There’s no doubt COVID-19 has changed our world. We’ve all been affected in some way, shape or form. It’s been a time a great uncertainty for all of us and a time of loss and tragedy for others. We’ve heard about promising treatments such as “monoclonal antibodies”, or “convalescent plasma”, and many have put hope in the vaccine and its ability to help decrease the death and destruction of the disease by helping building herd immunity across our nation and world. While COVID-19 treatment is still a work in progress, there are several things YOU can do and work on to make yourself as resilient as possible in the face of COVID-19 (or any other illness or injury for that matter). There are no vaccines or treatments that will ever be able to replace a strong, healthy, robust and resilient immune system. One thing we’ve learned from COVID-19 is that, aside from being elderly, metabolically unhealthy individuals are at much higher risk for COVID-19 complications. I am a nurse practitioner doing hospital pulmonary medicine and have seen many patients with serious cases of COVID-19. Aside from the elderly population (who is at risk due many reasons that come along with advanced age) almost every younger (<65) patient I have seen has significant underlying metabolic disease including obesity, high blood pressure, type 2 diabetes or pre-diabetes (insulin resistance), kidney disease, immune system dysfunction and/or cancer. Unfortunately, the powers at be have done a poor job in educating the public about how to improve health, boost your immune system and give the best chance of not only surviving but powering through a viral illness such as COVID-19.
What can YOU do to build resiliency?
Improve body composition, manage inflammation and optimize metabolic health:
Obesity is unhealthy for so many different reasons, including higher risk of severe COVID-19 complications. Obesity IS a pre-existing condition, even if there are no other “known” medical problems. Why is this the case? Well, there are many different reasons for this (which I will not go into here but check out the references or a simple Google search) but, what it boils down to is, obesity is a chronic state of inflammation. You see, inflammation is the basis of ALL disease processes, both acute and chronic. There are appropriate and inappropriate inflammatory responses. If you cut your finger, there will be an inflammatory response in the body to heal your wound. If you catch a cold (or COVID), your body will mount an inflammatory response to the pathogen and fight it off (causing fever, aches, runny nose and cough in the meantime). Many obese individuals have an exaggerated immune response to illnesses such as COVID-19, causing what many refer to as a “cytokine storm”, which is basically an exaggerated and harmful hyperimmune response that can lead to serious complications. Obesity makes it harder to breathe, can impair immune function (due to the chronic inflammation) and more likely to have insulin resistance and/or type 2 diabetes, which is also an independent risk factor for more severe COVID-19 illness. Will all obese people who contract COVID-19 have a severe response? No, as an individual’s immune response is a very heterogenous situation with many confounding factors such as genetics, lifestyle and various other inputs than can affect a person’s response to a virus.
Obesity can be part of a cluster of conditions known as metabolic syndrome, which also includes high blood pressure, insulin resistance/type 2 diabetes/“pre diabetes” and high cholesterol and triglyceride levels. Studies have shown metabolic syndrome can significantly increase the risk of severe COVID-19 complications by as much as five times!
How do you improve your metabolic health?
How do you improve your metabolic health to get your body on track to being as resilient as possible in the face of illness, injury or whatever life throws at you? While this list is not completely exhaustive, it is a reasonable place to start and spend some time focusing on, especially if you are not where you need to be from a metabolic health and body composition perspective
It’s probably no shock that not just improving, but optimizing personal nutrition is on this list. What we put into our bodies day in and day out matters! Food is information. If you put in unhealthy, toxic food, you can expect unhealthy, toxic results. If you put in healthy food that helps your body thrive, you, also, can expect to thrive and build resilience and minimize your risk of serious health issues, both acutely and long-term.
First and foremost, EAT REAL FOOD! If you eat real food such as various animal products, fruits and vegetables, healthy fats, nuts and avoid all the highly processed and/or sugar-laden foods and beverages you will be off to a good start, especially if you are presently eating the “standard American diet” (S.A.D.). That being said, there IS an OPTIMAL nutrition approach out there that will bring out the best in YOU. There are many basic nutrition principles that apply to almost everyone, but individual nutrition needs will differ from person-to-person.
Now, WHAT exactly to eat is a point of contention and debate. Even my own thoughts about this have changed over the years. If you asked me a year ago what I might put on the top of the list, I would probably have said “eat the rainbow” in regards to a consuming variety of colorful plants. But, science is science, and although I think eating plants is still fine and likely beneficial for many (but not all) people, I think the consumption of healthy animal products is KEY in overall health and wellness and should be at the top of the list. Like so many things, it is important to do your own research and draw your own conclusions.
Long-story short, animal products contain complete (or nearly complete) amino acids (the building blocks of protein), as well as a variety of important vitamins and minerals that are far more bioavailable than plant products. What this means is your body can actually USE the amino acids, vitamins and minerals much more effectively from animal products compared to plants. In addition, plants contain many “anti-nutrients” or other substances that can bind to and prevent absorption of nutrients. Also of concern, plants contain various defense chemicals that can cause various symptoms and issues in some people when eaten.
