Why Aren’t We Promoting Health to Combat COVID?

It's an unfortunate fact that health officials and pandemic response authorities, by and large, are completely ignoring the role a healthy lifestyle plays in the COVID-19 pandemic, focusing instead, almost exclusively, on the necessity for a vaccine.

According to Reuters,¹ the U.S. government is planning to launch an “overwhelming” COVID-19 vaccine campaign come November. An unnamed “senior White House administration official” is quoted saying:²

“The fine line we are walking is getting the American people very excited about vaccines and missing expectations versus having a bunch of vaccines in the warehouse and not as many people want to get it. You may not hear a lot about promoting vaccines over the airwaves in August and September but you'll be overwhelmed by it come November.”

But is a vaccine really going to be the answer people are hoping for? For example, many have bought into the mainstream narrative that masks are here to stay until or unless there's a vaccine, and getting vaccinated would mean the end to mask mandates.

Considering the fact that neither masks nor vaccines offer significant protection against the virus, chances are such hopes will get dashed. Maria Elena Bottazzi, a COVID-19 vaccine developer at Baylor College of Medicine, recently warned³ that social distancing and face masks will likely still be required even after a vaccine becomes available, as the vaccine will not offer 100% protection against infection.

So, don't be fooled. Vaccines will be in addition to what we are told to do now, not a replacement. Even Moderna's CEO Stéphane Bancel stated⁴ that if the vaccine reaches 90% effectiveness, which is beyond overly optimistic projection, people with high-risk health conditions will need to continue wearing masks.

In addition to not necessarily removing the “need” for masks and social distancing mandates in the future, the novel mRNA vaccines being developed against COVID-19 may also be an autoimmune disorder disaster in the making, as explained in “The Well-Known Hazards of Coronavirus Vaccines” and “Gates Tries to Justify Side Effects of Fast-Tracked Vaccine.”

SARS-CoV-2 Is Here to Stay

The Atlantic succinctly stated the truth of the matter on August 4, 2020, article, “The Coronavirus Is Never Going Away”:⁵

“If there was ever a time when this coronavirus could be contained, it has probably passed. One outcome is now looking almost certain: This virus is never going away … We will probably be living with this virus for the rest of our lives …

What does the future of COVID-19 look like? That will depend, says Yonatan Grad, on the strength and duration of immunity against the virus. Grad, an infectious-disease researcher at Harvard, and his colleagues have modeled⁶ a few possible trajectories.

If immunity lasts only a few months, there could be a big pandemic followed by smaller outbreaks every year. If immunity lasts closer to two years, COVID-19 could peak every other year …

In SARS, antibodies … wane after two years. Antibodies to a handful of other coronaviruses that cause common colds fade in just a year. ‘The faster protection goes away, the more difficult for any project to try to move toward eradication,' Grad told me.”

Many who have steadfastly isolated themselves for months on end and dutifully wear a mask everywhere they go probably do not want to hear this. If the virus isn't going away no matter what we do, then there are only two choices: Continue social distancing and mask-wearing for the remainder of our days, or return to life as it was pre-COVID when influenza seasons were met with blasé equanimity.

Post-COVID World Needs to Focus on Health

For many, neither of these options is satisfactory. They are, however, reality. COVID-19 is unlikely to be eradicated, and if you haven't contracted it already, you likely will at some point.

At present, it's still unclear whether you can contract it more than once, but if that's the case, then flu season will likely include the possibility of COVID-19 outbreaks as well.

Facing reality head-on is the best way forward if you ask me, and that means your best bet is to get yourself into good shape through diet and exercise. You simply cannot hide from this virus, for the simple reason that you cannot stop breathing.

At this point, it may be worth reminding yourself that life involves the risk of illness and death. Every day of every year of your life, you face the possibility of illness, be it an infectious disease or chronic illness.

Each year of your life you've faced the possibility of influenza, for example. Maybe a mild case, maybe a really serious one. Regardless, you've probably never considered isolating yourself for months each year and giving up on doing the things you love for fear you might get the flu and die.

Despite the fact that uptake of seasonal influenza vaccines has seen an uptick thanks to various mandates, the flu continues to circulate and affects large numbers of vaccinated individuals every year. Influenza has not been eradicated, and the flu vaccine has consistently been shown to provide very little in terms of protection against it.

In all likelihood, that's where we'll be with COVID-19 as well. The good news is that, much like with influenza, your chances of staying well, or only getting a mild case, are primarily dependent on your immune function, and this is something you can do something about.

Obesity Is a Significant Risk Factor for Severe COVID-19

We now have a significant amount of data showing that certain comorbidities raise your risk of severe COVID-19 illness and death. Among the top ones is obesity, so addressing excess weight will go a long way toward lowering your risk.

