Effects of 12 Weeks of Regular Exercise with Vitamin C Supplementation in Winter on the Rate of Respiratory Tract Infections in Male High School Students

Document Type : Research Paper


Department of Physical Education and Sport Science, Islamshahr Branch, Islamic Azad University, Tehran, Iran.


Introduction: Respiratory tract infections are health issues across the world, which impose high economic costs on families. Studies have shown that regular exercise and vitamin C supplementation positively influence health. The present study aimed to investigate the effects of 12 weeks of regular exercise and vitamin C supplementation on respiratory tract infections in male students. Methods: This clinical trial was conducted on 120 high school students, who were randomly assigned to four groups of 30, including placebo, exercise, exercise with vitamin C supplementation, and vitamin C supplementation. Groups two and three performed the selected exercises three sessions per week for 12 weeks. Groups three and four consumed three vitamin C tablets (250 mg) per week. Data were recorded on the duration of infection (day), frequency of the cases, and week of the first respiratory infection during the research period. Data analysis was performed in SPSS version 22 using one-way ANOVA and Tukey’s post-hoc at the significance level of P≤0.05. Results: The duration of respiratory infections in the exercise group was significantly shorter compared to the placebo group (P=0.001) and vitamin C group (P=0.02), also it was significantly shorter in the exercise group (P=0.007) and vitamin C group (P=0.007) compared to the exercise with vitamin C group. In the exercise with vitamin C group, the first week of pulmonary infection was longer than the vitamin C group (P=0.04). Conclusion: According to the results, regular exercise could effectively prevent respiratory infections in the male high school students, while the effectiveness of vitamin C was dose-dependent; therefore, more investigations should be focused on vitamin C supplementation.


1. Pham HT, Nguyen PTT, Tran ST, Phung TTB. Clinical and Pathogenic Characteristics of Lower Respiratory Tract Infection Treated at the Vietnam National Children’s Hospital. Can J Infect Dis Med Microbiol. 2020; 2020: 7931950. 
2. Li C-X, Li W, Zhou J, Zhang B, Feng Y, Xu C-P, et al. High- resolution metagenomic characterization of complex infectomes in paediatric acute respiratory infection. Sci Rep. 2020;10(1):1–11.
3. Schaad UB, Esposito S, Razi CH. Diagnosis and management of recurrent respiratory tract infections in children: a practical guide. Arch Pediatr Infect Dis. 2016;4(1):e31039.
4. Matthay MA, Zemans RL, Zimmerman GA, Arabi YM, Beitler JR, Mercat A, et al. Acute respiratory distress syndrome. Nat Rev Dis Prim. 2019;5(1):1–22.
5. Jafar Saffar M. Acute Lower Respiratory Tract Infections Including Pneumonia; Clinical Approach to Diagnosis and Treatment: A Narrative Review. J Clin Exc, 2014; 3(1): 29-45.
6. Zarneshan A. The Efficacy of Aerobic and Breathing Exercise Training on Asthma Control and Physical-Psychological Health Promotion in Women with Asthma. Iran J Heal Educ Heal Promot. 2018;6(2):179–88.
7. Rakati B. The Effect of Eight Weeks of Modified Pilates Training on Pulmonary Function and Quality of Life of Chemical Veterans. Iran J War Public Heal. 2019;11(4):183-8.
8. Ubolnuar N, Tantisuwat A, Thaveeratitham P, Lertmaharit S, Kruapanich C, Mathiyakom W. Effects of Breathing Exercises in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis. Ann Rehabil Med. 2019;43(4): 509–23.
9. Boretti A, Banik BK. Intravenous vitamin C for reduction of cytokines storm in acute respiratory distress syndrome. PharmaNutrition. 2020;12: 100190.
10. Rondanelli M, Miccono A, Lamburghini S, Avanzato I, Riva A, Allegrini P, et al. Self-care for common colds: the pivotal role of vitamin D, vitamin C, zinc, and echinacea in three main immune interactive clusters (physical barriers, innate and adaptive immunity) involved during an episode of common colds—practical advice on dosages and on the time to take these nutrients/botanicals in order to prevent or treat common colds. Evidence-Based Complement Altern Med. 2018;1-36. Article ID 5813095.
11. Harri H. Vitamin C Supplementation and Common Cold Symptoms: problems with inaccurate reviews. 2009; 12: 804-9.
12. Cheng RZ, Shi H, Yanagisawa A, Levy T, Saul A. Early Large Dose Intravenous Vitamin C is the Treatment of Choice for 2019-nCov Pneumonia. Orthomol Med News Serv. 2020; 16: 1-3.
13. Martin SA, Pence BD, Woods JA. Exercise and respiratory tract viral infections. Exerc Sport Sci Rev. 2009;37(4): 157–64.
14. (DGE) GNS. New reference values for vitamin C intake. 2015; 67(1):13-20. 
15. Grande AJ, Keogh J, Silva V, Scott AM. Exercise versus no exercise for the occurrence, severity, and duration of acute respiratory infections. Cochrane Database Syst Rev. 2020;(4).CD010596.
16. Bayat M, Asemani Y, Asemani S. Effect of exercise on upper respiratory tract infection in elite runners. J Sports Med Phys Fitness. 2020; 11. DOI: 10.23736/S0022-4707.20.10646-7.
17. Lee HK, Hwang IH, Kim SY, Pyo SY. The effect of exercise on prevention of the common cold: a meta-analysis of randomized controlled trial studies. Korean J Fam Med. 2014;35(3): 119–26.
18. Yavary M, Mousavi SAJ, Janani  L, Feizi Z, Vafa MR. Effect of supplementation of vitamin D, C and E on the lung spirometry and plethysmography in Idiopathic Pulmonary Fibrosis patients. RaziJournal of MedicalSciences. 2018; 25(170): 65-72.
19. Hemilä H, Louhiala P. Vitamin C may affect lung infections. J R Soc Med. 2007;100(11):495–98.
20. Gombart AF, Pierre A, Maggini S. A review of micronutrients and the immune System–Working in harmony to reduce the risk of infection. Nutrients. 2020;12(1): 236-46. 
21. Ran L, Zhao W, Wang J, Wang H, Zhao Y, Tseng Y, et al. Extra dose of vitamin C based on a daily supplementation shortens the common cold: A meta-analysis of 9 randomized controlled trials. Biomed Res Int. 2018;1-12. Article ID 1837634.