Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
1 May

H1ow N1ot to Get Swine Flu

Swine flu. Even the hype surrounding it is pandemic. It’s made headlines in every major newspaper and magazine. The CDC has a new press release every half hour. TV talking heads and radio pundits furrow their brows and express extreme consternation as they tell us to start “bracing for the worst.” President Obama has asked for another billion-and–a-half dollars (that we don’t have) to fend off this impending menace. Frightened school boards are halting classes everywhere until they are given a better action plan. Cruises are cancelled, trips are postponed, pigs are slaughtered, nations are blamed. It’s crazy.

I’m sorry. At this point, I’m not buying it.

I am not convinced that Swine flu H1N1 is any different from just about every other strain of flu we experience every year. Hong Kong flu, every Asian variety of the past two decades, duck flu, other bird flu, you name it. We know the CDC trades in hyperbole, but, hey, “we’re from the government and we’re here to help you.” On the other hand, in the past few hours there seems to be some consensus from clear-thinkers emerging that this swine flu might not be so fatal as strains that caused some prior pandemics. Too little too late?

In fact, there are viruses (and bacteria and fungi and parasites and…) around us all the time. So why don’t we all get sick all the time? Why do so many people get sick and die during epidemics? Every year in the US there are 50,000,000 cases of flu (all types) and 36,000 deaths. If everyone is exposed at some level (and I guarantee you, everyone is exposed) then why doesn’t everyone get sick? And if 50,000,000 get the flu, why don’t 50,000,000 die? It all comes down to the health of your immune system and the strength of your organ reserve. Of course, the Primal lifestyle guarantees both. In the vast majority of cases, people that die of the flu have extremely weakened immune systems and/or experience organ failure indirectly related to the flu (kidneys fail, heart fails, liver fails, etc). But what does that mean for you and me? If you have a healthy immune system and are otherwise in good shape, there’s a strong likelihood that routine exposure to swine (or any) flu will be handled by your immune system without you even noticing. Or maybe you’ll feel weird for a day or two and then you’ll shake it. And even if you should get sick, in 99.99% of cases you have nothing to fear from any form of flu except maybe the loss of a few days pay and a few days of feeling crappy. But only if your immune system is in good order.

So what can you do to bolster your immune system and make sure you fend off any attack – swine-related or otherwise?

1. Avoid Sugar

Sugar is a powerful immune suppressor. One dose of a big dessert or a bag of gumdrops scarfed at a movie can be enough to temporarily weaken the immune system and open the door to infection. That’s especially true if you’ve been eating Primally and clean for a while. Unfortunately, most Americans are susceptible because a lifestyle of sugar intake can result in perpetual immune suppression, the effects of which not only make them sitting ducks for the flu, but can also exacerbate heart disease and cancer.

2. Avoid Stress

Chronic cortisol (the major stress hormone) release is another powerful immune suppressor. As tough as times are, it behooves you to get a handle on stress and do whatever you can to mitigate it, whether it’s through meditation, yoga, prayer, biofeedback or just taking a few minutes each day to chill. People get sick when they are stressed out not from the stress itself, but from the fact that exposure to any virus or bacteria overwhelms their frail immune system.

3. Avoid Overly Stressful Workouts

Again, few things can suppress the immune system as quickly as chronic cardio or a single excessive weekend warrior workout (usually anything under 45 minutes is fine). I can pinpoint from my marathon days those exact individual workouts in which I knew immediately that I had gone too far or dug too deep. Invariably I came down with some URTI within a few days – not because I was newly exposed, but because I was vulnerable to anything and everything that was always floating in the air, on a doorknob or in a handshake.

4. Cut the Grains

This would normally be part of the first item “avoid sugar”, since grains tend to be converted to glucose pretty rapidly. But beyond their glucose load, grains (especially whole grains) and their glutens, lectins and phytates may have a collective immune altering or immune-suppressing effect in some (and I suspect most) people.

5. Avoid Stupid Exposure Mistakes

In many cases a mild exposure, like being in the same room with a flu “victim”, is enough to stimulate a healthy immune system to react in a way that further reduces the likelihood you’ll come down with your own case. On the other hand, shaking the hand of someone with the flu who just coughed or sneezed into it might put you over the edge if you then wipe you nose or rub your eyes (eyes are a very vulnerable entry point). I’m not the biggest fan of hand cleaners, but if you think you just got slimed, wash a decent hand soap just to be sure. No need to go OCD in this regard. I would never wear a mask on a plane, for instance, but I’m not telling you not to if you sit next to a cougher/sneezer.

