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You Have Choices

What You Can Do To Stay Healthy During COVID-19

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By Naomi Parrella, MD, FAAFP, Dipl. ABOM

Of course official updates on  COVID-19 are helpful. The WHO Director-General provides situation updates. The Centers for Disease Control offers a fact sheet and updates on the outbreak including how to protect yourself and your family during this time.

As more cities and states across the country settle in for lockdowns, knowledge of what each person can do is critical.

Avoiding unnecessary travel, appropriate hand washing, sanitizing high touch areas, social distancing and self-isolation are excellent ways to help limit the speed of spread of this infection. Now is the time to make the choices that promote your best health to allow your immune system to do what it does best– protect you and fight infections.

COVID-19 appears to more seriously affect older individuals, and those with comorbidities such as  lung disease, heart disease, high blood pressure, diabetes, and cancer.

As a physician taking care of individuals with chronic diseases, I know from my patients that simple lifestyle choices can reverse disease and augment the body’s natural healing abilities. By eliminating lifestyle choices that promote unnecessary inflammation, optimizing nutrition, and incorporating regular rest and recovery times, the immune system is more robust to foreign invaders and less likely to manifest harmful chronic inflammation.

First, lifestyle choices like not smoking, avoiding ultra-processed foods and other toxic exposures are important to preventing unnecessary inflammation. This will free your immune system to focus on your body’s unexpected intruders, like infectious agents.  

Smoking interferes with the immune system and aggravates all lung issues including viral and bacterial infections. Ultra-processed foods like packaged candy, snacks, cookies, cakes and pastries are associated with increased hypertension, type 2 diabetes and  increased mortality.

Eating foods combining sugar, salts and highly processed carbohydrates, with oils and other additives increases the risk of dying prematurely.

Recognize food can be medicine. The immune system requires macronutrients including proteins and fats- the building blocks of cells-including your immune cells, and micronutrients like vitamins and trace elements to function properly.

Vitamins A, D, B2, B6, B12, C, E, folic acid, niacin, iron, selenium, copper and zinc all play roles in cellular immune response and deficiencies may lead to impaired immune function.

While there are conflicting reports on the benefits of supplements, immune function and micronutrient absorption and requirements change throughout the life span.

Based on a 2018 review of these changes, there may be age-appropriate nutrition and supplementation that boost immunity including vitamin A, C, D, E and zinc in older adults. A follow up 2020 review suggests there is the most evidence for supporting the immune system with zinc, Vitamins C and D.

While diet and treating micronutrient deficiencies are not the answer to COVID-19, they both certainly could help the immune system work at its best. This may be just the time to focus on eating for health.

In addition to water, protein, and fats, some healthier food options provide key micronutrients for your immune system that can fit in a healthy diet.

For instance, zinc is highest in oysters, then red meats and dark meat poultry, shellfish and shrimp are great sources of zinc.

For vegetarian diets – baked beans, chickpeas, seeds like hemp seeds, pumpkin seeds, nuts such as pine nuts, cashews, almonds; dairy like full fat milk, yogurt, cheddar cheese are other options.

However, it is important to recognize that plant based sources of zinc such as legumes, include less zinc than animal-based foods and also include phytates that inhibit the absorption of zinc. Soaking, sprouting and fermenting can improve zinc’s bioavailability in vegetarian and vegan diets.

2020  research  shows report higher doses of Vitamin C may protect against coronavirus. Best dietary options for Vitamin C include raw bell peppers, broccoli, leafy greens, lemons, berries, kiwi, and tomatoes.

Vitamin D may require supplementation given limited sun exposure and decreased synthesis with aging. Fatty fish like salmon, herring, sardines, cod liver oil, egg yolks, and mushrooms are all natural sources of vitamin D. Vitamin D fortified milks and foods are also sources in addition to mushrooms for vegetarian and vegan diets.

Vitamin E is found in sunflower seeds, almonds, avocado, and leafy greens and has been shown to shorten duration of viral infections and decrease upper respiratory infections in older individuals.

Bottom line, eating a variety of meats, seafood, poultry, eggs, fresh vegetables, berries, nuts and seeds plus or minus dairy, will provide essential macro- and micronutrients to allow your body to function at its best.

If these foods are not a regular part of your diet, it’s a good idea to get a reputable multivitamin that includes these micronutrients. Taking excessive amounts of vitamins can be harmful, so please talk to your doctor or registered dietitian if you plan to take extra supplements.

In light of the increased stress of the knowns and unknowns of the COVID-19 virus and pandemic, the limited options and rapidly changing stories, recognize that each person’s decisions matter and understanding what is controllable vs. uncontrollable is helpful.

Find ways to connect with loved ones via text, email, telephone, video or social media and appreciate each other.

A patient recently sent me a message of gratitude through our electronic record briefly describing how I had helped her. How thoughtful and generous, and what a reminder of all the good around us.

Take time for rest and recovery times to allow your body and mind the time and space to process, repair and rebuild.

Staying up to date on health information and advice is important and while it can be alarming, it helps to focus on what you can do to help, and then to do it. After that, give yourself moments throughout the day to pause, take deep belly breaths, reflect on all your blessings and remind yourself that we are all in this together.

Spread appreciation to at least one other person every day. It makes a difference.

The world’s greatest minds are working on resolutions for this pandemic. You contribute by doing your part. Take care of your body so that you can help take care of others.

Dr. Naomi Parrella is assistant professor in the Department of Family Medicine and the Department of Surgery and the medical director for Rush University Center for Weight Loss and Lifestyle Medicine, and she is board-certified in family medicine and obesity medicine, and is a Public Voices Fellow through The OpEd Project.

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