as hydration is important too, right? Yeah, definitely. I mean, obviously we all need a certain level of hydration. But the other thing is that, you know, the barriers to our body,

such as the nasal tract, the respiratory tract and the gut, these are all covered with a layer of mucus. And this mucus is part of our immune system. And it's part of the defense of those delicate barriers to try and prevent things from breaking in there. And we know from other infections that being dehydrated can compromise these barriers and maybe make you more lightly to pick things up. As I say, we couldn't say for COVID-19 if this is the case, but for other things like colds and sluze, being dehydrated can make you a little more vulnerable. It's probably probably best to check with the NHS or just tune in without your feeling. When did you last have drink?

And what was that? Yeah. I think it's easy when you're south at home. You're almost out of your routine. Because when you're at work, I know I do, I have like a bottle and I'm like, right, okay, if I drink two of these per day, then that's fine. But I think sometimes it's all a bit adjusted when you're at home and you're in your living room. And so I guess it's keeping a tab on that. And that's really helpful to know about keeping your mucus strong. Not that that sounds like the most appealing goal, does it? Okay. Second back to nutrition. with inflammatory foods and alcohol and coffee and sugar moderation, but don't get too head up because doing one little thing isn't going to transform your outcome.

Yeah, and I just urge people to stay away from what I call the food prison where people get so worried about having a perfect diet that they're trying to eat perfectly, excluding lots of foods, and it's just really stressful. And stress is probably the biggest thing that's going to compromise your immune system. Like cortisol, the main stress hormone has a hugely dampening impact on our immunity and can leave people open to infections and lots of studies show this. So yeah, stress, although it's uncertain times, stay informed.

If you find you're getting sucked into reading too much and you're getting concerned, you know, just step away and go back to the main government websites, you know, with information that you can trust and follow the most up-to-date advice. So resting then sounds like it's pretty important from a biochemical perspective when it comes to your immunity as well as just a psychological one. Definitely. Although, you know, being active is really important for immune system too, but it's a delicate balance. So we know we need to be active. There's a theme.

There's a theme developing here. There's like ying and yang. Yeah, I like to talk about balancing everything. It's a delicate balancing act and it's not always one that we can obtain on our own. But being active throughout your day, getting your lymphatic system moving,

it helps with your immune cells performing their surveillance function, keeping a good level of muscle mass with resistance exercise, this is imperative because the gland in our bodies that produces our T cells, which are the master controllers of our immune system, this starts to decline from our 20s

and it's rejuvenated every time we are doing resistance training because our muscles produce a particular substance that helps keep it young. So we know we need to be doing resistance work, we need to have a good level of cardiovascular fitness, but doing extreme amounts of training, training like an athlete, and I know plenty of people who are not athletes, but they go to the gym like athletes, lots of high intensity interval training. This is actually suppressive for your immune system. And we know that athletes are much more vulnerable to picking up infections because of heavy

training loads, particularly if you're training, you ramp it up too quickly, or you don't give yourself adequate rest and recovery, or you're training, you know, fasted or low carb and doing really intense workouts, this leads you with a bit of an open window when your immune system suppressed, because the exercise is a stress similar to psychological stress and similar chemicals being produced. I mean, I love going to the gym as much as the next person when I've had to kind of rethink how I look at movement, and now, you know, I do a load of mobility stuff, which you can do at home. You can find great things on YouTube,

really gentle at-home workouts. It can also be relaxing if you are feeling quite stressed about work and what's happening in the world right now. So movement's important if you are self-isolating. If you have symptoms, listen to those symptoms, rest. You know, the reason that your brain is telling you that you probably don't feel like running around. But otherwise, you know, if you have a space in your home,

find something on YouTube, try something. you every little bit counts. If you're working from home, get up from your desk. You set a reminder every so often because it's more about doing your daily movement in all day long rather than being sedentary and then spending one hour running around like crazy and doing a gym class or something. Totally. I love that point. So it's about resistance training specifically is really important to your immune system. Okay. Is there anything else that you think people should be doing? any tips that you think people could really use right now?

I think that people really need to stay informed and updated with what's happening in the areas where they live with all the relevant websites and really, you know, take the message that we're all immunologically different by design. That's why we have case reports of, you know, healthy adults getting really ill with COVID-19. And then you have healthy adults with no sign symptoms at all, but testing positive. There's like a spectrum, if you imagine, a bell-shaped curve, we call it, where the majority will have these symptoms, but a small portion will have very severe symptoms and a small portion will have little-to-no symptoms.

And the problem with this virus that makes it different to others is that, you know, it's very transmissible. And because some people have very mild symptoms may not even have known that they were positive for this virus, they're going about their daily life and that's increasing the spread. and we need to take into account that a portion of our community are much more vulnerable than us, and we have a role to play in slowing that curve and taking part in that, as well as taking care of our own health. I think it's a real time that things don't happen for a reason,

but take a reason from why things are happening and do all those things that you've been meaning to do, but work has proved too important, and now it's time you're at home. You don't commute because everybody's been told to stay at home, cook some different food with all those unusual cans of beans and pulses that you have working at the back of your cupboard. Yeah. Use those cookbooks which have just... Exactly.

Untaps. I'm looking at mine now. Focus on the basics and don't look for the magic bullet because there isn't one, you know, and just know that you're doing the best, but even doing the best, you might still get sick and you might still have, you know, some experience a horrible illness. And I think that's the sad thing that, you know, often we look for these things to make us invincible and then we get ill anyway and we're like, but wait a minute, I was doing everything right and it can feel so frustrating. And, you know, it's much more complex than that.

So there's only so much you can do. And that is important. And that's important, not just for coronavirus, but that's important for longevity. And this is something I talk about in the book a lot about how to build strong immunity for life and whether all the ups and downs that come with it. I think modern life is busy and it's hard and this is a really good time to take stock and think, have I just been running 100 miles an hour and, you know, close to burnout? And now is maybe a time to realize that things should start to change.

So that's just to sum up then. That's basically good immunity is cumulative. But also that it's like it's not always that you will get back what you put in. Exactly. Yeah, we're complicated. And sometimes things work on paper. but, you know, they don't translate to what we see in the general population. Well, thank you so much, Dr. Machoki.

That's some really useful advice in there. And just a reminder that Jenna's book, Immunity, the science of staying well. Jenna, thank you so much for coming on the show. No problem. Thank you for having me. And thank you to all of you for listening. Before I go, it's important to note that this information is changing all the time. while we are attempting to keep our content as up to date as possible,

the situation surrounding the coronavirus pandemic continues to develop rapidly. So for any concerns and the latest advice, visit the World Health Organization. If you're in the UK, the NHS website can provide useful information and support. You can also check out the NHS-111 website. And for any US listeners, you can contact the Centre for Disease Control and Prevention. And just to say that if we do go on a break over the next few weeks, going for goal is a weekly show, there's a good chance that we might need to pause recording

during disruption caused by the coronavirus. So thank you, everyone, and for putting up with a slightly dodgy sound quality. As I mentioned, the start, I'm working from my home and doing this from my living room. So, yeah, everyone take care and stay well, and I will catch you soon. Bye.