(It would be great if we, as humans, made decision based purely on logic, but as expert sport psychologist Dr. Peter Jensen PhD points out, it’s not usually the case).
To achieve your athletic potential, you need to train hard and train often. This means walking the fine line between the appropriate amount of training (and life) stress and the positive adaptations it provides and pushing yourself over the edge. The sport science term pushing athletes just past their capacity to improve performance is called functional over-reaching (FOR), it’s what every good strength coach and sport scientist are striving to achieve. Unfortunately, the quest for constant gains means the possibility of stumbling over the line into too much stress (i.e. non-functional over-reaching), or the abyss of overtraining syndrome, when athletes are tired, rundown and progress stalls for months.(1) Incredibly, 70% of high level athletes have experienced or will experience over-training syndrome (OTS) at some point.(2)
Adding to all this complexity is the reality that increasing training volume is strongly associated with increased risk of upper respiratory tract infections (i.e. cold or flu) and upper respiratory symptoms.(3) Interestingly, even if you're athlete experiences pronounced symptoms of an infection - congestion, scratchy throat, fatigue, etc. - they're at similarly increased risk of diminished performance.(4)
Simply keeping your athlete healthy enough to train is a crucial piece of the high-performance puzzle. If you're healthy, you can train. And if you can train more than the competition, you'll have the best chance of winning (all other things being equal).
To fall victim to an infection, two things must happen; your immune system gets compromised and you're exposed to an infection. Let's take a closer looker at 11 factors that can increase your risk of catching a nasty bug.
1. Exercise - As I mentioned above, when your training load increases so too does your risk of URTI.(5) This is unavoidable for high-level athletes as they must follow their periodized training plan to achieve their goals and prep for competition. If you're about to enter an intense training period and you feel a scratchy throat, congestion or fatigue setting in, then shifting your focus to your sleep and nutrition strategies is key to supporting immunity.
2. Mental & Emotional Stress - If you're a person who get stressed out more easily, it actually makes you more susceptible to catching a cold or flu.(6) If you're a type-A personality, experience anxiety-like symptoms or are a general "worrier" than you’re at greater risk of infection as well. Key things to watch out for include fatigue, tension, anger and depression.
3. Sleep - Lack of sleep is major roadblock to a healthy immune system. If you get less than 7 hours of sleep per night your risk of cold and flu increases 3-fold.(7) Prioritize sleep if you're feeling like you're coming down with something (especially if you're hitting the gym hard).
4. Personal Hygiene – It’s not very sexy advice, but it plays a massive role in keeping you cold and flu free. Washing your hands regularly – before every meal and after contact with sick people - and keeping your hands away from your mouth and nose should be your top priority to reduce your risk of infection plummets.(8)
5. Poor Nutrition - If your diet doesn't have enough calories (i.e. energy) to meet the demands of your training, if you're training at high-intensity with low-carbohydrate availability, if your diet is restricted and low in vitamin D, zinc or iron (just to name a few) then you're likely compromising your immune system.(9) Nutrition is a key player for maintaining a robust immune system and reducing frequency and severity of colds and flu.
6. Dental Hygiene - You might not think brushing your teeth is a powerful immune booster, but in fact, it's a reliable method for reducing your risk of infection.(10) If you don't keep your teeth clean, bacteria accumulate in your oral mucosa, especially if you’re eating multiple meals and shakes throughout the day. Brush 2-3x a day to reduce your risk.
7. Sharing Water Bottles - A great motto for life is “Sharing is caring”, just not when comes to athletes and their immunity. Sharing water bottles increases your risk of mononucleosis infection 8-fold!(11) Stick to your own water bottle.. no sharing!
8. Travel – Plane travel can feel like an immunity Armageddon; waiting to succumb to the onslaught of microbes with nowhere to hide. There is always a handful of passengers - sneezing, coughing and touching everything in sight – increasing your risk of exposure to infection.(12) Unfortunately, they're putting you at risk and there isn't much you can do about it. Hand sanitizer, a face mask, and if the person next to you is ill, asking to changes seats are probably your best strategies.
