The compelling link between physical activity and the body's defense system

Nieman, David C.; Wentz, Laurel M.

doi:10.1016/j.jshs.2018.09.009

Cited by 1,340Exercise and Physiological ResponsesPhysical Activity and HealthCardiovascular and exercise physiology

The compelling link between physical activity and the body's defense system

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Nieman, David C., Wentz, Laurel M.·2019·Journal of Sport and Health Science

DOI 10.1016/j.jshs.2018.09.009PMC PMC6523821

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Abstract

This review summarizes research discoveries within 4 areas of exercise immunology that have received the most attention from investigators: (1) acute and chronic effects of exercise on the immune system, (2) clinical benefits of the exercise-immune relationship, (3) nutritional influences on the immune response to exercise, and (4) the effect of exercise on immunosenescence. These scientific discoveries can be organized into distinctive time periods: 1900-1979, which focused on exercise-induced changes in basic immune cell counts and function; 1980-1989, during which seminal papers were published with evidence that heavy exertion was associated with transient immune dysfunction, elevated inflammatory biomarkers, and increased risk of upper respiratory tract infections; 1990-2009, when additional focus areas were added to the field of exercise immunology including the interactive effect of nutrition, effects on the aging immune system, and inflammatory cytokines; and 2010 to the present, when technological advances in mass spectrometry allowed system biology approaches (i.e., metabolomics, proteomics, lipidomics, and microbiome characterization) to be applied to exercise immunology studies. The future of exercise immunology will take advantage of these technologies to provide new insights on the interactions between exercise, nutrition, and immune function, with application down to the personalized level. Additionally, these methodologies will improve mechanistic understanding of how exercise-induced immune perturbations reduce the risk of common chronic diseases.

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Immune function improves with regular physical activity.
“It is well known that immune function improves with regular PA, and those who are regularly active have a lower incidence, intensity of symptoms and mortality from various viral infections. 7-9”
From Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients (2021) · cites this paper as [7]
Regularly active individuals have a lower incidence, symptom intensity, and mortality from various viral infections.
“It is well known that immune function improves with regular PA, and those who are regularly active have a lower incidence, intensity of symptoms and mortality from various viral infections. 7-9”
From Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients (2021) · cites this paper as [7]

