Immune System of Human Body

The condition of the body is maintained at a constant level by modulating body temperature and blood pressure, to cope with changes in the environment inside and outside the body. This mechanism is called homeostasis. In homeostasis, the innate immune system plays an important role: it eliminates foreign substances (non-self) such as pathogens, viruses and cancer cells. However, it is known that immune function deteriorates with aging, and is impaired or stimulated by a poor lifestyle such as smoking, insufficient physical exertion or an unbalanced diet, and by adverse environmental changes and pollution. Deterioration of immune function causes or aggravates infection and malignant tumors, while excessive elevation of the immune system may cause things such as hay fever, atopic dermatitis or chronic inflammation. Studies in recent years have clarified that fiber and indigestive components in food are deeply involved in the maintenance of homeostasis and immune responsiveness.



BioBran is a functional food manufactured using a water-soluble rice bran dietary fiber component (hemicellulose B). Collaborative research with Prof. Mamdooh Ghoneum Ph.D. at the University of California, Los Angeles, USA (UCLA/Drew University of Medicine) on rice bran dietary fiber components has led to the discovery and establishment of processing and manufacturing methods of a food that optimally modulates the innate immune function of the body. It was subsequently demonstrated that BioBran has not only an immunostimulatory effect but also an immunomodulating effect. Extensive efforts to maximize its stability and taste have resulted in BioBran rice bran arabinoxylan. Currently, BioBran is widely used not only in Japan but also in more than 50 countries worldwide, and has an excellent reputation.
Patent No.5358219.

Daiwa Pharmaceutical Co., Ltd. has focused on a dietary fiber thought to have the potential to impact the immune response and developed a multifunctional food closely related to the Japanese foodstuff of ancient times, named BioBran (Rice Bran Arabinoxylan Compound).


Manufacturing Process




Characteristics

BioBran is a functional food produced by water-soluble dietary fiber (hemicellulose B) with an enzyme derived from shiitake mushrooms.

Suggested daily dose
1-3g/day

Property
Easy soluble in water and heat-stable

Mechanism of Action

Starch, dietary fiber, and BioBran are classified as polysaccharides. 
Starch is digested by saliva, pancreatic juice, and intestinal juice, and is absorbed in the small intestine as glucose. Dietary fiber is not digested, and is excreted unchanged. BioBran is known to be partly absorbed directly in the digestive tract, entering the blood stream.It activates the Natural Killer Cells, T cells, B cells, and macrophages, either directly in the blood, or indirectly via the Peyer's patch of the ileum, BioBran plays an important role in immunomodulation (immunostimulation, anti-inflammation, anti-allergy, antioxidation processes). Overall, it is considered to enhance the body's natural healing abilities, alleviate the adverse drug reactions of chemotherapeutic agents, and improve quality of life.







Usefulness as a functional food

1. Immunomodulatory action

(1) Immunostimulating action

▶Response of human NK cell activation to dose of BioBran
▶NK cell activation in cancer patients following BioBran intake
▶Stimulation of lymphocyte transformation
▶Promotion of differentiation of dendritic cells
▶Anticancer effect of BioBran

(2) Anti-inflammatory action

▶Influence on liver damage

2. Combination therapy with a chemotherapeutic agent

▶BioBran in combination with a chemotherapeutic agent

3. Improvement of quality of life

▶Effect of BioBran on survival and quality of life improvement in patients with progressive cancer

Safety

Single dose ~ LD50>36g/kg.
Repeated dose ~ NOAEL>200mg/kg/day.
Mutagenicity (Ames test) ~ Negative.

▶Response of human NK cell activation to dose of BioBran

Twenty-four healthy human volunteers were divided into three groups of 8, and assigned to ingest BioBran at 15mg/kg body weight (approximately equal to 1g), 30mg/kg body weight (approximately equal to 2g), and 45mg/kg body weight (approximately equal to 3g) every day for a period of two months to measure the effects on NK cell activity.

The activity in the 15mg/kg group was almost unchanged after 1 week but increased to twice the baseline activity after 1 month. The activity in the 30mg/kg group increased to about 3 times the baseline value after 1 week and then gradually increased to 5 times the baseline value by 2 months. The 45mg/kg group showed a pattern of increase similar to that in the 30mg/kg group, but the rate and degree of increase were greater than that of the 30mg/kg group. Following cessation of treatment, the NK cell activity levels gradually returned to baseline in each group.



