Diabetes Forecast

Grant Yourself Immunity

5 Ways to Keep Healthy this Cold and Flu Season

By Terri D'Arrigo ,


Oh, no, there it is: that little tickle in the back of your throat, the one that means you'll wake up tomorrow sounding like Yoda and feeling like someone spackled your sinuses shut.

Welcome to the cold and flu season. Most experts agree that having diabetes doesn't make you any more susceptible to catching a winter bug than someone without diabetes. But each year the average American adult will catch two to five colds and roughly 15 percent of the population will catch the flu, so chances are you'll find yourself sniffling into a tissue sooner or later.

Although it's almost impossible to escape the season completely unscathed--more than one doctor has joked that if you want to avoid the common cold entirely, don't ever leave your house--there are ways you can boost your resistance to infection. The good news is that, aside from an annual flu shot (which all people with diabetes should get every year), you can do this naturally, without buying a shopping basket full of pills, powders, syrups, or supplements. It all comes down to healthy habits.

First, let's look at what's going on inside. When foreign substances--bacteria, viruses, and other harbingers of infection collectively called antigens--invade your body, your immune system reacts in several ways. The immune system is set up to recognize the invaders as foreign and then attack. The unwanted guests are eventually eliminated by a cavalcade of the immune system's own infection-busting cells and proteins.

This ability to distinguish foreign cells from your own is critical to the success of a frontline attack. "The cells within the immune system operate on a lock-and-key basis, and cells won't attack until a key fits their lock," says Suzanne C. Segerstrom, PhD, professor in the Department of Psychology at the University of Kentucky and a researcher in the field of neuroimmunology. (Unfortunately, they can also misfire, which is how type 1 diabetes develops: Sometimes islet cell "keys" in the pancreas fit some of the immune cell "locks," causing the immune system to attack the islets, and resulting in type 1.) Meanwhile, white blood cells called B cells begin to produce antibodies, proteins that bind to the invaders, interfering with their work and marking them for further attack.

The entire immune response takes time, and while your body mounts its defenses and eventually launches a full-on war, you get symptoms. In many cases, once B cells are activated by a particular invader, they produce not only antibodies, but memory cells that can live in your body for years. Then the next time that particular invader barges in, the immune attack is immediate, and the invader doesn't have the chance to make itself comfortable (and you miserable). In fact, some survivors of the 1918 flu epidemic still have antibodies to that particular strain of the flu.

Alas, there are hundreds of cold viruses, which means that whenever you get a cold, it's caused by an invader your body has never fought before. Likewise, each year a different strain of flu virus becomes dominant, which is why you need a flu shot every year instead of just once. As catching hundreds of colds is not the most pleasant way to build your immunity, here are some ways you can strengthen your immune system to help it trounce even first-time invaders.

1. Avoid Chronic Stress

Into each person's life, stress will fall. Traffic, deadlines, and the occasional chaotic day of shuttling the kids around are facts of life for many of us. More dangerous, however, is chronic stress. This is the kind that occurs when events in your life change the way you see yourself or your role in society, and there's no apparent end in sight. In 2004, the University of Kentucky's Segerstrom and her colleague, Gregory Miller, PhD, codirector of the Psychobiological Determinants of Health Laboratory at the University of British Columbia, analyzed 293 studies and found that chronic stress suppresses the immune system's ability to recognize invaders and weakens the attack it can mount against them. However, chronic stress also keeps the immune system on a kind of yellow alert: The immune system remains activated at a low level, always wary of a potential fight. That can wear it down and damage its ability to turn itself on and off at more appropriate times. (See "Stress Less" for an in-depth look at dealing with stressors in your life.)

Coping with chronic diseases can contribute to chronic stress,so it's important that you get the help and support you need in controlling your diabetes. "Stress seems to perturb the immune system in a number of different ways," says Segerstrom, "including ways that could exacerbate the effects of diabetes." For example, you may have noticed higher blood glucose during stressful times in your life. That brings us to the next strategy.

2. Control Your Blood Glucose

According to the American Diabetes Association, people with diabetes are no more likely to catch a cold than people without diabetes. "I'm not aware of any evidence that people with diabetes are more prone to colds," says M. Sue Kirkman, MD, the Association's vicepresident of clinical affairs. However, once you do get sick, it may take you longer to get better. This is especially true should you catch the flu. "People with diabetes are more likely to have worse infections with the flu, which is why it's so important for them to get a flu shot each year," Kirkman says.

