Five Steps to Reduce Stress, Improve Immunity, and Decrease Your Risk of Coronavirus Infection
March 28, 2020 Blogs by: Tim Jennings, M.D.

1. Stay socially connected while socially distancing: While social distancing, which means limiting physical contact with others, is important to prevent the spread of the coronavirus, staying socially connected improves immune function and decreases the risk of being infected.

Studies comparing gene expression in lonely people to socially connected people found 209 genes expressed differently. Specifically, in the lonely group, genes that are associated with inflammation were turned on, whereas genes that have antiviral roles were turned off.[1] [2]

Steps to stay socially connected while staying physically apart, would include:

  • Engaging in activities with members of the household, talking and encouraging each other, playing games, doing puzzles—but also actually connecting and showing interest in each other.
  • Talking with friends and family on the phone, via Skype, or FaceTime
  • Creating online groups of friends or family for discussion, sharing, Bible study, and encouragement

2. Get 8 hours of sleep each night: Multiple studies have demonstrated that sleep is essential for healthy immune response. Those who sleep less than 8 hours each night have immune systems that are less responsive to infection, while those who sleep 8 hours each night make antibodies more effectively and are able to fight infections more readily. This is one factor why vaccines are not as effective in every person. Persons with chronic sleep deprivation do not get the same antibody production and subsequent protection from vaccines when compared to subjects who sleep 8 hours each night.[3] [4]

Steps to improve sleep include:

  • Decrease or eliminate stimulants, such as caffeine
  • Do not use alcohol as a sleep aid
  • >Use the night setting on electronic devices to decrease blue light
  • Don’t eat a heavy meal before bedtime
  • >Ensure a comfortable bed and cool sleeping environment
  • Ensure your room is dark
  • Keep animals out of the room and bed
  • Consider a sound machine or fan to create “white noise”
  • Establish a routine and schedule for going to bed and getting up—and stick to it
  • If sleep problems persist, see your doctor
  • Do not take sleep medications unless directed to do so by your doctor

3. Regular moderate aerobic exercise: Studies show that regular moderate to vigorous exercise of no more than 60 minutes enhances multiple immune functions. However, extreme exercise, such as running a marathon causes immune dysfunction. Regular moderate aerobic exercise improves macrophage activity, circulation of immunoglobulins, anti-inflammatory cytokines, neutrophils, and various lymphocytes. These changes improve the body’s immunosurveillance. Moderate “exercise is now viewed as an important immune system adjuvant to stimulate the ongoing exchange of leukocytes between the circulation and tissues” and improves the body’s immune response to vaccination. [5]

Steps to healthy exercise:

  • See your doctor to get a physical exam and start exercise under your doctor’s supervision
  • Begin low and go slow, gradually increasing duration and intensity
  • Choose an exercise you enjoy
  • Exercise outdoors when possible
  • Examples of aerobic exercise include: walking, running, biking, rowing, swimming.
  • The easiest to engage and maintain over time is regular walking—aim for 30–60 minutes a day, 5 days a week

4. Healthy Nutrition: The goal of healthy nutrition would be to move your diet away from foods that increase inflammation and impair immune response toward foods that decrease inflammation and improve immune response. Plant-based diets have been shown to do just that. A meta-analysis of 29 studies found that plant-based diets decreased a host of inflammatory factors and, thereby, decreased disease risk.[6]

Steps to healthy nutrition include:

  • Eat fruits, nuts, vegetables—the more colors the better as the colors are high in anti-inflammatory factors: berries, carrots, yams, spinach, etc.
  • Get your vitamin D level checked by your doctor and take vitamin D supplements to achieve a level of 75–100 nmol/L. Levels below 25 increase all causes of death, and levels above 140 increase all causes of death.[7] Studies show that normal vitamin D levels improve immune response and may reduce risk of infections, particularly viral infections like influenza and corona.[8] [9]
  • Avoid or minimize junk food as such foods are highly inflammatory

5. Laugh: In 2019, I wrote a blog on the benefits of laughter and will recap some of those benefits here.

Mirthful laughter reduces inflammation, improves diabetes control, and reduces incidence of heart attacks.[10] Other researchers found beneficial effects of laughter on the blood vessel. Nitric oxide is a chemical that the body uses to dilate blood vessels; mental stress was shown to degrade nitric oxide. This means that laughter minimizes the negative effects of stress by reducing the breakdown of nitric oxide, leading to vasodilatation and better blood flow.[11] On average, laughter increased blood flow by 22 percent and stress decreased blood flow by 35 percent. [12]

Laughter has been shown to improve the response of the immune system, which is especially important at this time.[13] In a study performed by Berk LS, et al., they found increased blood levels of interferon-gamma (an immune product that fights infections and cancers) in ten healthy fasting males after being shown a comedy video (p=0.02).[14] As a result, interferons have become a line of pharmacotherapy in viral infections, systemic carcinomas, hepatitis B and C, in addition to the development of antiretroviral drugs.