Response of human NK cell activation to dose of BioBran :

Ghoneum M.,“Enhancement of human natural killer cell activity by modified Arabinoxylan from rice bran (MGN-3)”, INT. J. IMMUNOTHERAPY XIV (2) 89-99 (1998)

▶NK cell activation in cancer patients following BioBran intake

NK cell activity was compared before and after 6 months of BioBran intake in 25 cancer patients with progressive disease, who received chemotherapy, surgery, and/or hormone therapy. Although a large difference in the baseline activity was observed between patients, all patients demonstrated an increase in NK cell activity after BioBran intake.



NK cell activation in cancer patients following BioBran intake :

Ghoneum M. and G. Namatalla, 87th Annual Meeting of the American Association for Cancer Research, 1996.

▶Stimulation of lymphocyte transformation

The proliferation of T-cell and B-cell lymphocytes was compared before and after BioBran intake. The proliferation of both T-cells and B-cells increased in the 3 patients following BioBran intake.



Stimulation of lymphocyte transformation:

Ghoneum M., 11th International AIDS Conference in Vancouver, 1996.

▶Promotion of differentiation of dendritic cells

Monocytes were isolated from the peripheral blood of healthy subjects and cultured in the presence of GM-CSF and IL-4 for 6 days, to prepare immature dendritic cells (iDC). On the 7th day, BioBran was added at various concentrations to the immature dendritic cells. The immature dendritic cells were incubated for 2 days and their maturation to dendritic cells was observed. The same operation was performed using two kinds of culture medium which have the effect of promoting the development of iDC to mature dendritic cells, designated mat DC1, and matDC2, respectively. In the immature dendritic cells (iDC), BioBran suppressed the expression of the monocyte marker CD14 and increased the expression of the dendritic cell marker CD83, both in a dose dependent manner. This result appears to show that BIoBran promotes the differentiation of dendritic cells.



Promotion of differentiation of dendritic cells :

Cholujova D., et al, “BioBran-augmented maturation of human monocyte-derived dendritic cells”, NEOPLASMA, 56, 2, 2009.

▶Anticancer effect of BioBran

Female Swiss albino mice were inoculated with 2.5 x 106 Ehrlich ascites carcinoma (EAC) cells into the right femoral region, and the tumor size determined on consecutive days, starting on the 8th day after inoculation until the 35th day. The control group received phosphate buffered saline (PBS), and the BioBran group received 40 mg/kg body weight of BioBran intraperitoneally three times a week for a period of 3 weeks, starting on the 8th day after the inoculation of EAC. After treatment, the tumor size was determined. The results showed a significantly greater suppression of tumor growth in the BioBran group compared to the control (PBS) group, starting on the 14th day after inoculation of EAC. The photographs of tumor on the 35th day also showed a tumor regression in the BioBran group.



バイオブランのin vivoにおける抗腫瘍効果
Anticancer effect of BioBran :

Ghoneum M., et al, “In vivo Tumor Inhibitory Effects of Nutritional Rice Bran Supplement MGN-3/Biobran on Ehrlich Carcinoma-Bearing Mice”, Nutrition and Cancer, 2008.

▶Influence on liver damage

Male Wistar rats (5 rats/group) were given intraperitoneal administration of 800 mg/kg D-galactosamine to induce liver disorder. Serum GOT and GPT were determined 24 hours after the administration of D-galactosamine, as induces of liver damage. One hour before administration of D-galactosamine, 20, 40, or 80 mg/kg of BioBran was administered intraperitoneally. The serum GOT and GPT in the control group without BioBran at 24 hours after the administration of D-galactosamine were 1410 IU/L and 445 IU/L, respectively. Compared to these values, serum GOT and GPT in the groups treated with BioBran were significantly lower at all doses.



Influence on liver damage :

Sanada H. and Y. Egashira, 7th meeting of the Japanese Association for Dietary Fiber Research, Tokyo, 2002.


▶BioBran in combination with a chemotherapeutic agent

Human breast cancer cells (MCF-7) (1 x 104 cells) were seeded into the wells of a plate and incubated for 3 days in the presence of differing concentrations of BioBran, and the chemotherapeutic agent daunorubicin (DNR). Viable cells were counted by the MTT method, and the concentration of DNR which reduced the number of viable cancer cells by 50% (IC50) was determined. DNR inhibited the survival of MCF-7 cells in a concentration-dependent manner, with the IC50 being 1μM. When MCF-7 cells were cultured in the presence of BioBran and DNR, the IC50 of DNR for MCF-7 was reduced significantly (IC50: 0.2μM).



