Exercising may make our immune systems more than five times better at fighting infection.
How Much Exercise Does It Take to Boost Immunity?
5/5 - (56 votes)
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Exercise can boost our immune system by so much that we can reduce the number of symptom days by 25 to 50 percent. Imagine if there was some drug that could do that—it would rake in billions, whereas, exercise is free and tends to only have good side effects.
It doesn’t even take much of a workout to get results. Studies find that if you let kids run around for just six minutes, the levels of immune cells circulating in their blood can increase by 50 percent, as they pour from the bone marrow and redeploy throughout the body. Even moderate exercise can also boost IgA production––protective antibodies that coat all of our moist membranes. Compared to a sedentary control group, those who performed aerobic exercises for thirty minutes three times a week for twelve weeks had a 50 percent increase in the levels of IgA in their saliva, and reported significantly fewer flu-related symptoms. Salivary IgA levels are associated with lower overall mortality risk over time—particularly cancer mortality—perhaps as a proxy for immune function more generally. And you can boost those levels with exercise.
Exercising may also boost the activity of natural killer cells––our immune soldiers that focus on eliminating both tumor cells and virus-infected cells. Here are five different types of cancer growing in a petri dish––mostly leukemias and lymphomas. Draw blood from people and drip on some of their natural killer cells into the dish, and they start killing off the cancer cells. Okay, but that was blood taken from someone before exercise. Draw blood after 30 minutes of cycling, and drop on the same number of natural killer cells, and they each kill cancer about 60 percent better. This may be one of the reasons why exercise seems to help both prevent cancer and improve cancer survival.
Might it improve vaccination responses? If aerobic exercise gets your immune cells to spill out from your bones, can’t you just slouch on the couch all year, then just jump up and take a brisk walk right before getting the jab? Studies to this effect performed on young adults had inconsistent results––for example, improving the antibody response to a flu vaccine in women, but not men, or to a meningitis vaccine in men, but not women.
Against half doses or weaker vaccines, acute exercise interventions appeared to work better, suggesting perhaps a ceiling effect whereby their immune responses were normally so robust exercise might not improve them further. But maybe it would work more consistently in older adults? Sadly, 45-minute moderate intensity aerobic exercise right before flu or pneumonia vaccinations didn’t seem to help in older adults. Even two months of 45-minute moderate intensity daily activity—six weeks before and two weeks after vaccination—appeared insufficient to make a difference. Eccentric resistance exercise––for example, slowly lowering heavy dumbbells after bicep curls or lateral raises to inflame the muscle right before the vaccine goes in also doesn’t seem to be a viable strategy.
What about exercise to reduce infection risk directly? In a study entitled “Moderate exercise protects mice from death due to influenzas virus,” mice exercised for 20 to 30 minutes four hours after flu virus exposure, and then each of the next three days, had nearly twice the survival rate (18 percent dying compared to 57 percent dead in the sedentary group). There’s nothing so dramatic in the human literature, but based on a study that followed more than a thousand adults through flu season, those who exercised even just a few days a week were sick about 40 percent fewer days than sedentary individuals. Randomized controlled interventional trials back this up. For example, one study found that while elderly sedentary women randomized to a mild range of motion and flexibility calisthenics control group had a 50 percent chance of getting an upper-respiratory illness during the fall season, those randomized to begin a half-hour-a-day walking program dropped their risk down to 20 percent. For conditioned athletes, though, the risk was just 8 percent. Exercising could potentially make our immune systems more than five times better at fighting infection.
In a year-long study, sedentary postmenopausal women randomized to 45 minutes of moderate-intensity exercise five days per week were experiencing three times fewer colds by the end of the study, compared to the control group, who were instead randomized to weekly stretching sessions––even though the exercise group only ended up exercising around four times a week. A similar study of younger overweight women found that 15 weeks of daily walking cut the number of days sick with upper respiratory tract infections symptoms in half, though this was due to cutting the duration of each episode in half, rather than cutting down on the frequency of illness.
In terms of more serious infections, randomizing older men and women to one-hour exercise classes twice a week for two years did not, unfortunately, cut down on the risk of coming down with pneumonia. Although yoga training can improve lung function in the elderly, it has yet to be shown to help prevent pneumonia either. There was, however, a treatment trial of yoga breathing exercises for pulmonary tuberculosis performed in India. Compared to a mindfulness meditation, “breathing awareness” control group, those randomized to the yoga group cleared their active infections faster. Even “laughter yoga” might help.