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The Neuroendocrinology of Stress: A Never Ending Story
Lightman, S. L. (2008) · Journal of Neuroendocrinology · doi:10.1111/j.1365-2826.2008.01711.x · Cited by 3,570 · see citing works
Exercise and the immune system: regulation, integration, and adaptation
Pedersen, B. K., & Hoffman-Goetz, L. (2000) · Physiological Reviews · doi:10.1152/physrev.2000.80.3.1055 · Cited by 1,710 · see citing works
Position statement. Part one: Immune function and exercise.
Walsh, N. P., Gleeson, M., Shephard, R. J., Gleeson, M., Woods, J. A., Bishop, N. C., Fleshner, M., Green, C., Pedersen, B. K., Hoffman-Goetz, L., et al. (2011) · PubMed · Cited by 1,250 · see citing works
Prevention, Diagnosis, and Treatment of the Overtraining Syndrome: Joint Consensus Statement of the European College of Sport Science and the American College of Sports Medicine
(2013) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318279a10a · Cited by 1,233 · see citing works
Self-citation
Inflammation: Depression Fans the Flames and Feasts on the Heat
Kiecolt-Glaser, J. K., Derry, H. M., & Fagundes, C. P. (2015) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2015.15020152 · Cited by 844 · see citing works
How much is too much? (Part 2) International Olympic Committee consensus statement on load in sport and risk of illness
Schwellnus, M., Soligard, T., Alonso, J.-M., Bahr, R., Clarsen, B., Dijkstra, H. P., Gabbett, T. J., Gleeson, M., Hägglund, M., Hutchinson, M. R., et al. (2016) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096572 · Cited by 836 · see citing works
Sports injuries and illnesses during the London Summer Olympic Games 2012
Engebretsen, L., Soligard, T., Steffen, K., Alonso, J. M., Aubry, M., Budgett, R., Dvořák, J., Jegathesan, M., Meeuwisse, W. H., Mountjoy, M. L., et al. (2013) · British Journal of Sports Medicine · doi:10.1136/bjsports-2013-092380 · Cited by 753 · see citing works
Muscle damage and inflammation during recovery from exercise.
Peake, J., Neubauer, O., Gatta, P. D. D., & Nosaka, K. (2016) · Journal of applied physiology · doi:10.1152/japplphysiol.00971.2016 · Cited by 740 · see citing works
Debunking the Myth of Exercise-Induced Immune Suppression: Redefining the Impact of Exercise on Immunological Health Across the Lifespan
Campbell, J. P., & Turner, J. E. (2018) · Frontiers in Immunology · doi:10.3389/fimmu.2018.00648 · Cited by 692 · see citing works
Extracellular Vesicles Provide a Means for Tissue Crosstalk during Exercise
Whitham, M., Parker, B. L., Friedrichsen, M. H., Hingst, J. R., Hjorth, M., Hughes, W. E., Egan, C. L., Cron, L., Watt, K. I., Kuchel, R. P., et al. (2018) · Cell Metabolism · doi:10.1016/j.cmet.2017.12.001 · Cited by 689 · see citing works
The microbiome of professional athletes differs from that of more sedentary subjects in composition and particularly at the functional metabolic level
Barton, W., Penney, N. C., Cronin, O., Garcia-Perez, I., Molloy, M. G., Holmes, E., Shanahan, F., Cotter, P. D., & O'Sullivan, O. (2018) · Gut · doi:10.1136/gutjnl-2016-313627 · Cited by 647 · cited 1× · see citing works
“Although research in this area is emerging, recent studies indicate that exercise and physical fitness diversifies the gut microbiota, enhancing the number of benign microbial communities.(142,143) The underlying mechanisms are still being explored, with no clear consensus, in part owing to confounding from diet, exer…”
Background
Anti-inflammatory effects of exercise: role in diabetes and cardiovascular disease
Pedersen, B. K. (2017) · European Journal of Clinical Investigation · doi:10.1111/eci.12781 · Cited by 617 · see citing works
Exercise and the Regulation of Immune Functions
Simpson, R. J., Kunz, H., Agha, N. H., & Graff, R. M. (2015) · Progress in molecular biology and translational science · doi:10.1016/bs.pmbts.2015.08.001 · Cited by 606 · see citing works
Update on Inflammation in Chronic Kidney Disease
Akchurin, O. M., & Kaskel, F. (2015) · Blood Purification · doi:10.1159/000368940 · Cited by 603 · see citing works
Effect of exercise training on chronic inflammation
Beavers, K. M., Brinkley, T. E., & Nicklas, B. J. (2010) · Clinica Chimica Acta · doi:10.1016/j.cca.2010.02.069 · Cited by 592 · see citing works
Infectious episodes in runners before and after the Los Angeles Marathon.
Nieman, D. C., Johanssen, L. M., Lee, J. W., & Arabatzis, K. (1990) · PubMed · Cited by 530 · see citing works
Self-citation
Foundations of Immunometabolism and Implications for Metabolic Health and Disease
Hotamışlıgil, G. S. (2017) · Immunity · doi:10.1016/j.immuni.2017.08.009 · Cited by 515 · see citing works
Cardiorespiratory fitness as a predictor of intestinal microbial diversity and distinct metagenomic functions
Estaki, M., Pither, J., Baumeister, P., Little, J. P., Gill, S. K., Ghosh, S., Ahmadi-Vand, Z., Marsden, K. R., & Gibson, D. L. (2016) · Microbiome · doi:10.1186/s40168-016-0189-7 · Cited by 476 · see citing works
The role of infiltrating immune cells in dysfunctional adipose tissue
Guzik, T. J., Skiba, D. S., Touyz, R. M., & Harrison, D. G. (2017) · Cardiovascular Research · doi:10.1093/cvr/cvx108 · Cited by 453 · see citing works
Sports injury and illness incidence in the Rio de Janeiro 2016 Olympic Summer Games: A prospective study of 11274 athletes from 207 countries
Soligard, T., Steffen, K., Palmer, D., et al. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-097956 · Cited by 441 · see citing works
Immune response to heavy exertion
Nieman, D. C. (1997) · Journal of Applied Physiology · doi:10.1152/jappl.1997.82.5.1385 · Cited by 409 · see citing works
Self-citation
Recovery of the immune system after exercise
Peake, J. M., Neubauer, O., Walsh, N. P., & Simpson, R. J. (2016) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00622.2016 · Cited by 395 · see citing works
Physical activity and immune function in elderly women
NIEMAN, D. C., HENSON, D. A., GUSEWITCH, G., WARREN, B. J., DOTSON, R. C., BUTTERWORTH, D. E., & NEHLSEN-CANNARELLA, S. L. (1993) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199307000-00011 · Cited by 393 · see citing works
Self-citation
Cytokine expression and secretion by skeletal muscle cells: regulatory mechanisms and exercise effects
Peake, J. M., Gatta, P. A. D., Suzuki, K., & Suzuki, K. (2026) · PubMed · doi:10.22029/eir.2015.1693 · Cited by 376 · see citing works
Position statement. Part two: Maintaining immune health.
Walsh, N. P., Gleeson, M., Pyne, D. B., Nieman, D. C., Dhabhar, F. S., Shephard, R. J., Oliver, S. J., Bermon, S., & Kajėnienė, A. (2011) · PubMed · Cited by 365 · see citing works
Self-citation
Inflammatory mediators in osteoarthritis: A critical review of the state-of-the-art, current prospects, and future challenges.
Rahmati, M., Mobasheri, A., & Mozafari, M. (2016) · Bone · doi:10.1016/j.bone.2016.01.019 · Cited by 365 · see citing works
Sports injuries and illnesses during the Winter Olympic Games 2010
Engebretsen, L. F., Steffen, K., Alonso, J. M., et al. (2010) · British Journal of Sports Medicine · doi:10.1136/bjsm.2010.076992 · Cited by 358 · see citing works
Carbohydrate ingestion influences skeletal muscle cytokine mRNA and plasma cytokine levels after a 3-h run
Nieman, D. C., Davis, J. M., Henson, D. A., Walberg-Rankin, J., Shute, M., Dumke, C. L., Utter, A. C., Vinci, D. M., Carson, J. A., Brown, A., et al. (2003) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01130.2002 · Cited by 353 · see citing works
Self-citation
Ultramarathon running and upper respiratory tract infections. An epidemiological survey.
Peters, E. M., & Bateman, E. D. (1983) · PubMed · Cited by 338 · see citing works
Connecting the immune system, systemic chronic inflammation and the gut microbiome: the role of sex
Rizzetto, L., Fava, F., Tuohy, K. M., & Selmi, C. (2018) · Journal of Autoimmunity · doi:10.1016/j.jaut.2018.05.008 · Cited by 331 · see citing works
The Effects of Moderate Exercise Training on Natural Killer Cells and Acute Upper Respiratory Tract Infections