BioBran in combination with a chemotherapeutic agent :
Ghoneum M. and S. Gollapudi, “MGN-3/Biobran, modified arabinoxylan from rice bran, sensitizes human breast cancer cells to chemotherapeutic agent, daunorubicin”, Cancer Detection and Prevention, 2008.

▶Effect of BioBran on survival and quality of life improvement in patients with progressive cancer

Two hundred and five patients with malignant tumors who were receiving treatment with alternative therapy and chemotherapy with mild adverse drug reactions were allocated into two groups. One of the groups (the control group) received conventional alternative therapy and chemotherapy, and the other group (BioBran group) was given 1 g of BioBran three times a day after each meal for 18 months, in addition to receiving the same therapy as the control group. The correlation between natural killer (NK) cell activity determined during the observation period and survival rate was studied.
The patients’ quality of life was assessed on a scale of 0 to 4 with regard to “pain”, “fatigue”, and “nausea” and 0 to 3 with regard to “appetite” at the start of, and during, the observation period. Of the 205 patients participating in the study, 53 patients of the control group could not continue the conventional alternative therapy and dropped out, and therefore 152 patients (56 patients in the control group and 96 in the BioBran group) were included in the analysis. The survival rates at the end of the observation period in the control group and the BioBran group were 35.8% and 54.2%, respectively. This represents a 50% higher survival rate in the BioBran group compared to the control group. It was also shown that higher NK cell activity was associated with a higher survival rate (Table 1). It was confirmed that the patients’ quality of life after the study had improved compared to the quality of life at the start of the study in both the control group and BioBran group; a notable improvement in appetite was observed in the BioBran group (Table 2).



Effect of BioBran on survival and quality of life improvement in patients with progressive cancer :

Takahara K., et al, “The Life Prolongation and QOL Improvement Effect of Rice Bran Arabinoxylan Derivative (MGN-3, BioBran) for Progressive Cancer”, Clinical Pharmacology and Therapy, 2004

Human Body Hydration ; FLUID BALANCE

Fluid balance is an aspect of the homeostasis of living organisms in which the amount of water in the organism needs to be controlled, via osmoregulation and behavior, such that the concentrations of electrolytes (salts in solution) in the various body fluids are kept within healthy ranges. The core principle of fluid balance is that the amount of water lost from the body must equal the amount of water taken in; for example, in human homeostasis, the output (via respiration, perspiration, urination, defecation, and expectoration) must equal the input (via eating, drinking, and parenteral intake).

Euvolemia is the state of normal body fluid volume, including blood volume, interstitial fluid volume, and intracellular fluid volume; hypovolemia and hypervolemia are imbalances. Water is necessary for all life on Earth. Humans can survive for 4 to 6 weeks without food but only for a few days without water.
Profuse sweating can increase the need for electrolyte replacement. Water-electrolyte imbalance produces headache and fatigue if mild; illness if moderate, and sometimes even death if severe. For example, water intoxication (which results in hyponatremia), the process of consuming too much water too quickly, can be fatal. Deficits to body water result in volume contraction and dehydration. Diarrhea is a threat to both body water volume and electrolyte levels, which is why diseases that cause diarrhea are great threats to fluid balance.

Water consumption

The amount of water varies with the individual, as it depends on the condition of the subject, the amount of physical exercise, and on the environmental temperature and humidity. In the US, the reference daily intake (RDI) for water is 3.7 litres per day (l/day) for human males older than 18, and 2.7 l/day for human females older than 18 including water contained in food, beverages, and drinking water. The common misconception that everyone should drink two liters (68 ounces, or about eight 8-oz glasses) of water per day is not supported by scientific research. Various reviews of all the scientific literature on the topic performed in 2002 and 2008 could not find any solid scientific evidence that recommended drinking eight glasses of water per day. For example, people in hotter climates will require greater water intake than those in cooler climates. An individual's thirst provides a better guide for how much water they require rather than a specific, fixed number. A more flexible guideline is that a normal person should urinate 4 times per day, and the urine should be a light yellow color.

A constant supply is needed to replenish the fluids lost through normal physiological activities, such as respiration, perspiration and urination. Food contributes 0.5 to 1 l/day, and the metabolism of protein, fat, and carbohydrates produces another 0.25 to 0.4 l/day, which means that 2 to 3 l/day of water for men and 1 to 2 l/day of water for women should be consumed as fluid to meet the Recommended Daily Intake (RDI). you can follow the watercure protocol formula . Details available for free from this blogsite.