In the U.K., obesity is now being targeted as part of the country's coronavirus prevention strategy.⁷ In a recent announcement, Prime Minister Boris Johnson said he intends to ban TV junk food advertising before 9 p.m. and limit in-store promotions. Online ads for unhealthy foods may also be banned.⁸

Johnson's decision was in large part influenced by his own bout with COVID-19, which he believes was made more serious by his excess weight. Several studies support his suspicion. As noted in the July 13, 2020, issue of the Journal of Virology:⁹

“Over the years, humans have adopted sedentary lifestyles and dietary patterns have shifted to excessive food consumption and poor nutrition. Overnutrition has led to the constellation of metabolic abnormalities that not only contributes to metabolic reprogramming but also limits host innate and adaptive immunity.

Impaired immune responses and chronic inflammation in metabolically diseased microenvironments provide the ideal conditions for viral exploitation of host cells and enhanced viral pathogenesis.”

Huntington Officials Urge Residents to Lose Weight

In the U.S., few officials have addressed the proverbial elephant in the room. The town of Huntington in New York stands out as a rare exception. As reported by Bill Maher in the featured video, Huntington officials have urged all 200,000 residents to “go on a diet because [with] COVID-19, you're twice as likely to have a poor outcome if you're obese.”

As noted by Maher, obesity has always killed us, albeit slowly. “Mixed with COVID, it kills you fast,” he says, adding:

“Why not an all-out campaign to educate the public on the dangers of a diet of sugary, chemical-laden crap? … Why not campaign to get decent food into poorer neighborhoods? Why not for every PSA for masks, a PSA for a recipe of a healthy meal?

I think so many lives could have been saved if at the very beginning of this crisis the medical establishment had made a more concerted effort to tell Americans, ‘While you're in lockdown, getting free money for not working, you need to do something too.' Even the poorest person could switch out soda at meals for water …

A national campaign to improve health could have improved our chances against this disease [and] made us feel better about ourselves to boot. But it was never even mentioned … We cannot have body positivity be a third rail anymore … This issue is too fundamental to who lives and who dies.”

Food Industry Needs to Do Better Moving Forward

Hopefully, the U.S. will eventually follow in the U.K.'s footsteps and take action against junk food advertisements. Clearly, advertising works, and it's not helping anyone make the right choices for their health. In the meantime, you'd be wise to take matters into your own hands.

There's little doubt that processed foods, junky snacks, and soft drinks are key culprits in the rise of obesity and chronic diseases that also inflate the risk of death from COVID-19. As such, they should be the first to be eliminated from your diet moving forward.

If anything good is to come of this pandemic, it would be the widespread recognition of the impact obesity has not just on chronic diseases, but also on viral contagions such as SARS-CoV-2. A recent editorial published in the BMJ highlights the importance of diet and the significant yet hidden influence the processed food industry has had in the COVID-19 pandemic:¹⁰

“It is now clear that the food industry shares the blame not only for the obesity pandemic but also for the severity of COVID-19 disease and its devastating consequences.

During the COVID-19 pandemic an increase in food poverty, disruptions to supply chains, and panic buying may have limited access to fresh foods, thus tilting the balance towards a greater consumption of highly processed foods and those with long shelf lives that are usually high in salt, sugar, and saturated fat.

Moreover, since the start of the COVID-19 pandemic the food industry has launched campaigns and corporate social responsibility initiatives, often with thinly veiled tactics using the outbreak as a marketing opportunity (for example, by offering half a million ‘smiles' in the form of doughnuts to NHS staff).”

They not only call on the food industry to immediately stop promoting unhealthy food and drinks but also call on governments to force reformulation of junk foods to better support health. With research showing that being obese doubles the risk of being hospitalized for COVID-19,^11,12 the authors noted:¹³

“These findings suggest that modification of lifestyle may help to reduce the risk of COVID-19 and could be a useful adjunct to other interventions, such as social distancing and shielding of high risk.”

Johns Hopkins University researchers have also suggested obesity might eventually shift the burden of COVID-19 onto younger patients, as a dataset of 265 COVID-19 patients showed younger individuals admitted to the hospital were more likely to be obese.¹⁴

Even Mild Obesity Raises COVID-19 Risks

According to recent research, even mild obesity can influence COVID-19 severity. Researchers from the Alma Mater Studiorum University of Bologna in Italy analyzed 482 COVID-19 patients hospitalized between March 1 and April 20, 2020,¹⁵ concluding “Obesity is a strong, independent risk factor for respiratory failure, admission to the ICU and death among COVID-19 patients.”

