UNC Health Talk

8 Ways to Strengthen Your Immune System

Living through a pandemic has a way of making you think about your immune system. Is it strong? Could it be stronger? Is it up to the task of fighting off COVID-19, flu and other viruses?

While no one can prevent every illness, most of us can make some simple changes that could improve our chances of avoiding infectious diseases and recovering fully when we do get them.

Here are eight tips from UNC Health family medicine physician Sarah Ruff, MD.

1. Get vaccinated.

No amount of healthy living can provide the protection against infectious disease that a vaccine can. Approved vaccines use tested, proven and safe technology to teach our immune systems how to fight off deadly viruses when we come in contact with them.

That’s why everyone who is eligible should get the COVID-19 vaccine as well as the annual flu shot, Dr. Ruff says. Taking a vaccine is like arming your immune system for future battle. Being vaccinated doesn’t mean you won’t ever get the flu or COVID-19, but it means that you’re much less likely to get seriously ill or die.

“There is a lot of talk about letting your body’s natural immunity take care of COVID-19 or the flu, but given what we know about these illnesses and how nondiscriminatory they can be as to who gets mild illness or severe illness or even dies, if there were a way to prevent death and hospitalization, why wouldn’t one choose that route?” Dr. Ruff says. “Vaccines help give your body’s natural immunity more weapons and strength to fight whatever might come its way.”

2. Eat a healthy, balanced diet.

Healthy foods provide nutrients, vitamins and minerals to keep us strong and well. Eat a varied diet that focuses on high-quality foods such as whole grains, nuts, and fresh fruits and vegetables. The more colorful your plate is, the better.

It’s better to get your vitamins and minerals from food rather than from supplements because your body uses and absorbs nutrients more efficiently when they come from whole food sources such as fruits and vegetables, Dr. Ruff says. But it’s worth asking your provider if there’s anything you might want to take in supplement form, such as vitamin D, which is critical for strong bones and teeth and difficult to get sufficiently from food.

3. Exercise regularly.

Good news if you flinch at the thought of super-intense workouts: Moderate exercise, rather than prolonged, vigorous exercise, is the real immune system booster. It’s just one of the physical and mental health benefits of being active.

“Recent studies have shown the benefits of moderate daily exercise over doing high-intensity exercise less frequently. Not only does moderate exercise improve blood sugar and lower blood pressure, thus preventing chronic disease, but it also helps to lower stress, which we know helps our immune system,” Dr. Ruff says.

Aim to do moderate exercise 150 minutes a week, which is about 30 minutes a day for five days a week. Examples of moderate exercise include jogging, swimming and walking at a brisk pace.

4. Maintain a healthy weight.

There is strong evidence that obesity negatively impacts the body’s immune system. In fact, obesity is a common risk factor in complications from the flu and COVID-19.

Having obesity does not automatically mean you will become sick with any illness, Dr. Ruff says, but “obesity, defined as a body mass index over 30, is associated with higher risk of chronic diseases like high blood pressure and diabetes, both of which increase your risk of complications from COVID-19.

5. Get plenty of sleep.

Not getting enough sleep can make you more susceptible to illness, and getting adequate sleep has been shown to be beneficial for immune function. That’s why you’re more likely to get sick when you’re exhausted.

Adults need seven to eight hours of sleep every night, teenagers need nine to 10 hours of sleep, and younger children usually need 10 or more hours of sleep.

The quality of your sleep matters, too.

“It’s not just a number but getting enough sleep so that you can feel rested. You need good sleep hygiene, so that the sleep that you get is restful and restorative,” Dr. Ruff says. A good first step is stopping screen use at least 30 minutes before bed; an hour is even better. Opt for reading a book or listening to music instead.

6. Minimize stress.

Long-term stress can cause imbalances in immune cell function. It can be difficult to reduce stress, but lifestyle measures such as exercise and adequate sleep can help, as can embracing mindfulness. If your stress feels unmanageable, talk to your doctor or find a therapist.

“Trying to minimize stress has so many different aspects, but my advice is to try to have good relationships and find calming activities,” Dr. Ruff says. “Most people also can lower their stress with exercise.”

7. Limit alcohol.

Research shows excessive alcohol consumption can have adverse immune-related health effects, including increasing a person’s susceptibility to pneumonia.

“Alcohol can disrupt the gut microbiome—the good bacteria that live in our gastrointestinal tracts and help our bodies fight off infection,” Dr. Ruff says, and that’s just one of the “mechanisms by which alcohol can affect the immune system negatively.”

If you choose to drink, do so in moderation. This means no more than one drink a day for women and no more than two drinks a day for men.

8. Don’t smoke.

Smoking, including vapingharms the immune system and can make your body less successful at fighting disease. It compromises your lung health, which is especially dangerous for viruses that attack the respiratory system, such as COVID-19 and the flu.

“Smoking is proven to decrease your ability to heal and to decrease your ability to fight disease,” Dr. Ruff says. “Quitting smoking can be one of the best things you can do to help yourself not get really sick or to recover well from disease.”

Of course, the best way to avoid COVID-19 is to continue the safety measures recommended by public health officials: Get vaccinated if you’re age 12 or older. Wear a mask indoors or in outdoor crowds. Physically distance from people outside your household whenever possible and wear a mask when it’s not possible. For added protection from the flu and other illnesses, wash your hands often and clean high-touch surfaces.


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