Training strategies to maintain immunocompetence in athletes

Clinical experience and empirical evidence have led to the modeling of exer cise and training as a form of stress on the immune system. Coaches, athlet es, and medical personnel are seeking guidelines on ways to reduce the risk of illness that compromises training or competitive performance. The immun e system is influenced by a wide range of physical, environmental, psycholo gical, and behavioural factors which, combined with clinical assessment, co llectively form the basis of the following intervention strategies: 1) trai ning: careful management of training Volume and intensity, variety to overc ome training monotony and strain, a periodised approach to increasing loads , and provision of adequate rest and recovery periods; 2) environmental: li miting initial exposure when training or competing in adverse environmental conditions (heat, humidity, altitude, air pollution) and acclimatising whe re appropriate; 3) psychological: teaching athletes self-management and cop ing skills and monitoring of athletes' responses to the psychological and p sychosocial stresses of high-level training and competition; 4) behavioural : adopting a well-balanced diet with adequate intake of macro- and micro-nu trients, limiting transmission of contagious illnesses by reducing exposure to common infections, airborne pathogens, and physical contact with infect ed individuals; and 5) clinical considerations: medical screening, patholog y testing, immunization and prophylaxis, and routine management of illness- prone athletes. Future experimental studies are required to develop and enh ance the effectiveness of these strategies in reducing illness in athletes.