How to Stay Healthy During the COVID-19 Crisis
April 23, 2020Stay Healthy During Times of Crisis
On March 16th, President Trump issued his guidelines entitled “15 Days to Slow the Spread.” Soon afterward, 90% of our country was told to not go to work or school or even leave their house at all, unless absolutely necessary.
As we wage a war against an unseen virus that has likely affected someone dear to you, we wage a second battle at home to keep our health and sanity intact.
Bariatric Surgery Patients Need to Stay Healthy
As a bariatric surgeon, many of my patients have struggled with obesity their entire lives. In their times of greatest need, they turned to us as healthcare professionals for guidance.
Whether through nutritional or psychological coaching, physical training, medical therapy, or surgery, patients turned to us to help them fight against obesity. Obesity has been linked to poorer outcomes during the prior influenza pandemics and again now during the coronavirus disease, or COVID-19, pandemic[i].
Historically, weight gain leads to other medical conditions such as high blood pressure, high cholesterol, diabetes, and sleep apnea. Being overweight or having other medical problems increases the risk of having a more severe infection if you get COVID-19. Infection most commonly causes fever, a dry cough, and muscle aches; however, sometimes it causes trouble breathing or pneumonia.
About 15% of people who get COVID-19 will develop severe disease needing hospitalization and about 1/3 of those will end up in the ICU. What can we do to keep ourselves safe?
How COVID-19 Spread So Quickly
There are two main reasons COVID-19 has spread so quickly to millions of people. First, it is a highly infectious virus that spreads easily through contact with objects, people, or even respiratory droplets.
Second, when someone gets infected, they don’t feel ill until 4-14 days later, but have been spreading the virus unknowingly. The most important thing to do is to realize anything you touch can contain the virus, therefore it is important to wash your hands and not touch your face where the virus can enter your body. Frequent handwashing (20 seconds with soap and warm water) or the use of hand sanitizer whenever you touch something outside your home will prevent the spread of the virus.
The term social distancing has also been popularized to prevent the spread. Generally, respiratory droplets don’t travel more than six feet, so staying six feet apart will keep droplets from hitting your face and entering your body. The use of a mask will help prevent exposure to viral particles, but these particles can accumulate on the outside of the mask. It is essential to remove it without touching your face, dispose of it or clean it, and then wash your hands each time.
Staying Healthy During COVID-19
Staying healthy and sane while worried about our loved ones, our finances, and being cooped up at home with the kids can be difficult. The first step to staying healthy is eating healthy.
Nutrition
For bariatric patients, follow your surgeon’s protocol for your surgery type and where you are in your journey, ie liquid phase, soft food, diabetes, etc. Another healthy option is the Mediterranean Diet. You can check out the specifics of the Mediterranean Diet.
The Mediterranean Diet (as an option): The only diet that has repeatedly been shown to combat obesity, cardiovascular disease, and diabetes is the Mediterranean Diet[ii]. A diet shouldn’t have negative connotations. Diet comes from the Greek term “diaita” which translates to “way of living” and the Mediterranean Diet describes an existence characterized by eating locally grown food and engaging in at least moderate daily physical activity.
The Mediterranean diet revolves around consumption of mostly fruits, vegetables, grains, olive oil, beans, nuts, legumes, and seafood. Moderate portions of poultry and dairy is allowed, and meat and sweet consumption should be sparse. Water is the beverage of choice.
This diet is naturally high in fiber and low in sugar. With greater consumption of healthy fats (mono and poly-unsaturated fats) like fish, olive oil, avocados, nuts, and seeds and lower intake of saturated fats, the risk of developing cardiovascular disease decreases greatly.
In addition, numerous other benefits have been described including weight loss, improvements in diabetes, decreased levels of inflammation, decreased risk of cancer, and decreased incidence of disorders like Alzheimer’s and Parkinson’s[iii].
Diet fads will always come and go, but the benefits of the Mediterranean diet have been documented for 40 years[iv]. Overall, try to consume multiple small meals per day starting each meal with protein. Don’t skip meals and don’t go more than 4-5 hours between meals. Try to drink at least 8 glasses of fluids per day.
Though the Mediterranean diet advocates consuming wine regularly in small amounts, the trend to drink more while isolated at home can be quite dangerous. During this crisis, the consumption of alcoholic beverages has increased dramatically over the past few weeks.