Nieman, D. C., Nehlsen‐Cannarella, S. L., MARKOFF, P. A., Balk-Limberton, A. J., Yang, H.-S., CHRITTON, D. B. W., Lee, J. W., & Arabatzis, K. (1990) · International Journal of Sports Medicine · doi:10.1055/s-2007-1024839 · Cited by 328 · see citing works
Self-citation
Carbohydrate and the cytokine response to 2.5 h of running
Nehlsen-Cannarella, S. L., Fagoaga, O. R., Nieman, D. C., Henson, D. A., Butterworth, D. E., Schmitt, R. L., Bailey, E. M., Warren, B. J., Utter, A., & Davis, J. M. (1997) · Journal of Applied Physiology · doi:10.1152/jappl.1997.82.5.1662 · Cited by 311 · see citing works
Effect of exercise training on C reactive protein: a systematic review and meta-analysis of randomised and non-randomised controlled trials
Fedewa, M. V., Hathaway, E. D., & Ward-Ritacco, C. L. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-095999 · Cited by 309 · see citing works
Effects of Exercise Training on Chronic Inflammation in Obesity
You, T., Arsenis, N. C., DiSanzo, B., & LaMonte, M. J. (2013) · Sports Medicine · doi:10.1007/s40279-013-0023-3 · Cited by 293 · see citing works
Moderate to vigorous physical activity and risk of upper-respiratory tract infection
MATTHEWS, C. E., OCKENE, I. S., FREEDSON, P. S., ROSAL, M. C., MERRIAM, P. A., & HEBERT, J. R. (2002) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200208000-00003 · Cited by 287 · see citing works
Anthocyanins and Flavanones Are More Bioavailable than Previously Perceived: A Review of Recent Evidence
Kay, C. D., Pereira‐Caro, G., Ludwig, I. A., et al. (2017) · Annual Review of Food Science and Technology · doi:10.1146/annurev-food-030216-025636 · Cited by 282 · see citing works
Exercise and the aging immune system
Simpson, R. J., Lowder, T. W., Spielmann, G., Bigley, A. B., LaVoy, E. C., & Kunz, H. (2012) · Ageing Research Reviews · doi:10.1016/j.arr.2012.03.003 · Cited by 281 · see citing works
Vitamin C supplementation reduces the incidence of postrace symptoms of upper-respiratory-tract infection in ultramarathon runners
Peters, E., Goetzsche, J., Grobbelaar, B., & Noakes, T. (1993) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/57.2.170 · Cited by 280 · see citing works
Incidence, Etiology, and Symptomatology of Upper Respiratory Illness in Elite Athletes
SPENCE, L., BROWN, W. J., PYNE, D. B., NISSEN, M. D., SLOOTS, T. P., MCCORMACK, J. G., LOCKE, A. S., & FRICKER, P. A. (2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31802e851a · Cited by 275 · see citing works
Exercise and type 2 diabetes: focus on metabolism and inflammation
Karstoft, K., & Pedersen, B. K. (2016) · Immunology & Cell Biology · doi:10.1038/icb.2015.101 · Cited by 260 · see citing works
Sports injuries and illnesses in the Sochi 2014 Olympic Winter Games
Soligard, T., Steffen, K., Palmer, D., Aubry, M., Grant, M., Meeuwisse, W. H., Mountjoy, M. L., Budgett, R., & Engebretsen, L. (2015) · British Journal of Sports Medicine · doi:10.1136/bjsports-2014-094538 · Cited by 259 · see citing works
Is infection risk linked to exercise workload?
Nieman, D. C. (2000) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200007001-00005 · Cited by 258 · see citing works
Self-citation
Endogenous Pyrogen Activity in Human Plasma After Exercise
Cannon, J. G., & Kluger, M. J. (1983) · Science · doi:10.1126/science.6836306 · Cited by 252 · see citing works
Performance success or failure is influenced by weeks lost to injury and illness in elite Australian track and field athletes: A 5-year prospective study
Raysmith, B. P., & Drew, M. K. (2016) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2015.12.515 · Cited by 240 · see citing works
Determination of future prevention strategies in elite track and field: analysis of Daegu 2011 IAAF Championships injuries and illnesses surveillance
Alonso, J., Édouard, P., Fischetto, G., Adams, B., Depiesse, F., & Mountjoy, M. (2012) · British Journal of Sports Medicine · doi:10.1136/bjsports-2012-091008 · Cited by 239 · see citing works
Upper respiratory tract infection is reduced in physically fit and active adults
Nieman, D. C., Henson, D. A., Austin, M. D., & Sha, W. (2010) · British Journal of Sports Medicine · doi:10.1136/bjsm.2010.077875 · Cited by 234 · see citing works
Self-citation
Influence of mode and carbohydrate on the cytokine response to heavy exertion
NIEMAN, D. C., NEHLSEN-CANNARELLA, S. L., FAGOAGA, O. R., HENSON, D. A., UTTER, A., DAVIS, J. M., WILLIAMS, F., & BUTTERWORTH, D. E. (1998) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199805000-00005 · Cited by 233 · see citing works
Self-citation
Acute phase response in exercise. II. Associations between vitamin E, cytokines, and muscle proteolysis
Cannon, J. G., Meydani, S. N., Fielding, R. A., FIATARONE, M. A., Meydani, M., Farhangmehr, M., Orencole, S. F., Blumberg, J. B., & Evans, W. J. (1991) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.1991.260.6.r1235 · Cited by 223 · see citing works
Acute exercise mobilises CD8+ T lymphocytes exhibiting an effector-memory phenotype
Campbell, J. P., Riddell, N. E., Burns, V. E., Turner, M., van Zanten, J. J. C. S. V., Drayson, M. T., & Bosch, J. A. (2009) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2009.02.011 · Cited by 220 · see citing works
Exercise Immunology: Practical Applications
Nieman, D. C. (1997) · International Journal of Sports Medicine · doi:10.1055/s-2007-972705 · Cited by 218 · see citing works
Self-citation
Occurrence of injuries and illnesses during the 2009 IAAF World Athletics Championships
Alonso, J. M., Tscholl, P. M., Engebretsen, L. F., et al. (2010) · British Journal of Sports Medicine · doi:10.1136/bjsm.2010.078030 · Cited by 214 · see citing works
OxInflammation: From Subclinical Condition to Pathological Biomarker
Valacchi, G., Virgili, F., Cervellati, C., & Pecorelli, A. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.00858 · Cited by 206 · see citing works
Glucose Ingestion Attenuates Interleukin‐6 Release from Contracting Skeletal Muscle in Humans
Febbraio, M. A., Steensberg, A., Keller, C., Starkie, R. L., Nielsen, H. B., Krustrup, P., Ott, P., Secher, N. H., & Pedersen, B. K. (2003) · The Journal of Physiology · doi:10.1113/jphysiol.2003.042374 · Cited by 202 · see citing works
The immunomodulating role of exercise in metabolic disease
Lancaster, G. I., & Febbraio, M. A. (2014) · Trends in Immunology · doi:10.1016/j.it.2014.02.008 · Cited by 193 · see citing works
Exercise and Psychosocial Factors Modulate Immunity to Influenza Vaccine in Elderly Individuals
Kohut, M. L., Cooper, M. M., Nickolaus, M. S., Russell, D. R., & Cunnick, J. E. (2002) · The Journals of Gerontology Series A · doi:10.1093/gerona/57.9.m557 · Cited by 193 · see citing works
The microbiota: An exercise immunology perspective
Bermon, S., Petriz, B. A., Kajėnienė, A., Prestes, J., Castell, L. M., & Castell, L. (2026) · PubMed · doi:10.22029/eir.2015.1697 · Cited by 193 · see citing works
Evidence for Anti-Inflammatory Effects of Exercise in CKD
Viana, J. L., Kosmadakis, G., Watson, E. L., Bevington, A., Feehally, J., BISHOP, N. C., & Smith, A. C. (2014) · Journal of the American Society of Nephrology · doi:10.1681/asn.2013070702 · Cited by 190 · see citing works
The complex immunological and inflammatory network of adipose tissue in obesity
Apostolopoulos, V., de Courten, M., Stojanovska, L., Blatch, G. L., Tangalakis, K., & de Courten, B. V. (2015) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201500272 · Cited by 186 · see citing works
Moderate exercise improves antibody response to influenza immunization in older adults
Kohut, M. L., Arntson, B. A., Lee, W.-L., Rozeboom, K., Yoon, K. J., Cunnick, J. E., & McElhaney, J. E. (2003) · Vaccine · doi:10.1016/j.vaccine.2003.11.023 · Cited by 184 · see citing works
Sports injuries and illnesses in the 2009 FINA World Championships (Aquatics)
Mountjoy, M. L., Junge, A., Alonso, J. M., Engebretsen, L., Drâgan, I., GERRARD, D. F., Kouidri, M., Luebs, E., Shahpar, F. M., & Dvořák, J. (2010) · British Journal of Sports Medicine · doi:10.1136/bjsm.2010.071720 · Cited by 182 · see citing works
Immunologic Mediators as Parameters of the Reaction to Strenuous Exercise
Northoff, H., & Berg, A. (1991) · International Journal of Sports Medicine · doi:10.1055/s-2007-1024743 · Cited by 181 · see citing works
