Nutritional Approach to Combating COVID-19

At the moment it is fairly difficult to think about anything other than COVID-19, and I don’t know about you, but despite my best efforts, it is taking a toll on my own anxiety and stress systems.

There are so many factors to consider – our own health, the health of our loved ones, our ability to be strong when it counts… and then the nutritional and psychological implications of a 30 day isolation period. Every single factor which places stress on our nervous system has the potential to decrease how robust our immune system is, which merely adds to the stress and worry. How do we escape?

After thinking about this for some time, I have come to the conclusion that we can’t. We simply have to accept it, accept what is happening in the world and around us, make peace with it, and look at all the positives it is going to bring, because, once you start thinking about it, there are many of these.

So we can’t escape and we can’t change what is happening.

But we CAN change and affect many things around us and those are the things that we need to focus on. With this post and those that follow, we are going to start looking at what we can do, to turn this around, and take some form of control back.

First of all, something we have a whole lot of control over is what we eat – our nutrition. Even if we are stressed and anxious we can eat in a way that nourishes our immune system, which will help to alleviate some of the anxiety around our health. Almost more importantly however, we can eat in a way that helps our nervous system to cope as the events unfold, and as the nervous system and immune system are intimately linked, this way, we are killing two birds with one stone. Interestingly, and to drive this point home, many of the nutrients are the same. So yay! Easy peasy. Let’s get started.

In this first post, we will address nutrition for the immune system and in Part 2, nutrition for anxiety, stress management and resilience.

PS In no way does this stand in the place of medical advice, and if you develop COVID-19 symptoms (runny nose, cough, sore throat, fever and shortness of breath) ensure you get medical advice and/or attention ASAP.

Nutrition for Optimal Immune Health & Defense.

First, a very quick, short and sweet overview. I categorise nutrients into three major fields:

Macronutrients (protein, carbs, fat, fibre)

Micronutrients (vitamins and minerals, such as zinc)

Phytonutrients (the amazing array of bioactive compounds we get from plants eg anthocyanins, from berries, are a potent antioxidant)

We will consider each one.

  •   Macronutrients

For overall health, every single macronutrient is important, which means that, for immune health, eating a well-balanced diet is your absolute first go-to. However, protein needs to be a major point of focus during this time, as not only does it contain the building blocks for important immune molecules (such as glutathione), but in addition, when we are sick, the breakdown of our muscle proteins is increased to help us both fight disease and recover. The major way to cover both immune demands and this increased loss is by eating high-quality dietary protein. That means your animal proteins, such as eggs, meat, fish, dairy if you can tolerate it, and whey protein powder if you happen to be a smoothie fan. If you don’t eat animal protein, soy is your highest quality plant-based protein. The recommended optimal intake for protein is at least 1.2 g per kg of body weight per day, although, for highly-active individuals and the elderly, this can increase to around 1.6 g per kg of body weight per day. The best way to ensure you are achieving this is to consume high-quality protein at every meal.

Alongside protein, fibre is essential for maintaining the health of your gut bacteria, which form an intimate alliance with your immune system, and if the immune system in the gut is compromised, so is that of the entire body. However, also super important to consider is that the gut bacteria ferment the fibre to produce short-chain of fatty acids, which appear to play key roles in immune cell recruitment and function, alongside many other important functions in the body. Fibre is also delivered in combination with a bunch of phytonutrients that add to the strength of the immune system (which we will cover in a bit). The absolute best sources of fibre are your fruits and vegetables, as well as nuts, beans, legumes and whole-grains. Some people find it hard to tolerate large amounts of nuts, beans, legumes and whole-grains, and if this is you, eating fresh produce is your best bet for optimal immune health. However, keep in mind that fibre can be overdone! Too much fibre can reduce the absorption of other key nutrients…so there is no need to go overboard, just be sure to include some form of fibre with every meal.

  •   Micronutrients

One of my favourite gurus in the micronutrient health world is Chris Masterjohn (CMJ). In a recent document, he outlined the most effective micronutrients specific to combating SARS-viruses such as COVID-19. In particular, these are zinc and copper.

Zinc has been shown to directly inhibit at least three mechanisms associated with the original SARS coronavirus, indicating that it is likely to be a key micronutrient here as well. In general, zinc interferes with the ability of the virus to replicate and function inside a cell. CMJ pairs zinc with elderberry extract (which we will talk about under phytonutrients), which may be able to prevent the virus actually entering a cell in the first place, so is the first line of defence.