9. Extreme Environments - If you're training at altitude, or in extremely hot and humid environments, your immune system can be impacted. Altitude has been shown to reduce sIgA levels, potentially increasing risk of infection, while hot climates can lead to dehydration and reduced plasma volume, also potentially compromising immunity.(13,14)
10. Drugs - If your athlete or client is taking medications like corticosteroids for arthritis, asthma or allergies, or if they’re taking immune-suppressive medications for an auto-immune condition they may also be more susceptible to colds and flu.
11. Vaccination History - If you're team is traveling abroad and you haven't had all the appropriate vaccinations (i.e. hep C, hep B, flu vaccine) then you're increasing your risk of infection.(15) This is not only a performance problem, but a potentially serious health problem.
These 11 factors are some of the most common reasons why your immune system is compromised, and risk of infection increased. Reducing this risk factors, as best as you can, will go a long way to keeping you cold and flu free this winter (or anytime of the year for that matter!) so you can keep training and keep improving.
What about factors that can positively impact your immunity? Here's a short-list of high-impact factors;
1. Sleep (Listen to Dr. Amy Bender PhD talk sleep strategies in athletes)
2. Nutrition (Check out 21 Foods To Boost Your Immunity)
3. Relaxation (Learn how deep-breathing impacts performance)
4. Periodized Exercise
5. Holidays (When was the last time you actually went on holiday? If you can't remember... you need a holiday!)
Maximize your performance high this winter by minimizing your exposure to colds and flu. Next, add a few fundamental strategies that increase pillars of recovery; sleep, nutrition and mental stress.
Dr. Marc Bubbs ND, MSc(c), CISSN, CSCS
Want to learn 10 evidence-based strategies to reduce illness in athletes? Download my FREE infrographic here! (Coming soon...)
Today, we just don’t enough sleep. Our modern high-tech society seems to be wreaking havoc on our sleep time (and quality), and ultimately health and performance. The average America adult gets only six and a half hours of sleep per night and alarmingly 33% of the population gets less than 6 hours of sleep per night. One of the most common question I get from clients to offset their sleep debt is “can I just sleep more on the weekends?” It’s an interesting question, but unfortunately the current research suggests no… you need to be consistent with your sleep to reap the health and performance benefits.Read More
Today, over 33 percent of America gets less than 6 hours of sleep, which throws your blood sugar and insulin levels out of whack, ramps up cravings, and shoots your cortisol stress levels through the roof. No wonder you’re tired.
One of the most common complaints from clients is fatigue. Practicing in a busy downtown clinic in a major city means I see a lot of Type A clients constantly on the go from work and play.
Whether it’s trouble getting out of bed in the morning without hitting snooze three times, struggling through afternoon energy crashes or not getting to bed early enough, sleep has a major impact on mental and physical health (and performance).
We sleep less than our grandparents’ generation, and we’re constantly stimulated by connectivity. We’re overtaxed!
The average person today gets 1.5-2.0 hours less sleep than our grandparents’ generation, and when you combine that with the constant stimulation of mobile devices and connectivity, our brains and bodies are generally overtaxed and under-recovered. (1) Before you add more “siestas” into your day, you need to understand how sleep works to maximize your naps.
What Is a Sleep Cycle?
There are two main types of sleep: rapid eye movement (REM) and non-rapid eye movement (non-REM), which are separated into four stages. You can think of REM as “active” sleep and non-REM as “quiet” sleep.
In Stage 1 (non-REM), you’re settling down to rest and you drift in and out of sleep. This period lasts 5-10 minutes, during which the brain produces theta waves that slow brain activity. It’s the period between wakefulness and sleep. (If someone woke you up at this point, you would probably say you weren’t even asleep.)
In Stage 2 (non-REM), your body temperature drops and your heart and breath rate become more regular. Ironically, your brain produces small bursts of activity in preparation for deeper sleep phases. You spend about 20 minutes in this phase.
Stage 3 (non-REM) is when slow delta brain waves kick in, your muscles relax, blood pressure drops, and you transition from light to deep sleep. This is your deepest sleep, when your body really starts repairing and rebuilding your muscles, memory, immunity, hormones, nervous system, etc. It’s like taking your car into the mechanic: deep sleep tunes-up the body so it’s running on all cylinders.
