Nonmedical things you can do to fight coronavirus

[D_W]

I've taken some interest in things that I can do to make Covid-19 less serious if eventually getting it. I have underlying asthma, but it's not severe, so it's not clear what effect it may have.

I'm also a little fat (BMI 30), and that seems to be a clear risk, despite initial advice suggesting that BMI 40 was a cutoff.

People of lower weight (0.6% of critical admissions in the UK are BMI 18 and lower - they must be greater than 0.6% of the population) and who seek regular exercise seem to fare better.

The short answer appears to be (scabbed from some studies as well as a UK physician posting updated information on youtube):
* stop smoking if you smoke
* engage in moderate exercise if you can - moderate is something like half hour of raised heart rate (more intense than walking). Excessive or to exhaustion in prior viral response studies was associated with poorer outcome, so not none and not too much. A little early to know if this prior study information applies to COVID, but you're playing odds with unknowns. Extreme exercises contract respiratory infections at a higher rate than non-exercisers.
* lose weight - 6 tenths of one percent of critical admissions in the UK were individuals with BMI under 18.

So, the weight and the exercise that I've generally put off for a decade, now seems like a good time to address it. I hope some others here will join me.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2803113/ (exercise effect on upper-respiratory infections - this isn't a direct fit, but there is information further down in the study about various mice-based data when introducing a new virus to mice who are either control, moderate exercise or intense. One of the studies shows moderate exercise that didn't start until exposure and the outcome is better. Again, not a direct fit to COVID, but we're playing odds unless we hear otherwise - a lot of life is like that).

Other benefits that we (slightly tubby minimal exercisers) may experience:
* better sleep (decreasing neck thickness with weight decreases the effect of apnea)
* improved cognition and mood
* reducing effects of diabetes, or deferring the onset (for those of us not diabetic)
* improved blood pressure

I'm sure this list could be much longer.

 

[Bodgers]

Interesting stuff.

Something I read from a doctor on the front lines in Italy recently was saying that most people in his ICU have one or all of:

Overweight
Hypertension
Diabetes

 

[Sheffield Tony]

BMI of under 18 is classed as underweight, not much chance of getting there from where I am in a helpful timescale, even if I wanted to. Though the shakves of Waitrose last Friday made it look like it might be on the cards.

 

[D_W]

News is a problem in my opinion when it's relied on to get a sense of actual numbers. I work in general with numbers and data, i'm not a doctor and none of this is intended as medical advice. But, I've noticed that the news has a fascination now with younger patients who become critically ill.

This is a problem with news in general across the board, and this isn't a political statement is that our brains see a sampling of the news stories as a sample of the data universe, and it is not.

What you say is true - the actual statistics bear out that those are great risks in this case. What is the risk factor? I don't know. Early on, some of the news stories wanted to tell us "facts" that this was a fatal disease for the aged and infirm. Now, they want to scare us into (by story selection) believing that it's an indiscriminate killer like a mall shooter.

The reality is that there's something in the data for us. Not necessarily certainties, but things that can help us with odds. As people (and as someone who is indecisive and generally anxious, i'm included in this), we want black and white answers and we're not satisfied with odds if that's all that's available.

I have begun doing what I mentioned in here. I'll admit that it sucks passing up the chocolate covered raisin bin, and there are brownies upstairs that I pummeled the last couple of days. I guess someone else can eat them. nobody else in my family has any risk factors for covid that I know of. I'll never get to BMI from 30 - that's probably about 140 pounds for a male 5'9", but I"m starting at 207. I've had excuses for years (no hypertension, etc, no sign of diabetes) after being a man of 140 pounds younger and often road cycling back then.

This is a great chance for many of us to realize that in bad, we can do good. For ourselves and others. This one is my doing good for me.

 

[MikeG.]

The categories may be called different things in the USA, perhaps, but a BMI of 30 here is "Obese".