All forms of zinc supplementation are useful, including sprays, lozenges and tablets, and the recommended dose to fight the virus is 10-15 mg 4 times per day, spaced well apart. These can be taken with food, or on an empty stomach, but if taken with food, it is recommended to avoid nuts, beans, grains and legumes, as these may interfere with full absorption of zinc.

Of course, zinc is potentially best obtained from food, primarily from oysters. However, since oysters are not common fare for the majority of people, supplementation is your best bet.

When you purchase a supplement, check that it is not in the zinc picolinate or zinc oxide forms, as these are not well absorbed, and once the threat of the virus has diminished, keep taking around 10 to 15 mg per day, as this is one mighty nutrient for overall health.

Copper is toxic to viruses, including coronaviruses, which is why copper surfaces are effective for hygiene maintenance. Copper works synergistically with zinc, and we should aim to get around 1 mg of copper for every 10 to 15 mg of zinc. This means that if you are taking 15 mg of zinc four times per day, you will need at least 4 mg of copper per day. Many supplements provide zinc and copper together, although copper from foods is superior to copper from pills. The best food sources to provide 2 mg copper are 2 oysters, 25 g spirulina, 40 g shiitake mushrooms, 50 g sesame seeds, 50 g cocoa powder, 56 g of 90% dark chocolate and 70 g of 70% dark chocolate. I know which one my go-to is going to be! However, since you would need 2 or 3 times the amount in each of these servings, supplementation is going to be necessary with a high zinc intake.

My personal approach moving forward is going to be 15 mg zinc 4 times per day, with 4 mg of copper from a supplement, and as much dark chocolate as I want. Why wouldn’t I?

Phytonutrients

Ah, nature, in all her glorious wisdom, who provided us with more healing compounds than you can poke a stick at right there in our garden. Or the fresh produce aisle of your local supermarket. For overall health, every single herb, vegetable and fruit is beneficial, when consumed in moderation. However, different phytonutrients work in different ways and some are more (and less) beneficial for a respiratory virus like COVID-19.

Elderberry. As I mentioned above, CMJ also states that elderberry has been shown to prevent the ability of the SARS coronavirus to enter cells, and so for this reason, it is an effective supplement to add to your virus prevention list. If you already have the virus, it is unlikely to reverse its effects, so zinc and copper are your best bets for this, although taking elderberry will definitely not hurt!

The recommended dose for elderberry extract is 700-1000 mg per day. After extensive searching, and finding that many elderberry supplements are sold out, I came across this Product: which would require 4-5 servings per day to provide the recommended elderberry dose. However, it also contains Vitamin C, for which the research is equivocal – while some studies show it is highly beneficial for respiratory infections, others show it may increase the inflammatory response. Personally, I am going to buy this supplement and take it, as a preventative measure, since it is all I can find! However, if I were to contract the virus, I would likely stop and focus on zinc and copper.

Allicin. In addition to elderberry, allicin, the key bioactive ingredient in garlic, has been shown to play a significant role in fighting a viral infection. Keep in mind that you have to eat garlic raw in order to gain the maximal benefits of allicin, which may not go down too well unless you are in self-isolation, in which case go nuts! However, allicin supplements are easy to come by, and I am going to add these to my regime. While CMJ recommends 180 mcg stabilised allicin per day, the supplements I have been able to find easily are 3000 to 4000 mcg per day, so I am just going to take these as is and hope for the best.

Oils of oregano, tea-tree and eucalyptus. We can also look at some essential oil powerhouses for fighting viruses. Oil of oregano is a traditional remedy for respiratory viral infections, as well as gastrointestinal viruses and inflammatory conditions, and research in animals is supporting this traditional use. While pure oregano oil can be taken internally, it must be totally pure for consumption, so a good alternative is to put a couple of drops on the soles of the feet. Oregano can be combined with tea tree oil and eucalyptus, also shown in research studies to possess potent antiviral activity. Both tea-tree and eucalyptus can be toxic when taken internally, so topical application, or aroma diffusion, is recommended.

Is there anything I should avoid?

Yes. Most definitely. As always, limit inflammatory foods such as refined sugar, refined vegetable oils and processed meats. In addition, CMJ recommends avoiding supplementation with high levels of Vitamin A and Vitamin D, as these can increase the production of molecules in the body that may benefit viruses like coronavirus.

Wrapping up….

