At Risk?

Athletes are often considered the healthiest human specimens--with good reason.

They can bike across a state in a day. Run dozens of miles. Swim distances that make the average person quiver.

But could they also be putting themselves at risk?

Some long-distance runners, swimmers and cyclists believe their vigorous training routines, especially during peak periods, lower their immune system’s ability to fight illnesses such as the flu. While they can’t prove it, these athletes can provide an abundance of anecdotal evidence to support their claim, especially during what has been a particularly wicked flu season.

According to doctors, though, there are few clinical studies available that address these concerns, and no conclusive data to date. At this point it is impossible for doctors to tell whether a case of flu was brought on by training or a multitude of factors such as stress or coming into contact with others who carry the virus.

“A lot of what we know now is limited,” said John DiFiori, an assistant professor in the division of sports medicine at UCLA. “This is one area where there is a great interest, but a lot of research has yet to be done. Right now, we have more questions than answers.”

Studies have shown that vigorous exercise changes cell counts in the athlete’s immune system for a period of three to 72 hours after the exercise ceases, but there is no established connection between those changes and sickness rates.

“At least in theory,” DiFiori said, “there is this period of time after a vigorous amount of exercise where, based on these studies, it would imply that an individual would be more susceptible to becoming infected.

“That said, there has been very little data that shows a link between what is happening to these cells and infections in a clinical sense.”

Recovery Time

Nearly 10 years ago, Irvine bicyclist Chuck Bramwell, a picture of fitness and health, stepped up his training in preparation for a tour across America. As the 21-day, 2,950-mile tour from Huntington Beach to Savannah, Ga., approached, Bramwell increased his mileage to about 200 a day.

It’s a common practice among elite athletes: When events loom, training routines zoom.

But not for long, in Bramwell’s case. A particularly nasty case of the flu blindsided him in the middle of August, of all times.

Interestingly, Bramwell’s doctors said his illness may have been brought on by nothing more than going too hard too fast without allowing his body the proper time to recover.

“I think there are times where if you increase the volume of exercise, it could cause you to possibly pick up something abnormal,” said Bramwell, a 48-year-old computer programmer.

At least from an observational standpoint, Wadie Najm, one of UC Irvine’s team doctors, agrees.

“You do see and do feel that people who overtrain have a higher disposition to having upper-respiratory tract infections [such as the flu],” Najm said. “[But] you have to remember that the possibility of that is not just related to the stress of sports, it also relates to having stress from other things.”

Lack of sleep, excessive travel, poor diet, work-related anxiety and emotional instability can also be contributing factors.

There is also the issue of coming into contact with others who carry the flu virus. Athletes are often in close quarters and if one gets sick, the likelihood increases that others will too. And athletes, like everyone else, are exposed to the flu in the workplace and public areas such as shopping malls.

The effect of this year’s harsh flu season on athletes is hard to pinpoint, Najm said, but he “doesn’t see any higher numbers of athletes having the flu than people in the general population.”

Still, Mission Viejo mountain biker Cameron Brenneman--who’s just getting over an illness that sidelined him with a fever of 104 degrees in early December--said the flu wiped out a significant number of his biking brethren.

“It’s weird because when I got sick, everyone I know from riding got sick in a one-month period,” said Brenneman, 22, a junior at Long Beach State. “They all got the flu similar to what I had.

“They might have gotten it otherwise, but it seems like they’re more likely to get it because their immune system is broken down a little bit from training.”

Scott Zornig, a 40-year-old Rancho Santa Margarita swimmer, had not taken two days off in a row from work in his life before coming down hard with the flu in December. His illness knocked him out for 2 1/2 days, and three weeks later, he still has a lingering cough.

Was his illness somehow related to his training?

“I don’t know,” said Zornig, a sales manager for a technology company in Irvine. “I think it is true that when you’re training your immune system is weakened. That could be how I have it.”

As anecdotal evidence, Zornig pointed to the fact that neither his wife nor his two children got the flu while fellow athletes were ravaged.

“It does seem like more of my friends that work out extensively have had the flu than my friends or the people I know who do not work out. Maybe a correlation can be drawn there.”

Plea for Immunity

It may take years for doctors and scientists to conclude whether vigorous exercise weakens athletes’ immune systems.

In the meantime, doctors and athletes do agree on some ways to optimize health while training.

UCLA’s DiFiori, who’s also a team physician for the school’s athletic department, said athletes should consider the care of their bodies an integral part of their training. They must replenish fluids, electrolytes and carbohydrates regardless of whether they’re concerned about infection. DiFiori also recommends proper rest and a well-balanced diet that includes the prodigious caloric intake elite athletes require.

Distance runner Scott McKenzie of Orange takes such advice seriously.

“When we’re gearing up and we have our mileage real high, we’re real careful about our situations,” said McKenzie, who has participated in races as long as 100 miles. “I get real diligent about staying real hydrated and eating good quality foods, trying to get as much rest as I can, avoiding stressful situations if possible, whether personally or at work.

“I think you’re more susceptible, but I don’t think you necessarily get a whole lot [more illnesses], because you take extra care. I don’t know how accurate this analogy is, but if you ride a bicycle you’re more susceptible to getting a head injury; but if you wear a helmet while doing so, you’re a little less likely.”

Future Benefits

Future generations of elite athletes could certainly benefit from the knowledge of whether vigorous training makes them more susceptible to illnesses such as the flu. If such training does increase susceptibility to illness, new training routines could be developed. Supplements or new drugs could gain widespread acceptance as immune-system boosters.

On the other hand, if strenuous training is found to have negligible effects, athletes could work out as hard as they like without the fear of getting sick.

For the time being, though, athletes feel stuck in a quagmire, while doctors say their sole concern should be simply taking care of themselves.

“They are at the same risk of anyone else as far as we know at this time,” Najm said. “This is from the scientific point of view.”