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Defensive Moves - immune response in elderly
American Fitness, July, 2001
Immune response in elderly depends on physical activity rather than enriched diet.
Reprinted from a press release by kind permission of the American College of Sports Medicine (ACSM).
The American College of Sports Medicine (ACSM) recently published a study in its official monthly journal, Medicine & Science in Sports & Exercise[R], that compared the effects of skills-training exercise to the effects of foods enriched with vitamins and micronutrients on the cellular immune response in frail elderly persons. The purpose of this research was to assess the effects of exercise and diet in a population not extensively studied: persons over 70 years who need more care.
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The team of researchers, led by Marijke J. M. Chin A Paw, Wageningen University, The Netherlands, reviewed previous studies which had proven that immune responses decline with age, possibly because of decreased physical activity and/or nutritional deficiencies. It had been suggested that supplements rich in micronutrients would improve immunity, but few studies have researched the effects of exercise training. Also, trials previously performed used healthy elderly subjects. "We know that physical activity and nutritional intake are often marginal in the frail elderly," says Chin A Paw. "So we decided to develop an exercise program, provide micronutrient-enriched foods instead of supplements and studied the effects of both. The results were interesting, and may be useful for care personnel and further study."
Subjects for the study were recruited by mail from several senior programs. Criteria included being at least 70, needing care but living independently, not taking multivitamins, not being regularly active and experiencing stable health. The final study sample included 112 participants whose mean age was 79.2.
The study took place over 17 weeks and was based on a two-by-two factorial design that permitted assessment of both independent and interactive effects of exercise and nutrition. Forty-four subjects were assigned to supervised group exercise, 55 to enriched food products, 60 to both and 58 to the control group. The dropout of 56 subjects did not affect distribution among the groups. Dropouts after the interventions began were largely due to changes in health status.
The exercise group performed 45 minutes of supervised progressive mobility performance twice a week, starting with warm-up activities and ending with cool-down stretching and range-of-motion movement. The median attendance rate for exercise sessions was 90 percent. Subjects not in the exercise group participated in a social program every two weeks with a creative therapist and were visited at home in the off-weeks.
The nutritional intervention, intended to improve micronutrient intake, provided subjects with fruit and dairy products enriched with vitamins and minerals usually low in this group. Subjects complied with the nutritional intervention at a high rate. The exercise and control groups received identical foods, with the same energy content, but non-enriched.
Subjects were assessed for several characteristics. Skin test measurement (a mean of four readings) assessed cell-mediated immunity. Physical fitness was tested with manual dexterity, reaction time, standing balance hip/spine flexibility, hand grip strength, shoulder flexibility and quad strength. To measure functional capacity, researchers checked parameters, such as gait speed, step length, standup time from a seated position and dressing in a coat. Physical activity, weight, body mass index and biochemical deficiency were also measured, using standard assessments.
After 17 weeks, the exercise program had a small but statistically significant beneficial effect on cellular immune response. The researchers cautiously concluded that exercise may be beneficial in frail inactive elderly persons. An added positive effect of the exercise program was its adaptability. It was especially designed for frail elderly persons using inexpensive equipment. The program was also set up to be adaptable to real-life circumstances that could be carried over to a more active lifestyle, even for this population.
Although the nutrient-enriched food did not affect cellular immune response in the 17-week period, blood vitamins, mineral concentrations and enzyme activity did increase--thus yielding a positive effect. The researchers suggest future studies of longer duration that include possible effects on morbidity, noting that the level of duration of supplementation in this study may have been insufficient for an effect to become apparent.
About ACSM
The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 18,000 members throughout the U.S. and the world are dedicated to promoting and integrating scientific research, education and practical applications of sports medicine and exercise science to maintain and enhance physical performance, fitness, health and quality of life.
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