A delicate topic has been simmering for weeks among researchers, doctors, nutritionists and the like on social media: the link between metabolic dysfunction (obesity, type 2 diabetes, insulin resistance, high blood pressure) and poorer outcomes in COVID-19.
I’ve read the research and there are real concerns. UK cardiologist, Dr Aseem Malhotra, named his recent article on this subject: “COVID-19 and the Elephant in the Room”. Metabolic health researcher, Ivor Cummins, was recently interviewed about it and completely misinterpreted by a tabloid journalist who concluded: “now is not the time to give up custard creams”.
What are people to make of this? Is it fair or realistic to focus on losing weight or controlling weight at a time when many people are stressed enough already, exercise is restricted, choice of foods is restricted and access to the food cupboard is decidedly unrestricted?
I think that journalist was right to a certain extent. Fretting over diet (or anything really) isn’t going to help the immune system. Crash dieting is likely to be stressful for the body at the very time that it needs nurturing. And of course there’s a very real worry for some people about getting access to any food at all, never mind access to special food.
But neither Ivor Cummins nor Aseem Malhotra make statements without scientific evidence. Like me, they work with people with metabolic dysfunction in both a voluntary and professional capacity. It could be argued that it would be negligent to avoid telling people about this important piece of the COVID-19 puzzle.
So the big question for me becomes: where does this leave a person with weight or other metabolic health concerns at this difficult time?
My answer is that this need not be overwhelming. If you are in a place where you can take some small steps towards improving your health, it might be easier than you think.
I tell my patients that there are two points of action that can make a big difference:
Action Point #1 Select a small change that is doable for you.
Can you do any of these?
- Go to bed half an hour earlier.
- Relax for an hour before sleep with a novel, music, an audiobook, a meditation?
- Switch off screens (phones, TV, laptop, etc,) an hour before sleep.
- Leave at least a one-hour gap between food and bedtime.
- Get some daylight on your face in the morning, not through glass, not long after waking.
- Bare some flesh in the sun around mid-day (research shows 9 minutes is great for boosting vitamin D production but take care not to burn).
- Set a reminder on your phone to stand up and move around at least once an hour.
- Look up some breathing exercises.
- Shop around online for free guided meditations.
All or any of these things can help optimize sleep and mitigate stress, both of which are vitally important to metabolic health and the health of the immune system.
Action Point #2 Use up but don’t re-buy processed, food-like products.
This is the number one dietary change you can make to move towards better metabolic health. It’s not possible for everyone under lockdown. But are there one or two factory-made products you could phase out?
- Which products would your great-grandmother not recognize as food?
- Become a food analyser: ask yourself about each item, “fake or real?”
- Do you know what each ingredient on the label actually is? If not, it’s probably a highly-processed product.
- Can you swap an industrially-processed food for a real food – oven chips for a potato popped in the oven/microwave, crisps for nuts, biscuits for oatcakes, bought cakes/desserts for natural yoghurt served with fruit and nuts?
- Reassess your go-to nurturing foods – can you climb up from sugary chocolate to darker chocolate? Can you afford to replace custard creams with fresh (or tinned) fruit and cream? Can you keep your sweet indulgence to once a day, a time when you relax and really enjoy it guilt-free, and then have a plan for alternative, real and lower-sugar, foods at other times of day?
- Use up processed foods you have in while making sure they don’t take up more than a quarter of your plate at a time.
- Consider which foods you are using for important protein – meat, fish, cheese, eggs, quinoa, beans, etc. – and then consider how you can add a green or colourful vegetable or some salad.
- How much of your shopping list is real food? Meat, fish, cheese, eggs, nuts, seeds, yoghurt, cream, vegetables, salad, fruit? Fresh is good but foods that are easy to store such as eggs, nuts/seeds/nut butter, tinned sardines/tuna/salmon/mackerel are packed with nutrients. Frozen veg is great to have at hand.
- If vegetables feel bland and boring, try sauteeing them in olive oil and butter with a pinch of salt. Try a stir-fry with whatever veg you have to hand: garlic and ginger are your friends (as are spices, herbs, pepper, soy sauce, fish sauce, chili flakes).
- If you’re concerned for someone unable to go out, ask if you could (safely) drop them something green – a cabbage, say, or a pack of green beans or broccoli. (Some kind souls good at cooking are making an extra lasagne to drop off for a relative or neighbour in need.)
You’ve got this.