Exercise and the incidence of upper respiratory tract infections
HEATH, G. W., FORD, E. S., CRAVEN, T. E., MACERA, C. A., JACKSON, K. L., & PATE, R. R. (1991) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199102000-00002 · Cited by 175 · see citing works
The Wisconsin Upper Respiratory Symptom Survey is responsive, reliable, and valid
BARRETT, B., BROWN, R., MUNDT, M., SAFDAR, N., DYE, L., MABERRY, R., & ALT, J. (2005) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2004.11.019 · Cited by 173 · see citing works
Acute exercise preferentially redeploys NK-cells with a highly-differentiated phenotype and augments cytotoxicity against lymphoma and multiple myeloma target cells
Bigley, A. B., Rezvani, K., Chew, C., Sekine, T., Pistillo, M., Crucian, B. E., Bollard, C. M., & Simpson, R. J. (2013) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2013.10.030 · Cited by 172 · see citing works
Human inflammatory and resolving lipid mediator responses to resistance exercise and ibuprofen treatment
Markworth, J. F., Vella, L. D., Lingard, B. S., Tull, D., Rupasinghe, T., Sinclair, A. J., Maddipati, K. R., & Cameron‐Smith, D. (2013) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00128.2013 · Cited by 163 · see citing works
Physical activity and immune senescence in men
Shinkai, S., KOHNO, H., Kimura, K., Komura, T., Asai, H., Inai, R., OKA, K., Kurokawa, Y., & Shephard, R. J. (1995) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199511000-00008 · Cited by 160 · see citing works
Exercise has the guts: how physical activity may positively modulate gut microbiota in chronic and immune-based diseases
Codella, R., Luzi, L., & Terruzzi, I. (2018) · Digestive and Liver Disease · doi:10.1016/j.dld.2017.11.016 · Cited by 158 · see citing works
Meditation or exercise for preventing acute respiratory infection: a randomized controlled trial
Barrett, B., Hayney, M. S., Muller, D., Rakel, D., Ward, A., Obasi, C. N., Brown, R., Zhang, Z., Zgierska, A., Gern, J., et al. (2012) · The Annals of Family Medicine · doi:10.1370/afm.1376 · Cited by 156 · see citing works
The multifaceted link between inflammation and human diseases
Rajendran, P., Chen, Y., Chen, Y., Chung, L.-C., Tamilselvi, S., Shen, C.-Y., Day, C. H., Chen, R., Viswanadha, V. P., Kuo, W., et al. (2018) · Journal of Cellular Physiology · doi:10.1002/jcp.26479 · Cited by 154 · see citing works
Prevalence of illness, poor mental health and sleep quality and low energy availability prior to the 2016 Summer Olympic Games
Drew, M. K., Vlahovich, N., Hughes, D. C., Appaneal, R., Burke, L. M., Lundy, B., Rogers, M. A., Toomey, M., Watts, D., Lovell, G. A., et al. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-098208 · Cited by 152 · see citing works
Anthocyanins and their physiologically relevant metabolites alter the expression of IL‐6 and VCAM‐1 in CD40L and oxidized LDL challenged vascular endothelial cells
Amin, H., Czank, C., Raheem, S., Zhang, Q., Botting, N. P., Cassidy, A., & Kay, C. D. (2015) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201400803 · Cited by 150 · see citing works
The effects of exercise on vaccination responses: A review of chronic and acute exercise interventions in humans
Pascoe, A. R., Fiatarone Singh, M. A., & Edwards, K. M. (2014) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2013.10.003 · Cited by 149 · see citing works
Infectious episodes in runners before and after a roadrace.
Nieman, D. C., Johanssen, L. M., & Lee, J. W. (1989) · PubMed · Cited by 143 · see citing works
Self-citation
Immune Response to a 30-Minute Walk
Nieman, D. C., Henson, D. A., Austin, M. D., & Brown, V. A. (2005) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000149808.38194.21 · Cited by 143 · see citing works
Self-citation
Exercise and gut immune function: evidence of alterations in colon immune cell homeostasis and microbiome characteristics with exercise training
Cook, M. D., Allen, J. M., Pence, B. D., Wallig, M. A., Gaskins, H. R., White, B. A., & Woods, J. A. (2016) · Immunology & Cell Biology · doi:10.1038/icb.2015.108 · Cited by 140 · see citing works
Consensus Statement Immunonutrition and Exercise.
Bermon, S., Castell, L. M., Calder, P. C., BISHOP, N. C., Blomstrand, E., Mooren, F. C., Krüger, K., Kavazis, A. N., Quindry, J. C., Senchina, D. S., et al. (2017) · PubMed · Cited by 138 · see citing works
Self-citation
Effect of exercise training on cardiometabolic risk markers among sedentary, but metabolically healthy overweight or obese post-menopausal women with elevated blood pressure
Arsenault, B. J., Côté, M., Cartier, A., Lemieux, I., Després, J., Ross, R., Earnest, C. P., Blair, S. N., & Church, T. S. (2009) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2009.05.009 · Cited by 132 · see citing works
IL‐6 Gene Expression in Human Adipose Tissue in Response to Exercise – Effect of Carbohydrate Ingestion
Keller, C., Keller, P., Marshal, S., & Pedersen, B. K. (2003) · The Journal of Physiology · doi:10.1113/jphysiol.2003.044883 · Cited by 130 · see citing works
Modulation of Natural Killer Cell Activity in Peripheral Blood by Physical Exercise
Pedersen, B. K., Tvede, N., HANSEN, F. R., et al. (1988) · Scandinavian Journal of Immunology · doi:10.1111/j.1365-3083.1988.tb02400.x · Cited by 129 · see citing works
Exercise without Weight Loss Does Not Reduce C-Reactive Protein
Church, T. S., Earnest, C. P., Thompson, A. M., Priest, E. L., Rodarte, R. Q., Saunders, T. J., ROSS, R., & Blair, S. N. (2010) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181c03a43 · Cited by 126 · see citing works
Immune response to exercise training and/or energy restriction in obese women
Nieman, D. C., Nehlsen‐Cannarella, S. L., Henson, D. A., Koch, A. J., Butterworth, D. E., Fagoaga, O. R., & Utter, A. C. (1998) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199805000-00006 · Cited by 124 · see citing works
Self-citation
Effects of mode and carbohydrate on the granulocyte and monocyte response to intensive, prolonged exercise
Nieman, D. C., Nehlsen‐Cannarella, S. L., Fagoaga, O. R., Henson, D. A., Utter, A. C., Davis, J. M., Williams, F. E., & Butterworth, D. E. (1998) · Journal of Applied Physiology · doi:10.1152/jappl.1998.84.4.1252 · Cited by 124 · see citing works
Self-citation
Muscle Cytokine mRNA Changes after 2.5 h of Cycling: Influence of Carbohydrate
NIEMAN, D. C., DAVIS, J. M., HENSON, D. A., GROSS, S. J., DUMKE, C. L., UTTER, A. C., VINCI, D. M., CARSON, J. A., BROWN, A., MCANULTY, S. R., et al. (2005) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000175054.99588.b1 · Cited by 122 · cited 2× · see citing works
“Nieman et al.21 1828 marathon runners and 134 runner controls (aged 36.9 § 0.2 years) Participants reported illness symptoms 2 months before and 1 week after March 42.2-km race Illness incidence 6£ higher in runners who finished race vs. controls (13% vs. 2%).”
BackgroundInfluentialSelf-citation
A multifactorial evaluation of illness risk factors in athletes preparing for the Summer Olympic Games
Drew, M. K., Vlahovich, N., Hughes, D. C., Appaneal, R., Peterson, K. M., Burke, L. M., Lundy, B., Toomey, M., Watts, D., Lovell, G. A., et al. (2017) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2017.02.010 · Cited by 122 · see citing works
Metabolic signals and innate immune activation in obesity and exercise
Ringseis, R., Eder, K., Mooren, F. C., & Krüger, K. (2026) · PubMed · doi:10.22029/eir.2015.1696 · Cited by 120 · see citing works
Exercise in Regulation of Inflammation-Immune Axis Function in Cancer Initiation and Progression.
Koelwyn, G. J., Wennerberg, E., Demaria, S., & Jones, L. W. (2015) · PubMed · Cited by 120 · see citing works
Influence of carbohydrate on the immune response to intensive, prolonged exercise.
Nieman, D. C. (1998) · PubMed · Cited by 119 · see citing works
Self-citation
The Effect of Exercise on Secretory and Natural Immunity
MACKINNON, L. T., Chick, T. W., van As, A., & Tomasi, T. B. (1987) · Advances in experimental medicine and biology · doi:10.1007/978-1-4684-5344-7_102 · Cited by 117 · see citing works
Cardiorespiratory fitness and the metabolic syndrome: Roles of inflammation and abdominal obesity
