Immune Health and Active Living

Staying healthy for the holidays with nurse practitioner Jessie Bawden

November, 2018

During the holiday season we socialize in close quarters, get less sleep, and often set aside our healthy diets as we ring in the New Year with more alcoholic drinks than advisable. To help maintain your immune system and make the most of the holiday season, I’ve got you covered with a few tips.SLEEP

Quality sleep is thought to be an important predictor of immunity and in turn susceptibility to the common cold1. It is recommended that adults get 7-9 hours of sleep every night2. As we embark on work events, neighbourhood parties and family gatherings, remember that sleep deprivation puts us at risk for illness. Studies show that poorer sleep efficiency and shorter sleep duration in the weeks preceding exposure to a rhinovirus were associated to lower resistance to illness1. Keep this in mind as your sleep habits slip during these busy (and fun) months.HYGIENE

Let’s face it. Life is crazy busy. But if we don’t take care of ourselves how do we expect to stay healthy? Make sure you schedule time to get enough sleep, do regular exercise, eat healthy meals, drink plenty of water and find ways to reduce stress in your life.

Hygiene refers to practices that help maintain health and prevent the spread of diseases.

It is well known that we should all be washing our hands frequently to prevent the spread of respiratory viruses3. The Centre for Disease Control4 has listed these as the most important times to wash your hands with hot, soapy water:

  • Before, during, and after preparing food
  • Before eating food
  • Before and after caring for someone who is sick
  • Before and after treating a cut or wound
  • After using the toilet
  • After changing diapers or cleaning up a child who has used the toilet
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After handling pet food or pet treats
  • After touching garbage

A Cochrane Systemic Review concluded the highest quality randomized control trials suggest respiratory virus spread can be prevented by hygienic measures, such as handwashing, especially around younger children 5.NUTRITION

There will be parties and there will be food this holiday season.  Overall, continuing to abide by Canada’s Food Guide with particular attention to portion size will be helpful in avoiding illness.

But is there anything that we can ADD to our diet to be proactive?

Research6 shows probiotics were better than placebo in reducing the number of participants experiencing episodes of acute upper respiratory tract infection (URTI), the mean duration of an episode of acute URTI, antibiotic use and cold-related school absence. This suggests probiotics may be more beneficial than placebo for preventing acute URTIs. Aim to include lactic acid bacteria and bifidobacteria, which are commonly consumed in fermented foods, such as yogurt and soy yogurt, or as dietary supplements6.

In addition, Canadian Family Physician published an article on the use of complementary and alternative medicine for prevention of the common cold and concluded that vitamin C can be recommended. Taking at least 1 g of vitamin C per day can be recommended for the prevention of colds based on good evidence of moderate reduction in symptom duration in adults and children. While it only reduces symptoms by 1 to 2 days, it is cheap, safe, and simple to use7.ALCOHOL

The Canadian Centre on Substance Use and Addiction suggests limiting total number of drinks per week to 10 for women and 15 for men. They also acknowledge special occasions and suggest limiting drinking no more than 3 drinks (for women) or 4 drinks (for men) on any single occasion8. These suggestions are made to promote your long-term health but what about alcohol’s role in making us susceptible to acute illness? Excessive alcohol use is associated with pulmonary oxidative stress, which may adversely affect innate immunity leading to increased pneumonia susceptibility and severity and acute respiratory distress syndrome9. If you are going to consume alcohol, consider staying within the suggested amounts if you want to avoid getting ill.

COLD AND FLU TIPS

The common cold is seen frequently by Primary Care Providers (PCPs). It is almost always a viral illness (e.g. rhinovirus). On average, it affects adults 2 to 4 times per year7. Influenza viruses cause 5% to 15% of acute respiratory infections, resulting in fever, headache, myalgia, and fatigue. Both of these illnesses usually run their course within 10 days and the treatments available are measures to ease your discomfort.

If you happen to become ill with a viral illness such as a cold or a flu, consider staying home from school or work in order to protect others (especially those at risk for adverse outcomes such as young children and the elderly) from the spread of infection. Rest and stay hydrated. Use antipyretics like acetaminophen or ibuprofen to treat any fever or pain. Consider using non-pharmacological measures such as nasal saline rinses and humidity to combat congestion. There is also evidence to support using natural health products for the treatment of the common cold.

Visit your PCP (Family Physician or Nurse Practitioner) if you are concerned that you might have developed a secondary infection such as bacterial sinusitis, otitis media or pneumonia. If you have an underlying condition that might weaken your ability to fight these common viral illnesses, consider seeing your Primary Care Provider sooner for advice on how best to manage.

Hope these tips help you have a healthy holiday season!

References:

1. Cohen, S., Doyle, W.J., Alper, C.M., Janicki-Deverts, D., and Turner, R.B. (2009). Sleep habits and susceptibility to the common cold. Archives of Internal Medicine, 169(1): 62-67. DOI: 10.1001/archinternmed.2008.505
2. Hirshkowitz M, Whiton K, Albert SM, et al. (2015). National Sleep Foundation’s updated sleep duration recommendations: Final report. Sleep Health, 1: 233-43.
3. Allan, G.M. and Arroll, B. (2014). Prevention and treatment of the common cold: making sense of the evidence. CMAJ, 186 (3) 190-199. DOI: https://doi.org/10.1503/cmaj.121442
4. https://www.cdc.gov/handwashing/when-how-handwashing.html
5. Jefferson T, Del Mar CB, Dooley L, Ferroni E, Al‐Ansary LA, Bawazeer GA, van Driel ML, Nair S, Jones MA, Thorning S, Conly JM. (2011). Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database of Systematic Reviews, Issue 7. Art. No.: CD006207. DOI: 10.1002/14651858.CD006207.pub4.
6. Hao Q, Dong BR, Wu T. (2015). Probiotics for preventing acute upper respiratory tract infections. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD006895. DOI: 10.1002/14651858.CD006895.pub3.
7. Nahas, R. and Balla, A. (2011). Complementary and alternative medicine for prevention and treatment of the common cold. Canadian Family Physician, 57 (1) 31-36.
8. http://www.ccsa.ca/Resource%20Library/2012-Canada-Low-Risk-Alcohol-Drinking-Guidelines-Brochure-en.pdf
9. Burnham, E.L., McNally,A., Gaydos, J., & Brown, L.S. (2016). The relationship between airway antioxidant levels, alcohol use disorders, and cigarette smoking. Alcoholism: Clinical and Experimental Research, 40(10).