The very evolution of laughter is thought to have been as an antidote to stress, the release of nervous energy. Within 60 minutes of people watching a comedy video (complete with “Gallagher’s classic Sledge-O-Matic finale”), levels of the stress hormone cortisol in their bloodstreams were cut by more than half. Since cortisol acts as an immunosuppressant, which is why cortisol-like steroids like prednisone are used for inflammatory autoimmune diseases, the drop in cortisol with laughter may explain why those laughing heartily at a humorous video had improvements in natural killer cell function compared to those randomized to a control group watching tourism videos. (Replicating these results today might be difficult given the choice of comedic stimulus: Bill Cosby.)
Please consider volunteering to help out on the site.
- Nieman DC. Moderate exercise improves immunity and decreases illness rates. Am J Lifestyle Med. 2011;5(4):338-345.
- Schwindt CD, Zaldivar F, Wilson L, et al. Do circulating leucocytes and lymphocyte subtypes increase in response to brief exercise in children with and without asthma? Br J Sports Med. 2007;41(1):34-40.
- Pal S, Chaki B, Bandyopadhyay A. High intensity exercise induced alteration of hematological profile in sedentary post-pubertal boys and girls: A comparative study. IJPP. 2021;64:207-214.
- Klentrou P, Cieslak T, MacNeil M, Vintinner A, Plyley M. Effect of moderate exercise on salivary immunoglobulin A and infection risk in humans. Eur J Appl Physiol. 2002;87(2):153-158.
- Phillips AC, Carroll D, Drayson MT, Der G. Salivary immunoglobulin a secretion rate is negatively associated with cancer mortality: the West of Scotland Twenty-07 Study. PLoS One. 2015;10(12):e0145083.
- Bigley AB, Rezvani K, Chew C, et al. Acute exercise preferentially redeploys NK-cells with a highly-differentiated phenotype and augments cytotoxicity against lymphoma and multiple myeloma target cells. Brain Behav Immun. 2014;39:160-171.
- McTiernan A, Friedenreich CM, Katzmarzyk PT, et al. Physical activity in cancer prevention and survival: a systematic review. Med Sci Sports Exerc. 2019;51(6):1252-1261.
- Edwards KM, Burns VE, Reynolds T, Carroll D, Drayson M, Ring C. Acute stress exposure prior to influenza vaccination enhances antibody response in women. Brain Behav Immun. 2006;20(2):159-168.
- Edwards KM, Burns VE, Adkins AE, Carroll D, Drayson M, Ring C. Meningococcal A vaccination response is enhanced by acute stress in men. Psychosom Med. 2008;70(2):147-151.
- Edwards KM, Pung MA, Tomfohr LM, et al. Acute exercise enhancement of pneumococcal vaccination response: a randomised controlled trial of weaker and stronger immune response. Vaccine. 2012;30(45):6389-6395.
- Long JE, Ring C, Drayson M, et al. Vaccination response following aerobic exercise: can a brisk walk enhance antibody response to pneumococcal and influenza vaccinations? Brain Behav Immun. 2012;26(4):680-687.
- Hayney MS, Coe CL, Muller D, et al. Age and psychological influences on immune responses to trivalent inactivated influenza vaccine in the meditation or exercise for preventing acute respiratory infection (MEPARI) trial. Hum Vaccin Immunother. 2014;10(1):83-91.
- Campbell JP, Edwards KM, Ring C, et al. The effects of vaccine timing on the efficacy of an acute eccentric exercise intervention on the immune response to an influenza vaccine in young adults. Brain Behav Immun. 2010;24(2):236-242.
- Lowder T, Padgett DA, Woods JA. Moderate exercise protects mice from death due to influenza virus. Brain Behav Immun. 2005;19(5):377-380.
- Nieman DC, Henson DA, Austin MD, Sha W. Upper respiratory tract infection is reduced in physically fit and active adults. Br J Sports Med. 2011;45(12):987-992.
- Nieman DC, Henson DA, Gusewitch G, et al. Physical activity and immune function in elderly women. Med Sci Sports Exerc. 1993;25(7):823-831.