Wedell‐Neergaard, A., Krogh‐Madsen, R., Petersen, G. L., Hansen, Å. M., Pedersen, B. K., Lund, R., & Brüünsgaard, H. (2018) · PLoS ONE · doi:10.1371/journal.pone.0194991 · Cited by 114 · see citing works
Training-related and competition-related risk factors for respiratory tract and gastrointestinal infections in elite cross-country skiers
Svendsen, I. S., Taylor, I. M., Tønnessen, E., Bahr, R., & Gleeson, M. (2016) · British Journal of Sports Medicine · doi:10.1136/bjsports-2015-095398 · Cited by 112 · see citing works
Effect of Physical Exercise on Blood Mononuclear Cell Subpopulations and in Vitro Proliferative Responses
Tvede, N., Pedersen, B. K., HANSEN, F. R., Bendix, T., Christensen, L., Galbo, H., & Halkjær-Kristensen, J. (1989) · Scandinavian Journal of Immunology · doi:10.1111/j.1365-3083.1989.tb01137.x · Cited by 109 · see citing works
Phenolic Metabolites of Anthocyanins Modulate Mechanisms of Endothelial Function
Edwards, M., Czank, C., Woodward, G., Cassidy, A., & Kay, C. D. (2015) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf5041993 · Cited by 103 · see citing works
Potential Impact of Nutrition on Immune System Recovery from Heavy Exertion: A Metabolomics Perspective
Nieman, D., & Mitmesser, S. (2017) · Nutrients · doi:10.3390/nu9050513 · Cited by 103 · see citing works
Self-citation
Is Exercise Protective Against Influenza-Associated Mortality?
Wong, C.-M., Lai, H.-K., Ou, C., Ho, S. Y., Chan, K.-P., Thach, T., Yang, L., Chau, Y., Lam, T.-H., Hedley, A. J., et al. (2008) · PLoS ONE · doi:10.1371/journal.pone.0002108 · Cited by 102 · see citing works
Metabolomics approach to assessing plasma 13- and 9-hydroxy-octadecadienoic acid and linoleic acid metabolite responses to 75-km cycling
Nieman, D. C., Shanely, R. A., Luo, B., Meaney, M. P., Dew, D. A., & Pappan, K. L. (2014) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00092.2014 · Cited by 101 · see citing works
Self-citation
Viral Illnesses and Sports Performance
Roberts, J. A. (1986) · Sports Medicine · doi:10.2165/00007256-198603040-00006 · Cited by 100 · see citing works
The immunology of exercise. A brief review
Simon, H. B. (1984) · JAMA · doi:10.1001/jama.252.19.2735 · Cited by 99 · see citing works
Carbohydrate supplementation affects blood granulocyte and monocyte trafficking but not function after 2.5 h or running
Nieman, D., Fagoaga, O., Butterworth, D., Warren, B., Utter, A., Davis, J., Henson, D., & Nehlsen-Cannarella, S. (1997) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/66.1.153 · Cited by 98 · see citing works
Self-citation
Flavonoid metabolites reduce tumor necrosis factor‐α secretion to a greater extent than their precursor compounds in human THP‐1 monocytes
di Gesso, J. L., Kerr, J. S., Zhang, Q., Raheem, S., Yalamanchili, S. K., O’Hagan, D., Kay, C. D., & O'Connell, M. A. (2015) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201400799 · Cited by 96 · see citing works
Training-related risk of common illnesses in elite swimmers over a 4-yr period.
Hellard, P., Avalos, M., Guimaraes, F., Toussaint, J., & Pyne, D. (2015) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000461 · Cited by 95 · see citing works
Inflammation and oxidative stress are lower in physically fit and active adults
Shanely, R. A., Nieman, D. C., Henson, D. A., Jin, F., Knab, A. M., & Sha, W. (2011) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/j.1600-0838.2011.01373.x · Cited by 93 · see citing works
Self-citation
Aging and immunity – Impact of behavioral intervention
Müller, L., & Pawelec, G. (2013) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2013.11.015 · Cited by 93 · see citing works
Moderate-Intensity Exercise Reduces the Incidence of Colds Among Postmenopausal Women
Chubak, J., McTiernan, A., Sorensen, B. E., Wener, M. H., Yasui, Y., Velasquez, M., Wood, B. L., Rajan, K. B., Wetmore, C. M., Potter, J. D., et al. (2006) · The American Journal of Medicine · doi:10.1016/j.amjmed.2006.06.033 · Cited by 92 · see citing works
Serum Metabolic Signatures Induced By a Three-Day Intensified Exercise Period Persist After 14 h of Recovery in Runners
Nieman, D. C., Shanely, R. A., Gillitt, N. D., Pappan, K. L., & Lila, M. A. (2013) · Journal of Proteome Research · doi:10.1021/pr400717j · Cited by 92 · see citing works
Self-citation
Complement and Immunoglobulin Levels in Athletes and Sedentary Controls
Nieman, D. C., Tan, S. C., Lee, J. W., et al. (1989) · International Journal of Sports Medicine · doi:10.1055/s-2007-1024887 · Cited by 92 · see citing works
Self-citation
Prolonged submaximal eccentric exercise is associated with increased levels of plasma IL-6
Rohde, T., MacLean, D. A., Richter, E. A., Kiens, B., & Pedersen, B. K. (1997) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.1997.273.1.e85 · Cited by 92 · see citing works
Competing with injuries: injuries prior to and during the 15th FINA World Championships 2013 (aquatics)
Mountjoy, M. L., Junge, A., Benjamen, S., et al. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2014-093991 · Cited by 91 · see citing works
Physical Activity, Sedentary Behavior, and Inflammatory and Hemostatic Markers in Men
Parsons, T. J., Sartini, C., Welsh, P. I., Sattar, N. A., Ash, S., LENNON, L. T., Wannamethee, S. G., Lee, I.-M. M., Whincup, P. H., & Jefferis, B. J. M. H. (2016) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001113 · Cited by 91 · see citing works
Influence of training load on upper respiratory tract infection incidence and antigen‐stimulated cytokine production
Gleeson, M., BISHOP, N. C., Oliveira, M., & Tauler, P. (2011) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/j.1600-0838.2011.01422.x · Cited by 90 · see citing works
Effects of total and regional fat loss on plasma CRP and IL-6 in overweight and obese, older adults with knee osteoarthritis
Beavers, K. M., Beavers, D. P., Newman, J. J., Anderson, A. M., Loeser, R. F., Nicklas, B. J., Lyles, M. F., Miller, G. D., Mihalko, S. L., & Messier, S. P. (2014) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2014.11.005 · Cited by 89 · see citing works
Injury and illness in aquatic sport: how high is the risk? A comparison of results from three FINA World Championships
Prien, A., Mountjoy, M. L., Miller, J., Boyd, K. T., van den Hoogenband, C. R., GERRARD, D. F., Cherif, M. Y., Lu, Y., Nanousis, K., Liscano, E. I. O., et al. (2016) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096075 · Cited by 89 · see citing works
Chronic Exercise Reduces Illness Severity, Decreases Viral Load, and Results in Greater Anti‐Inflammatory Effects than Acute Exercise during Influenza Infection
Kohut, M. L., Sim, Y., Yu, S., Yoon, K. J., & Loiacono, C. M. (2009) · The Journal of Infectious Diseases · doi:10.1086/606014 · Cited by 87 · see citing works
Exercise and the incidence of upper respiratory tract infections.
Heath, G. W., Ford, E. S., Craven, T. E., et al. (1991) · PubMed · Cited by 87 · see citing works
Upper Respiratory Symptoms, Gut Health and Mucosal Immunity in Athletes
Colbey, C., Cox, A. J., Pyne, D. B., Zhang, P., Cripps, A. W., & West, N. P. (2018) · Sports Medicine · doi:10.1007/s40279-017-0846-4 · Cited by 87 · see citing works
Physical Activity, Stress, and Self-Reported Upper Respiratory Tract Infection
Fondell, E., Lagerros, Y. T., Sundberg, C. J., Lekander, M., Bälter, O., Rothman, K. J., & Bälter, K. A. (2010) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181edf108 · Cited by 86 · see citing works
Immunometabolism: A Multi-Omics Approach to Interpreting the Influence of Exercise and Diet on the Immune System
Nieman, D. C., Lila, M. A., & Gillitt, N. D. (2019) · Annual Review of Food Science and Technology · doi:10.1146/annurev-food-032818-121316 · Cited by 85 · see citing works
Self-citation
Effect of prolonged exercise and carbohydrate ingestion on type 1 and type 2 T lymphocyte distribution and intracellular cytokine production in humans
Lancaster, G. I., Khan, Q., Drysdale, P., WALLACE, F. A., Jeukendrup, A. E., Drayson, M. T., & Gleeson, M. (2004) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00754.2004 · Cited by 83 · see citing works
