Choosing a heathy lifestyle can help optimize your immune system and better protect you from Covid-19 

As more statistics from around the world become available, we are seeing that a large percentage of hospitalizations and deaths due to Covid-19 are people with underlying conditions. The World Health Organization reports that 8 out of 10 deaths are occurring in individuals with at least one underlying co-morbidity, largely in those with cardiovascular diseases, hypertension (high blood pressure) and diabetes.¹ The CDC reports that closer to 90% of hospitalizations had underlying conditions.² In the United States obesity has taken the top spot. Our young adults with obesity are at a high risk for complications from this virus. Doctors at NYU Langone Health analyzed 4,000 patients with Covid-19. They found overweight patients under age 60, were twice as likely to be hospitalized as their thinner cohorts. Those that were obese were 3 times more likely to be hospitalized. Though we are all susceptible, it looks like the healthier we are the more likely we can beat this novel virus. What do underlying conditions and Covid-19 have in common? It is inflammation. The good news is conditions such as high blood pressure (HBP), type 2 diabetes, obesity, cardiovascular disease and metabolic syndrome, can be turned around with diet and lifestyle changes.³ The WHO recently stated, “It is becoming clearer that the healthier you were before the pandemic plays a crucial role. People who age healthily are less at risk”.¹

Older people are more heavily impacted by Covid-19 due to changes associated with aging, decreased immune function and more co-morbidities.¹ So even if you are older, the healthier you are the more capable you will be to fight the virus and it is never too late to improve your health! 

Instead of just waiting for a miracle drug or vaccine, we can take the fear and helplessness we feel and turn it into action. We can view these hard times as a wakeup call to improve our health. Optimizing our health is an opportunity to increase our chances of survival, should we catch this novel virus. The healthier we are as a nation, the fewer hospitalizations and deaths we will have decreasing the burden on our healthcare system and economy. Though we must use all our precautions not to get the virus and spread it to those who are vulnerable, we can still take control of our health to better protect ourselves, our families and our nation if we do get it. 

In functional medicine we use some basics to establish good health. These are: 1. Nutrition 2. Sleep 3. Exercise 4. Stress reduction 5. Nutraceuticals (supplements). These 5 basic pillars can improve your immune system and overall health.^5,6 Changes in these areas can help lower blood pressure, decrease cardiovascular risks, balance blood sugar, resolve chronic inflammation and improve our immune systems.^4,5,12

Though I preach this lifestyle to patients, family and friends all the time, in order to live a long happy life, it is now more essential than ever. There are so many simple things we can do to improve our health, such as getting on a regular sleep schedule of 7-8 hours (for adults), adding more fruits and vegetables to our daily meals, cutting down on simple carbs and sugar and of course exercise. Lowering our stress levels by getting outside and connecting to nature or meditating also balance hormones and give the immune system a big boost.¹⁴ You don’t have to make radical changes or be on a special diet, even small changes to improve health are beneficial. 

Information on Covid-19 is constantly evolving, but it appears that deaths due to Covid-19 may be due a cytokine storm.⁸  This is an excessive or uncontrolled release of proinflammatory cytokines by the immune system. If the reaction becomes uncontrolled, and too many immune cells are activated in a single place, the cytokine storms have potential to do significant damage to body tissues and organs. A cytokine storm occurring in the lungs can cause fluids and immune cells to accumulate and eventually block off the airways, potentially resulting in death.⁹ This cytokine storm also produces excessive free radicals or oxidative stress. These free radicals are unstable molecules that can cause signignificant tissue damage, like pulmonary fibrosis and organ failure.¹⁰ A sedentary lifestyle, consuming sugar and simple carbs, lack of sleep, smoking, uncontrolled stress and excessive drinking, all add to our oxidative stress levels. A lifestyle of consuming lots of fruits, vegetables and herbs plus regular exercise and good sleep habits, gives us the antioxidants needed to neutralize the accumulation of free radicals. 

Many Americans are overweight yet malnourished, and many have normal weight, but still have abnormal blood sugar and inflammation levels. We are not getting the nutrients we need to have optimal health and allow our innate immune systems to work at their best. Type 2 diabetes, HBP, metabolic syndrome, cardiovascular disease and obesity all have underlying chronic inflammation in common.^4,7 Our high processed food, simple carbohydrate diets, low in fiber and phytonutrients (from plants), plus lack of exercise are a leading cause of these inflammatory conditions. ⁵ 

There is no research yet connecting chronic inflammation in these underlying conditions to the cytokine storm in Covid-19, but the players are very much the same. Cytokines like Interleukin 1, Interleukin 6 and Tumor necrosis factor alpha are elevated in people with underlying conditions such as type 2 diabetes, obesity & HPB.^4,7 These same cytokines have also been recorded as elevated as part of the cytokine storm seen in Covid-19 patients.⁸ We know poor lifestyle choices lowers the ability of our innate immune system to function at an optimal level.⁶  These chronic diseases may be linked to the pathogenesis of Covid-19 and the destructive cytokine storm that causes hospitalization and death.^11,13 Chronic inflammation takes the body out of balance and this increased inflammatory load may lead us to dive down more easily into the cytokine storm. Now that we know chronic diseases share several commonalities with infectious disorders like Covid-19, we need to use this information to fight this pandemic.¹¹ The United States is a leader in chronic diseases and deaths due to Covid-19. Let’s be a leader in fighting this pandemic by using this knowledge to better our health. We are all sacrificing so much for this virus. My wish is that we could ban together to help each other live a healthier life. Progress towards better health can help lift our nation out of this crisis.   

1. http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/statements/statement-older-people-are-at-highest-risk-from-covid-19,-but-all-must-act-to-prevent-community-spread
2. https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm
3. https://www.sciencedaily.com/releases/2019/09/190902181602.htm
4. https://www.ahajournals.org/doi/full/10.1161/circulationaha.114.009990
5. https://www.academia.edu/18337961/Nutrition_and_Inflammation?email_work_card=view-paper
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6689741/
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4418473/
8. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30628-0/fulltext
9. https://www.sinobiological.com/resource/cytokines/cytokine-storm
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2718525/
11. https://www.ijidonline.com/article/S1201-9712(20)30136-3/pdf
12. https://www.ncbi.nlm.nih.gov/pubmed/23307037
13. https://www.nbcnews.com/health/health-news/man-hospitalized-covid-19-learns-he-also-has-diabetes-why-n1180026
14. http://Black DS, Slavich GM. Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Ann N Y Acad Sci. 2016;1373(1):13–24. doi:10.1111/nyas.12998

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