This pandemic has changed every area of our lives — including fitness and our workouts. So, what can we expect in 2021 when it comes to fitness trends? I recently got a chance to talk to NPR’s All Things Considered about how to better make your fitness resolutions happen in this crazy COVID time, and it’s really made me reflect on just how much has changed in the fitness world since a year ago. I’ve been lucky enough to have been sweating in my garage gym for a full year now (talk about serendipitous timing there), but this time has…
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The way it’s reported, you’d think that susceptibility to COVID-19 severity is equally distributed across the world’s population. But when you compare case and mortality rates between countries, differences emerge. There are even differences within countries and states and cities. It’s clear that other variables besides simple exposure to the virus and infection are at play. Research continues to emerge regarding risk factors for severe COVID-19.
What are they?
And, more importantly, can you modify any of the variables?
Does Blood Type Predict COVID-19 Severity?
Early on, researchers noticed an apparent association between blood type and coronavirus infection. Those with A or B-type blood were more likely to be positive; those with type O were less likely to carry the virus.https://journals.lww.com/ccejournal/Fulltext/2020/06000/Gender_Difference_Is_Associated_With_Severity_of.26.aspx‘>2 All 12 studies analyzed had similar results; there was very little heterogeneity.
Is this caused by sex, though? After all, from what I could tell, the meta-analysis failed to control for other variables that might have differed between the groups, like metabolic syndrome or obesity. And yet sex does play a role, even when a risk factor like obesity is accounted for. Other research confirms that overweight men are at greater risk for coronavirus severity than overweight women, for example, and we know from previous research that men and women have different types of immune responses to viruses and vaccines.https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/31069‘>4
Verdict: Sex matters. Men are at greater risk.
Selenium Status and COVID-19
Early on, I noticed that selenium status plays a big role in susceptibility to a number of different viruses, including the flu, the original SARS, and many others. The viruses sequester selenium and utilize it to replicate and to weaken the host. Many of the original places where COVID-19 took hold had abysmal levels of soil selenium; this translates to lower levels of selenium in the food grown in the soil and a higher risk of population-wide selenium deficiency.https://www.mdpi.com/2072-6643/12/7/2098‘>6
Verdict: Likely. This hasn’t been proven to be causal, but it’s certainly trending in that direction. It can’t hurt to eat a couple Brazil nuts every day.
Can Adequate Vitamin D Improve Coronavirus Outcomes?
The earliest coronavirus hot spots were actually colder, cloudier spots with low UV-indexes. Wuhan, China, had a ton of cloud cover in January and always has a lot of air pollution which further blocks the UV light. Lombardy, Italy, also had pollution problems and UV index too low to produce much vitamin D. And now, studies are finally coming out lending credence to the idea that vitamin D protects against severe infection.
In Iran, COVID-19 patients with vitamin D levels above 30 ng/ml had a lower risk of severe infection and death.https://www.medrxiv.org/content/10.1101/2020.06.21.20136903v2‘>8
It’s not just vitamin D, of course. Vitamin D is more likely a marker of sun exposure, which confers a multitude of other immune and health benefits. One such benefit with known links to COVID-19 is nitric oxide. Another is normalization of the circadian rhythm. So don’t assume mega-dosing vitamin D supplements will protect you from COVID-19 as much as getting natural sunlight will. Most of these people probably weren’t supplementing (or even thinking about) vitamin D at all. They went into the infection with the levels they had.
Verdict: Aim for 30 ng/mL and above. Get plenty of sunlight.
Does Obesity Make You More Susceptible?
Obesity is an enormous complicating variable. It’s not just because obese people are more likely to be unhealthy in other ways, although that’s probably part of it. It’s because obesity itself is unhealthy. Body fat secretes more inflammatory compounds and promotes an elevated baseline of inflammation. The coronavirus damages your body in part by up-regulating those inflammatory compounds. If you’re starting with elevated inflammation, you’re making the virus’ job that much easier.
Sure enough, obesity is linked to COVID-19 severity.https://www.acpjournals.org/doi/10.7326/M20-3742#f1-M203742‘>10 Extreme obesity (BMI of 45+) is even worse, with some research suggesting it quadruples the risk of severe COVID-19.https://www.staradvertiser.com/2020/08/13/breaking-news/amid-covid-19-pandemic-people-with-diabetes-struggle-to-get-insulin/‘>12 Among Chinese patients in another study, the mortality risk was 7.8% in those with diabetes and 2.7% in those without diabetes.https://pubmed.ncbi.nlm.nih.gov/32231171/‘>14
However, those hypertension patients taking ACE inhibitors had a lower risk of severity or death than those hypertension patients who were not being treated.https://www.nature.com/articles/s41586-020-2550-z‘>16 In another study, between 20-50% of unexposed people showed t-cell activity against COVID-19.https://pubmed.ncbi.nlm.nih.gov/32650004/‘>18
Both dietary omega-3s and omega-6s have been shown to strongly influence tissue levels of omega-3 and omega-6 and thus inflammatory/anti-inflammatory eicosanoid balance. My guess is that seed oil-eating people with elevated tissue omega-6s are at a greater risk for severe COVID-19 than people with more balanced omega-6:omega-3 tissue levels.