Exercise alters the immune response to equine influenza virus and increases susceptibility to infection
Folsom, R. W., Littlefield-Chabaud, M. A., French, D. D., Pourciau, S. S., Mistric, L., & Horohov, D. W. (2001) · Equine Veterinary Journal · doi:10.2746/042516401776249417 · Cited by 82 · see citing works
Can exercise-related improvements in immunity influence cancer prevention and prognosis in the elderly?
Bigley, A. B., Spielmann, G., LaVoy, E. C. P., & Simpson, R. J. (2013) · Maturitas · doi:10.1016/j.maturitas.2013.06.010 · Cited by 75 · see citing works
Bananas as an Energy Source during Exercise: A Metabolomics Approach
Nieman, D. C., Gillitt, N. D., Henson, D. A., Sha, W., Shanely, R. A., Knab, A. M., Cialdella-Kam, L. A., & Jin, F. (2012) · PLoS ONE · doi:10.1371/journal.pone.0037479 · Cited by 74 · see citing works
Self-citation
Exercise and leukocyte interchange among central circulation, lung, spleen, and muscle
Adams, G., Zaldivar, F., Nance, D., Kodesh, E., Radom-Aizik, S., & Cooper, D. (2011) · Brain, behavior, and immunity · doi:10.1016/j.bbi.2011.01.002 · Cited by 73 · see citing works
Emerging roles of pro-resolving lipid mediators in immunological and adaptive responses to exercise-induced muscle injury.
Markworth, J. F., Maddipati, K. R., & Cameron‐Smith, D. (2018) · PubMed · Cited by 72 · see citing works
Upper respiratory tract infection in athletes: influence of lifestyle, type of sport, training effort, and immunostimulant intake.
König, D., Grathwohl, D., Weinstock, C., Northoff, H., & Berg, A. (2000) · PubMed · Cited by 71 · see citing works
Carbohydrate Supplementation and the Lymphocyte Proliferative Response to Long Endurance Running
Henson, D. A., Nieman, D. C., Parker, J. C., Rainwater, M. K., Butterworth, D. E., Warren, B. J., Utter, A. C., Davis, J., Fagoaga, O. R., & Nehlsen‐Cannarella, S. L. (1998) · International Journal of Sports Medicine · doi:10.1055/s-2007-971962 · Cited by 71 · see citing works
Self-citation
Meditation or exercise for preventing acute respiratory infection (MEPARI-2): A randomized controlled trial
Barrett, B. P., Hayney, M. S., Muller, D., Rakel, D. P., Brown, R., Zgierska, A. E., Barlow, S., Hayer, S. D., Barnet, J. H., Torres, E. R., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0197778 · Cited by 68 · see citing works
Elderly men with moderate and intense training lifestyle present sustained higher antibody responses to influenza vaccine
de Araújo, A. L., Silva, L. C. R., Fernandes, J. R., Matias, M. D. S. T., Boas, L. S., Machado, C. M., Garcez-Leme, L. E., & Benard, G. (2015) · AGE · doi:10.1007/s11357-015-9843-4 · Cited by 67 · see citing works
Metabolomics-Based Analysis of Banana and Pear Ingestion on Exercise Performance and Recovery
Nieman, D. C., Gillitt, N. D., Sha, W., Meaney, M. P., John, C. S., Pappan, K. L., & Kinchen, J. M. (2015) · Journal of Proteome Research · doi:10.1021/acs.jproteome.5b00909 · Cited by 67 · see citing works
Self-citation
Exercise Improves Host Response to Influenza Viral Infection in Obese and Non-Obese Mice through Different Mechanisms
Warren, K. J., Olson, M. M., Thompson, N. J., Cahill, M. L., Wyatt, T. A., Yoon, K. J., Loiacono, C. M., & Kohut, M. L. (2015) · PLoS ONE · doi:10.1371/journal.pone.0129713 · Cited by 66 · see citing works
Impact of Acute Intermittent Exercise on Natural Killer Cells in Breast Cancer Survivors
Evans, E. S., Hackney, A. C., McMurray, R. G., Randell, S. H., Muss, H. B., Deal, A. M., & Battaglini, C. L. (2015) · Integrative Cancer Therapies · doi:10.1177/1534735415580681 · Cited by 65 · see citing works
Does Regular Exercise Counter T Cell Immunosenescence Reducing the Risk of Developing Cancer and Promoting Successful Treatment of Malignancies?
Turner, J. E., & Brum, P. C. (2017) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2017/4234765 · Cited by 65 · see citing works
Influence of carbohydrate on cytokine and phagocytic responses to 2 h of rowing
Henson, D. A., Nieman, D. C., Nehlsen‐Cannarella, S. L., Fagoaga, O. R., SHANNON, M., BOLTON, M. R., Davis, J. M., GAFFNEY, C. T., Kelln, W., Austin, M. D., et al. (2000) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200008000-00005 · Cited by 63 · see citing works
Self-citation
Comparison of Watermelon and Carbohydrate Beverage on Exercise-Induced Alterations in Systemic Inflammation, Immune Dysfunction, and Plasma Antioxidant Capacity
Shanely, R. A., Nieman, D. C., Perkins-Veazie, P. M., Henson, D. A., Meaney, M., Knab, A. M., & Cialdella-Kam, L. A. (2016) · Nutrients · doi:10.3390/nu8080518 · Cited by 61 · see citing works
Self-citation
Chronic exercise stress in mice depresses splenic T lymphocyte mitogenesis in vitro.
Hoffman‐Goetz, L., Keir, R., Thorne, R., et al. (1986) · PubMed · Cited by 58 · see citing works
Dose–Response Relationship between Exercise and Respiratory Disease Mortality
Williams, P. T. (2013) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000142 · Cited by 58 · see citing works
Exercise-induced B cell mobilisation: Preliminary evidence for an influx of immature cells into the bloodstream
Turner, J. E., Spielmann, G., Wadley, A. J., Aldred, S., Simpson, R. J., & Campbell, J. P. (2016) · Physiology & Behavior · doi:10.1016/j.physbeh.2016.06.023 · Cited by 56 · see citing works
Influence of Acute Vitamin C and/or Carbohydrate Ingestion on Hormonal, Cytokine, and Immune Responses to Prolonged Exercise
Davison, G., & Gleeson, M. (2005) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.15.5.465 · Cited by 55 · see citing works
Changes in natural killer cell subpopulations over a winter training season in elite swimmers
Rama, L. M. P. L., Teixeira, A. M., de Matos, A. T. S., Borges, G. F., Henriques, A., Gleeson, M., Pedreiro, S., Filaire, E., Alves, F., & Paiva, A. A. (2012) · European Journal of Applied Physiology · doi:10.1007/s00421-012-2490-x · Cited by 55 · see citing works
Preparticipation predictors for championship injury and illness: cohort study at the Beijing 2015 International Association of Athletics Federations World Championships
Timpka, T., Jacobsson, J., Bargoria, V., Périard, J. D., Racinais, S., Rønsen, O., Halje, K., Andersson, C., Dahlström, Ö., Sprečo, A., et al. (2016) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096580 · Cited by 55 · see citing works
Metabolic recovery from heavy exertion following banana compared to sugar beverage or water only ingestion: A randomized, crossover trial
Nieman, D. C., Gillitt, N. D., Sha, W., Esposito, D., & Ramamoorthy, S. (2018) · PLoS ONE · doi:10.1371/journal.pone.0194843 · Cited by 55 · see citing works
Self-citation
Mobilizing Immune Cells With Exercise for Cancer Immunotherapy
Simpson, R. J., Bigley, A. B., Agha, N. H., et al. (2017) · Exercise and Sport Sciences Reviews · doi:10.1249/jes.0000000000000114 · Cited by 54 · see citing works
Signatures of anthocyanin metabolites identified in humans inhibit biomarkers of vascular inflammation in human endothelial cells
Warner, E. F., Smith, M. J., Zhang, Q., et al. (2017) · Molecular Nutrition & Food Research · doi:10.1002/mnfr.201700053 · Cited by 52 · see citing works
The effects of carbohydrate supplementation during the second of two prolonged cycling bouts on immunoendocrine responses
Li, T., & Gleeson, M. (2005) · European Journal of Applied Physiology · doi:10.1007/s00421-005-0024-5 · Cited by 51 · see citing works
Effect of an intense period of competition on race performance and self‐reported illness in elite cross‐country skiers
Svendsen, I. S., Gleeson, M., Haugen, T. A., et al. (2015) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.12452 · Cited by 50 · see citing works
Acute bouts of exercise induce a suppressive effect on lymphocyte proliferation in human subjects: A meta-analysis
Siedlik, J. A., Benedict, S. H., Landes, E. J., Weir, J. P., Vardiman, J. P., & Gallagher, P. M. (2016) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2016.04.008 · Cited by 50 · see citing works
Ecological Immunology through the Lens of Exercise Immunology: New Perspective on the Links between Physical Activity and Immune Function and Disease Susceptibility in Wild Animals