As a bariatric patient, it is important to limit the consumption of alcoholic beverages. Aside from the antioxidant benefits of red wine, most alcoholic beverages contain no nutritional value and are “empty calories.” Per gram, alcohol has more calories than both carbohydrates or proteins. Furthermore, it can negatively affect normal nutrient absorption and fat burning since alcohol can’t be stored in the body and its elimination take first priority[v].
Lastly, while the body is trying to break down the alcohol, it also adversely affects our sleep. Though you may fall asleep faster, the quality of your sleep will be worse. Even just one drink will elevate your heart rate and reduce your deep sleep, which is known to be restorative[vi].
Why is sleep so important? A good night’s rest will give you more energy and better control of your eating habits. Many studies show that inadequate sleep (< 6 hours) is associated with greater hunger and increased consumption of calories[vii].
Fitness and Activity
But it’s not just what we eat, we need to move as well. Daily exercise will help you control your weight, reduce your risk of heart disease and stroke, improve your blood sugars, strengthen your bones and muscles, and improve your sleep.
It also helps fight off dementia and improves your mood, helping you to combat these new stresses in our life. Improving your health will help you resist infection and increase your ability to fight infection if you do get sick.
How much exercise should we aim for? Just 30 minutes a day of moderate exercise (brisk walk) or even 15 minutes of intense exercise will allow you to reap the benefits discussed above. For even more efficiency, try high-intensity interval training regimens, where 20-60 seconds of high-intensity exercise is alternated with 20-120 seconds of lower intensity exercise to recover. Strength training utilizing our large muscle groups and core-training helps balance your body. Go outside and walk, but keep at least six feet away from others. Many gyms and websites are offering free classes online, take advantage of them.
Social Distancing
Lastly, social distancing should have been called physical distancing, because we need our families, communities, and social circles to help us destress and get through these difficult days.
Though we may have separated ourselves from our loved ones physically, we are still able to reach out to friends and family. Call people and check in on them. Use apps like Zoom or Google Meet to set up group video chats. Take advantage of your cell phone or computer’s built-in videoconferencing abilities by using Facetime and Skype.
The Silver Lining and Stay Positive
In closing, we are going through an extremely difficult part of our lives, and our stress and anxiety levels are at all-time highs. Remember to stay positive, practice self-care, and keep a good sense of humor. Try to eat healthy, live healthy, and be active. Reach out to others because helping them is the best way to help yourself. There is a silver lining… we now have more time to spend with family, to better ourselves, and to help those around us.
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References
[i] Dietz et al. Obesity and its Implications for COVID-19 Mortality. Obes. Apr 1 2020; EPub ahead of print.
[ii] Franquesa et al. Mediterranean Diet and Cardiodiabesity: A Systematic Review through Evidence-Based Answers to Key Clinical Questions. Nutrients. Mar 2019; 11(3): 655
[iii] Romagnolo and Selmin. Mediterranean Diet and Prevention of Chronic Diseases. Nutrition Today. Sept/Oct 2017; 52(5): 208-222
[iv] Keys, A. Seven Countries: A Multivariate Analysis of Death and Coronary Heart Disease Harvard Univ Press. 1980
[v] Lieber, CS. Alcohol: Its Metabolism and Interaction with Nutrients. Ann Rev Nutr. 200; 20: 395-430
[vi] Roehrs and Roth. Sleep, Sleepiness, and Alcohol Use. Alcohol Res Health. 2001; 25(2): 101-9
[vii] Zhu et al. Effects of sleep restriction on metabolism-related parameters in healthy adults: A Comprehensive Review and Meta-Analysis of Randomized Controlled Trials. Sleep Med Rev. 2019; 45: 18-30
 | ABOUT THE AUTHOR Heath Antoine, MD, is an American Board of Surgery-certified general surgeon and Cleveland Clinic-trained advanced laparoscopic and bariatric surgeon. He performs laparoscopic weight loss surgeries such as the Roux-en-Y gastric bypass, the sleeve gastrectomy, and more complicated revisional bariatric surgery at Advanced Surgical & Bariatrics of NJ, PA. |
| Nutrition Disclaimer: If you have a nutrition plan that you are following, specific dietary restrictions and needs, continue with your plan. All information on ObesityHelp.com is intended for informational purposes only. The information is not intended to be a replacement nor a substitute for a consultation with a qualified medical professional. Please contact a medical professional with any questions and concerns that you may have. |