- Chubak J, McTiernan A, Sorensen B, et al. Moderate-intensity exercise reduces the incidence of colds among postmenopausal women. Am J Med. 2006;119(11):937-942.
- Nieman DC, Nehlsen-Cannarella SL, Markoff PA, et al. The effects of moderate exercise training on natural killer cells and acute upper respiratory tract infections. Int J Sports Med. 1990;11(6):467-473.
- Dangour AD, Albala C, Allen E, et al. Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial. PLoS Med. 2011;8(4):e1001023.
- Bezerra LA, de Melo HF, Garay AP, et al. Do 12-week yoga program influence respiratory function of elderly women? J Hum Kinet. 2014;43:177-184.
- Visweswaraiah NK, Telles S. Randomized trial of yoga as a complementary therapy for pulmonary tuberculosis. Respirology. 2004;9(1):96-101.
- Gervais M, Wilson DS. The evolution and functions of laughter and humor: a synthetic approach. Q Rev Biol. 2005;80(4):395-430.
- Berk LS, Tan SA, Fry WF, et al. Neuroendocrine and stress hormone changes during mirthful laughter. Am J Med Sci. 1989;298(6):390-396.
- Bennett MP, Zeller JM, Rosenberg L, McCann J. The effect of mirthful laughter on stress and natural killer cell activity. Altern Ther Health Med. 2003;9(2):38-45.
- Bigley AB, Spielmann G, LaVoy EC, Simpson RJ. Can exercise-related improvements in immunity influence cancer prevention and prognosis in the elderly? Maturitas. 2013 Sep;76(1):51-6. doi: 10.1016/j.maturitas.2013.06.010. Epub 2013 Jul 17. PMID: 23870832.
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
Exercise can boost our immune system by so much that we can reduce the number of symptom days by 25 to 50 percent. Imagine if there was some drug that could do that—it would rake in billions, whereas, exercise is free and tends to only have good side effects.
It doesn’t even take much of a workout to get results. Studies find that if you let kids run around for just six minutes, the levels of immune cells circulating in their blood can increase by 50 percent, as they pour from the bone marrow and redeploy throughout the body. Even moderate exercise can also boost IgA production––protective antibodies that coat all of our moist membranes. Compared to a sedentary control group, those who performed aerobic exercises for thirty minutes three times a week for twelve weeks had a 50 percent increase in the levels of IgA in their saliva, and reported significantly fewer flu-related symptoms. Salivary IgA levels are associated with lower overall mortality risk over time—particularly cancer mortality—perhaps as a proxy for immune function more generally. And you can boost those levels with exercise.
Exercising may also boost the activity of natural killer cells––our immune soldiers that focus on eliminating both tumor cells and virus-infected cells. Here are five different types of cancer growing in a petri dish––mostly leukemias and lymphomas. Draw blood from people and drip on some of their natural killer cells into the dish, and they start killing off the cancer cells. Okay, but that was blood taken from someone before exercise. Draw blood after 30 minutes of cycling, and drop on the same number of natural killer cells, and they each kill cancer about 60 percent better. This may be one of the reasons why exercise seems to help both prevent cancer and improve cancer survival.
Might it improve vaccination responses? If aerobic exercise gets your immune cells to spill out from your bones, can’t you just slouch on the couch all year, then just jump up and take a brisk walk right before getting the jab? Studies to this effect performed on young adults had inconsistent results––for example, improving the antibody response to a flu vaccine in women, but not men, or to a meningitis vaccine in men, but not women.
Against half doses or weaker vaccines, acute exercise interventions appeared to work better, suggesting perhaps a ceiling effect whereby their immune responses were normally so robust exercise might not improve them further. But maybe it would work more consistently in older adults? Sadly, 45-minute moderate intensity aerobic exercise right before flu or pneumonia vaccinations didn’t seem to help in older adults. Even two months of 45-minute moderate intensity daily activity—six weeks before and two weeks after vaccination—appeared insufficient to make a difference. Eccentric resistance exercise––for example, slowly lowering heavy dumbbells after bicep curls or lateral raises to inflame the muscle right before the vaccine goes in also doesn’t seem to be a viable strategy.
