We are all in a heightened state of alert during the COVID-19 pandemic. We should be. Concerns about masks and hand sanitizers and social distancing and quarantine are real and necessary. Do all the things, they make a difference.
What are often left out of the conversation are the real impacts of underlying health conditions and how they impact the course and severity of COVID-19 as well as other respiratory illnesses. The CDC has provided a list of these conditions, but what is not highlighted is the fact that these same conditions increase the risk of death in and of themselves and at a much higher rate than COVID-19.
Some of these conditions are nonmodifiable: We cannot change our age, reverse an immunocompromised condition like being a transplant recipient, but we can improve or even reverse high blood pressure, diabetes, metabolic syndrome, high cholesterol, cardiac inflammation, and obesity. We also know that regular exercise, stress reduction, and a healthful diet can improve these conditions. However, some of us may benefit from screening for these conditions BEFORE we meet the clinical disease criteria.
Traditionally, fasting blood sugar/glucose can confirm a diagnosis of diabetes, but a fasting insulin with a hemoglobin A1c level along with the glucose level can identify “pre”-diabetes which can also increase risk for infections as well as cancer and cardiovascular disease. Any woman with a family history of diabetes or personal history of being overweight, having PCOS or gestational diabetes should have these tests. If any of these parameters are elevated, there are specific diet, lifestyle, supplements, and medications that can help to lower your risk.
Remember, heart disease, like diabetes, is often silent, meaning you can have significant risk for stroke, heart attack, and even cancer without any symptoms. Cardiovascular health is best assessed in non-symptomatic patients with a cholesterol screening and cardiac-C-reactive protein to measure cardiac inflammation. As above, diet, lifestyle, supplements and/or medications may be used to normalize abnormal values.
Finally, being overweight or obese by body mass index may not be a perfect assessment, but we do know that it may predict metabolic issues like (pre)cardiovasular disease and (pre)diabetes and has been independently linked as a risk factor to COVID-19; annual screening is necessary to survey risk. Its not weight itself that is the issue, it is the underlying conditions like elevated inflammation, blood sugar, cholesterol, asthma, sleep apnea and reflux that are more of a concern. It is important that overweight and obese patients get the tests listed above as well as tests of thyroid function, inflammation, and cortisol to screen for any contributing factors.
Lifestyle modification does not have to be dramatic; no one is suggesting you use your quarantine time to get a bikini-ready body. But implementing new healthful habits that will improve your resistance to acute infections like the flu and COVID-19 as well as decrease your chances for chronic diseases like cancer, diabetes and cardiovascular disease in the future are easy to do…a little goes a long way! Mediterranean diet has been the most supported in research to decrease chronic disease and increase lifespan. If you need assistance, a local registered dietician and/or meal prep services can help. Exercise does not need to be excessive, a brisk walk 5 days per week for 45-60 minutes would be all that is needed, throwing in a couple days of bodyweight exercises for the gold star! If you crave community, there are so many local businesses that are offering low cost or free virtual fitness, barre and yoga classes.
Stress definitely can have a negative impact on immune function and having to home school, work from home, and be with immediate family 24 x7 while being separated by friends and other family members can certainly increase stress. See my resources page for referrals for meditation apps and therapists that can help support you during this time if needed.
Finally, even though we are all COVID-focused, other health issues deserve to be addressed as well. Don’t let preconception plans, fertility issues, menstrual problems, mental health concerns or perimenopausal changes take a back seat. Hormonal issues can also impact immune function as evidenced by the fact that women are more likely to have asthma and allergy exacerbations and are at increased risk for infections during PMS, and hormone balancing can help.
If you are interested in getting lab testing for the conditions indicated above, contact me, and we can do a virtual appointment and get the labs ordered and assessed so you can get started on your individualized plan for health and wellness, for now and in the years to come.
Great reminders! It’s an important time to stay healthy and commit to getting even healthier!