Trace elements

In terms of mineral nutrients intake, it is unclear what the drinking water contribution is. However, inorganic minerals generally enter surface water and ground water via storm water runoff or through the Earth's crust. Treatment processes also lead to the presence of some minerals. Examples include calcium, zinc, manganese, phosphate, fluoride and sodium compounds. Water generated from the biochemical metabolism of nutrients provides a significant proportion of the daily water requirements for some arthropods and desert animals, but provides only a small fraction of a human's necessary intake.

There are a variety of trace elements present in virtually all potable water, some of which play a role in metabolism. For example, sodium, potassium and chloride are common chemicals found in small amounts in most waters, and these elements play a role in body metabolism. Other elements such as fluoride, while arguably beneficial in low concentrations, can cause dental problems and other issues when present at high levels. Water is essential for the growth and maintenance of our bodies, as it is involved in a number of biological processes.

Medical use

Effects of illness

When a person is ill, fluid may also be lost through vomiting, diarrhea, and hemorrhage. An individual is at an increased risk of dehydration in these instances, as the kidneys will find it more difficult to match fluid loss by reducing urine output (the kidneys must produce at least some urine in order to excrete metabolic waste.)

Oral rehydration therapy

Main article: Oral rehydration therapy

 

Oral rehydration therapy (ORT), is type of fluid replacement used as a treatment for dehydration. In an acute hospital setting, fluid balance is monitored carefully. This provides information on the patient's state of hydration, renal function and cardiovascular function.

• If fluid loss is greater than fluid gain (for example if the patient vomits and has diarrhea), the patient is said to be in negative fluid balance. In this case, fluid is often given intravenously to compensate for the loss.
• On the other hand, a positive fluid balance (where fluid gain is greater than fluid loss) might suggest a problem with either the renal or cardiovascular system.

If blood pressure is low (hypotension), the filtration rate in the kidneys will lessen, causing less fluid reabsorption and thus less urine output.

An accurate measure of fluid balance is therefore an important diagnostic tool, and allows for prompt intervention to correct the imbalance.

Routes of fluid loss and gain

Fluid can leave the body in many ways. Fluid can enter the body as preformed water, ingested food and drink and to a lesser extent as metabolic water which is produced as a by-product of aerobic respiration (cellular respiration) and dehydration synthesis.

Input

A constant supply is needed to replenish the fluids lost through normal physiological activities, such as respiration, sweating and urination. Water generated from the biochemical metabolism of nutrients provides a significant proportion of the daily water requirements for some arthropods and desert animals, but provides only a small fraction of a human's necessary intake.
In the normal resting state, input of water through ingested fluids is approximately 1200 ml/day, from ingested foods 1000 ml/day and from aerobic respiration 300 ml/day, totaling 2500 ml/day.

Regulation of input

Main article: Thirst

Input of water is regulated mainly through ingested fluids, which, in turn, depends on thirst. An insufficiency of water results in an increased osmolarity in the extracellular fluid. This is sensed by osmoreceptors in the organum vasculosum of the lamina terminalis, which trigger thirst. Thirst can to some degree be voluntarily resisted, as during fluid restriction.

The human kidneys will normally adjust to varying levels of water intake. The kidneys will require time to adjust to the new water intake level. This can cause someone who drinks a lot of water to become dehydrated more easily than someone who routinely drinks less.

Output

• The majority of fluid output occurs via the urine, approximately 1500 ml/day (approx 1.59 qt/day) in the normal adult resting state.
• Some fluid is lost through perspiration (part of the body's temperature control mechanism) and as water vapor in expired air. These are termed "insensible fluid losses" as they cannot be easily measured. Some sources say insensible losses account for 500 to 650 ml/day (0.5 to 0.6 qt.) of water in adults, while other sources put the minimum value at 800 ml (0.8 qt.). In children, one calculation used for insensible fluid loss is 400 ml/m² body surface area.
• In addition, an adult loses approximately 100 ml/day of fluid through feces.
• For females, an additional 50 ml/day is lost through vaginal secretions.

These outputs are in balance with the input of ~2500 ml/day.

Regulation of output

The body's homeostatic control mechanisms, which maintain a constant internal environment, ensure that a balance between fluid gain and fluid loss is maintained. The hormones ADH (Anti-diuretic Hormone, also known as vasopressin) and Aldosterone play a major role in this.

