Written by: Gregory Howard, MD is a Lifestyle Medicine physician who practices
preventive medicine as the medical director of MHP Bone Health and Lifestyle
Medicine, after serving 15 years as the director of MHP Sports Medicine.
He is an inaugural member of the American College of Lifestyle Medicine
Board Certification class and is a member of the teaching faculty for
Franciscan Family Practice Residency in Indianapolis, IN. He prioritizes
teaching his patients at every office visit, engaging them as partners
in their endeavor to improve longevity and quality of life.
Our communities need a fresh approach to protecting ourselves as the novel
coronavirus swings back around for another approach, even as the first
pass of the contagion has recently seen a resurgence. Unfortunately few,
if any, prominent health officials are addressing the need for blunting
or preventing the most severe problems associated with this novel coronavirus.
So together, lets take a breath and reflect on the current state of the
COVID-19 pandemic, as it has affected the United States. After only 5
months of exposure to the novel coronavirus, the US has seen 3 million
people infected with the novel coronavirus and we have seen the passing
of 150,000 people due to this virus.
In Indiana, my state government has addressed the challenge with an aggressive
early approach, which limited a great many people from being harmed by
the virus. We closed schools earlier than many states and limited exposure
to infections by closing non-essential businesses and recommending the
use of masks when in public. In comparison to many areas of the country,
we have managed to blunt the full force of the virus, although we have
not “locked it down” by any stretch. Astoundingly, this is
the “good news.”
The bad news: We are not done with this virus. And not every state has
been nearly as aggressive as my state at trying to balance public safety
and economic flexibility and those other states are now seeing their cases
spike once again. We are not out of the woods by a long shot.
Furthermore, it’s reasonable to expect that as we reopen more businesses
and as we begin to interact with more people, the simple fact is that
we will all be increasing our exposure to this infectious agent. If we
add to the above realities the fact that the flu will be coming in the
next 3-6 months, we really need to take seriously the idea of making ourselves
a harder target for COVID-19 to hit.
How are we to reduce the risk for being harmed by the virus if we contract
it? How do we reduce the burden of disease for a contagion for which we
have no cure or vaccine?
Get yourselves to Wellness Bootcamp. No kidding. How do we prepare young
men and women for the rigors of military life? They spend between 8-12
weeks in basic training, depending upon the service, to become more physically
fit and more informed in order to defend themselves and their teams against
looming adversity. This is no different for our communities at large.
We need to become harder targets for the virus to harm.
The first steps we need to take in Basic Training include the measures
we already know: keep up social distancing, remember thorough hand cleansing
and always wear a mask, in order to dampen the spread of disease.
The expectation of experts is that approximately 60-70 percent of the country
will contract this disease if we don't develop a vaccine in a timely
fashion. What are we to do if we contract it?
We need to reduce our body’s level of chronic low grade inflammation.
The virus appears to be especially good at attacking people who have higher
levels of inflammation; this is the same inflammation which is also the
most significant cause of our most crushing chronic diseases: Obesity.
Diabetes. High blood pressure. We now know that these diseases are exacerbated
by inflammatory changes happening at the cellular level and this chronically
destructive environment is what harms our body’s organs. It just
so happens that the virus also targets these same people and it flares
their inflammatory response, to the point that it can kill people.
By aggressively lowering our inflammation level, we might in turn lower
the risk that the virus poses to us, while at the same time managing our
chronic diseases. Truly a win-win scenario, if we’ve ever seen one.
So what are we actually going to be able to do? How can we concretely make
a difference in the risk of the disease becoming fulminant and really
doing damage to someone?
Answer: Use the warm weather during these summer months to effectively
and aggressively alter your lifestyle to increase health and if you have
been prescribed medications, take them routinely to get control of your
Summer is an ideal time for getting healthier. People are naturally more
active in the summer months. The weather is more inviting, the days are
longer, people are more likely to access fresh foods. Summer weather is
also a natural suppressant for respiratory viruses in general - we just
have to hope this one follows the model of other coronaviruses and influenza
by diminishing in the summer months.
Furthermore, the following are recommendations Lifestyle Medicine physicians
might make to patients to create concrete action steps so that we might
begin to reduce our underlying inflammatory levels. They might not pertain
to you personally, but they are examples of guidelines which we often
recommend to patients for making lasting changes in their lifestyle. If
you have questions about whether these are appropriate steps for you to
take, please contact your physician and ask if they are safe for you to do.
- As a part of your diet - eat 1-2 servings of fruits & vegetables
with all meals, including breakfast; eat 15g of fiber in a day as a start
and build to 30g of fiber each day; limit your total window in which you
eat to 8-12 hours; finally, and which might be the most difficult for
many people to start making a part of their lifestyle, reduce the total
amount of, or avoid, pro-inflammatory foods such prepackaged highly sweetened
foods and drinks, highly processed foods and even reducing or eliminating
most meats, especially highly processed meats such as lunch meats and bacon.
- Begin a daily exercise habit- start with walking 10 minutes for the first
week, every day, just hard enough to make you breath harder; increase
time by 5 minutes per week until reaching 30 minutes; increase speed to
the point where a conversation is difficult but manageable; add 10 -15
minutes of lifting small weights or resistance bands while watching a
favorite TV program. There is great evidence that 30 minutes of moderate
exercise increasing longevity and reduces the underlying cause of many diseases.
- Improve your sleep - turn the phone off 30 minutes before sleep; avoid
caffeine in the afternoon; take a magazine or book to bed instead of the
phone; wake up at the same time every day and eat the first meal at the
same time- it can improve sleep consistency. Sleep is an extremely important
period of healing for the body and many of us have a great deal of trouble
getting enough. Please seek medical help if this is an area in which you
- Reduce stress - some examples might include trying “mindfulness”
for 2 minutes per day the first month. Add 1-2 minutes every week until
reaching 15-30 minutes per day; schedule appointments with your counselor
every 2-4 weeks if helpful; pray for 5 minutes per day if followers of
faith; spend time in a stress reduction hobby 15 minutes or more per day;
take a mid-day mini-nap if it is feasible.
Now is our moment to make a difference.
We need to enroll ourselves in basic training to protect our health while
we have the time. We need to help ourselves to physically resist the looming
viral infections to come. We need to narrow the target window for COVID-19
to hit us by reducing our chronic systemic inflammation. We have a small
window of opportunity to make this happen during the summer months - let’s
move it or lose it my friends!