Stage 3 sleep is the deepest, restoring your body’s muscles, memory and immune system.
In Stage 4, you enter REM sleep and your body becomes extremely relaxed (in fact, paralyzed) and your brain more active. Rapid eye movement begins in this stage (thus the REM acronym), as well as your dreams. Most people spend about 20% of their sleep in REM.
Your body rolls through all of these stages every 90 minutes, but they don’t happen in sequence. You start off in stage 1, then progress to stages 2 and 3 before your body reverts back into stage 2. This cycle occurs multiple times before you hit REM sleep, about every 90 minutes.
Benefits of Napping
Adding naps into your routine can provide numerous health benefits. Remember, a nap is usually only light sleep (20-60 minutes in phase 1-3) or one sleep cycle (90 minutes), whereas in deep sleep overnight, your body will roll through multiple cycles. Check out the of benefits of napping below:
1. Naps Improve Brain Function
Napping is the ultimate brain-hack. Research shows even a 5-15 minute nap can significantly improve cognitive function for the next 1-3 hours, something most of us can really use during that afternoon slump. (2)
2. Naps Prevent Weight Gain
If you don’t get enough sleep time at night, you’re over 50% more likely to be obese. (3) That’s no joke. If you know you aren’t getting to bed early enough at night, make time to decompress during the day to maintain a healthy body composition. The extra sleep and recovery from a midday nap can help mitigate these effects.
3. Naps Support Athletic Performance
Not getting enough sleep is also a performance killer. The American Academy of Sleep Medicine recently found that sleep restriction reduced maximal aerobic power, energy expenditure and time to exhaustion in athletes. (4) It’s no wonder elite athletes nap so often!
4. Naps Improve Immune Defenses
If you get less than six hours of sleep nightly, you’re at 4.5x greater risk of catching a cold or flu. (5) This is one of the reasons why you get sick when you’re trying to hit a deadline and burning the midnight oil (at the expense of sleep) or when you’re a new parent who is constantly waking up throughout the night to comfort or feed your baby. Napping can help offset this effect and increase immune function.
5. Naps Can Boost Your Memory
Pre-school kids do this as part of their daily routine, and now the research shows it helps to improve memory consolidation. That’s right, a 30-minute nap within four hours of a learning task significantly improves memory; increasing this to 45-60 minutes for adults could make your memory five times more effective. (6) We always think doing “more” is the answer, but this research highlights that taking the time to rest will increase your efficiency.
6. Naps Improve Resiliency from Travel
If you travel for work and fly across multiple time zones, it deeply impacts your body’s circadian hormone output, significantly raising cortisol and adrenaline stress hormones and reducing sleep quality. (7) Naps help build resiliency by increasing the amount of time you spend in parasympathetic “rest and digest” mode.
7. Naps Lower Blood Pressure
If you’re always on the go, regularly drinking caffeine, or in poor health, you may have high blood pressure. Studies show that taking a regular afternoon nap is inversely associated with heart attacks. (8) Another great reason to make time for a siesta.
How Long Should You Nap?
Your body runs on a 24-hour biological clock, known as your circadian rhythm. This rhythm peaks in the morning (to wake you up) and falls in the evening (to prepare you for sleep). It also bottoms out a little in the afternoon, one of the reasons we all feel a little fatigue around then. During this 24-hour cycle, we have two periods of intense dips: one between 2am to 4am, and the other approximately 10 hours later. If you wake up earlier, this afternoon dip will be more towards 1-2pm, while if you start your day a bit later, it may be anytime between 2-4 pm. It’s important not to nap too close to bedtime, as this will shift your circadian rhythm and you’ll struggle to fall asleep.
The early afternoon is the best time to nap. If you sleep too close to bedtime, it’ll shift your circadian rhythm.
The duration and timing of your nap are important factors to consider. If the timing of your nap is off, you’ll likely wake up tired, groggy and disoriented (not the effects you were likely aiming for). Below are three napping strategies that can help boost your mental and physical performance. Use the one that works best for you.