6. Do Get Some Sunshine

The immune system requires vitamin D to function optimally and sunlight is the best way to ensure you get enough D (a vitamin D supplement won’t hurt either). Winter is cold and flu season not just because we are inside sharing our sputum, but because we spend less time getting sunshine and vitamin D.

7. Exercise Appropriately

If you follow the PB, you’ll know that getting a fair amount of low-level aerobic activity and a few focused strength sessions each week will have an immune-boosting effect.

8. Eat Good Fats and Avoid Bad Fats

Omega 3s, mono-unsaturates and even most saturated fats will support healthy immune systems. On the other hand, any intake of trans and hydrogenated/partially hydrogenated fats will compromise immunity, as will excessive intake of the Omega 6 fats found in many vegetable oils.

The swine flu is nothing new. Whether you get sick or not is entirely up to you. To paraphase George W. Bush “Flu me once, shame on — shame on you. Flu me — you can’t get flued again”  Take responsibility for your own health and, fer cryin’ out loud, don’t be flued by the hype.

Further Reading:

Dear Mark: Should I Get a Flu Shot?

Achieve Your Health Goals by “Getting Real”

9 Natural Cold and Flu Remedies (plus one)

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. Thank you for your perspective. I was leaning this way but appreciate hearing what you have to say. How many thousands of people die from the flu each year, without a single extra penny being spent? But as soon as we add an adjective onto the word “flu” (swine flu, avian flu etc), its suddenly ok to overreact and spend millions!

    Holly wrote on May 1st, 2009
  2. P.S. Yay for being primal for 7 months and not getting sick ONCE during that time!

    Holly wrote on May 1st, 2009
  3. Mark,

    Thank you for putting out this article. I wasn’t in the least bit worried. I always think it is funny when people say “the flu is going around”…or “there is a bug going around”.

    My response is “so what, I am not going to get sick”.

    It makes me smile when people act like they have no choice but to get sick…or they act like their lifestyle and diet don’t have any role in getting sick.

    I also like your points on sugar and grains. It is good to be reminded of the fact that they weaken the immune system.

    One last thing…bring on the sunshine! I know you must have been catching some ray in SoCal.

    Best Swine Flu post I’ve read!


    Rusty - Fitness Black Book wrote on May 1st, 2009
  4. Great timely article, Mark. I guess there really are just a handful of solid principles that lead to a healthy life. I’m passing this on to my friends and family. I’ve got an aunt that’s been a slather over all the swine flu news. This should calm her nerves a bit.

    Manatoa wrote on May 1st, 2009
  5. I’m much more afraid of dying from the infection caused by the vehicles (CNN, MSNBC, Fox, etc.) carrying the news, than the ones carrying the flu.

    Good stuff Mark, as always.

    emergefit wrote on May 1st, 2009
  6. I’m not really scared of the flu itself, but as the principal of a school I’m just waiting for rumor that one of our kids is sick and the parents start calling to ask why we haven’t closed the school.

    Jonathan wrote on May 1st, 2009
  7. Good post, Mark. Invaluable information as always…

    Oh, and you and I both know that this “pandemic” improves ratings, sells papers, generates hits, and sells advertising slots.

    michael deluca wrote on May 1st, 2009
  8. Good stuff Mark, I agree 100%

    Jerry wrote on May 1st, 2009
  9. 36,000 people die every year in the US from ‘regular’ flu. By comparison, this is peanuts.

    Greg at Live Fit wrote on May 1st, 2009
  10. I would not say their are school closings everywhere- Some states like Texas, Delaware and New York where confirmed cases of Swine Flu have been recordered have closed. To do otherwise would be irresponsible. See it over hype? Hope so because if it isn’t then we have a problem.

    ps- a majority of our public is so under healthed because of their diet –many are in danger.
    I do not feel like one of them but I am as concern about this as I am about North Korea or Iran developing Nukes they can launch but not as much as whether Jennifer Aniston gets over Brad Pitt and finds happiness. Over hype is far better than a lack of awarness.

    pjnoir wrote on May 1st, 2009
  11. Good stuff. I guess I can come out of my plastic bubble now!

    I’ll add in my favorite defense too, Apple Cider Vinegar….worked for Jack Lalanne…works for me.

    Mike OD - Life Spotlight wrote on May 1st, 2009

    This post explains why the symptoms of swine flu may be no worse than the seasonal flu. That said, due to the underlying genetics of the virus, it will likely spread much faster and infect more people, putting enormous strain on healthcare infrastructure.

    fluffhedd wrote on May 1st, 2009
  13. What I have been reading about this flu suggests that really healthy immune systems might in fact contribute to higher mortality probability. Mortalities for this flu are due to secondary pneumonia that comes from an immune response that is too energetic which leads to the patients own fluids accumulating in his or her lungs. This is at least a partial explanation as to why younger, healthier people seem to be the victims.