Although diabetes doesn't affect your risk of catching a cold, which is a virus, studies have shown that prolonged high blood glucose may lower your resistance to illness and infection caused by bacteria. "Some older studies using petri dishes indicate that high blood glucose will impair white blood cells that fight bacterial infections," Kirkman explains. This is important to keep in mind because although colds and the flu are viruses, the sinus infections that can accompany them are often caused by bacteria. Certain bacteria may also cause pneumonia.

In general, it's a good idea to control your blood glucose not only to keep your white blood cells strong (and your diabetes at bay), but also because prolonged high blood glucose acts on your immune system much the same way stress does: Your system kicks into that yellow alert—with the resultant wear and tear.

3. Move It

Stress may be one of the leading causes of weakened immunity, but physical activity is the mother of all resistance. Studies have shown that people who exercise regularly get about half as many respiratory infections as do couch potatoes.

First, exercise has a direct impact on immunity, says Paul Coen, PhD, postdoctoral associate and researcher in the Department of Medicine in the Division of Endocrinology and Metabolism at the University of Pittsburgh. "When you exercise, it places short-term stress on your body, and your immune system responds," he explains. "The beauty is that, unlike chronic stress, the stress of exercise has a beginning and an end, so your immune response has a beginning and an end. When you exercise your body, you're also exercising your immune system and its ability to turn itself on and off." Second, exercise is a stress-blaster. "It releases tension and alleviates psychological stress and will also help you keep your blood glucose in good control," says Coen.

You don't have to go out and run marathons to reap the rewards of physical activity. (In fact, overtraining will lower resistance--weekend warriors, beware.) Just 30 minutes of moderate physical activity five times a week will do the trick. This could be any activity that gets your heart rate up and makes you sweat without making you so winded you can't talk easily--walking, country line-dancing, riding a bike, even heavy-duty housecleaning. And here's a bonus: Regular physical activity will help you sleep better, which takes us right to no. 4.

4. Get Some Rest

Sleep affects your immune system in two ways. First, getting enough sleep helps your body maintain a balance of certain immune cells called monocytes. A study conducted by researchers in Lübeck, Germany, revealed that the percentage of one type of monocyte in the blood increased during sleep and decreased during wakefulness. Another kind of monocyte increased during wakefulness and decreased during sleep. Keeping the percentages of these cells balanced by getting enough sleep may allow your body to to maintain equally strong immunity against the different kinds of invaders these cells attack.

On the other hand, not getting enough sleep can squelch immunity and make you more likely to get sick. It doesn't take long for the effects of sleep deprivation to take hold, either: Researchers at the University of California-San Diego found a decrease in boththe number and effectiveness of natural killer cells in study participants after the participants had just one night of sleep deprivation.

5. Eat Right

Nutrition is vitally important for people with diabetes in terms of good blood glucose control and maintaining a healthy weight. But it's also important for keeping your immunity strong, says Judith Wylie-Rosett, EdD, RD, head of the Division of Health, Behavior, and Nutrition in the Department of Epidemiology and Population Health at Albert Einstein College of Medicine in New York.

The focus should be on foods that are high in antioxidants, including fruit (particularly berries), broccoli, and leafy greens such as spinach and kale. "Think of getting a whole rainbow of foods," Wylie-Rosett says. Although she leans toward fresh fruits and vegetables, in some instances frozen may be better than fresh. "If fresh produce has been in transport or out on the stand long enough to wither, it may have lost some of its nutrients. Most frozen foods have been flash frozen, before the nutrients start to deteriorate," she says. "Look for packages of mixed vegetables, but go easy on the ones with sauces."

As for drinking vast quantities of orange juice in an attempt to drown a cold in vitamin C, that's a "don't," she says. "It will make your blood glucose too high, and if anything, it will act more as a decongestant [than a weapon against a cold]." It can also cause stomach upset and diarrhea.

As a person with diabetes, there's no need to think that you are "weak" or more prone to being "sickly." But you do need to take care of yourself. Making healthy living a priority in your life will boost your immunity and keep those nasty winter bugs at bay.



Take the Type 2
Diabetes Risk Test