The Desk Worker’s Nap
If you work at a desk all day, it’s not easy to carve out 60 or 90 minutes to nap during the day. The “desk worker’s” nap is only 15-20 minutes in stage 2 sleep, but helps to quickly recharge your brain to boost cognitive function. Aim for anytime between 2pm and 4pm.
The Entrepreneur’s Nap
If you work for yourself or set your own hours, it’s possible to carve out a longer stretch for napping during the day. Business owners usually work really long days, so getting a full 60 minutes allows you to get into stage 3 sleep and consolidate better memory. Again, aim for between 2pm and 4pm.
The Athlete’s Nap
If you’re training intensely, your body will benefit from a full 90-minute sleep cycle (with REM sleep) to maximize recovery from training. This type of sleep enhances nervous system and muscular repair, as well as boosting creativity (for the artist types who want to take advantage too!). Athletes normally perform two-a-day training, so the nap may be a bit earlier, between 1pm and 2pm, to allow time before the afternoon training session.
We are busier today that we’ve ever been, and sleep usually takes a back seat when you’re pressed for time. Reboot your mental and physical performance by adding a daily nap into your routine. It’s an incredible health hack that can supercharge your brain and body so they can keep up with your hectic pace.
Dr. Marc Bubbs ND, CISSN, CSCS
Want to learn more? Listen Dr. Amy Bender PhD talk naps and sleep on the Dr. Bubbs Performance Podcast...
Check out more articles in the SLEEP SERIES...
Did you know that four out of every five visits to the doctor’s office is stress-related? In today’s 24/7 society, stressors present themselves in many different forms: mental stress from a busy work day, physical stress from an intense training session or constantly being on the run, or emotional stress from relationships with family or friends. Although stress is essential for overall health (it provides the mental and physical challenges required to stimulate positive adaptation), if you have chronic or excessive stressors or poor coping mechanisms it may result in adrenal dysfunction and/or altered cortisol rhythm.
Why Are Your Adrenals So Important To Stress?
Your adrenal glands are small triangular-shaped glands positioned on top of your kidneys that secrete specific hormones in response to stressful stimuli. The glands are made up of two parts: the inner medulla that produces the hormone adrenaline in response to stress and the outer cortex that produces cortisol. Let’s take a look at how these two hormones drive your response to stressors in your environment.
When adrenaline is produced, it triggers the breakdown of body-fat for fuel and acts by raising your blood pressure and heart rate to increase your alertness. If you enjoy a cup of coffee in the morning, you’re getting a nice little jolt of adrenaline from the caffeine that helps to increase mental focus and work capacity during exercise. This happens instantly via your sympathetic fight or flight nervous system, which is a direct connection between your brain and adrenal glands.
Whereas adrenaline preferentially catabolizes (breaks down) fat, cortisol breaks down muscle tissue to provide fuel for your body. Like adrenaline, its job is to increase your blood sugar levels to provide energy for the body to overcome the stressful event. From an evolutionary perspective, this was critical for escaping from wild animals or other threats. Nowadays, you experience a boost when you’re in the gym or training hard, but when your session is over, your stress levels should return to baseline. (If you adrenals are out of balance, this isn’t always the case and has significant negative repercussions).
Today’s Stress Response
In nature, a stressor is short-term then subsides. For example, a zebra grazing in the savannah might spot a lion in the distance resulting in a boost of adrenaline and cortisol to increase the heart rate, breath rate, and shunt blood to its working muscles should it need to run for its life! The subsequent chase might last 10-20 minutes, then it would be over and the zebra could go back to relaxing and grazing.
Thankfully, in today’s world we don’t often have to run away from lions or bears, but “modern” stressors actually exert a much more debilitating toll on our body. How is this possible?
Today, stressors last all day long! The emails don’t stop, the deadlines don’t stop, and the commitments don’t stop. Your body – and more importantly your brain – are experiencing constant and prolonged stressors, far longer than would be experienced in nature. This leads to a heavy burden on your adrenal glands and your body.
