Lifestyle Medicine and COVID-19

By Dr Rob Lawson with additional research by Dr Nir Brosh

The focus of lifestyle medicine is of course on non-communicable disease. So with the COVID-19 virus dominating our thoughts at the moment, you could be forgiven for thinking lifestyle medicine can offer us little in the way of guidance or comfort.

Of course, no amount of lifestyle change can protect you from catching a virus such as COVID-19. But there are other ways in which it can help – not least as we try to cope with the stresses and challenges of living during a pandemic.

Also, people’s chronic, long-term conditions don’t disappear during a communicable disease crisis. So continuing with a lifestyle medicine approach to treating, managing and reversing these conditions remains critical – even when communicable disease is dominating the headlines.

There are also things we can do ourselves to protect our mental health and wellbeing, which can be under serious challenge, particularly during periods of enforced isolation. And many of us are naturally worried and stressed about the unfolding situation. Again, lifestyle medicine offers us some ways to mitigate against these stresses and strains on the human body and mind.

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What we can do

There are simple lifestyle measures we can take to protect our immune system. This means even if we get infected with the virus, our innate defence mechanisms will function at their best, helping the body fight the infection efficiently and recover faster.

Prevention as always is better than cure. So following the government’s advice on avoiding contact with anyone testing positive for COVID-19 or who have any of the identified symptoms is critical – to protect us as individuals and to limit the impact of the virus’ spread across society. Advice on regular and thorough hand washing should also be followed.

To ensure our immune system functions at its best a good place to start is by avoiding stress (not easy at the present time obviously). Stress weakens our immunity, and stress-reducing techniques such as meditation, yoga, and tai-chi, can be very helpful.

There are other steps which can help – not just in terms of protecting and optimising our immune system but to improve our mental health and wellbeing …

Relationships – Be with people you love and communicate regularly with loved ones – strong and supportive relationships can boost immunity significantly.

Stay active – moderate physical activity supports optimal immune function. Be creative with what you have around you in your home if you’re self-isolating. A can or two in joined oven gloves – resistance exercises here we come! Your stairs suddenly look different too – a friend indeed. If you have a garden try to get outside and do a spot of digging or weeding!

Diet and nutrition Eat a balanced and healthy diet – including plenty of rainbow foods. Vegetables, whole grains, legumes and fruits all contain powerful anti-oxidants, that help the body in eliminating invaders.

Sleep – sleep deprivation is linked to a weakened immunity and makes us more susceptible to infections. Make sure that you get enough hours of quality sleep every night. This seems to help fend off viral infections.

Alcohol – drink only in moderation. Large amounts of alcohol impede our immunity, try to stay with one glass of red wine. People can drink more when stressed. However, this is only likely to increase our anxiety – not reduce it.

Feed your gut bacteria – our healthy gut bacteria help support the immune system. ‘Happy Microbes’ in our gut actually secrete anti-inflammatory substances which contribute to our immunity. So make sure to feed them well by adding fibre and foods with live cultures like sauerkraut, Kefir, some live yogurts and Kimchi.

Avoid sugary foods and beverages – Sugar disrupts immune cells’ function, and the effect is significant. Avoid eating sweets, chocolate, sodas (soft drinks) and juices. Read labels carefully at the supermarket since many prepared foods and spreads also contain sugar.

Avoid junk foods – avoid junk food and fast food as much as possible. It puts extra workload on your body and may deplete immune resources

Stop smoking – even temporarily. Smoking stunts the cilia, microscopic hairs that ‘throw’ inhaled viruses and germs out of our body. Without the work of the cilia, we are much more exposed to respiratory infections. Stopping smoking will reactivate the cilia and add to your protection.

Consider taking Vitamin C – it has been shown to reduce severity and duration of Influenza infections in some people, and it is completely safe to use. 2000 mg per day in two divided doses is a frequently recommended dosage

Vitamin D – if you have low vitamin D levels, taking a supplement is important for your immunity. In the northern hemisphere we may be relatively more depleted in winter months. We don’t know for sure but already Vit D3 supplementation is advised for the elderly.

The important thing is to do what you can to help yourself – and help your neighbour too where possible. We will overcome this crisis by keeping together and looking out for each other. In the West at least, this is the gravest public health crisis caused by a communicable disease in generations. And while lifestyle medicine offers us no quick fixes it is part of the solution if we are to come through this crisis.

Dr Rob Lawson
Chair, British Society of Lifestyle Medicine

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Resources

Cohen, Sheldon, David AJ Tyrrell, and Andrew P. Smith. “Psychological stress and susceptibility to the common cold.” New England journal of medicine 325.9 (1991): 606-612.

Cohen, Sheldon, et al. “Social ties and susceptibility to the common cold.” Jama 277.24 (1997): 1940-1944.

Cohen, Sheldon, et al. “Does hugging provide stress-buffering social support? A study of susceptibility to upper respiratory infection and illness.” Psychological science 26.2 (2015): 135-147.

Nieman, David C., et al. “Upper respiratory tract infection is reduced in physically fit and active adults.” British Journal of Sports Medicine 45.12 (2011): 987-992.

Barrett, Bruce, et al. “Meditation or exercise for preventing acute respiratory infection: a randomized controlled trial.” The Annals of Family Medicine 10.4 (2012): 337-346.

Bryant, Penelope A., John Trinder, and Nigel Curtis. “Sick and tired: does sleep have a vital role in the immune system?.” Nature Reviews Immunology 4.6 (2004): 457-467.

Ibarra-Coronado, Elizabeth G., et al. “The bidirectional relationship between sleep and immunity against infections.” Journal of immunology research 2015 (2015). https://www.pcrm.org/news/blog/foods-boost-immune-system

Zhang, Chenchen, et al. “Impact of a 3-months vegetarian diet on the gut microbiota and immune repertoire.” Frontiers in immunology 9 (2018): 908.

Antunes, Krist Helen, et al. “Microbiota-derived acetate protects against respiratory syncytial virus infection through a GPR43-type 1 interferon response.” Nature communications 10.1 (2019): 1-17.

Myles, Ian A. “Fast food fever: reviewing the impacts of the Western diet on immunity.” Nutrition journal 13.1 (2014): 61.

Martineau, Adrian R., et al. “Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data.” bmj 356 (2017): i6583.

Laaksi, Ilkka, et al. “An association of serum vitamin D concentrations< 40 nmol/L with acute respiratory tract infection in young Finnish men.” The American journal of clinical nutrition 86.3 (2007): 714-717.

Hemilä, Harri, and Elizabeth Chalker. “Vitamin C for preventing and treating the common cold.” Cochrane Database of Systematic Reviews 1 (2013). https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system