• If the body is becoming fluid-deficient, there will be an increase in the secretion of these hormones, causing fluid to be retained by the kidneys and urine output to be reduced.
• Conversely, if fluid levels are excessive, secretion of these hormones is suppressed, resulting in less retention of fluid by the kidneys and a subsequent increase in the volume of urine produced.

Antidiuretic hormone

Main article: Antidiuretic hormone

If the body is becoming fluid-deficient, this will be sensed by osmoreceptors in the organum vasculosum of lamina terminalis and subfornical organ.These areas project to the supraoptic nucleus and paraventricular nucleus, which contain neurons that secrete the antidiuretic hormone, vasopressin, from their nerve endings in the posterior pituitary. Thus, there will be an increase in the secretion of antidiuretic hormone, causing fluid to be retained by the kidneys and urine output to be reduced.

Aldosterone

Main article: Renin-angiotensin system

 

A fluid-insufficiency causes a decreased perfusion of the juxtaglomerular apparatus in the kidneys. This activates the renin-angiotensin system. Among other actions, it causes renal tubules (i.e. the distal convoluted tubules and the cortical collecting ducts) to reabsorb more sodium and water from the urine. Potassium is secreted into the tubule in exchange for the sodium, which is reabsorbed. The activated renin-angiotensin system stimulates zona glomerulosa of the adrenal cortex which in turn secretes hormone aldosterone. This hormone stimulates the reabsorption of sodium ions from distal tubules and collecting ducts. Water in the tubular lumen cannot follow the sodium reabsorption osmotically, as this part of the kidney is impermeable to water; release of ADH (vasopressin) is required to increase expression of aquaporin channels in the cortical collecting duct, allowing reabsorption of water.

Healing Waters by Dr Bruce Becker

If you think the water just makes people feel 
good, you don’t know the half of it. Here’s a 
physiological explanation of the surprising and 
amazing ways the simple act of being in the 
water promotes well-being.

It doesn’t take long to notice that people in pools 
are having fun. Nor does it take long to see 
happy faces in a group of aquatic exercisers, or a 
smile replace the facial stress lines of someone
sinking into a hot tub. The feeling of relaxation 
after a vigorous pool workout is wonderful, and
unlike most other exercise experiences.

As a scientist, I’ve been impressed with the 
consistency and universality of these observa-
tions. When I began to work with Olympic 
athletes who were used to vigorous exercise 
routines, they often commented on the difference
in their post-exercise comfort from an aquatic 
exercise session vs. their normal exercise routine
. But there’s too much scientist in me not to 
wonder why these findings occur with such 
frequency and regularity. As I researched the 
medical literature,I couldn’t find much to 
explain such common events. But when I began 
to dig into the basic science literature, I did find 
information that provided some potential 
explanation.

The physiology of immersion has been studied 
extensively since we prepared to put man into
space in the late 1960s because the closest proxy
to weightlessness on the planet is to be found
when immersed in water. To study the physio-
logical changes that would occur in space, it
became important to study those changes 
occurring during immersion. The physiological 
alterations were profound and led to further 
research of specific body systems. Still, most of 
this research was not translated into medical 
applications, but rather, was located in highly 
scientific physiology journals.

Even today, there’s relatively little research on 
the clinical applications of aquatic activity or 
exercise to be found in medical journals. This 
crossover from basic science into clinical
application is called translational research
and it is only beginning to emerge for aquatics.
But as more people turn to the water for therapy 
and healing, that body of evidence is growing 
daily. If the industry can capitalize on these
findings, understand and promote them
effectively, aquatics could become the next big
health craze, with the promise of helping
everything from high blood pressure
to heart failure. 
Given that the American Heart Association says
72 million Americans suffer from high blood 
pressure and more than 79 million have cardio-
vascular disease, that could be a powerful 
incentive. The nation, in turn, could save huge
amounts in health expenses if the public were 
educated about the value of aquatic activity, if 
the political powers directed public expenditures
toward pool construction to improve public 
access and the medical establishment understood
the potential value of aquatic activity across a 
wide range of clinical problems. But it must start
with us. It must start with understanding why 
water is so healing.