van Dijk, J. G. B., & Matson, K. D. (2016) · Integrative and Comparative Biology · doi:10.1093/icb/icw045 · Cited by 50 · see citing works
Leucocytosis after violent Exercise.
Larrabee, R. C. (1902) · PubMed · Cited by 48 · see citing works
Effects of Graded Carbohydrate Supplementation on the Immune Response in Cycling
Scharhag, J., Meyer, T., Auracher, M., Gabriel, H. H. W., & Kindermann, W. (2006) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000191437.69493.d4 · Cited by 48 · see citing works
Increased Risk of Upper Respiratory Infection in Military Recruits Who Report Sleeping Less Than 6 h per night
Wentz, L. M., Ward, M. D., Potter, C., Oliver, S. J., Jackson, S., Izard, R. M., Greeves, J. P., & Walsh, N. P. (2018) · Military Medicine · doi:10.1093/milmed/usy090 · Cited by 48 · see citing works
Self-citation
Sports Injury and Illness Epidemiology: Great Britain Olympic Team (TeamGB) surveillance during the Sochi 2014 Winter Olympic Games
Palmer-Green, D., & Elliott, N. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2014-094206 · Cited by 46 · see citing works
Development of the discipline of exercise immunology.
Shephard, R. J. (2010) · PubMed · Cited by 46 · see citing works
Influence of Exercise Mode and Carbohydrate on the Immune Response to Prolonged Exercise
Henson, D. A., Nieman, D. C., Blodgett, A. D., Butterworth, D. E., Utter, A. C., Davis, J. M., Sonnenfeld, G., Morton, D. S., Fagoaga, O. R., & Nehlsen‐Cannarella, S. L. (1999) · International Journal of Sport Nutrition · doi:10.1123/ijsn.9.2.213 · Cited by 45 · see citing works
Self-citation
Role of endurance exercise in immune senescence
Nieman, D. C., & Henson, D. A. (1994) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199402000-00007 · Cited by 45 · see citing works
Self-citation
Splenic immune responses following treadmill exercise in mice
Hoffman‐Goetz, L., Thorne, R., & Houston, M. E. (1988) · Canadian Journal of Physiology and Pharmacology · doi:10.1139/y88-230 · Cited by 43 · see citing works
A proteomic study of plasma protein changes under extreme physical stress
Balfoussia, E., Skenderi, K., Tsironi, M., Anagnostopoulos, A. K., Parthimos, N., Vougas, K. N., Papassotiriou, I., Tsangaris, G. T., & Chrousos, G. P. (2013) · Journal of Proteomics · doi:10.1016/j.jprot.2013.12.004 · Cited by 43 · see citing works
Aging, exercise, training, and the immune system.
Shinkai, S., Konishi, M., & Shephard, R. J. (1997) · PubMed · Cited by 43 · see citing works
Reduced Total and Cause-Specific Mortality from Walking and Running in Diabetes
Williams, P. T. (2014) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000000197 · Cited by 40 · see citing works
Detection of Functional Overreaching in Endurance Athletes Using Proteomics
Nieman, D. C., Groen, A. J., Pugachev, A., & Vacca, G. (2018) · Proteomes · doi:10.3390/proteomes6030033 · Cited by 40 · see citing works
Self-citation
The Protective Effects of a Polyphenol‐Enriched Protein Powder on Exercise‐Induced Susceptibility to Virus Infection
Ahmed, M., Henson, D. A., Sanderson, M. C., Nieman, D. C., Gillitt, N. D., & Lila, M. A. (2014) · Phytotherapy Research · doi:10.1002/ptr.5208 · Cited by 39 · see citing works
Self-citation
A single bout of dynamic exercise enhances the expansion of MAGE-A4 and PRAME-specific cytotoxic T-cells from healthy adults.
LaVoy, E. C. P., Bollard, C. M., Hanley, P. J., et al. (2015) · PubMed · Cited by 37 · see citing works
Acute high-intensity interval exercise induces comparable levels of circulating cell-free DNA and Interleukin-6 in obese and normal-weight individuals
Ferrandi, P. J., Fico, B. G., WHITEHURST, M. A., Zourdos, M. C., Bao, F., Dodge, K. M., Rodriguez, A. L., Pena, G. S., & Huang, C. (2018) · Life Sciences · doi:10.1016/j.lfs.2018.04.007 · Cited by 37 · see citing works
Illness Among Paralympic Athletes
van Rensburg, D. C. J., Schwellnus, M. P., Derman, W. E., et al. (2018) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2018.01.003 · Cited by 35 · see citing works
Influence of Carbohydrate on Immune Function Following 2 h Cycling
Nieman, D. C., Henson, D. A., Gojanovich, G. S., Davis, J. M., Murphy, E. A., Mayer, E. P., Pearce, S., Dumke, C. L., Utter, A. C., McAnulty, S. R., et al. (2006) · Research in Sports Medicine · doi:10.1080/15438620600854793 · Cited by 34 · see citing works
Self-citation
A prospective cohort study of 7031 distance runners shows that 1 in 13 report systemic symptoms of an acute illness in the 8–12 day period before a race, increasing their risk of not finishing the race 1.9 times for those runners who started the race: SAFER study IV
Tonder, A. V., Schwellnus, M. P., Swanevelder, S. A., Jordaan, E., Derman, W. E., & van Rensburg, D. C. J. (2016) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096190 · Cited by 34 · see citing works
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Wu, S., Ma, C., Yang, Z., Yang, P., Chu, Y., Zhang, H., Li, H., Hua, W., Tang, Y., Li, C., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0148448 · Cited by 33 · see citing works
Aerobic exercise attenuates pulmonary inflammation induced byStreptococcus pneumoniae
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Autologous serum collected 1 h post-exercise enhances natural killer cell cytotoxicity
Gupta, P., Bigley, A. B., Markofski, M. M., Laughlin, M. S., & LaVoy, E. C. P. (2018) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2018.04.007 · Cited by 31 · see citing works
Smoking, leisure-time exercise and frequency of self-reported common cold among the general population in northeastern China: a cross-sectional study
Zhou, G., Liu, H., He, M., Yue, M., Gong, P., Wu, F., Li, X., Pang, Y., Yang, X., Ma, J., et al. (2018) · BMC Public Health · doi:10.1186/s12889-018-5203-5 · Cited by 30 · see citing works
Effect of Prolonged Exercise and Carbohydrate on Total Neutrophil Elastase Content
BISHOP, N. C., Walsh, N. P., & SCANLON, G. A. (2003) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000078927.08049.a8 · Cited by 29 · see citing works
Aerobic Exercise Protects from Pseudomonas aeruginosa-Induced Pneumonia in Elderly Mice
Durigon, T. S., MacKenzie, B., Oliveira‐Junior, M. C., Santos‐Dias, A., Angelis, K. D., Malfitano, C., da Palma, R. K., Guerra, J. M., Damaceno‐Rodrigues, N. R., Caldini, E. T. E. G., et al. (2018) · Journal of Innate Immunity · doi:10.1159/000488953 · Cited by 28 · see citing works
Influence of Carbohydrate and Age on Lymphocyte Function Following a Marathon
Henson, D. A., Nieman, D. C., Pistilli, E., Schilling, B. K., Colacino, A. R., Utter, A. C., Fagoaga, O. R., Vinci, D. M., & Nehlsen‐Cannarella, S. L. (2004) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.14.3.308 · Cited by 25 · see citing works
Self-citation
Arterial Thickness and Immunometabolism: The Mediating role of Chronic Exercise
Antunes, B. M., Cayres, S. U., Lira, F. S., et al. (2016) · Current Cardiology Reviews · doi:10.2174/1573403x12666160126115317 · Cited by 23 · see citing works
Chronic fatigue syndrome and the athlete
Parker, S., Brukner, P. D., & Rosier, M. J. (1996) · Sports medicine, training, and rehabilitation/Sports medicine, training and rehabilitation · doi:10.1080/15438629609512057 · Cited by 17 · see citing works
Recent acute prerace systemic illness in runners increases the risk of not finishing the race: SAFER study V
Gordon, L., Schwellnus, M. P., Swanevelder, S. A., et al. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096964 · Cited by 17 · see citing works
Identification of a select metabolite panel for measuring metabolic perturbation in response to heavy exertion
Nieman, D. C., Gillitt, N. D., & Sha, W. (2018) · Metabolomics · doi:10.1007/s11306-018-1444-7 · Cited by 17 · see citing works
Self-citation
Exercise prior to influenza vaccination for limiting influenza incidence and its related complications in adults
Grande, A. J., Reid, H. A. B., Thomas, E. E., Nunan, D., & Foster, C. E. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011857.pub2 · Cited by 15 · see citing works
To the Editor-in-Chief
MACKINNON, L. T. (1986) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-198610000-00018 · Cited by 6 · see citing works