This is by no means an extensive list! Every single macro, micro and phytonutrient has a role to play in our overall health and therefore, our immune health, when consumed in a balanced way. However, the nutrients that have been mentioned and described here were selected as those most beneficial for immune health, in the specific context of the SARS family of coronaviruses.

At the very least, if they assist in reducing some of the anxiety that you might feel at this time, that will be a huge benefit in and of itself. Share this list with friends and family, and possibly assist older family members in obtaining some of these supplements. Everything we can do to enhance our immune health, and the health of those we care about at this time is on the table.

Keep well! And stay tuned for Part 2….

 

-Carlene Starck

COVID-19: Everything thing you need to know

Now deemed a Global Pandemic we are learning more day by day about COVID-19. With all the hysteria across the media, it has become difficult to determine what is hype and what is true. From people panic shopping and fighting over toilet paper, the world is going a little bit crazy.

In this post, we will aim to provide you with an overview of accurate up to date information. Following this post, we will discuss strategies on how to combat this issue.

Hysteria:

First of all, I need to address the panic, we all need to calm down……… There is no need to prepare for the end of the world and stock up on supplies like toilet paper and food. Well not in New Zealand at least as we produce all essential supplies (food, toilet paper etc) in New Zealand, we are not reliant on global markets. Even the supermarkets are requesting for everyone to calm down and to shop as normal, there is plenty to go around. 

From a hysteria standpoint, the timing couldn’t be worse for NZ/ southern hemisphere with the changing of seasons and drop in temperature and as we head into flu season. As a result of lack of education and understanding of COVID-19, people that are suffering from common flu are unnecessarily concerned for the worst and stressing our health system which is going to need every spare bed atm. What is the difference between common flu and COVID-19? Stay tuned as we will highlight this below so you can stay informed and rest easy.

Important: COVID-19 is treatable.

 

Stop stressing! 

Don’t forget stress is one of the leading causes of disease (something I have written extensively around) so you are not doing yourself any favours worrying about things you cannot control. Our hope in this article is by sharing the facts we can help in easing any anxiety or stress you may have. Our next post will begin to address what you can do to mitigate this and the anxiety around it.

What is it COVID-19?

Similar to SARS, research points out that the virus also originates from bats. COVID-19 causes respiratory and intestinal infections in animals and humans. 

What happens in the respiratory system and immune system in response to the virus?

  1. Your body will produce mucus in an attempt to contain or trap the virus. 
  2. The infection involves overstimulation of the body’s defences against viral infections. Cytokines, proteins secreted by certain immune cells, signal for more immune cells to enter the picture and try to engulf the virus, resulting in cell death and increased inflammation.
  3. Due to the high replication rate of the coronavirus, it often overwhelms the immune responses leading to local tissue destruction and depletion of infection-fighting cells. Cytokines also can travel via the circulatory system to other organs such as the kidneys, liver, and small intestine. Dramatic increases in cytokines are referred to as a cytokine storm and this appears to be a distinguishing feature of severe respiratory viruses vs lesser viruses like the common cold.

Not all people with the virus will experience all three stages and also in some cases, you may be a carrier of a virus but have no symptoms (meaning you can unsuspectingly pass it on).

How COVID-19  spreads

As a new disease, we are still learning how it spreads but below as of 19th of March the CDC believe these are major methods: 

 

  • Human interaction

 

    • Between people who are in close contact with one another (within about 6 feet).
    • Passed through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

 

  • Can someone spread the virus without being sick?

 

    • People are thought to be most contagious when they are most symptomatic (have symptoms)
    • Potentially it is possible before people show symptoms. However, it is not thought to be the main method in which the virus spreads.

 

  • Contaminated surfaces or objects

 

The virus could potentially spread through cross-contamination of surfaces or objects that have the virus on it and a person touching it and then touching the mouth, nose or possibly eyes. However, this is not thought to be the main method for the virus spreading.

 

What happens if you feel sick?

Remember that symptoms of the common cold or seasonal flu can be similar to symptoms of coronavirus, which can make it difficult to determine what might be going on. Especially with New Zealand heading towards flu season. Here is a great chart to review symptoms and determine next steps.

Determine what you are dealing with

We encourage anyone with signs of a respiratory infection or COVID-19 (fever, dry cough, and shortness of breath) to contact their primary care physician for guidance. Ideally where possible connect with your doctor online or by phone to reduce the risk of transmission. 