What kind of animal products should you eat? I’m not just talking about endless chicken breasts, I’m recommending eating a variety of animal products as well as consideration for eating “nose to tail”, such as considering eating organ meats. Organ meats are very nutritious and truly are nature’s multivitamin. If you can’t stomach (pun intended) the thought of eating organs, there are several organ supplement companies out there. Eating plenty of “red meat” from responsibly sourced beef (or wild game) is also of paramount importance as, pound for pound, red meat is one of if not the most nutritious food on the planet as it contains highly bioavailable protein and nutrients such as zinc, iron, selenium, B vitamins and many more. Check out Sacred Cow book by Diana Rodgers, RD and Robb Wolf for additional information about the awesomeness of beef and for an environmentally sustainable model to raise and farm beef.
There have been many scientific papers published discussing the high nutritional value of animal products. Check out these quotes and read the scientific sources if you wish… I’m not making this stuff up:
“Animal source foods are energy-dense and an excellent source of high-quality and readily digested protein [4,5]. The proteins in these foods are considered the highest quality available, as they contain a full complement of essential amino acids and most resemble the proteins of the human body in their amino acid composition. Animal source foods are also an efficient source of micronutrients. The main micronutrients offered in abundant and bioavailable form by animal source foods are iron, zinc, and vitamin A from meat, and vitamin B12, riboflavin and calcium from milk [5,6].”
“To meet the average daily requirements for energy, iron, or zinc, a child would need to consume 1.7–2.0 kg of maize and beans in one day. This is far more than a child can tolerate, while the same requirement could be met with 60 g (2 oz) of meat per day“
“The iron and zinc from vegetarian diets are generally less bioavailable than from nonvegetarian diets because of reduced meat intake as well as the tendency to consume more phytic acid and other plant-based inhibitors of iron and zinc absorption.“
On this same topic, it is so important to hit optimal protein intake.
This is a bit of an assumption, but I’m willing to guess that most Americans are not eating OPTIMAL protein. The minimal protein intake to stay alive (which is only 0.36 grams per pound of body weight or around 64 grams for an average sedentary man who is 180 lbs) is a far cry from what is optimal. What exactly is optimal? Well, as with most things, this varies from person-to-person, but I usually recommend a starting point of about 0.8-1 gram of protein per pound of ideal bodyweight. For example, if you are a 200 lb man who “should” weigh around 170 lb, you should aim for about 136-170 grams of protein a day. Protein is satiating, helps build muscle and repair tissues, and healthy animal products high in protein are also high in all the other good stuff such as B vitamins, Zinc, creatine, Vitamin D3, EPA and DHA (omega 3’s) and so much more.
In summary, eat responsibly sourced (when able) animal products and hit your optimal protein target to build and maintain lean muscle, repair and regenerate tissues. Protein is also very satiating, has a higher thermal effect (boosts metabolism) compared to carbs, is good for your bone health and much more.
Ok, aside from hitting protein goals and eating a wide variety of animal products, what else should I eat?
Eat plants if you like them. Yes, if you like them AND they benefit you (or if you think they do). Not all people handle certain (or all) plants very well. Figure out the ones you like and tolerate and consume them. Many people have trouble with their gut and cannot handle plants very well. Many argue plant fiber is needed to optimize gut health due to the “pre-biotic” properties (feeding the healthy gut bacteria). Another argument is plants contain many vitamins and minerals essential for health. This is somewhat true. The ability of humans to digest and actually use the nutrients from plants varies greatly from person-to-person for a variety of reasons from genetic reasons and issues with gut health.
“Antioxidants like phytates or polyphenols can bind with certain micronutrients in the gastrointestinal tract and prevent absorption into the body. Phytates are found in the outer layer of plants and can bind with minerals like zinc, calcium or iron, which prevents their absorption in the intestines. Polyphenols are a compound found in plants that can also interfere with mineral absorption in the intestines.”
Some people who don’t tolerate vegetables very well might do better with fruits. Fruits such as avocados, berries and certain citrus fruits can be part of a healthy diet. It’s important to remember that modern fruits have been grown to be much larger, sweeter and less nutrient dense than their fruit “ancestors” of decades ago. It is important to not go overboard on fruit consumption, especially if you have extra bodyfat to lose and/or you have metabolic syndrome. Fruits contain varying amounts of fructose which is metabolized in the liver and converted to triglycerides and stored as fat.