There are two types of stress: distress (the negative type) and eustress (the positive type, which would include mirthful laughter). Distress increases stress hormones—such as beta-endorphins, corticotrophins, and catecholamines—but laughter (a form eustress) decreases these hormones, fortifies activity of natural killer (NK) cells, activates T cells and B cells, and increases Ig levels. This means that laughter is capable of combating the negative aspects of distress and fortifying the immune system to help fight against various immune mediated illnesses.[15]

Steps to laugh:

  • Check out our Reasonette comics
  • Watch non-vulgar comedy programs or stand-up comics
  • Play interactive games like Pictionary or Balderdash
  • Tell jokes to friends or family
  • Choose to see the humor in life

[1] Genome Biology 2007, 8:R189

[2] PNAS vol. 108 no. 7; Cole, 3080–3085, doi: 10.1073/pnas.1014218108

[3] Michael R. Irwin, Sleep and Infectious Disease Risk, Sleep, Volume 35, Issue 8, 1 August 2012, Pages 1025–1026.

[4] Prather AA, et al., Sleep and antibody response to hepatitis B vaccination. Sleep. 2012 Aug 1;35(8):1063-9. doi: 10.5665/sleep.1990.

[5] Nieman, D., Wentz, L., The compelling link between physical activity and the body’s defense system, Journal of Sport and Health Science, Volume 8, Issue 3, May 2019, Pages 201-217.

[6]> Eichelmann F., et al., Effect of plant-based diets on obesity-related inflammatory profiles: a systematic review and meta-analysis of intervention trials. Obes Rev. 2016 Nov;17(11):1067-1079. doi: 10.1111/obr.12439. Epub 2016 Jul 13.

[7] Durup D et al. A reverse J-shaped association of all-cause mortality with serum 25-hydroxyvitamin D in general practice, the CopD study. J Clin Endocrin Metab. 2012;978:2644-2652

[8] Grant WB, Lahore H,. McDonnell SL, et al. Vitamin D supplementation could prevent and treat influenza, coronavirus, and pneumonia Infections. Preprints. 2020;2020030235.

[9] Chung C, Silwal P, Kim I, Modlin RL, Jo EK. Vitamin D-cathelicidin axis: at the crossroads between protective immunity and pathological inflammation during infection. Immune Netw. 2020;20:e12-38.

[10] Berk, L., et al, Mirthful laughter, as adjunct therapy in diabetic care, attenuates catecholamines, inflammatory cytokines, C-RP, and myocardial infarction occurrence, FASEB Journal, Vol. 22, No. 1_supplement, March 2008

[11] Wikipedia, The Free Encyclopedia. Nitric oxide; [Revised December 24, 2008].

[12]Vascular Medicine; Watching funny movies boosts blood flow to the heart. Health & Medicine Week,1660. Research Library database.(Document ID: 980266611); 2006.

[13]Berk LS, Tan SA, Fry WF. Eustress of humor associated laughter modulates specific immune system components. Annals of Behavioral Medicine. 1993;15:11.

Berk LS, Tan SA, Fry WF. et al. Neuroendocrine and stress hormone changes during mirthful laughter. American Journal of the Medical Sciences. 1989;298:390.

>Berk LS, Tan SA, Nehlsen-Cannarella SL. et al. Humor associated laughter decreases cortisol and increases spontaneous lymphocyte blastogenesis. Clinical Research. 1988;36:435A.

Martin RA. Is Laughter the Best Medicine? Humor, Laughter, and Physical Health. Current Directions In Psychological Science.2002;11(6):216–8.

[14] The Laughter – Immune Connection. Berk LS, Tan SA; [Revised November, 1996].

[15]Berk LS, Tan SA, Napier BJ. et al. Eustress of mirthful laughter modifies natural killer cell activity. Clinical Research. 1989;37:115A.


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Tim Jennings, M.D. Timothy R. Jennings, M.D., is a board-certified psychiatrist, master psychopharmacologist, Distinguished Life Fellow of the American Psychiatric Association, Fellow of the Southern Psychiatric Association, and an international speaker. He served as president of the Southern and Tennessee Psychiatric Associations and is president and founder of Come and Reason Ministries. Dr. Jennings has authored many books, including The God-Shaped Brain, The God-Shaped Heart, and The Aging Brain.