Modifiable Lifestyle Risk Factors

It’s time to get beyond just masking, social distancing, vaccining, and quarantining. While helpful, these measures are by themselves proving inadequate as this infectious disease rages on. 

As with virtually every other disease, improving the health of the population is critical. Over the past year I’ve challenged with mainstream medical advice at the lack of healthy behaviors that do make a difference. This is an opportunistic disease and there is a lot in your control that you can do to minimize your risk. You are not just a sitting duck, there is a lot you can do to lessen your own risk of a bad outcome. Let’s spread some hope and good cheer by learning what we can do to have better immunity no matter what is out there.

And finally, there is some hope, I’ve seen some statewide public service announcements in support of commonsense COVID prevention strategies such as optimizing your vitamin D, staying active, eating nutrient-dense foods and boosting your immune system with supplements such as vitamins C & D, quercetin and zinc.

Modifiable Risk Factors for SARS-Co-V-2

The title above is linked to the actual paper posted Oct. 2021 in Integrative Medicine: A Clinicians Journal done by Michelle Simon, PhD, ND,* Joseph Pizzorno, ND, Editor in Chief,* and Joseph Katzinger, ND*.
(Joseph Pizzorno, ND is one of my favorite IFM doctors)

This study looked at modifiable lifestyle factors that effect your risk of covid whether you are vaccinated or not, partially vaccinated, have natural immunity from having covid, or are vaccinated and boosted.

Many studies have now shown that key risk factors for SARS-CoV-2 infection, severity, and even death are modifiable. 

This study is an attempt to identify and prioritize the most important modifiable factors in preventing and limiting the effects of this infectious disease.

 First un-modifiable risk factors:

  • Being male confers a higher rate of covid-19 related death vs. being female.
  • Age confers a greater risk with a strong gradient, especially for those over 80.
  • Black and South Asian descent confers higher risk

Modifiable risk factors:

  • Blood sugar – diabetics have highest risk but even those with without diabetes but who have high blood sugar are at higher risk
  • Co-morbidities associated with Cardio-metabolic heath; diabetes, obesity, hypertension, and heart failure 
  • Obesity – When compared to non-obese patients, obese patients had significantly higher risks of infection, hospitalization, severity of disease, incidents of mechanical ventilation, ICU admission, and mortality. 
  • Diabetes Both type 1 diabetes and type 2 diabetes have similar adjusted odds ratios for hospitalizations and for greater illness severity, compared with not having diabetes. Factors significantly associated with greater illness severity in type 1 diabetes were glycated hemoglobin, hypertension, race, recent diabetic ketoacidosis, health insurance status, and less diabetes technology use.
  • Diet – The effect of diet quality was assessed using a healthful plant-based diet score which emphasized healthy plant foods such as fruits and vegetables through smartphone-based questionnaires of 592 571 participants in the COVID-19 Symptom Study in the United States and United Kingdom. 
    • Participants who followed ‘plant-based diets’ and ‘plant-based or pescatarian diets’ had 73% lower odds 
    • Patients who reported following ‘low carbohydrate/high protein diets’ had greater odds of moderate to severe COVID-19 than those following plant-based diets 
      • Important NOTE: Impossible Burgers and Beyond Burger are not healthy plant based meat substitutes. They are both made with GMO ingredients heavily sprayed with roundup, they offer no nutrition and are a highly processed food.

Environmental Factors

While these may be a little less in our control, they are somewhat in our control.

  • Poor air quality has been associated with a significant detrimental effect on patient outcomes with COVID-19 independently of comorbidities, as well as sociodemographic and socioeconomic factors. 
    • Air filters at the very minimum in your bedroom at night will help, and whole house especially in the winter can be helpful since the house is closed up.
  • Heavy Metals – for Covid urinary concentrations of cadmium, mercury, and lead were found to be higher both in those with greater disease severity, as well as deceased patients. It is well known and documented that higher levels of arsenic, cadmium, lead, and mercury lead to increased risk of respiratory damages, immune impairment and inflammation.
    • We do Have ways of boosting our clearance of heavy metals, such as sweating every day, eating fermented foods, getting in a sauna, eating lots of dark leafy greens and cilantro as these chelate metals from our bodies. In addition to avoiding sources of mercury such as dentist offices that still use amalgam and being aware of which fish are higher in mercury, these are just a few ways we can reduce our heavy metal burden.

Nutritional Status and Supplements 

  • Vitamin D has been the subject of a relatively large number of studies that consider a nutrient effect in COVID-19 patients. Studies have focused on the vitamin D levels upon admission, various forms and levels of supplementation while in hospital, genetic predisposition as assessed through SNPs (single-nucleotide polymorphisms) associated with vitamin D metabolism, and vitamin D booster therapies alone or in combination. Largely, these studies support a positive role for vitamin D in decreasing mortality and lessening adverse outcomes from infection with SARS-CoV-2. 
    • 59% of hospitalizations are patients with low Vitamin D independent of age and chronic lung diseases
    • Vitamin D supplementation was significantly associated with reduced ICU admission and mortality and reduced risk of adverse outcomes.
    • Those hospitalized who were given 5000 IU of Vitamin D in the hospital had a shorter recovery time
  • Probiotics – taking pre and pro biotics has been shown to increase the efficacy of flu vaccines. In Covid trials they found supplementing with a variety of what they termed “oral bacteriotherapy” in the hospital reduced death rates, in the study 11% of those treated with oral bacteriotherapy vs. 33% not treated.