Using body mass index (BMI) to define obesity, the researchers found an increased risk for more severe COVID-19 infection started at a BMI of 30, which is considered “mild” obesity (a BMI between 25 and 29.9 is considered overweight). Lead study author Dr. Matteo Rottoli said in a news release:¹⁶

“Health care practitioners should be aware that people with any grade of obesity, not just the severely obese, are a population at risk. Extra caution should be used for hospitalized COVID-19 patients with obesity, as they are likely to experience a quick deterioration towards respiratory failure, and to require intensive care admission.”

Specifically, patients with mild obesity had a 2.5 times greater risk of respiratory failure and five times greater risk of being admitted to an ICU compared to nonobese patients. But get this, those with a BMI of over 35 were 12 times more likely to die from COVID-19.¹⁷

“Whereas a BMI ≥ 30 kg/m2 identifies a population of patients at high risk for severe illness, a BMI ≥ 35 kg/m2 dramatically increases the risk of death,” the researchers explained.¹⁸

Risk of Death Increases Along With Weight

July 2020 report¹⁹ by Public Health England also reviews research demonstrating how excess weight affects COVID-19 outcomes. For example, one systematic review found that, compared to healthy weight patients, patients with a BMI above 25 were:

• 3.68 times more likely to die
• 6.98 times more likely to need respiratory support
• 2.03 times more likely to suffer a critical illness

The report also highlights data showing the risk of hospitalization, intensive care treatment, and death progressively increase as your BMI goes up. As for how obesity raises risks during viral infections, the chronic, low-grade inflammation it causes is a likely factor.

Inflammation triggered by obesity is also thought to be responsible for the threefold greater risk of pulmonary embolism (blood clots in the lungs) seen in obese COVID-19 patients.^20,21 Obesity-related dysregulation of lipid synthesis can also aggravate lung inflammation, thereby contributing to increased disease severity in viral respiratory infections specifically.²²

In addition to that, excess body weight and fat deposition around the internal organs put pressure on your diaphragm, which makes it more difficult to breathe when you have a respiratory infection.²³ Other mechanisms by which obesity may increase COVID-19 severity, include:²⁴

• Increasing leptin resistance and lipotoxicity, as the accumulation of lipids may be exploited by viruses to enhance viral entry and replication
• A combined effect of chronic systemic inflammation and the induction of a cytokine storm

Losing Weight Will Lower Your COVID-19 Risk

The take-home message here is that if you are obese, even if only mildly so, focusing on getting down to a healthy weight may help you ward off viral illnesses, including COVID-19. Losing weight will also help you avoid other obesity-related health problems such as diabetes, high blood pressure, and heart disease — all of which, by the way, raise your risk of COVID-19 complications and death.

According to a study by The Istituto Superiore di Sanità, Italy's national health authority,²⁵ more than 99% of fatalities from COVID-19 occurred among people who had underlying medical conditions. Among that 99%, 76.1% had high blood pressure, 35.5% had diabetes and 33% had heart disease either alone or as comorbidities.²⁶

One of the most powerful strategies to optimize your weight is to restrict your eating window to six to eight hours each day, making sure to eat your last meal at least three hours before bedtime. This is known as time-restricted eating or intermittent fasting and is a powerful intervention to reduce insulin resistance and restore metabolic flexibility.

With respect to diet recommendations, my experience is consistent with a cyclical ketogenic diet being highly effective to restore metabolic flexibility and reduce insulin resistance.

This involves radically limiting carbs (replacing them with healthy fats and moderate amounts of protein) until you're close to or at your ideal weight, as this will allow your body to start burning fat as its primary fuel and to increase the sensitivity of your insulin receptors.

Most people use carbs as their primary fuel source (thanks to excessive and frequent carb intake). They have lost the ability to effectively burn fat for fuel, which in turn leads to metabolic dysfunction, insulin resistance, and weight gain. Once you have regained your ideal body weight, then you can cycle carbs back in a few times a week.

One of the best books written on this subject is my classic “Fat for Fuel.” If you haven't read it, then you are in for a treat, as COVID-19 is the catalyst that will motivate you to not only read the book but apply for its radical metabolic benefits.

Additionally, get regular exercise each week and increase physical movement throughout your waking hours, with the goal of sitting less than three hours a day. Making sure you're getting sufficient sleep (typically eight hours for most adults) and tending to your emotional health are also important factors that can influence your weight, general health, and immune function.

Chronic stress, for instance, may increase your risk for visceral fat gain over time,²⁷ which means addressing your stress levels is imperative for maintaining your ideal weight. Taking steps to lead a healthy lifestyle overall will have a snowball effect, helping you to reach a healthy weight while also bolstering your resilience against infection and disease.

Article updated to reflect the correct spelling of Stéphane Bancel's name.