Can what you eat save you from COVID-19?

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According to experts in the field, nutrition is the biggest coronavirus risk factor that not enough people are talking about.

“We have two epidemics: obesity and COVID-19,” said Dr. Mariela Glandt, a Harvard University and Columbia University trained endocrinologist and nutritionist who now lives in Israel and runs a clinic for diabetics in Ramat Aviv.

She said, “As long as the pandemic is still going on, anyone who cares about their health should do everything they can to improve the risk factors that they control” – among them diet.

While eating right cannot prevent contracting coronavirus, optimal metabolic health can help prevent the negative impact of infection, several studies have shown. That’s because “good nutrition and maintenance of a healthy body weight is essential for adequate immune function, supporting resistance to infectious disease and reducing adverse outcomes in the event of illness,” according to Prof. Mona Boaz of the Department of Nutrition Sciences in the School of Health Sciences at Ariel University.

“A poor diet, like the modern American diet, with its junk food, ultra-processed starches and cheap fats, causes metabolic dysfunction that can be a disaster when it’s combined with the coronavirus,” Glandt wrote in an eBook titled How to Eat in the Time of COVID-19 that she recently published with Ross Wollen and Jessica Apple.

The book was published by ASweetLife, which describes itself as “the Internet’s trusted authority on the art of living well with diabetes.”

Severe COVID-19 – hospitalization, treatment in an intensive care unit, mechanical ventilation and even death – has been associated with higher body mass index, the Centers for Disease Control has said.

Specifically, obesity defined by BMI increases the odds of hospitalization by 76%, Boaz showed in a paper that is soon to be published but has not yet been peer reviewed. She said the likelihood of ICU admission increases by 67%, mechanical ventilation by 119% and death by 37% – all according to recent studies.

Moreover, a study that was published in the peer-reviewed journal PLOS One at the end of last month showed that people with high sugar values but who were not diagnosed with diabetes were also at risk of severe COVID-19 morbidity or mortality.

The researchers from Hebrew University of Jerusalem, Meuhedet Health Services, Jerusalem College of Technology and Hadassah-University Medical Center conducted a retroactive study among all individuals over the age of 18 who were insured by Meuhedet and contracted the virus between March and October 2020.

Of the 37,121 people who tested positive, 707 of them had severe disease, including 244 who died.

THE NORMAL blood sugar level in an adult is 70 to 100 milligrams per deciliter (mg/dL) of blood sugar after an eight-hour fast. Patients with 105-125 mg/dL were 1.5 times more likely to have severe COVID than patients with sugar lower than 105. Patients with between 125-140 mg/dL were twice as likely to develop complications.

“The aim of the study was to identify risk factors for severe coronavirus illness that can be treated ahead of time,” explained Dr. Michal Shauly-Aharonov of the Jerusalem College of Technology.

Obesity, high blood pressure, diabetes and many forms of cardiovascular disease are symptoms of an underlying medical condition called insulin resistance, Glandt wrote in her book.

“Insulin is the hormone that allows your body to utilize the glucose in the food that you eat. Normally, this is a healthy and natural process – insulin levels rise when eating, and subside to very low levels between meals,” Glandt explained. “Insulin is a storage and growth hormone and it is critical that there be a balance between high and low levels.

“But when you eat a diet full of sweets and starches, your insulin production can grow out of control. Eventually, your cells become resistant to insulin, dulling its effect, which just causes your body to produce even more of it, as your body struggles to move glucose [sugar] out of your blood and into your cells,” she said.

High sugar levels mean there is no more room to store sugar in a person’s cells and so the sugar stays in the blood. If a person stops bringing sugar into their body, their sugar level will decline.

Through her own clinic, she has managed to get 97% of clients off insulin through diet management. The average client loses eight kg. (18 lbs.) in the first six months. Moreover, some 65% of clients normalize their blood sugar to the extent that they are no longer considered diabetic.

She advocates for the ketogenic diet, which includes avoiding all seed oils, such as canola, soybean, sunflower and corn; avoiding all sugars; and keeping complex carbohydrates to a minimum.

Boaz, on the other hand, has said that a modified Mediterranean diet to achieve the right balance, which includes fish, nuts, hummus, tahini and refried beans, is high in fruits and vegetables, whole grains and olive oils and low in processed foods.

“This particular pandemic highlighted the impact that obesity can have on the immune system,” Boaz said.

She stressed that public health policy should be directed at improving diet quality, especially among youths who are much more likely to follow healthful practices if taught from an early age.

“Logic would tell you,” Boaz said, “being adequately nourished and maintaining a healthy diet is always to your benefit.”