I mentioned in a previous blog that the research is indicating that those with excess weight are experiencing worse infections with SARS-CoV-2 virus (1). In this blog, I'm going to discuss the implications of this connection and give you some helpful tips for ways you can start to improve your risk factors for Covid-19 today.
The CDC blatantly states that having a BMI of over 30 puts you at a higher risk of severe illness from Covid-19 and that having a BMI of over 25 may put you at increased risk (2).
Wondering what your BMI is? Here's a link to the NHLBI BMI calculator.
While I don't want ANYONE to feel guilty over their weight status, I do believe there is a place for honesty in reporting the risk factors for Covid-19. In my opinion, Dietitians think they are loving their clients by supporting body positivity and refusing to be honest about the real risks their clients are facing. I choose to be optimistic about health while being truthful about the risks of certain chronic diseases. I don't want to see my patients go down the endless loop of weight gain, diagnoses, medications, and chronic pain.
It is also widely recognized that there are a variety of factors playing into each person's story. Food addiction is very real. The governments of the United States and Canada have helped create an environment where food is saturated in fat, sugar, and salt- all of which are very addictive. Health inequalities amongst minorities is another very serious issue, where we see that those who belong to minority ethnic communities face much higher rates of chronic disease such as high blood pressure, diabetes, and heart disease.
Did you know that obesity disproportionately impacts those of Hispanic and black ethnicity? This isn't just because of cultural styles of cooking but often has to do with socioeconomic status and consequential access to good education, housing, parks, grocery stores, mental health resources, and so much more (1).
These are likely the same reasons we are seeing a disproportionate number of coronavirus cases among minorities. While a change to this inequality must be accomplished on a large scale policy and community development level, it's important for those on both sides of the inequality to be aware of the role they play.
Despite the seeming inability of us, the little people, to play a role in changing the dynamic of obesity, we DO have the ability to make small scale changes to the way we live and the ability to share these changes with those around us.
What am I talking about?
Well, I started out on my path to nutrition as a very middle of the road nutrition gal. I believed in all the same stuff the government tells us about health and nutrition and was planning on counseling my patients accordingly. What did this mean? I was likely going to counsel people to enjoy certain foods (red meat, dairy, processed foods) in moderation, to work to manage diseases like obesity, diabetes, and heart disease with a healthy balanced diet, and try my best to help people without making them feel any negative emotions about the choices that led them to where they are.
What has changed between that Lucy and the one writing this blog today? I learned that there is an incredible wealth of research out there that says this type of moderation diet doesn't actually help people. In fact, I managed to still gain weight myself while following a relatively healthy vegetarian diet in the United States. I still had lots of dairy and processed foods in my diet because I believed in "moderation", but was seeing firsthand how a message like that doesn't work!
When I learned about a plant-based diet and it's role in preventing, treating, and even reversing our top 10 killers in America (heart disease, cancer, chronic respiratory infections, kidney disease, diabetes, and stroke being among those 10 notable for being preventable), I couldn't turn my back on the research.
Since then I have helped family members, members of my community, and patients see improvements in their health like reducing medications, losing weight, and feeling good for the first time in years.
And that's NOT because I am a dietitian. To be honest, I have barely had an impact in the world by being an RD. But I HAVE had an impact because I am an active member of my family, community, and city and work to put this information out there for others to hear.
You can do the same by making some changes to your health and telling others around you about them. This is called a grassroots movement, and it's actually one of the most effective ways to implement large-scale change!
But back to obesity and Covid-19. What is the mechanism for why people with an increased weight are at an increased risk of severe illness?
According to one article in The Journal of Metabolic Surgery and Allied Care, there might be a role for a very unique protein that normally functions in the renin-angiotensin-aldosterone system, an important regulator of blood pressure. Unfortunately, the same protein that mediates the response of RAAS (ACE 2) is the same protein the SARS-CoV-2 binds to. Researchers discovered that there is a higher expression of the ACE 2 protein in adipose tissue (especially visceral or belly fat). Higher amounts of the protein may be the link between why those with higher fat levels are experiencing a more severe viral load/infection (3). Other factors noted by the CDC to possibly explain the obesity-covid link is the impaired immunity, decreased lung capacity, and possibly even lower vaccine responses by those with excess weight (1).
The authors comment that even modest weight loss might play a role in reducing this imbalance and consequently reducing the severity of the disease (3).
Now that we know that obesity places us at a higher risk of severe infection, what is there to be done? As mentioned, even small or modest weight loss can improve our risk factors. So here are 5 things that you can do to see a weight change without radically changing your diet (although, if a radical change is what you want, you can reach out to me about what that might look like).
STOP DRINKING SUGARY BEVERAGES. From soda to Starbucks, your body doesn't need those extra calories. Switching to water, flavored water, carbonated water, and black coffee and unsweetened hot or iced tea can help you cut out unnecessary calories. Many people lose weight by losing these calories alone.
Incorporate more fiber into your diet. Fiber binds fat and cholesterol in your gut and keeps them from getting absorbed. Incorporate more fruit, vegetables, whole grains, and beans into your diet to get this wonderful fat cutting hack. See some of my recipes, or try any of the hundreds of recipes available at ForksOverKnives.com
Choose fruit as your snack or dessert. Fruit is naturally low in calories, so choosing it as a snack can be a great way to reduce overall calorie intake while still feeling full and satiated after a snack. It can also be a great way to naturally satisfy that sweet tooth. The more you choose natural sugars to satisfy that craving, the more you will dislike the over-sweet flavor of your normal go-to sugary desserts.
Cut your meat intake in half. If you normally eat meat with every meal, try skipping meat at lunch or dinner. If you only have it a few days a week, try only once a week. Reducing the amount of meat you consume reduces your intake of saturated (highly storable) fat, along with pro-inflammatory markers and improves your blood sugar response.
Go on a walk. My favorite phrase from one of Dr. Michael Greger's videos/books is "strolling plant-eaters". More often than not, what's keeping you in a bad place healthwise is your diet and not your activity level. Being only moderately active (like taking daily walks) but having a nourishing and health-promoting diet will do so much more for you than running a marathon.
These simple changes- cutting sugar-sweetened beverages, eating more fiber, choosing low-calorie snacks, reducing meat, and getting a little exercise- might be surprisingly effective. You won't know until you try them. If you've found yourself in a weight-loss rut after trying these, then you might need to talk to me about what could be causing that.
Reach out! I have a free 15-minute consultation that I extend freely to everyone, whether they are in my province or not.
As always, continue to read what I am posting, as I try to make it as relevant to current situations as possible. Sign up on my homepage for my newsletters to stay up to date.
This article was written by:
1.Obesity, Race/Ethnicity, and COVID-19. Cdc.gov. Published January 8, 2021. Accessed January 20, 2021. https://www.cdc.gov/obesity/data/obesity-and-covid-19.html
2. CDC. COVID-19 and Your Health. Cdc.gov. Published December 30, 2020. Accessed January 20, 2021. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html
3. Iannelli A, Favre G, Frey S, et al. Obesity and COVID-19: ACE 2, the Missing Tile. Obes Surg. 2020;30(11):4615-4617. doi:10.1007/s11695-020-04734-7