Forget everything you ever learned about fat. There was a plethora of misleading information that started in the late 1950’s about the dangers of fat intake, and many false accusations were made about higher risk of heart disease and death using erroneous and weak evidence by association (and evidence that contradicted this theory was left out). Consequently, dietary fats were replaced with simple, processed carbohydrates and other highly processed oils and various other fat substitutes which has led to a deterioration of our metabolic health and a fear of healthy fats. Healthy fats are crucial to having a healthy body as these play a role in cellular health and with the production of important hormones such as testosterone, estrogen and progesterone. Healthy fats include sources such as avocados, extra virgin olive oil, full fat dairy products (if you tolerate dairy), fats found in animal products, fatty fish (sardines, mackerel, salmon, for example) and nuts. Fats that should be avoided are trans fats (artificial fats found in many processed foods, fried foods, pastries, desserts, fast foods), vegetable oils, hydrogenated oils (such as margarine and found in processed foods) and seed oils as these are highly processed and inflammatory.
Avoid toxic foods
Avoid toxic foods that will hinder your body composition and your health. At the top of the list are highly refined carbohydrates and simple sugars. Foods containing these refined carbohydrates are literally killing us. Our bodies our NOT designed to handle excessive, chronic consumption of refined carbs, highly processed foods and simple sugars. Regular consumption of these foods turns on various processes in our bodies that work against us. Our muscles and liver become resistant to insulin, which sets the stage for type 2 diabetes and many other diseases. Our livers start turning into fat which sets the stage for many, many health issues. Our bodies, over time, become slowly damaged and insulin resistant which sets the stage for cardiovascular disease, strokes, dementia, kidney disease, vision loss, wounds, amputations, vision loss, cancer, loss of function and decreased immune system. It’s no wonder that obesity and metabolic syndrome are a huge risk factor for severe COVID-19 disease…the body is simply not equipped to handle a viral attack. This “toxic” list of food includes all refined carbs in the form of cereals, breads, pastries, cookies, candy, desserts, pasta, bagels, chips and pizza. Even more dangerous is DRINKING your sugar and calories. Soda, juice, sweetened coffee drinks and energy drinks are TOXIC to your health! These are rapidly absorbed into the bloodstream, causing a massive insulin surge which then hits the liver and can contribute to fatty liver disease and insulin resistance. Fructose, which is found in many of these foods and drinks, is especially harmful and damaging and stimulates the formation of uric acid (risk for gout) and increases triglycerides and fat storage. It alters various hormones in your body and tells your body not to burn fat but to make fat and store it! It is a dysregulation of an evolutionary survival strategy gone awry.
Optimize your Vitamin D level:
Do you know your 25-hydroxyvitamin D (25-OHD) level? Optimal (not just normal) 25-OHD levels are paramount for optimal immune function. Vitamin D is much more of a hormone that it is a “vitamin” and plays many important roles in the body and is involved in immune function, calcium absorption, can affect mood, plays a role in kidney, cardiovascular health and so much more. Unfortunately, studies have shown that over 80% of patients hospitalized with serious COVID-19 infection had low 25-OHD levels (<20 ng/dL). Exposing large areas of your skin to sun (this varies from person-to-person) is the best way to synthesize vitamin D. Depending on where you live, this might be impossible for many months of the year or just simply impractical. There are foods that contain a fair amount of vitamin D, but most people who are deficient/sub-optimal will require supplementation. Although a 25-OHD level of 20 ng/dL is considered to be “normal”, many practitioners recommend a higher level than this to be optimal, such as 30-60 ng/dL. Check with your healthcare provider and figure out what is best for you. And, remember, if you decide to supplement with vitamin D, make sure it is vitamin D3 and you take it with a meal (for absorption) or that it is made with an oil, such as coconut oil or medium chain triglyceride oil as it cannot be absorbed on its own.
Sleep is so important for optimal health. In fact, it’s a near “tie” with nutrition in order of importance. Some might argue optimal sleep is more important than nutrition! I’ll argue BOTH are paramount to optimal health. We, collectively, do a very bad job when it comes to having restorative sleep. There is SO much research and evidence linking poor sleep to about every disease known to man. The opposite seems to be true as well, getting optimal, restful sleep seems to have a protective effect on the body and likely PREVENTS, or at least delay, the onset of many metabolic based diseases such as insulin resistance and dementia (and many more).
Some basic recommendations:
- Have bedtime routine and go to bed at the same time and wake up at the same time as much as possible
- Shoot for at least 7 hours of sleep a night—that means actual sleep, not just time spent in bed. Go to bed early enough to allow time to fall asleep. Sleep quality matters and should be restful and restorative.
- Wind down at least an hour before bedtime. Do something relaxing, avoid too much stimulation, especially from screens.
- Don’t drink caffeine too late in the day. For most people I recommend avoiding caffeine after about noon.
- Prioritize sleep over exercise. Don’t cut your sleep short to make it to the 4:30 am body combat class…you will pay for it in the long run. If you really want to go to the early class then get to bed early so you get your 7+ hours of sleep.