Finding balance

To understand why aquatics is so good for your 
health, you must first understand some basic 
physiology. Our bodies are constantly trying to 
seek a physiological balance point called 
homeostasis. This state preserves optimum 
function despite changes in position, activity, 
stress, aging or disease. The effort to find 
homeostasis is what propels most of the 
functional adaptations that occur during 
immersion in water, with some changes being 
immediate and others only after a period of time.
Like many adaptations, a cascade of other 
physiological changes occur, some sequentially 
and some concurrently.
Here’s how it works: Because water compresses
the body, it pushes blood into the deep vessels
during immersion. As the bather steps into 
deeper water, blood is pushed upward, first into
the large capacity vessels of the pelvis and 
abdomen. Then as depth increases yet further, 
blood is pushed above the diaphragm into the 
chest. With neck depth immersion, nearly three-
quarters of a quart (1 US quart=946.353 ml) of 
blood is displaced, with two-thirds of it going 
into large pulmonary vessels and one-third into 
the heart.
The heart responds to this extra volume of blood
by increasing the amount propelled with each 
beat, which is called stroke volume. At rest 
during neck-depth immersion, stroke volume 
normally increases approximately 30 percent. 
The total volume of blood propelled by the heart 
during a minute is called cardiac output, and this
also increases nearly 30 percent. That’s approxi-
mately the same increase that occurs during light
exercise, so even at rest during neck-depth
immersion, the heart is performing just as it 
would during exercise on land. At the same time
, the body senses that more blood is being
pushed into circulation,so to adjust, the arterial 
blood vessels relax without causing an increase 
in blood pressure. Thus, healthy individuals will
lower their blood pressure during immersion, 
and usually so will individuals with elevated
blood pressure (hypertension.) The magnitude
of this drop is related to the temperature of the
water.

Usually, there’s an initial brief increase in blood 
pressure upon entering cold water and also 
extremely warm water. Maybe that’s why in the 
past, it was often stated that individuals with 
hypertension should avoid hot tubs. Many 
physical therapy texts also say that patients with 
elevated blood pressure should not undergo 
aquatic therapy. In actual fact, immersion may 
benefit such patients.

Heart and health

Patients with congestive heart failure are another
clinical population that has been counseled to 
avoid aquatic exercise or even immersion. But 
several recent Japanese and Israeli studies have 
found that for people with mild to moderate 
heart failure, aquatics may be a very useful and 
therapeutic environment. That’s because 
immersion offers a unique combination of 
benefits: It decreases circulatory resistance and 
improves heart contraction efficiency. One of 
these studies compared the effects of aquatic 
exercise with rest in a group of patients with 
moderate congestive heart failure. It was found 
that the aquatic exercise group of patients 
significantly improved in muscle function, 
walking distance, aerobic fitness and exercise 
capacity.
They also experienced nearly 40 percent
improvement in their quality of life. One reason
may be that during immersion, the increased 
blood volume is pushed into deeper tissues. 
Muscle circulation then improves and there’s a 
consequent increase in oxygen delivery, which 
is useful for muscle healing or recovering from 
exercise. A study done on astronauts in training 
showed that the blood flow into their calves was
increased by nearly 250 percent at rest during
neck-depth immersion. At the same time, the 
kidneys see an increase in blood volume. 
Sensors within the heart and elsewhere interpret 
the increase in blood volume as a potential 
overload, so the body sends signals to the
endocrine system to reduce this blood volume. 
As a result, the kidneys begin their role in 
regulating blood volume through excreting 
sodium and potassium, and along with those 
ions, water. As all aquatics professionals have 
experienced firsthand, this process produces an
increase in urine volume and the kidneys also 
become slightly more efficient. In ancient Greek
and Roman times, when medications were very
limited, immersion was actually used as a way 
to treat individuals with kidney disease.
Stress is another ailment that immersion can 
help alleviate. Some of the same hormones that 
the body uses to regulate arterial function and 
tone are a component part of our body’s 
response to stress. These hormones are called 
catacholamines. During immersion, the body 
sends out a signal to alter the balance of these 
catacholamines in a manner that is similar to the 
balance found during relaxation or meditation.
Not all of the effects of this alteration are known
, but probably these changes are important in 
modifying the heart rhythm in a manner to 
mimic a relaxed state, and also in creating some 
of the feeling of relaxation that occurs following 
aquatic activity.