What is Adrenal Dysfunction?
While the physiological mechanisms have evolved over millions of years, the realities of sitting at a desk and having to juggle all the mental tasks from work and home life can leave your brain (and body) stuck in “fight or flight” sympathetic overdrive. For some this can manifest itself as the over-production of adrenaline and cortisol, while for others the reverse can happen and you may feel sluggish or fatigued.
In years past, clients complaining of prolonged fatigue were often diagnosed with ‘Adrenal Fatigue’, the inability of the adrenal glands to keep up with a person’s busy life or increased number of stressors. Today, we understand this is not the whole story. A new area of medicine called psycho-neuro-endocrine-immunology (now that’s a mouthful!) or PNEI is uncovering that your brain is really the root cause of adrenal dysfunction, and therefore the key player in supporting your adrenals and stress response. In short, the hypothalamus area of your brain is the master switch that tells your adrenal glands to ramp up the production of adrenaline and cortisol (over-performing adrenals), or dial it back (under-performing adrenals).
Do You Have Symptoms of Adrenal Dysfunction?
In clinical practice, I see many patients with either over-performing or under-performing adrenals. There are symptoms on each end of the spectrum that indicate adrenal dysfunction. If you have difficulty waking up in the morning, poor energy during the day, feel better after eating meals, or have diminished libido then chances are your adrenal glands are underperforming.
If you’re a person with naturally high energy levels, have high blood sugars, experience excessive sweating, have difficulty falling asleep, or feel like your mind continually races with a list of tasks and deadlines then you may be suffering from over-performing adrenals. This constant fight or flight sympathetic dominance chronically elevates cortisol levels and may lead to roadblocks in your quest for a slimmer waistline, faster 10k run time or better overall health.
There is one more piece to this complex puzzle. Your daily cortisol rhythm can also get thrown out of balance by stress. In the morning, your cortisol should be at its highest to wake you up from deep sleep and get you ready to attack the day. In the evening, your level starts to lower and should be at its lowest point at bedtime. This allows the sleep hormone melatonin to ramp up and prepares your body for deep, restorative sleep.
If you suffer from general fatigue, poor recovery from workouts, low mood, and your short-term memory is poor (e.g. you often forget what to pick for dinner, where you left your phone, or your client’s name) then poor daily cortisol rhythm may be your area of adrenal dysfunction. If you struggle to get out of bed in the morning, hit snooze multiple times, or feel desperate for a coffee to get going then chances are your morning cortisol rhythm is out of balance. If you struggle to fall asleep at night, wake up throughout the night, or classify yourself as a night owl then you likely have an altered evening cortisol rhythm.
It is important to address adrenal dysfunction and/or altered cortisol rhythm as they can lead to serious negative consequences. These include increased inflammation, poor memory, increased risk of anxiety or depression, reduced testosterone production, slow thyroid function, increased belly-fat, decreased lean muscle mass, poor blood sugar control or insulin resistance, and cognitive decline.1 If you’re not sure whether your adrenals are functioning optimally, you can request a salivary-cortisol test.2
The Adrenal Dysfunction Fix
Diet is the first place to start when correcting adrenal dysfunction. It’s critical to obtain the building blocks essential for supporting a healthy stress response. The Paleo diet is the perfect place to start.
First, increase your intake of healthy saturated fats, such as butter, ghee, or coconut oil. Studies show that fatigued and over-stressed athletes are better able to recover and maintain performance on a high fat diet, in particular when high in saturated fats.3
Next, make sure you are achieving an adequate intake of protein, as high cortisol levels will quickly break down precious muscle tissue and leave you in a catabolic state. Aim for 0.7-0.9g of protein per pound of bodyweight.
Finally, it’s not only what you add to your diet, but also what you remove. If you’re suffering from adrenal dysfunction or altered cortisol rhythm then discontinue your caffeine intake – coffee, black tea, chocolate – for 4 weeks. Sugar and caffeine cravings are classic signs of adrenal dysfunction, so be sure to eliminate all processed sugars and carbs for 4 weeks.