The stuff about "6 tenths of one percent of critical admissions have a BMI of under 18" is worth taking with a pinch of salt. What percentage of the population falls into this category? More salient even than that is what percentage of the at-risk population fall into that category? A BMI of 18 is under the healthy category (18.5 and under is "underweight"). If the percentage of underweight people in hospital with C19 is less than the percentage of underweight people in the at-risk population, then there is something of interest here. Until we have that information, there's nothing to see here folks, let's move along.

Having said all that, it is of course always in your health interests not to be a smoker, and not to be overweight. The evidence couldn't be clearer.

 

[D_W]

BMI of under 18 is classed as underweight, not much chance of getting there from where I am in a helpful timescale, even if I wanted to. Though the shakves of Waitrose last Friday made it look like it might be on the cards.

I agree. I won't get to 18 either, but I can move in that direction. There seems to be a pattern in the data that better blood sugar control leads to better outcomes (improves with exercise, even if it doesn't resolve), and the mouse studies in the link showing that moderate exercise, even after viral introduction (was it influenza and rhino virus? not the same thing) led to better outcome.

I know - "you can't exercise if you have the coronavirus due to the respiratory effects", that's true after they become a strong symptom. But other than that, it's probably still possible. Again, an odds thing and not a certainty.

 

[D_W]

The categories may be called different things in the USA, perhaps, but a BMI of 30 here is "Obese".

The stuff about "6 tenths of one percent of critical admissions have a BMI of under 18" is worth taking with a pinch of salt. What percentage of the population falls into this category? More salient even than that is what percentage of the at-risk population fall into that category? A BMI of 18 is under the healthy category (18.5 and under is "underweight"). If the percentage of underweight people in hospital with C19 is less than the percentage of underweight people in the at-risk population, then there is something of interest here. Until we have that information, there's nothing to see here folks, let's move along.

Having said all that, it is of course always in your health interests not to be a smoker, and not to be overweight. The evidence couldn't be clearer.

Same thoughts. I couldn't find any information about the BMI distribution in lower percentages in the UK (found something - not sure how reliable - 1.5-2% underweight in the UK). Data too scant for significance.

Categories above 30 average occupy about 50% more in percentage of critical admissions than they do by population distribution. (35-40% vs. 25% of the population in the only cumulative distribution that I can find). No separate data on 40+ bmi - that's 7% of critical admissions but some of the higher percentages may be understated in terms of critical admissions as the physician presenting the data mentioned that critical care isn't given to some high risk patients if the doctors have an opinion that improved outcome chance doesn't warrant it.

We will need to see more death data than critical admission cohorts.

There does appear to be a significant link between weight and risk, though. Is it 50%, 25%, 100%? Hard to tell.

 

[D_W]

The underweight category (based on information in another country with less obesity than the UK, and a higher underweight population) appears to be an odd thing. because of the metric, it occurs at younger ages. Is a bias of the the metric.

It becomes less prevalent at mid ages and then is prevalent again at later ages.

All cause death is higher for people in the underweight category than the regular category, but one would wonder if some of that has to do with the fact that people seem to be introduced into the category at later ages due to illness. The study doesn't delineate.

I can safely say that I only know one underweight male (this is the united states) well, so it's not like I could draw any parallels. He has an unhealthy fascination with not eating much, but I don't think it's clinical (like an anorexic).

Still, waiting for more and better data that is with and without comorbidities to see if us fatties without significant risk factors (on the bubble with asthma, but minor asthma doesn't seem to qualify) like hypertension, diabetes, etc, do as well as non-fatties without comorbidities.

Curious how the original risk factor group (which was a lot of chinese data) even had a significant group of folks BMI 40+

 

[Cheshirechappie]

Cut out junk food, ready meals and sugary drinks.
Eat three meals a day, don't snack between them.
Eat until hunger is satisfied, then stop.
Eat lots of fresh fruit an veg, fresh meat, fresh fish, eggs, bit of dairy.
Stay hydrated - water, tea, coffee, but not canned soft drinks.
Cut down drastically on sugar and sugary foods.
Cut down drastically on carbohydrates - potatoes, rice, pasta, bread, baked goods.
Eat simple carbohydrates such as oats (porage), not processed ones.