If you develop severe symptoms or are in the high-risk groups outlined below and develop shortness of breath, call 111 or go to the nearest emergency room after calling ahead for safe arrival instructions. 0800 358 5453

 COVID-19 risk factors:

If you are high- or medium-risk and fall within any of these risk factors below, it is recommended that you self-isolate and practice social distancing for a minimum of 14 days, even if you have no symptoms. 

 

  • Age: 

 

While the overall global mortality rate of COVID-19 is currently estimated to be around 3.4% by the WHO (as of March 3), early reports out of China and a similar pattern identified in Italy (the highest number of coronavirus deaths outside of China) show that the mortality rate increases with age. The mortality rate is highest (14.8%) for those over the age of 80. This most likely due to older individuals often suffer from at least one chronic health condition that stresses their immune system, increasing their risk. 

Children are rarely affected by the disease. 

 

  • Pre-existing conditions

Adults with preexisting conditions like heart disease and diabetes or chronic lung conditions such as asthma, emphysema, COPD have a greater risk of being affected by any virus, including COVID-19 because of decreased ability to fight off infections due to a less robust immune response. In China, coronavirus patients with heart disease had a 10 per cent mortality rate, while those with diabetes had around a 7 per cent mortality rate, far greater than the global average — which WHO estimated at 3.4% on March 3rd.

 

  • Immunocompromised adults 

Immunocompromised means the inability to normally respond to environmental exposures including viruses or bacteria due to a weakened immune system. People who are immunocompromised include those with diabetes, heart disease, hepatitis B, chronic kidney disease, autoimmune conditions, malnutrition, and cancer because those conditions do lessen one’s ability to mount an adequate immune response. 

 

  • Smoking

 

Adults who smoke on a regular basis (cigarettes, cigars, marijuana) are at an increased risk for more severe upper respiratory infections overall. Some Experts believe that this is one of the reasons that men in China died more often than women from coronavirus was because of their smoking habits. 

Social distancing: bell curve

Why should we consider social distancing? 

This is a manageable/treatable disease but if we don’t control the spread we will surpass the health systems capacity and will result in a higher mortality rate as health professionals won’t be able to keep up with demand. The primary goal is to slow the spread of disease, a concept which is being referred to as  “flattening the curve” which you will see depicted down below. Essentially it will provide us the time to manage the disease but more importantly and often forgotten it will also allow the health system the capacity to deal with other business as usual cases eg. trauma, surgeries, chronic diseases etc. If capacity is maxed out COVID-19 patients won’t be the only ones who will suffer the consequences! 

The new research also showed that 97.5% of people who are infected develop symptoms within 11.5 days. About 1% of patients, however, show symptoms after 14 days – outside the window of the CDC’s quarantine guidelines.

Cure

Once again no need to fear. The University of Queensland Centre for Clinical Research director Professor David Paterson told news.com.au they have seen two drugs used to treat other conditions (Malaria and HIV) wipe out the virus in test tubes.

Prof Paterson said the medications given to some of the first positive cases of COVID-19 in Australia, had already resulted in “disappearance of the virus” and complete recovery from the infection. 

Another reason for us to flatten the curve and provide scientists like Prof Paterson the time they need to design a cure which could be distributed worldwide.

Keeping safe in the meantime

It is simple, practice good hygiene and social distancing where possible. 

  • Most importantly due to the nature of how it spreads through bodily fluid, if coughing or sneezing do so into your left elbow as many people are now greeting using right elbow touch instead of a handshake (weird I know, but best to be safe than sorry).
  • Wash hands frequently (at minimum 20 sec, see image below) and carry a hand-sanitiser with you and use frequently (if you can find one…).
  •  
  • If you use tissues, do not reuse them, throw out after use.
  • Avoid highly populated areas, where possible.
  • Aim to keep a 1.5m distance between other individuals to prevent spread.
  • Clean and disinfect everything after use.
  • Avoid travel were possible. 

Sick or medium-high risk

  • Self-isolate a minimum of 14days.
  • Wear a mask around other people. You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). 

Future

The news is not all bad. I am one to always look on the bright side and there are plenty of learnings to take away from this outbreak. For example, it will greatly impact our lives in so many ways, some of which we probably haven’t thought about yet. I will touch on some of these in future posts, I will discuss things like the future of the workplace etc.

Next post

Stay tuned for our next post where we will discuss the science and nutrition around prevention and management of COVID-19.