Busy work days or long hours in the gym can leave you burning the candle at both ends and therefore being stuck in the fight or flight sympathetic overdrive. If the root cause of adrenal dysfunction starts in the brain, it makes sense to incorporate techniques that directly impact your central command center.
Meditation is an ancient technique that helps restore your cortisol rhythm and adrenal function by stimulating your “rest and digest” parasympathetic nervous system via the vagus nerve in your brain.
Not convinced? A recent study of medical students showed that those engaging in daily mindfulness meditation practices had much lower blood cortisol levels compared to a placebo.4 Meditation has also been shown to significantly improve anxiety and depression, classic symptoms of adrenal dysfunction.5
Try this simple technique before bed to improve your “resiliency” and capacity to cope with stress:
- Start by sitting with your eyes closed.
- Inhale deeply through your nose; let your belly expand for three seconds
- At the end of your inhale, hold your breath for one second.
- Exhale deeply through your nose for another count of three seconds; let your belly draw inward toward your spine.
- Repeat for 5-10 minutes.
Did you know that today we sleep a whopping 500 hours less each year than our grandparent’s generation? This sleep debt places a tremendous burden on our resiliency or capacity to cope with stress.
If you get less than 7 hours sleep per night, struggle to fall asleep, or wake up frequently during the night your cortisol levels will be elevated and you’ll be cutting yourself short on the recovery front.6 To support deep sleep, make sure your bedroom is set up for optimal recovery. How can you improve your sleep quality? Here are some simple tips:
- Turn down the lights in your house after 9 p.m.
- Shut off your television or laptop at least 45 minutes before bed.
- Make sure your bedroom is completely dark. Try using blackout blinds or an eye mask to prevent unwanted light.
- Keep your bedroom cool and wear loose-fitting clothing or sleep naked
We’ve got a in-depth article on how to get better sleep if you want to know more.
There are several herbs that can support adrenal dysfunction, depending on whether you suffer from over-active or under-active adrenals, or cortisol rhythm dysfunction. A key nutrient called alpha-GPC can benefit all types of adrenal dysfunction. Supplementing with alpha-GPC provides the hippocampus with the right building blocks to restore normal cortisol rhythm by supporting the production of acetylcholine, a key neurotransmitter concentrated in the hippocampus that can be depleted by busy work schedules, lacking sleep or high stress.7 Take 500-1,000mg daily upon rising for 8-12 weeks.
Prioritize the fundamentals of diet, sleep, and controlling your stress response (e.g. proper breathing) to upgrade your adrenal function and correct symptoms of adrenal dysfunction. Train your brain and fuel your body correctly to increase your resiliency and keep your stress response system in balance.
Dr. Marc Bubbs ND, CISSN, CSCS
Want to learn more? Listen to Dr. Doug Kechijian talk "Mental Performance In High Stress Situations" on the Dr. Bubbs Performance Podcast...
Check out more articles in the "Cortisol Stress" Series...
Reynolds G. The Hormone Edge. J of Physio. NY Jan 14, 2012.
Manetti L et al. Usefulness of salivary cortisol in the diagnosis of hypercortisolism:comparison with serum and urinary cortisol. 2013. Eur J Endocrinol 168(3):315-21
Antonio, J et al. Essentials of Sports Nutrition and Supplements. Humana Press. New York, NY.
Turakitwanakan W et al. Effects of mindfulness meditation on serum cortisol of medical students. J Med Assoc Thai 2013 Jan;96 Suppl 1:S90-5.
Wurtzen H et al. Mindfulness significantly reduces self-reported levels of anxiety and depression: results of a randomised controlled trial among 336 Danish women treated for stage I-III breast cancer. Eur J Cancer 2013 Apr;49(6):1365-73.
Leproult R, Copinschi G, Buxton O, et al. Sleep loss results in an elevation of cortisol levels the next evening, Sleep. 1997;20:865-870.
DiPerri R. et al. A multicenter trial to evaluate the efficacy and tolerability of alpha-glycerylphosphorylcholine versus cytosine diphosphocholine in patients with vascular dementia. J Int Med Res. 1991. Jul-Aug;19(4):330-41.