What about exercise to reduce infection risk directly? In a study entitled “Moderate exercise protects mice from death due to influenzas virus,” mice exercised for 20 to 30 minutes four hours after flu virus exposure, and then each of the next three days, had nearly twice the survival rate (18 percent dying compared to 57 percent dead in the sedentary group). There’s nothing so dramatic in the human literature, but based on a study that followed more than a thousand adults through flu season, those who exercised even just a few days a week were sick about 40 percent fewer days than sedentary individuals. Randomized controlled interventional trials back this up. For example, one study found that while elderly sedentary women randomized to a mild range of motion and flexibility calisthenics control group had a 50 percent chance of getting an upper-respiratory illness during the fall season, those randomized to begin a half-hour-a-day walking program dropped their risk down to 20 percent. For conditioned athletes, though, the risk was just 8 percent. Exercising could potentially make our immune systems more than five times better at fighting infection.
In a year-long study, sedentary postmenopausal women randomized to 45 minutes of moderate-intensity exercise five days per week were experiencing three times fewer colds by the end of the study, compared to the control group, who were instead randomized to weekly stretching sessions––even though the exercise group only ended up exercising around four times a week. A similar study of younger overweight women found that 15 weeks of daily walking cut the number of days sick with upper respiratory tract infections symptoms in half, though this was due to cutting the duration of each episode in half, rather than cutting down on the frequency of illness.
In terms of more serious infections, randomizing older men and women to one-hour exercise classes twice a week for two years did not, unfortunately, cut down on the risk of coming down with pneumonia. Although yoga training can improve lung function in the elderly, it has yet to be shown to help prevent pneumonia either. There was, however, a treatment trial of yoga breathing exercises for pulmonary tuberculosis performed in India. Compared to a mindfulness meditation, “breathing awareness” control group, those randomized to the yoga group cleared their active infections faster. Even “laughter yoga” might help.
The very evolution of laughter is thought to have been as an antidote to stress, the release of nervous energy. Within 60 minutes of people watching a comedy video (complete with “Gallagher’s classic Sledge-O-Matic finale”), levels of the stress hormone cortisol in their bloodstreams were cut by more than half. Since cortisol acts as an immunosuppressant, which is why cortisol-like steroids like prednisone are used for inflammatory autoimmune diseases, the drop in cortisol with laughter may explain why those laughing heartily at a humorous video had improvements in natural killer cell function compared to those randomized to a control group watching tourism videos. (Replicating these results today might be difficult given the choice of comedic stimulus: Bill Cosby.)
Please consider volunteering to help out on the site.
- Nieman DC. Moderate exercise improves immunity and decreases illness rates. Am J Lifestyle Med. 2011;5(4):338-345.
- Schwindt CD, Zaldivar F, Wilson L, et al. Do circulating leucocytes and lymphocyte subtypes increase in response to brief exercise in children with and without asthma? Br J Sports Med. 2007;41(1):34-40.
- Pal S, Chaki B, Bandyopadhyay A. High intensity exercise induced alteration of hematological profile in sedentary post-pubertal boys and girls: A comparative study. IJPP. 2021;64:207-214.
- Klentrou P, Cieslak T, MacNeil M, Vintinner A, Plyley M. Effect of moderate exercise on salivary immunoglobulin A and infection risk in humans. Eur J Appl Physiol. 2002;87(2):153-158.
- Phillips AC, Carroll D, Drayson MT, Der G. Salivary immunoglobulin a secretion rate is negatively associated with cancer mortality: the West of Scotland Twenty-07 Study. PLoS One. 2015;10(12):e0145083.
- Bigley AB, Rezvani K, Chew C, et al. Acute exercise preferentially redeploys NK-cells with a highly-differentiated phenotype and augments cytotoxicity against lymphoma and multiple myeloma target cells. Brain Behav Immun. 2014;39:160-171.
- McTiernan A, Friedenreich CM, Katzmarzyk PT, et al. Physical activity in cancer prevention and survival: a systematic review. Med Sci Sports Exerc. 2019;51(6):1252-1261.
- Edwards KM, Burns VE, Reynolds T, Carroll D, Drayson M, Ring C. Acute stress exposure prior to influenza vaccination enhances antibody response in women. Brain Behav Immun. 2006;20(2):159-168.