Exercise and endurance

The connection between exercise and stress 
reduction has been well-established, and the
work the body must do in water may be one 
reason. During immersion, compression of the 
chest wall combined with the increased blood 
volume makes it more work to breathe — 
approximately 60 percent more with water up 
to the neck. This, in turn, can lead not only to 
lower stress,but also better performance during 
land workouts.
In my experience working with Olympic level
athletes, a frequent comment was how much the 
aquatic workouts had added to their overall 
feeling of fitness. I believe what they were 
noticing is that strengthening the muscles of 
respiration had significantly improved their 
respiratory efficiency, so during a land based
workout they didn’t feel so “winded.”
If the workload increase is 60 percent during 
inactive immersion, there is almost certainly a 
much greater workload increase during 
immersed exercise. Blood and water are viscous
substances, and the force required to move 
against viscosity is related to velocity in a 
complex equation. Essentially, as the frequency 
of respiration increases, so does the work of 
displacing blood from the chest cavity to allow 
air in. The chest wall must then expand against
the compression of surrounding water. As a 
consequence, deep-water exercise potentially
could be a very useful method of strengthening 
the muscles of respiration,which could be 
helpful in athletes, as well as in the rehabilita-
tion of people with respiratory weakness or 
other lung diseases.

We decided to test that possibility in astudy 
completed last year at Washington State 
University. We worked with two groups of WSU
students, 50 in each group. One group did land-
based aerobics for a 50-minute period, three 
times per week for a semester.
The other group did aquatic aerobics 50 minutes
per session three times per week. We measured 
aerobic conditioning, percent age of body fat, 
and a number of measures of respiratory 
efficiency and strength. All of the students 
increased in their aerobic fitness, all decreased 
their body fat percentages, and all improved in 
some of the respiratory measures. But only the 
aquatic students showed improvement in their 
respiratory endurance measures. We plan to 
repeat this study with more focus on higher-fit 
student athletes to see if the same effect is noted.
There is a potentially major benefit of improving
respiratory endurance because as the muscles of 
respiration fatigue, the body begins to shunt 
blood from the lower extremities up to the chest 
muscles to support respiratory effort. Obviously, 
in an athlete who is reliant upon the legs, 
robbing these muscles of blood flow to supply 
the muscles of respiration causes a decrease in 
athletic performance. A basketball player who is
getting respiratory fatigue will “hang on his 
shorts,” which can be seen often at the end of a 
basketball game. This action aids the accessory 
muscles of respiration. But if at the same time, 
the leg muscles are being starved of blood, the 
player is going to feel like his or her legs are 
“dead.” Studies have shown that exercise 
activities to improve endurance of the muscles 
of respiration actually do improve athletic 
performance, but deep-water exercise would be 
an easier and potentially more efficient means of
producing such an effect, while allowing the 
athlete to decrease stress forces upon the spine 
and lower extremities simultaneously.

Rehab and weight loss 

This latter effect occurs because of the off-
loading effects of buoyancy. At waist-level 
immersion depth, the hips, knees, ankles and 
feet have a 50 percent reduction in loading due 
to buoyancy; at mid-chest depth, there’s a 75 
percent offloading. As a consequence, this effect 
may be used to excellent clinical benefit in 
facilitating recovery from training, or 
rehabilitating from a lower extremity or spine 
injury. The combination of joint offloading, with
the improvement in deep-tissue circulation 
makes the aquatic environment very useful in 
rehabilitation. In fact, even before these effects 
were known, deep-water exercise was used to 
improve racehorse performance without 
exposing the animals to the trauma of the 
racetrack. Owners found they could nearly triple
the expected race career of a horse if they used 
aquatic training for a significant part of the 
workout regimen. In working with Olympic 
distance runners through the Nike development 
program, we tried to have about one-third of the 
training done in water, which seemed to reduce 
injuries as well as improve performance. The 
value of aquatic exercise in patients with osteo-
porosis has been controversial. The aquatic 
environment would be ideal for this group 
because of the frequent coexistence of joint 
disease and the decreased risk of fractures from 
falling during land based exercise. Many such 
patients have a fear of falling that limits their
 tolerance of a land-based walking program, an 
activity that has been shown to build bone 
mineralization and reduce osteoporosis. Most 
studies of aquatic exercise have not shown a 
useful benefit upon bone mineralization, 
however. Studies comparing regular aquatic 
exercisers with regular land-based exercisers 
have shown better bone mineralization in the 
land-based groups at nearly all ages from 
adolescence through senior groups. This does 
not mean that aquatic exercise lacks a place in 
this group of individuals. In my practice, I will 
typically start such a patient in an aquatic
exercise regimen, which has been well shown to
boost lower extremity strength and endurance, 
as well as improve balance. The combination of 
increased strength and balance skills is usually 
sufficient to enable that individual to embark 
upon a walking program safely and begin the 
bone-building process. Another controversial 
point is how aquatic exercise works for obese 
individuals. Because of the offloading produced by buoyancy, the aquatic environment seems ideal, especially in persons with decreased lower extremity strength. It has been shown that aquatic exercise is less efficient in decreasing body fat percentages than land-based programs. Even at Olympic levels of training, these athletes have a higher percentage of body fat than their track athlete peers, as can be seen readily. The swimmers have sculpted 
beautiful bodies with higher percentages of body fat,
whereas the track athletes have greyhoundslim
bodies with very, very low percentages.
Despite this concern, the value of
exercise in obese individuals is absolutely
essential, and aquatics may be a tremendously
useful method of initiating a program
and losing weight over time. While
it may not be as efficient from an absolute
standpoint, it is still effective and likely to
be better sustained because of the lower
risk of joint injury in aquatics for this group.