    This has been mentioned in the news…

    What do you all think?

    Mike Panian wrote on May 1st, 2009
  14. As Mike has already stated, having a robust immune system will be more of a hindrance if this virus mutates in a particular way. Victims of Spanish flu died from Cytokine storm – an over-reaction of the immune system leading to pneumonia or massive organ failure.

    Anyone with romantic notions of health & disease should do their homework and start to take this seriously. This is a very real threat to everyone, immuno-suppressed or not.

    Alexl wrote on May 1st, 2009
  15. #3…CrossFit on a 3/1 schedule? =P Sorry had to.

    George wrote on May 1st, 2009
  16. This has already been mentioned a bit in the comments, but I’ve been meaning to put this out there to PBers- do you actually find yourself getting sick less? With colds, flu, etc.?

    Lately I have been incorporating some PB principals to my diet, and eating a lot better, but still eating large amounts of unhealthy sugar “vices”. Now I’ve come down with a stomach flu thing (NOT swine flu). It has really shown me that I need to cut out the unhealthy sugar. Just not worth it.

    I wanted to also put this out there to the PBers- when you do get sick, what do you eat? A lot of the “sick food” that I have always consumed while I am recovering isn’t PB (ginger ale, bread, etc.).

    CC wrote on May 1st, 2009
  17. Mike and Alexl, I am of the opinion that this strain is not so virulent as was first predicted. The cytokine storm thing can be a consideration with other, more virulent strains. I suspect that the cytokine storm is an effect of a malfunctioning immune system similar to what happens in autoimmune diseases and may be tremendously impacted by diet. For that reason, I’m back to wanting to do everything to shore up my own immune system and have it working the way it evolved to work. Primal Blueprint style.

    Mark Sisson wrote on May 1st, 2009
  18. George, sure….why not.

    #3…CrossFit on a 3/1 schedule? =P Sorry had to.

    Mark Sisson wrote on May 1st, 2009
  19. As a point of fact, it is not the flu itself which causes the vast majority of flu-related mortality (deaths). Flu infections are generally self-limiting and tend to run their course fairly quickly. Rather, the flu virus opens a pathway for bacterial infection by compromising pulmonary tissues, then a secondary bacterial infection sets in, exascerbates fluid production in the lungs (pneumonia) and in some cases sepsis (bacterial proliferation in the blood) – which causes “flu-related” mortality. In the early twentieth century we did not have antibiotics to combat the secondary infections, and “flu” outbreaks were deadly. The Spanish flu epidemic of 1918 killed around 16 million people worldwide, but scientists in that day mistakenly thought a specific bacterium was to blame – because they did not know viruses (which were too small to observe in those days) existed. So they named the bacteria “haemophilus influenza” thinking it was to blame for the cause of the epidemic. The problem for people in 1918 is that there were no antibiotics available in those days. Today, in developed nations like ours, “flu” outbreaks don’t represent major threats to the population, because we can kill the secondary infection with a variety of antibiotics readily available in local hospitals, and stop progression to pneumonia. People in developing nations, however, are not so fortunate; they have no adequate medical facilities and medicine, they live in squalid conditions by our standards, and “flu” outbreaks progress through bacterial infection, pneumonia, and sepsis, and can kill thousands. The last major flu outbreak attributed to a single strain of flu in the United States was during the winter of 1968-69. Just over 33,000 people died of “flu” that year, which is about average for most years in the U.S. But once again, in those days we lacked the variety and strength of antibiotics we enjoy today. The possibillity of a major, life threatening flu outbreak in the United States is highly unlikely, and the public alarm raised by uninformed media outlets and government officials is unfounded. Wash your hands and maintain good health. You’ll be fine.

    Bob H wrote on May 1st, 2009
  20. Aw, wish it was all that simple. I know that eating according to the PB has improved my immune system, but I was hit with pneumonia as a kid and it has left my system weaker :( I can tick all of those boxes, and yet I’m just getting over a bout of laryngitis. For me it’ll be a case of ‘everything that doesn’t kill you makes you stronger’ but I certainly intend to keep up my healthy lifestyle to help my system out.

    Jess wrote on May 1st, 2009
  21. Thank You for this Article Mark. People seem to forget that an ounce of prevention is worth a pound of cure, or uncooked bacon in this case…

    Dave | The Intelligent Workout wrote on May 2nd, 2009
  22. But Mark… how do you sell billions of dollars worth of Tamiflu for your pharma buddies without fear mongering the masses?