Flagged first, then by citations

Research works printed but not linked: 6

[9]Mackinnon L.T. Changes in some cellular immune parameters following exercise training Med Sci Sports Exerc 18 1986 596 597 3773678
[55]Simpson R.J. Kunz H. Agha N. Graff R. Exercise and the regulation of immune functions Prog Mol Biol Transl Sci 135 2015 355 380 26477922
[123]Antunes B.M. Cayres S.U. Lira F.S. Fernandes R.A. Arterial thickness and immunometabolism: the mediating role of chronic exercise Curr Cardiol Rev 12 2016 47 51 26818486 PMC4807718
[139]Koelwyn G.J. Wennerberg E. Demaria S. Jones L.W. Exercise in regulation of inflammation-immune axis function in cancer initiation and progression Oncology (Williston Park) 29 2015 908 922 26676894 PMC4909049
[177]Nieman D.C. Henson D.A. Role of endurance exercise in immune senescence Med Sci Sports Exerc 26 1994 172 181 8164534
[179]Simpson R.J. Kunz H. Agha N. Graff R. Exercise and the regulation of immune functions Prog Mol Biol Transl Sci 135 2015 355 380 26477922

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Authors: Nieman, D. C., & Wentz, L. M.
Affiliations: Appalachian State University (US)
Corresponding author: Nieman, David C.
ORCID: Nieman, David C.
Wentz, Laurel M.
Venue: Journal of Sport and Health Science
Publisher: Elsevier BV
Published: 2019-05
Volume: 8
Issue: 3
Pages: 201-217
ISSN: 2213-2961 (ISSN-L)
2095-2546
DOI: 10.1016/j.jshs.2018.09.009
PMC: PMC6523821
OpenAlex: W2900790963
Cited by: 1,340
References: 176
Citations by year: 2026: 115 · 2025: 150 · 2024: 146 · 2023: 207 · 2022: 228 · 2021: 274 · 2020: 206 · 2019: 11 · 2018: 1 · 2013: 2
FWCI: 15.45
Type: journal article
Language: en
Open access: diamond
doi.org
Licence: cc-by-nc-nd
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by-nc-nd/4.0/ (vor)
Locations: Journal of sport and health science/Journal of Sport and Health Science (publishedVersion, cc-by-nc-nd)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics: Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
Keywords: exercise immunology, physical activity, immune system, acute exercise effects, long-term training effects, exercise-induced immunosuppression, upper respiratory tract infection, inflammatory markers, immunosenescence, aging immune system, cytokines, metabolomics, proteomics, lipidomics, microbiome, personalized exercise, chronic disease risk

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