STRESS RELIEF During immersion, the body sends out a signal to alter the balance of a certain
type of hormone, which creates a balance similar to relaxation or meditation. 

Many of these individuals can participate
successfully for years in a group format, and
I’ve seen people whose lives were totally
changed because of such a program.

On the whole, the response of the human
body to the aquatic environment is profound.
Perhaps it is because all of us spent the initial
formative months of our lives immersed
in a warm-water pool of amniotic fluid that
we can so readily sink into a pool with
relief. Such an environment would provide
protection and the optimum conditions for
growth during this critical period.

But the combined effects of all the properties
of water, from buoyancy through
hydrostatic pressure to its thermal conductive
properties make the aquatic environment
tremendously useful and effective for health
recovery and maintenance, and recreation.

At Washington State University, we are striving 
to create a body of clinically directed 
translational research so that such an
understanding might emerge within the
public, as well as the medical profession.
We’re also trying to create a broader 
understanding of the immense value of aquatics
for high-level athletic training because the
public seems to relate to the effectiveness of
this kind of effort as well.
It is my hope and belief that in the
future, we will see a wetter, happier and
healthier world. ■

WAYS TO BROADEN SUPPORT

FOR AQUATIC HEALTH
■ Broad public awareness campaigns
■ Education within the medical community
■ More active community involvement
■ Legislative advocacy
■ Promotion and dissemination of clinical
research in consumer and medical media.

This diagram shows what’s happening in the body before a person enters the water, and what happens afterward. The changes are significant, especially those involving blood flow and the heart. The deeper a person is immersed, the more the health benefits increase. At neck level, even the brain
is affected because more blood is forced upward from the lower extremities.

PHYSIOLOGY AND IMMERSION

Negative atrial pressure
Negative pleural pressure
Flattened diaphragm
Blood pooled in abdomen,pelvis,and lower
extremities

BEFORE IMMERSION DURING IMMERSION
More venous compression. Heart size
increases 30% and rate slows 20%.
Heart pumps more blood; chest wall is
compressed. Plural pressure increases.
Lungs contain more blood and body
works harder to move air. 
More blood is distributed to kidneys and brain.
The diaphragm is elevated higher during 
inspiration and expiration.
As the water level rises, the abdomen is 
compressed and more blood is forced
upward into the chest cavity.
Pelvis vessel compression occurs.
Venous and lymphatic compression begin
progressively pushing blood upward.

Neck Level

Diaphragm level

This diagram shows what’s happening in the body before a person enters the water, and what happens afterward. The changes are significant, especially those involving blood flow and the heart. The deeper a person is immersed, the more the health benefits increase. At neck level, even the brain is affected because more blood is forced upward from the lower extremities. PHYSIOLOGY AND IMMERSION Negative atrial pressure Negative pleural pressure Flattened diaphragm Blood pooled in abdomen, pelvis, and lower extremities BEFORE IMMERSION DURING IMMERSION More venous compression. Heart size increases 30% and rate slows 20%. Heart pumps more blood; chest wall is compressed. Plural pressure increases. Lungs contain more blood and body works harder to move air. More blood is distributed to kidneys and brain. The diaphragm is elevated higher during inspiration and expiration. As the water level rises, the abdomen is compressed and more blood is forced upward into the chest cavity. Pelvis vessel compression occurs. Venous and lymphatic compression begin progressively pushing blood upward. Neck Level Diaphragm level
(CLICK FOR DIAGRAM )