    You’re such a party pooper!

    pnw fitness wrote on May 2nd, 2009
  23. Love the title of the article (the added 1’s). Very clever.

    Karin wrote on May 2nd, 2009
  24. Alright Mr Fritos & Lime; that was NOT a very PB snack idea! but I might have made it a few months ago :-) I’m with the others: I have felt healthier this winter & only Almost caught the crud. The yoga & pilates I started recently have worked loose the “sediments” in my lungs so as to feel even healthier. Now, I’m off to take suggestion #6 to its full extent! I’m headed to Cancun for a week & I am NOT afraid. Hey, I live way up high in the mtns (might snow later today) & we look fwd to our sun-time this time of year. I’ll have my supplements in tow & might even quaff a marg or 2, for Vitamin C of course…

    Peggy wrote on May 2nd, 2009
  25. I would like to dig up some of my previous doctors, give them the good kicking they so richly deserve and then bury them again.

    I was written off as a “weak and sickly” child. Nearly thirty years ago I told my doctor I thought I might be diabetic (diagnosis made by a diabetic colleague) and he wrote me up as having “fanciful notions”.

    Curiously in the five years since I finally discovered that I actually WAS diabetic and started low carbing, and moving into a Primal type diet, I have never been healthier or fitter. Those winter colds either pass me by or don’t hit me nearly as hard as many others.

    The only thing that I find a tad worrying is that I have not had any form of flu at all for years. If this one hits will this lack of exposure mean lack of immunity? I also ponder the point made above about the immune system actually causing some of the fatality. But then why is it so much milder outside of its Mexican origins? Currently many unanswered questions.

    One thing’s for certain sure, if I’d had any spare moneys I’d have invested them in Roche, might have made back some of my losses 😛

    Trinkwasser wrote on May 2nd, 2009
  26. Trinkwasser, the fact that you haven’t gotten sick doesn’t mean that your immune system hasn’t been busy identifying all the bugs you’ve been exposed to and keeping you from feeling all the symptoms. When the bugs “don’t hit you as hard” is when you know your immune system is working well.

    Mark Sisson wrote on May 2nd, 2009
  27. This recent submission to Digg helps put swine flu in its place as well.

    Dave | The Intelligent Workout wrote on May 3rd, 2009
  28. You have mirrored my feelings on this latest ‘pandemic’ to a tee! The fears over Avian ‘flu fizzled out and most people had forgotten about it so wham-bam here comes Swine ‘flu to put you back into panic mode – Pleeez!

    Alex wrote on May 4th, 2009
  29. you are more likly to be hit by a bus then to die from swine flu

    thecoolone wrote on May 5th, 2009
  30. I am a principal in Michigan, I receive all kinds of information from health departments and the CDC on situations like this. Yesterday they sent me a notice that the flu isn’t nearly as bad as they feared and we are not supposed to close our schools if there is a suspected case of the swine flu.

    Just supposed to maintain the same health practices we would follow for any other illness.

    Jonathan wrote on May 6th, 2009
  31. We believe this is a man made virus-made in the govt lab. The govt want to force vaccines on everyone and this was a good scare tactic.The drug companies own our politicians and this is just the beginning of what they want to do for profits. They want to start children on chloesterol drugs. Doesn’t anyone see the what is going on? The TV drug ads are part of this. You will never see alternative medicine, supplements and other natural items put on the corporate owned media. When CODEX is ratified at the end of 2009 you will see the beginning of laws to stop us from buying supplements and alternative medicine. This has already started in Europe with the European Union. Search the Internet before it is too late to find out the truth of what the wealthy elite/corporations have in mind. Monsanto and GMOs are just the beginning. This flu scare is a hoax and people are falling for it!

    kate wrote on May 6th, 2009
  32. as already noted, strong immune systems are more likely to kill you with certain strains of flu. I doubt that diet was a factor – the flu of 1918 killed people in all countries: at a time when diets likely differed a good deal more between countries than they do now. The common factor was that young healthy people with strong immune systems were the victims.

    Now that the aggressive public health response appears to have contained this flu, expect lots of pooh-poohing of the reaction. The problem is that any time a disease jumps across species, it:
    1. tends to be highly infectious, since no natural immunity has built up;
    2. tends to mutate fast and widely, since it’s exploiting new hosts.
    The more people catch it (1), the more likely it will mutate into something truly lethal. We may have dodged this one, but it (or something like it) will be back..

    Doug K wrote on May 6th, 2009

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