I grew up with Sesame Street—when the show was very new. I grew up with the “letter of the day.” So, today’s letter of the day is J. Why J? Because it is a letter I don’t think we are hearing enough about in our current media. Specifically, I want to talk about “Neiman’s J.”3-5
I have written about Neiman’s J several times. Interestingly (for me at least), I keep seeing it—the J-shape curve—appear in papers relating to BMI, exercise, etc. as these relate to infection, hospitalization, admission to the ICU, ventilation, and death in the current health crisis.1-2 Consistently, these and other studies suggest moderation. Moderate exercise—exceeding the proposed guidelines, but not to an extreme. Moderate body composition—healthy, not over-fat and not under-muscled (the ideal result of maintaining Neiman’s J of physical activity). Healthy eating. No smoking. Low-to-moderate consumption of alcohol. Seven to eight hours of sleep nightly.
We don’t hear about these preventative health measures. A friend shared an article in The Atlantic6 about the you-know-what and how it is here forever and “this is how we live with it.” The subtitle was: “We can’t avoid the virus for the rest of our lives, but we can minimize its impact.” Frankly, I found nothing of value in the article. It suggests that through vaccination or infection (preferably vaccination) the virus will transition to an endemic—much like the flu and common cold. But, accepting that the virus will go the way of other viruses is not going to solve much. People still get very sick from virus like the cold and flu. People still die. Neiman’s J, however, tells us that we can minimize our risk of infection. The extensive work in exercise immunology informs us that we can make ourselves less-hospitable hosts to viral infection. Diet, exercise, and weight loss do not zero our risk, but they do significantly impact our risk of severe infection. They should be addressed in our pandemic preparedness!
The vaccine is effective in flattening the J in the short term. It keeps the ends of the J out of the hospital (and the morgue).
In the long-term, we want to be moving toward the base of the J—where the risk of infection is lowest. This should be a priority in pandemic preparedness. It should be a public health priority. Moving to the base of the J will significantly reduce health care costs across the country. It warrants significant consideration.
Be your best today; be better tomorrow.
Carpe momento!
1Gao, M., Piernas, C., Astbury, N. M., Hippisley-Cox, J., O’Rahilly, S., Aveyard, P., & Jebb, S. A. (2021). Associations between body-mass index and COVID-19 severity in 6·9 million people in England: a prospective, community-based, cohort study. The Lancet (online). doi: 10.1016/S2213-8587(21)00089-9
2Kompaniyets, L., Goodman, A. B., Belay, B., Freedman, D. S., Sucosky, M. S., Lange, S. J., Gundlapalli, A. V., Boehmer, T. K., & Blanck, H. M. (2021). Body Mass Index and Risk for COVID-19-Related Hospitalization, Intensive Care Unit Admission, Invasive Mechanical Ventilation, and Death—United States, March-December, 2020. Morbidity and Mortality Report, 70:1-8.
3Nehlsen-Cannarella, S. L., Neiman, D. C., Balk-Lamberton, A. J., Markoff, P. A., Chritton, D. B., Gusewitch, G., & Lee, J. W. (1991) The effects of moderate exercise training on immune response. Med Sci Sports Exerc 23(1):64-70.
4Neiman, D. C. (1990) The effects of moderate exercise training on natural killer cells and acute upper respiratory tract infections. Int J Sports Med 11(16):467-473.
5Nieman, D. C. (1994) Exercise, upper respiratory tract infection, and the immune system. Med Sci Sports Exerc 26:128-139.
6https://www.theatlantic.com/science/archive/2021/08/how-we-live-coronavirus-forever/619783/?utm_campaign=the-atlantic&utm_medium=social&utm_source=facebook&fbclid=IwAR2ydXHKvxPUFpnQDJm5CZRlapB0yKXCMBi0TPX-rsiSrQVoYpyT2nnxIF8