Tips for staying healthy

Taking care of yourself doesn’t have to be complicated. Eat well. Get enough sleep. Exercise. And find a doctor you can depend on.

Dr. Victoria Dimitriades offered these words of advice plus other simple, yet insightful tips on how to stay healthy during her presentation, “General Care for Individuals with PI,” an IDF Forum held on September 17.

Clinical Professor of Pediatrics, Chief in the Division of Allergy, Immunology and Rheumatology at the University of California Davis Health, Dr. Dimitriades said healthy habits aren’t difficult to practice but commitment and consistency are necessary for success.

“(People with PI) have greater self-care needs. These are probably above and beyond what the general public needs to be concerned with in everyday care. But that being said, a lot of these things are fairly self-explanatory, and sometimes it’s just a great idea to go through and make sure you’re addressing all these components of your self-care,” said Dr. Dimitriades.

“It’s important to take charge of your medical and personal care because that allows you to be an active participant, not only in your understanding of what’s happening, but also in your treatment of what is happening.”

Maintaining health, particularly in the time of COVID, starts with basic hygiene:

• Wash your hands for 20 seconds with soap and water at mealtime and when contact is made with other people
• Use hand sanitizer and bacterial wipes in between
• Avoid touching your eyes, nose, and mouth
• Shower and bathe regularly
• Brush your teeth and keep up with dentist visits

To further prevent exposure, wear a mask, physically distance yourself from others, and avoid enclosed spaces without good ventilation for prolonged periods. Many in the PI community have already been following this protocol prior to the pandemic, said Dr. Dimitriades.

Masking, in particular, is not a new concept, she explained, as it’s been used for decades as a physical barrier to prevent infection and slow community transmission of many types of diseases.

“But what I really like and what I think is super impactful for our community is we’re starting finally to have discussions on face mask use that is beyond just for the community and very much for (persons with PI). That is, we are now finding that masks do more than protect others from transmission - they also protect us,” she said.

“So, it turns out they’ve looked at several infection cohorts and found that when patients were wearing masks during their exposures they were much more likely to have mild disease. They had a lower viral exposure just because they were wearing masks.”

Dr. Dimitriades stressed the importance of having a primary care provider as a resource for general yearly visits, easy access for sick visits, immunizations, and preventative care.

“They need to be the coordinator of your medical care and be your medical home,” she said.

Your PCP can also help you determine which vaccines are right for you.

“Most patients with PI can receive the vaccines that are currently recommended but it’s important to follow-up with your provider to see which are safe for you,” said Dr. Dimitriades.

Another key component in keeping your body healthy is nutrition. Until recently, the scientific community viewed nutrition as simply a catalyst to make the building blocks for the immune system operate.

“But it turns out now in the last several years that we’re realizing that this is a living being and nutrition can actually affect not only how your immune system is made but how it responds to things like infection or stress or cancer and so we’re starting to learn a lot about how specific types of foods can play a role in how your immune system responds,” said Dr. Dimitriades.

Macronutrients are the basic building blocks that help make the baseline part of your immune system, providing the structure of the immune cells and signals. Macronutrients are protein, carbohydrate, and fat. People with PI are at greater risk of protein-energy malnutrition because when they struggle with chronic infection, they probably don’t eat as well as they should.

Another key part of nutrition are micronutrients, slightly more sophisticated molecules that include vitamins and minerals that control the activation or inhibition signals of the immune system. Micronutrients are iron, zinc, copper, selenium, and vitamins ABCDE, as well as Omega 3 and Omega 6 fatty acids, and all can be mapped to certain immune system functioning.

The best way to boost your immune system, said Dr. Dimitriades, is to include foods naturally rich in nutrients and vitamins like fruits, vegetables, grains, protein, and dairy. Choose whole foods, or fresh foods, versus processed foods for better health and weight control.

Try your best to keep your nutrition balanced so that obesity doesn’t present a challenge. Fat cells cause inflammation in the areas where they are deposited, which can induce a poor immune response, cause autoimmune stimulation, and lead to slow wound healing and susceptibility to respiratory, gastrointestinal, and liver infections.

Dr. Dimitriades also recommends exercise which is linked to a lower risk of upper respiratory infections, has anti-inflammatory effects on the brain, and boosts endorphins. In addition, try yoga or stretching to reduce stress and increase IgA production – one of our frontline antibodies to fight off infection.

Another way to reduce vulnerability to infection is to get a good night’s rest, said Dr. Dimitriades. Sleep is restorative for the immune system and it can improve infection outcomes and reduce your risk of future infections.

Chronic sleep deficiency disturbs the immune balance because of loss of inflammation control and increases the risk for cardiovascular disease, metabolic diseases such as diabetes, autoimmune diseases like arthritis, and neurodegenerative diseases like Alzheimer’s.

If you’ve followed all the guidelines for staying healthy, and infection still manages to take hold, Dr. Dimitriades suggested following these steps:

• See your doctor and follow the recommended treatment plan
• Rest and sleep
• Drink plenty of fluids, avoiding caffeine and alcohol
• Maintain nutrition