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THE IMMUNE SYSTEM AGAINST CORONA VIRUS Low-carb nutrition and immune function

As you may have read at Diet Doctor, we believe the evidence is strong to support the many health benefits of eating low-carb diets. In fact, it may be more important now than ever to maintain a healthy lifestyle, including a long-term healthy eating pattern. That means an eating pattern that provides essential nourishment and also keeps your blood sugar and weight in check. It appears that individuals with type 2 diabetes and other metabolic conditions are at higher risk of complications from COVID-19. The evidence is clear that low-carb and ketogenic diets can be effective tools for treating and reversing these metabolic conditions. While we can’t prove that low-carb nutrition boosts immune function per se, it makes sense to limit the conditions (e.g. high blood pressure or high blood sugar) that might make things worse. In addition, one recent study showed that a keto diet reduces the risk of mice infected with influenza. That’s a far cry from saying a keto diet will do the same for influenza in humans or for COVID-19. But one question we should ask is, if we follow a diet that is proven to help with weight loss and metabolic health and may also beneficially affect immune function, what do we have to lose? With that in mind, here are some of our top tips to decrease your risk of catching the virus or having complications from COVID-19.

The Basics

These are things that you can do today that don’t cost anything. We recommend you prioritize these basic steps for protecting and improving your health — and potentially your immune system. While these actions are always important aspects of maintaining good health, they may be crucial during times of increased risk, like now.

Proper Handwashing

The coronavirus is killed by proper handwashing for 20 seconds with soap or using hand sanitizer that is greater than 60% alcohol.

Don’t Smoke

Smokers have an increased risk of catching infections and suffering severe complications from those infections. We shouldn’t need more reasons not to smoke, but a time like this highlights the importance even more.

Get Adequate Sleep

Sleep is important for health in general, and as a bonus, it may also benefit our immune function. For instance, one study showed those with insomnia had, on average, less immune response to the influenza vaccine, while another study in twins showed those with worse sleep had altered expression of genes related to immune function. Last — and we can file this one under “How in the world did they convince people to do this study?” — 153 volunteers were inoculated with the rhinovirus (the virus that can cause the common cold). They found those who slept less than seven hours were three times more likely to develop symptoms than those who slept more than eight hours. Again, the science in this area may not be robust, but when it comes to overall health, proper sleep helps. In times like these, you should prioritize sleep hygiene. If you’re isolated at home, that likely means more time on electronics like tablets, phones, and TVs. This may be a good time to invest in blue-light blocking glasses and to look for non-tech related activities to do in the evening, like puzzles, crosswords, or reading an actual book (not an ebook!).

The Right Amount Of Exercise

Observational studies show that those who exercise tend to suffer fewer infections than those who do not. While those studies have confounding variables, the general consensus is that exercise overall is likely beneficial, with some caveats. Some studies show bouts of strenuous exertion (1.5 hours with an average hear rate>75%maximum) may temporarily decrease immune function. In addition, elite athletes who “overtrain” tend to suffer from infections more frequently than others. Our advice? Stay active, but remember: now is not the time to start a new high-intensity exercise routine. If you already enjoy strenuous exercise, consider decreasing the frequency or intensity by 10-20% (this is not scientifically backed but is recommended by some experts). Also, try to focus on home or outside exercise. Shared gym equipment, like weights and cardio machines, maybe surfaces that transmit the virus. For more guidance, see our Let’s Get Moving course or our recently published exercise guide.

Stress Management

While acute stressors may temporarily enhance immune functions, chronic stressors likely diminish immune function. Worrying about the stock market, stressing about having enough toilet paper, and focusing on the uncertainties of the future can raise cortisol levels, which may negatively impact our immune function. While data is difficult to interpret in this area, one study showed medical students with increasing stress levels before their final exams had decreased function of natural killer cells, the cells that are the “first responders” of our immune system. We can’t make this stressful situation disappear. But we can all take measures to control our response to stress. Meditation, mindfulness exercises, and getting outside and going for walks are all examples of activities that are free and relatively easy to do. The website Ten Percent Happier has a free“coronavirus sanity guide” that may help. Whether stress management techniques help your immune system or not, they can potentially help blood pressure, blood sugar, and make your days much more pleasant. If you drink alcohol, drink in moderation: In times of stress, some people turn to alcohol as a coping mechanism. While meditation, nature walks, and mindfulness exercises are likely healthier ways of coping, for some they aren’t enough, and alcohol adds a little something extra. There’s no judging here. We all have to do what we can to get through tough times. However, studies show a relationship between chronic heavy alcohol consumption and increased susceptibility to infections. Perhaps most pertinent for the discussion about COVID-19, some of these studies showed increased risk among heavy drinkers of acute respiratory distress syndrome (ARDS), the lung complication responsible for most of the COVID-19 related deaths. The trick is knowing where to draw the line. While there is little science, most experts suggest that a reasonable daily limit is two drinks for men and one drink for women. Keep in mind that following a low-carb lifestyle may decrease your tolerance to alcohol, so you may need to adjust your intake. You can read more about alcohol and low-carb lifestyles in our evidence-based guide.

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