- Edwards KM, Burns VE, Adkins AE, Carroll D, Drayson M, Ring C. Meningococcal A vaccination response is enhanced by acute stress in men. Psychosom Med. 2008;70(2):147-151.
- Edwards KM, Pung MA, Tomfohr LM, et al. Acute exercise enhancement of pneumococcal vaccination response: a randomised controlled trial of weaker and stronger immune response. Vaccine. 2012;30(45):6389-6395.
- Long JE, Ring C, Drayson M, et al. Vaccination response following aerobic exercise: can a brisk walk enhance antibody response to pneumococcal and influenza vaccinations? Brain Behav Immun. 2012;26(4):680-687.
- Hayney MS, Coe CL, Muller D, et al. Age and psychological influences on immune responses to trivalent inactivated influenza vaccine in the meditation or exercise for preventing acute respiratory infection (MEPARI) trial. Hum Vaccin Immunother. 2014;10(1):83-91.
- Campbell JP, Edwards KM, Ring C, et al. The effects of vaccine timing on the efficacy of an acute eccentric exercise intervention on the immune response to an influenza vaccine in young adults. Brain Behav Immun. 2010;24(2):236-242.
- Lowder T, Padgett DA, Woods JA. Moderate exercise protects mice from death due to influenza virus. Brain Behav Immun. 2005;19(5):377-380.
- Nieman DC, Henson DA, Austin MD, Sha W. Upper respiratory tract infection is reduced in physically fit and active adults. Br J Sports Med. 2011;45(12):987-992.
- Nieman DC, Henson DA, Gusewitch G, et al. Physical activity and immune function in elderly women. Med Sci Sports Exerc. 1993;25(7):823-831.
- Chubak J, McTiernan A, Sorensen B, et al. Moderate-intensity exercise reduces the incidence of colds among postmenopausal women. Am J Med. 2006;119(11):937-942.
- Nieman DC, Nehlsen-Cannarella SL, Markoff PA, et al. The effects of moderate exercise training on natural killer cells and acute upper respiratory tract infections. Int J Sports Med. 1990;11(6):467-473.
- Dangour AD, Albala C, Allen E, et al. Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial. PLoS Med. 2011;8(4):e1001023.
- Bezerra LA, de Melo HF, Garay AP, et al. Do 12-week yoga program influence respiratory function of elderly women? J Hum Kinet. 2014;43:177-184.
- Visweswaraiah NK, Telles S. Randomized trial of yoga as a complementary therapy for pulmonary tuberculosis. Respirology. 2004;9(1):96-101.
- Gervais M, Wilson DS. The evolution and functions of laughter and humor: a synthetic approach. Q Rev Biol. 2005;80(4):395-430.
- Berk LS, Tan SA, Fry WF, et al. Neuroendocrine and stress hormone changes during mirthful laughter. Am J Med Sci. 1989;298(6):390-396.
- Bennett MP, Zeller JM, Rosenberg L, McCann J. The effect of mirthful laughter on stress and natural killer cell activity. Altern Ther Health Med. 2003;9(2):38-45.
- Bigley AB, Spielmann G, LaVoy EC, Simpson RJ. Can exercise-related improvements in immunity influence cancer prevention and prognosis in the elderly? Maturitas. 2013 Sep;76(1):51-6. doi: 10.1016/j.maturitas.2013.06.010. Epub 2013 Jul 17. PMID: 23870832.
Motion graphics by Avo Media
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Title
How Much Exercise Does It Take to Boost Immunity?
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
For more on the benefit of exercise, check out:
- Exercise vs. Drugs for Depression
- Longer Life Within Walking Distance
- Standing Up for Your Health
- How Much Should You Exercise?
- How Many Steps Should We Get Every Day?
- Exercise is Medicine
- Does Exercise Extend Your Lifespan or Just Your Healthspan?
- How Much Exercise Is Too Much?
For the impact of exercise on weight loss, check out:
- The Exercise “Myth” for Weight Loss
- The Secret to Weight Loss Through Exercise
- Is It the Diet, the Exercise, or Both?
Overexertion can increase risk of infection, but there are things we can do to mediate the effect. See, for example, Preserving Athlete Immunity with Chlorella and Preserving Immune Function in Athletes with Nutritional Yeast.
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