Fermented food options:
In the dairy family (milk NOT so good for you, fermented milk = good for you:): Plain yogurt, Cottage cheese, sour cream, kefir, raw cheese, buttermilk, creme fraiche, lassi, arayan (pronounced iron)

Other drinkable probiotic beverages
Kombucha, beet kvass, wine and beer if no added sulfites or other anti bacterial agents.

Condiments that are fermented include:
Olives from an olive bar, pickles that have been pickled in a salt brine, apple cider vinegar, soy sauce, miso soup, mustard, mayonnaise, ketchup, Tabasco sauce, and Worcestershire sauce. Making some of your own condiments is a good way to ensure you are getting fermented condiments.

Other fermented foods: Fermented fish (popular in Asian cultures), dosa batter used to make Indian dosas, tempeh in Japan, and poi from Hawaii
Chocolate 🙂 cocoa beans are actually fermented to make chocolate. Make sure you get dark chocolate 70% or darker.
Fermented vegetables of all types, fermented in a salt brine like: Sauerkraut and kimchi and your own homemade fermented vegetables

  • Vitamin C – Without question, low levels of vitamin C greatly increased risk of infection, serious disease, and death from COVID-19. One study found that 82% of those with severe disease had vitamin C levels lower than 0.4 mg/dL (normal range: 0.4-2 mg/dL), while another reports that 94% of those in the ICU had no measurable vitamin C! 
  • 6 or 7 months ago I was listening to a podcast with Dr. Aristo Vojdani who looked at T-helper cell counts between the critically ill and those who recovered more easily from covid, he found the critically ill had very low T-cell counts. Both vitamin C and mushrooms can boost your T cells.
    • Vitamin C rich foods: Citrus, berries, fruits and vegetables!
  • Vitamin K – low vitamin K status correlated with higher mortality risk.

Vitamin K rich foods:
K1 = dark leafy green vegetables such as kale, mustard greens, spinach, parsley and many more
K2 = animal sources and fermented foods such as natto, brie, gouda

  • Omega 3 status – Adequate dietary intake of omega 3s improves viral immunity in general. When critically ill patients were treated with omega 3 supplementation in the hospital they saw significant improvements in survival rate vs. those not treated; 3% mortality in treated group vs. 21% in the untreated group.

Omega 3 rich foods:
Nuts and seeds

  • Quercitin – The flavonoid quercetin is especially important since it both binds to the SARS- CoV-2 spike protein and inhibits an enzyme needed for viral replication.
    • The need for and length of hospitalization were significantly reduced among those receiving quercetin supplementation after diagnosis. Quercetin significantly decreased viral load, symptomatology, and several laboratory measures of inflammation and damage. 

Quercitin rich foods – ORGANIC IS IMPORTANT, quercitin is a flavanoid, roundup kills flavonoids! If you are eating food sprayed with roundup you will have less quercitin and virus killing flavonoids in your diet.

    • Onions have always been my first choice for quercetin — the outer layers of the onion have the most quercetin as do the the greens of spring onions and red onions, Capers — fresh first, canned second, Elderberry juice concentrate, Dill weed, fresh, Cilantro, fresh, Banana peppers, raw, Fennel leaves, Juniper berries, Oregano, Radicchio, Red Leaf Lettuce, Watercress, Asparagus, Okra, Bee pollen, Cocoa powder, Apple skins, Chia seeds, Hot green chili peppers, cranberries

And the list goes on and on, there are a lot of vegetables that contain quercetin and can help our body fight diseases — so basically as I keep saying “EAT YOUR VEGETABLES”! It is your best and most proven method to maintain health amidst a pandemic or not.

  • Combination Nutrient Therapy, Vitamin D, Magnesium, and B12 – Those who received 1000 IU/d oral vitamin D3, 150 mg/d oral magnesium, and 500 mcg/d oral vitamin B12 upon admission if they did not initially require oxygen were less likely to need oxygen therapy or intensive care support.
    • Supplementation, it may be helpful during this time to supplement with with Vitamin D (check blood levels first), omega 3s, and quercitin.

Potential Risk Reductions from modifiable factors:

  • Optimal Vitamin D = 73% decreased risk of adverse outcome 
  • Healthy Omega 3 levels = 72% risk reduction
  • Quercitin supplementation = 68% reduction
  • Eating a vegan diet = 73% reduction
  • A pescatarian diet = 59% reduction
  • NOT eating a high protein diet = 74% reduction

I think its quite eye opening to look at these numbers and see the biggest benefit comes from a dietary approach!

You can see there are a lot of modifiable healthy living options that make a difference, this pandemic should be a motivation to tackle what keeps one locked in unhealthy behaviors.

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