Verdict: We’ll see.
Primal Blueprint Primal Omegas: a high-quality source of the two key omega-3 fatty acids, EPA and DHA
Fermented Cabbage Intake
Most of the countries with low COVID-19 mortality rates have a long tradition of eating fermented cabbage. There’s South Korea with kimchi and the Balkans and Central Europe with sauerkraut. And in a recent study, researchers found that fermented cabbage intake predicted low COVID-19 mortality.https://www.medrxiv.org/content/10.1101/2020.04.04.20053058v1.full.pdf‘>1 It happened during an extended conversation.
Overall, the most recent study I could find on the subject came to a similar conclusion.https://www.medrxiv.org/content/10.1101/2020.07.13.20041632v2‘>3
However, before you freak out, the story is more complicated than that.
Not all the samples grew; some subjects’ breath samples “didn’t take.” Some samples actually saw their viral particles decline in number. The smallest particles were the most successful at replicating, but the smallest particles also contained the lowest viral load.
The rate of growth was fairly low compared to how actual infections play out. The most successful samples only grew by 400% after six days. And that’s in an isolated human cell. When an entire human gets infected with COVID-19, the virus grows by thousands of percentage points every 8 hours or so.
That said, the virus is aerosolized, some of that aerosol contains replicable viral particles, and if you breathe enough of them in—probably by staying indoors with an infected person or people for an extended period of time — it’s possible to be infected. It’s pretty clear that larger droplets remain the big risk, though.
Can you be reinfected with COVID-19?
A pretty convincing thread of anecdotes out of Iran (one of the earliest and hardest-hit countries) claims that reinfections are occurring. This would suggest that immunity wanes, at least in some people.
Some experts have floated the idea that COVID-19 may be the type of virus that stays with you and cycles through active and dormant periods, like Epstein-Barr or herpes does. It hasn’t been around long enough to know yet whether or not that is the case.
Can we reach herd immunity for coronavirus without a vaccine?
At first, the antibody immunity data wasn’t very encouraging: antibody levels in the population weren’t anything close to crossing the herd immunity threshold, and the antibody response to COVID-19 seemed to diminish and wane after a few months.
But more recently, scientists are finding evidence of robust and widespread T-cell immunity. T-cells from other coronaviruses, like SARS, various animal coronaviruses, and perhaps even the common cold may work on COVID-19. This cross-immunity is long-lasting, too; even though SARS hit 17 years ago, many of the subjects in the study still had T-cell immunity against it.www.nature.com/articles/s41577-020-0389-z‘>5
From what I’m reading and hearing from experts, this has the potential to be a hugely positive development. My hope is that the huge death numbers are behind us, or at least trending that way. I hope those T-cell cross-immunity numbers persist in subsequent reports. I hope we start looking at T-cell immunity and not just antibody immunity.
Where I Stand
We’ll beat this thing. Of that there’s no doubt. We’ve made it to the other side of epidemics with much more primitive knowledge, tools, and technology. But here’s what I really worry about, other than the deaths, potential long-term health ramifications, and anything “physical.”
I’m seeing a lot of fear. I’m seeing people lose their appreciation for the rest of humanity. I’m seeing people use dehumanizing language to describe people who have different views on the seriousness of the virus. Neighbor doesn’t wear a mask? Don’t assume they’re evil or callous. Neighbor wants people to shelter in place? Don’t assume they’re authoritarians-in-waiting.
I worry about people who are too scared, too paralyzed to do the kinds of activities that are actually quite low-risk and would probably increase health and resistance, like going outside for hikes (even, gasp, with friends and family), getting sun and fresh air and exercise, moving through space and time rather than sitting hunched over your smartphone, scrolling through your echo chamber of choice.
Relax. Stay cautious and vigilant, yes. Stay safe. Don’t put yourself or anyone else at risk. No flippancy. But don’t forget to have fun and loosen up where you can. Low- to no-risk activities are out there. Do those.
If you have kids, they’re stressing out too. Believe me, they’re like sponges. They reflect what you’re giving off. Do it for them, if nothing else.
Lose the vitriol and the fear, more than anything. That stuff doesn’t go away so easily. Those divisions we’re building up between neighbors and family members and citizens may persist long after the pandemic has ended. Don’t let that happen!
We can do this.
Anyway, that’s how I’m viewing this whole coronavirus thing right now. Cautious but optimistic. What about you? How are you handling everything? Where do you see things going in the next few weeks?
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From COVID-19 to fighting for racial justice, right now stress is high for all of us — including our kids. While we encourage you to continue having necessary conversations with your children about racism and COVID-19 often (recent Sesame Street specials can help if you don’t know where to begin — get them here and here), it’s also important to help yourself and your kids to self-care by giving them tools to manage big feelings (and the awareness from us that those big feelings may manifest differently in our kids’ behaviors than they do in ours). To help us with…
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