Exercise won't lose you weight, but it will improve cardio-vascular health and you'll feel better.

Don't bother with faddy diets.

Have a think about what humans evolved to live on. no Krispy Kreme doughnuts for paleolithic hunter-gatherers.

Soundbite version - eat real food, not too much, mostly plants.

 

[doctor Bob]

I've just done my BMI, 21.7.
I am running 5 times a week and have a home gym I use regularly, I eat very sensibly.
I think to get to 18 when a mature age would be very very difficult.

 

[Rorschach]

My BMI is 18.3 and I am the fattest I have ever been, about 10 years ago when I was a lot more active (walked 2.5miles each way for work every day as well as 8 hours on my feet) it was just over 17. My BMI has gone up but my diet is probably better than it was then, back then I ate way too much sugar and carbs, my carbs are lower now and I eat more fat, meat and vegetables and a lot less sugar and processed foods.

 

[RogerS]

... But, I've noticed that the news has a fascination now with younger patients who become critically ill.

.....

There is a reason for that, I suggest. Until that started happening, all the media stories were about how it was mainly elderly people who got the serious version. Hence, 'we are invincible' thought the younger demographic. We'll go down to the beach and have a party. We'll just carry on as we were. Social-distancing ? Give us a hug. Great at spreading the virus.

Hopefully now their sense of 'invincibility' has taken a serious knock and they can start behaving now with a bit more social responsibility.

 

[Rorschach]

... But, I've noticed that the news has a fascination now with younger patients who become critically ill.

.....

There is a reason for that, I suggest. Until that started happening, all the media stories were about how it was mainly elderly people who got the serious version. Hence, 'we are invincible' thought the younger demographic. We'll go down to the beach and have a party. We'll just carry on as we were. Social-distancing ? Give us a hug. Great at spreading the virus.

Hopefully now their sense of 'invincibility' has taken a serious knock and they can start behaving now with a bit more social responsibility.

Yes I can see why they are doing it, to scare young people. Any young person with an inkling of common sense though would see that so far we have had a handful of cases of people under 30 dying or people with no underlying health conditions. But since they are not doing autopsies we don't actually know if they had any underlying health conditions. So many things go undiagnosed until later life. They could have heart murmurs or pre-diabetes. Someone I worked with in younger life dropped dead from a burst blood vessel in her brain aged 21, no pre exisiting health conditions that they knew of.

 

[MikeG.]

...... back then I ate way too much..... carbs, my carbs are lower now......

Carbs aren't bad. Carbs are a necessary part of our diet. As with all things diet-related, there are no "bad" categories of food, just bad balances. Carb intake should be closely related to energy expenditure. There's good reason why endurance athletes (thin as a stick, universally) eat inordinate amounts of carbohydrate. Try doing a long bike ride without an adequate intake of carbs beforehand and during the ride, and the result will be hypoglycemia ("the bonks" or "hitting the wall"). Here's Chris Froome's analysisof his amazing 50 mile solo to win the Giro D'Italia 2018. Listen to how much he talks about fueling.

 

[Rorschach]

...... back then I ate way too much..... carbs, my carbs are lower now......

Carbs aren't bad. Carbs are a necessary part of our diet. As with all things diet-related, there are no "bad" categories of food, just bad balances. Carb intake should be closely related to energy expenditure. There's good reason why endurance athletes (thin as a stick, universally) eat inordinate amounts of carbohydrate. Try doing a long bike ride without an adequate intake of carbs beforehand and during the ride, and the result will be hypoglycemia ("the bonks" or "hitting the wall"). Here's Chris Froome's analysisof his amazing 50 mile solo to win the Giro D'Italia 2018. Listen to how much he talks about fueling.

