Severe COVID-19 Risk Factors & Pre-emptive Measures
Part of the COVID-19 fear is that there is still so much we do not know about the virus, and about the risk factors. By now, most of you know that severe cases and fatalities are disproportionately affecting the elderly, those with serious pre-existing medical issues, and those that are immunocompromised. Perhaps you’ve noted that men are at a significantly elevated risk than women. Many reports, cohort studies, and meta-analyses have come out that diabetes, elevated blood sugar, and blood pressure are key risk factors.[2-6] David Sinclair, Professor of Genetics at Harvard and famous for his work on longevity and NAD+, broke down some of the reasons which make elevated blood glucose seem detrimental with COVID-19 in a sequence of tweets. Of course, this is simply his initial assessment and outside his field.
What if you Have Hypertension and Elevated Blood Glucose?
First off, these risk factors are simply that, risk factors. Simply having elevated blood pressure or blood sugar is not an immediate death sentence if, or perhaps more appropriately when, you become infected with SARS-CoV-2. For instance, Tom Hanks is 63 years old with type II diabetes and is recovering. This is not to take away from the seriousness of the issue or to suggest any sort of survivor bias, but to simply acknowledge that even when at an elevated risk, the chances of the virus being deadly are still far lower than those of full recovery. What is important is that we can make strides to decrease the burden on our healthcare systems, not just through flattening the curve but by working to lower our own risk factors, hopefully resulting in fewer hospitalizations and less strain on the dwindling reserve of intensive care unit (ICU) beds and ventilators. Some estimates suggest that COVID-19 will be around for 2 years before we reach herd immunity, meaning that some of us have up to 2 years to make lifestyle changes and lower our risk. The better we do regarding self-quarantine and social distancing, the longer the average time we have to lower our risk factors before we (likely) become infected.
Strategies to Improve our Health Markers
The first thing you need to consider is that all long-term improvements to metabolic health parameters currently known to elevate the risk for COVID-19 require long-term solutions. There is no magic pill, and effective strategies are typically far more effective when used in conjunction with others. Certainly, as easy as it is while we hole up in self-isolation, now is not the time to increase our binge eating of junk food and binge drinking. Now is the time to focus on our health, to maintain what we can of our regimen if it has always been a priority for us, or to take the steps needed to make it a priority if it has been neglected.
There is no “perfect” diet for everyone, despite what many will tell you. The best diet for you likely has many variables, such as your activity level, genetic make-up, microbiome, and also your own cravings. Some food groups may work better for each of us, but the most important consideration may be what we can adhere to for the long-term. A diet may respond very well to an individual in the short-term, but if adhering to it is unsustainable, it has no real benefit. Some pertinent advice:
-Cut down on “junk” food, such as chips, baked desserts, candy, and soda.
-Pick up a cheap fiber and have a glass full of water with fiber shortly before meals. This may help to increase the feeling of fullness, leading to less binge eating.
-Try incorporating a fruit and vegetable smoothie into your daily routine. Let the fruits sweeten the smoothie. Avoid adding sugar or even juice. Use water as the liquid base. To give it a taste boost, add some almonds and walnuts. Most grocery stores have maintained a stock of fresh fruits and vegetables.
-Stop drinking alcohol to excess. Alcohol can be a useful hormetic tool, as I wrote about here, when dosed appropriately. Do your best not to drink every day, and not to reach intoxication.
Many snack out of boredom, I am one of these people. Try some healthier options:
-Seaweed or baked kale chips instead of potato chips.
-Instead of cheese on bread or crackers, try cheese on apple slices.
-Try veggie platters to snack on while you watch movies or TV.
Exercise right now is non-negotiable for anyone capable. Sure, in most areas all gyms of any kind are closed. Mass gatherings, including running groups and outdoor workout groups, are prohibited. It takes extra determination to remain active. As I discussed last week, this is the time where that extra determination is most critical. Many of us are fortunate to have access to equipment we can use in our homes during this isolated period, or access to trails and outdoors to get exercise while maintaining social distancing. I’m fortunate to have many options. I have numerous forested parks where I can walk 1-2 hours a day, I have mats and a heavy bag on my patio to do rounds of kickboxing, and I have weights. Some are not as fortunate, stuck in their homes with no exercise equipment. Here are some solutions to keep active:
-Pace in your living room while watching TV or on the phone. Anything you can do to keep your step count as high as possible, do it.
-Bodyweight workouts. Body squats and push-ups require no equipment. Body squats, body squats, body squats. For those that are particularly unfit, with bad knees or tight hips, try these strategies:
-Put flip flops, or another 1” or so flat object underneath each heel. It allows better form and to get deeper into your squats. Keep your chest proud, don’t bend over. Push your knees out while you squat.
-Don’t overdo it on day one. If you aren’t used to squatting, do a few squats, even one, periodically. Get in the groove of doing them and increase your load. It is better to keep doing them every day, than to do too many one day, hobble around for days after, and give up. If you’re waiting for something in the kitchen, or as you stand up, try to do 1-2 body squats just to keep moving. Make it a habit. As you get more fit, dedicate time in your day to complete more rigorous workouts.
Keep your core strong to protect your back. If needed, find Youtube, or Instagram videos for form, but start a program of doing various sit-ups and crunches. If it is grueling to do multiple types of exercise at once, devote 15 minutes per body part spaced out throughout the day to keep yourself active and moving.
Fasting and Time Restricted Eating
I’ve done a fair bit of writing on fasting and time-restricted eating, with part 3 of my series on hormesis dedicated to it, and a follow-up article “Fasting Gets Easier” I wrote later. In regard to stand alone benefits, I am not quite sold on time-restricted eating. That said, it creates discipline and makes fasting itself easier, and if you can avoid binging during your window, it can help in calorie restriction, which of course is what this comes down to. It’s critical to keep our caloric intake under control. Fasting and time-restricted eating are great tools for this.
Get Sufficient Sleep
Sleep is critical. In fact, I detailed why sleep is critical, and strategies for improving sleep across a 4-part series:
Within the series I pointed out that a single night of poor sleep can lead to raised cortisol levels (stress), and negatively impact glucose tolerance, creating a temporary prediabetic like state, the opposite of what we need to be doing in order to protect ourselves, both during this pandemic and for our future health.
Many of us are working from home, meaning we save on the commute. For others, our hobbies and activities are reduced or absent. There is very little reason to be sacrificing our sleep at this time. Focus on your sleep habits and get sufficient rest.
It is ALWAYS a good time to take control of your health. During this pandemic, doing so could improve your own outcome. Importantly, it could reduce the likelihood you need critical care, and reduce the strain on our hospitals. We still don’t know enough about COVID-19, and there’s a chance that these risk factors, aren’t that much of a risk. We don’t know how many people will be infected, and we don’t know the timelines; it may be a week until any of us are afflicted, or it may be two years (or never). The important consideration is that resolving to improve our health right now can only help. If it makes no difference regarding COVID-19, it is still creating healthy habits that will improve our health and lives.