- Here are a couple of links to sleep articles I wrote for more details: here and here
- For additional information on sleep check out two of my faves Matthew Walker, PhD and Dr. Kirk Parsley.
Exercise is medicine, plain and simple. Exercise programs will vary greatly from person to person but should include strength training, cardiovascular training and some degree of high intensity training (these can and do overlap to some degree).
Strength training: Muscle is a glucose “sponge”. This means when you do strength training, your muscles help absorb the glucose (usually from carbs) and lessen the potential damage from excessive glucose in the bloodstream. Think of muscles as a glucose disposal site. If too much glucose gets circulated around your body, then excessive insulin is released. Too much insulin is linked with many health issues. Too much glucose in the brain over many years can lead to dementia. Too much glucose in the vessels over many years leads to cardiovascular disease. Related to this, insulin resistance often occurs in the muscle (insulin is supposed to drive glucose into the muscle) and strength training helps to prevent, or reverse, this process. Nothing transforms and sculpts your body better than strength training. The more muscle you build and retain over the years, the better off you will be.
“Cardio”: Cardiovascular exercise is good for you but shouldn’t be done in excess. Zone 2 aerobic training (60-70% of max heart rate) is good for your brain, cardiovascular system, mitochondria (energy production) and has been proven to improve insulin sensitivity in the muscles and liver. Cardiovascular exercise should not be the SOLE component of an exercise program. Excessive cardio can and will burn through muscle mass and does very little for achieving ideal body composition. Excessive cardio (such as endurance training involving marathons and distance triathlons) over many years puts an individual at risk not only for injuries and wear and tear on the joints, but also at risk for cardiovascular problems such as arrhythmias and atherosclerosis (hardening of the arteries). This is especially the case if sustained efforts above the Zone 2 training is a frequent and prolonged occurrence. It’s a bit of “the law of diminishing returns” meaning zero cardio probably is bad, some regular cardio is good/great, but more/excessive cardio is not better and might even be harmful.
High intensity interval training. Also known as “HIIT”. This is when you do short bursts of high intense exercise, oftentimes approaching max heart rate, then backing down and resting. This can be done via sprinting, cycling, rowing, incorporated into strength training and various other modalities. HIIT is also a great way to improve insulin sensitivity, boost metabolism and improve various hormones, such as growth hormone. But, like most things, more is not always better. These HITT workouts should be brief and infrequent. This varies from person to person but, on average, you are looking at workouts that are under 20 minutes in length and performed once, maybe twice, a week. These workouts are so intense you get a great “bang for your buck” but, due to the intense nature of these workouts, adequate recovery is very important.
Last, but not least, is to just be active! Walk or ride your bike whenever and wherever you can. Take the stairs. Park in the farthest out spot in the parking lot. Go for a walk first thing in the morning and after dinner or during your lunch break. Don’t sit for extended periods of time and get up and move at a leisurely pace whenever you can. Is it a beautiful day and you’re off work? Go hiking, get out in nature and enjoy life!
Find Balance—manage stress
Learn to find balance in life and don’t sweat the small stuff. We live in a society where we, for whatever reason, praise those who work the most and roll our eyes at people who incorporate relaxation on any sort of regular basis. We are over-committed with inadequate downtime, although COVID-19 restrictions have had a potentially positive effect on this since most regular activities have been, or still are, cancelled or at least highly modified. During this unexpected and extended downtime, hopefully you’ve taken some inventory of what really matters in life and made a plan to focus on this moving forward, even after life has returned to normal. Life should not always be about working harder and longer hours to make more money to buy things you don’t need that won’t provide happiness or contentment. There’s nothing wrong with money and things, but this should not be the sole focus of life. Enjoy your family and friends. Get out in nature. Take a nap. Learn a new hobby. Serve others in need. Learn to say “no” to commitments that are of little value or where the negatives outweigh the positives. You see, chronic stress, which is often the result of poor decisions, financial stress and poor time management, will wear your body down and make it more susceptible to illness…our bodies simply were not created for chronic, unrelenting stress!
In conclusion, masks, vaccines and social distancing certainly have their place, but YOU are responsible for making yourself as resilient as possible in the face of a pandemic or anything else life throws your way. It’s not solely up to the government, employers or schools to keep people healthy. If you rely on others (especially the government) to have your best interests in mind, you are surely kidding yourself! Do the OPPOSITE of what everyone else is doing as most of Americans are overweight, out of shape, sick, tired and depressed. Eat real food, avoid toxins, lift heavy things, sleep well, move frequently and enjoy life and you will be doing far better than 90% of people.
Thanks for reading!
Interested in knowing your diabetes risk and want to know your detailed cholesterol numbers? Check out the link below and let me know if you are interested in getting a Diabetic Risk Assessment ordered by me followed by a one-on-one consultation to go over your results!