Carbs are great if you are using them, like athletes, and back then I probably was using them more effectively. If you live a more sedentary lifestyle though then carbs are stored as fat and you tend to eat way more than you need. Sugar and highly refined carbs are the worst for that as they not only get converted into fat easily but they also spike your blood sugar causing diabetes later in life.
I try to be more active but I have to accept that I live a more sedentary life than I used to so I try to limit my carbs and eat more fats and proteins instead.

 

[Woody2Shoes]

My bmi has been stable at around 25 for years. I tell myself that's because I have more muscle mass than average (!). To be fair, I do a lot of lifting and shifting and climbing around roofs etc. In truth, I have a very healthy diet except for my beer habit. I read that the polyphenols in hops may be beneficial against pathogens, so I reckon I'm actually self-medcating!
I could probably expect to live longer without beer, but it would certainly feel longer....

 

[Racers]

Just done my bmi 26.1 overweight, so thats a load of pineapples.

Pete

 

[RogerS]

... But, I've noticed that the news has a fascination now with younger patients who become critically ill.

.....

There is a reason for that, I suggest. Until that started happening, all the media stories were about how it was mainly elderly people who got the serious version. Hence, 'we are invincible' thought the younger demographic. We'll go down to the beach and have a party. We'll just carry on as we were. Social-distancing ? Give us a hug. Great at spreading the virus.

Hopefully now their sense of 'invincibility' has taken a serious knock and they can start behaving now with a bit more social responsibility.

Yes I can see why they are doing it, to scare young people......

No. Not to scare them but to try and instil some sort of social conscience in them and an appreciation of their actions.

 

[D_W]

My bmi has been stable at around 25 for years. I tell myself that's because I have more muscle mass than average (!). To be fair, I do a lot of lifting and shifting and climbing around roofs etc. In truth, I have a very healthy diet except for my beer habit. I read that the polyphenols in hops may be beneficial against pathogens, so I reckon I'm actually self-medcating!
I could probably expect to live longer without beer, but it would certainly feel longer....

That's the one thing that occurs to me with healthy thin people (seventh day adventists are often used as an example here in the states) living longer. They are extremely disciplined and regimented (many are vegetarians, and few carry any extra weight), but then they live much longer like that and I don't think I'd want to live longer like that!! I think I'd want to live less long.

 

[D_W]

...... back then I ate way too much..... carbs, my carbs are lower now......

Carbs aren't bad. Carbs are a necessary part of our diet. As with all things diet-related, there are no "bad" categories of food, just bad balances. Carb intake should be closely related to energy expenditure. There's good reason why endurance athletes (thin as a stick, universally) eat inordinate amounts of carbohydrate. Try doing a long bike ride without an adequate intake of carbs beforehand and during the ride, and the result will be hypoglycemia ("the bonks" or "hitting the wall"). Here's Chris Froome's analysisof his amazing 50 mile solo to win the Giro D'Italia 2018. Listen to how much he talks about fueling.

Carbs are great if you are using them, like athletes, and back then I probably was using them more effectively. If you live a more sedentary lifestyle though then carbs are stored as fat and you tend to eat way more than you need. Sugar and highly refined carbs are the worst for that as they not only get converted into fat easily but they also spike your blood sugar causing diabetes later in life.
I try to be more active but I have to accept that I live a more sedentary life than I used to so I try to limit my carbs and eat more fats and proteins instead.

There's a strange broscience thing going on now about all carbs being bad. I did the keto diet for a while. It works. You couldn't exercise heavily on it, though (and the advice is to not do that, anyway- only - ignoring the steroid taking advisors on youtube). While my weight went down on keto, my bloodwork wasn't sustainable long term, so I'm back to just cutting consumption to match what I'm doing, instead.

But the issue isn't carbs or this or that, it's overeating. Mike has it right. If you can't "empty" the body of easily accessible fuel from time to time one way or another, you'll suffer consequences from it.

Most of the people advocating improved bloodwork from keto or carnivore or whatever are quoting studies done where 80% of the consumed fat was polyunsaturated. I don't know anyone who has been able to do keto and eat like that. I couldn't.