Covid-19: A Functional Medicine Response
As our nation continues to battle the Covid and the effects of the shut down, many people are looking to get healthy and improve their immune system. These people want to do all they can to decrease their chances of getting the virus, or minimize the severity if they do contract it.
Functional medicine is focused on creating health within the body. It both approves of these efforts, and is able to provide some clear direction to support the immune system through basic lifestyle changes.
In a recent article, “The Functional Medicine Approach to COVID-19: Nutrition and Lifestyle Practices for Strengthening Host Defense” authors Hanaway and Minich explore many things we can do to support our immune system!
Health and Covid-19
According to Minich and Hanaway, “The developing symptoms of COVID-19, as well as the progression of illness and fatality, are clearly a function of the overall health status of the individual. Complex, chronic diseases such as obesity, hypertension, and diabetes are directly correlated with risk of disease severity and mortality.”
Recognizing this correlation between our lifestyle and our risk is an important step towards change. When we know better, we can do better! Embracing some of these lifestyle changes will be challenging to do, but a strong understanding of the science can give us the motivation to follow through.
So, let’s look at these lifestyle interventions that include nutrition, sleep, exercise, stress reduction, and connection.
Nutritional Choices
The foods we eat have an incredible impact on our bodies ability to maintain health. Research has shown that our gut health directly impacts our immune system and overall health.
Each meal we eat influences our system. When we choose healthy foods we supply nutrients to the body and support healthy immune function. On the other hand, when we choose poorly it disrupts the system.
One way that foods impact our health is the way that food influences inflammation pathways in the body. Chronic inflammation is a huge issue in our health, leading to all kinds of disease. It will be beneficial to eliminate foods that add to this burden of inflammation - processed foods, refined grains, sugar, trans fat, etc. Inflammation can also be addressed by balancing the amount of omega 3 and omega 6. Modern diets generally leave us lacking in omega 3 essential fatty acids. Intentionally eating foods rich in omega 3 or supplementation, can address this concern and help fight inflammation.
One of the dangers we hear about with Covid “is referred to as a ‘cytokine storm,’ or an abundance or oxidative stress (1).” Dietary intervention can also address oxidative stress - the imbalance between free radicals and antioxidants in the body. Since free radicals break down tissue in the body and destroy our health, it is crucial that we decrease our exposure to free radicals and provide our bodies with the antioxidants necessary to detox from them. In addition to fruits and vegetables, foods such as herbs, spices, nuts, seeds, and chocolate contain antioxidants.
Minich and Hanaway explain that “the gastrointestinal tract harbors a majority of immune system activity, (so) it is essential to keep it nourished with the necessary nutrients for a healthy gut microbiome.” Eating a large variety of plant based foods - especially fermented ones - is a great way to support the microbiome in the gut.
Take Away:
- Lighten the burden of inflammation: Avoid processed foods, refined grains, sugar, trans fat, etc. Balance the ratio between omega 3 (anti inflammatory) and omega 6 (inflammatory) by increasing omega 3 intake. Eating wild caught fatty fish is a great way to do this!
- Decrease exposure to free radicals: The way we cook or food impacts the amount of free radicals created. Grilling, frying, and broiling our food will increase the burden of free radicals. Boiling or steaming food will result in less exposure.
- Increasing intake of antioxidants: Foods high in antioxidants include fruits, vegetables, legumes, herbs, spices, nuts, seeds, and chocolate.
- Balance gut microbiome: Eating a diet rich in fruits and vegetables is great for balancing the microbiome. Variety is especially important, so aim for 9-13 servings each day. Fermented foods - yogurt, kefir, sauerkraut, etc. - are especially beneficial.
Handling Stress
Stress is not all bad. We need some level of stress for normal functioning, but we learn how to handle this stress. While acute stress impacts the immune system, it is the chronic unresolved stress that is especially damaging. Chronic stress has been found to suppress and dysregulate the immune system.
Stress causes the sympathetic nervous system to tell the body to release epinephrine and norepinephrine. This results in an inflammatory state with increased inflammatory cytokines. The body then releases cortisol which can lead to decreased levels of proinflammatory cytokines in the body.
We want healthy balanced cytokines levels in the body because they are the molecules that are responsible for communication among cells during an immune response. It is no wonder that chronic stress has been found to put people at a higher risk of viral infections and is associated with greater severity of respiratory disease.
According to Minich and Hanaway, research has shown that “practices such as yoga, meditation, mindfulness, tai chi, qigong, relaxation response, and breath regulation... benefit immune regulation.”
Take Away:
- Find ways to handle stress: yoga, meditation, mindfulness, gardening, etc.
- Develop a practice: consistency of a practice you find helpful is the key.
Sleep
Getting good sleep is extremely important for our immune system. While we sleep, our bodies are able to reset and repair. Sleep disturbances affect inflammatory cytokines and inhibit proper immune cell response.
It can take days for our body to recover from sleep deprivation. When we are trying to support our immune system, getting consistent adequate sleep is crucial. Practicing good sleep hygiene should be viewed as a key factor in supporting our immune system.
Take away:
- Quantity of sleep: Getting 7-8 hours of sleep each night.
- Quality of sleep: Both measurements of actual REM sleep and perception of sleep quality impact our health.
- Sleep hygiene: limit blue light before bed, develop a consistent sleep schedule, create an environment to encourage quality sleep (like a dark, quiet, cool room)
Movement
Staying physically active has a large impact on our immune system. Movement increases the white blood cell count and antibodies in our blood. White blood cells are the immune systems fighter cells that work with antibodies to neutralize pathogens like viruses and bacteria.
At the same time, movement decreases the levels of stress hormones, guarding you from the negative effects of too much epinephrine, norepinephrine, and cortisol. The increased circulation that occurs when we are active also provides oxygen and nutrients to the cells, while eliminating waste.
People who have been physically active are encouraged to continue their level of activity even when accommodations must be made for social distancing rules. Those who have not been physically active may benefit from moderate physical activity, but they may need to build up their endurance.
Moderate physical activity can be helpful when feeling a little under the weather, but care should be taken not to be too strenuous as that can have a negative impact on your immune system. Those who are acutely sick with a fever, body aches, etc. would likely benefit more from rest than physical exercise.
Take Away:
- Stay Active: Find an activity that you enjoy. Make sure that you can do it safely at the level right for your situation.
- Consistent movement: Ideally, 30 minutes of exercise each day, or 150 minutes a week, is a good goal for most people.
Social Connections
Our personal relationships influence our immune health in a significant way. Depending on the quality of the relationship it can have either a positive or negative impact on our health. Social isolation, grief, and conflict has been found to increase inflammation while decreasing immune function.
Minich and Hanaway explain that “that individuals who feel this sense of interconnection... have favorable gene expression, decreased stress, increased antibodies, and better health outcomes. They state, “For immune health, the focus should be on reducing exposure to interactions perceived as hostile and non-supportive and, at the same time, on emphasizing and encouraging time with others who are positive or affirming.”
It is, however, important to note that each person's personality and situation is different. Many people withdraw instinctually when they are sick. Allowing for these differences in personality and circumstance is important, and preferences should be honored.
Take away:
- Find meaningful connections: Feeling a sense of interconnection has a positive influence on our immune system. Social connections can be made with individuals, groups, or even a higher power.
- Avoid toxic relationships: Negative stressful relationships can impact our immune system in an unhealthy way. Creating boundaries or stepping away from difficult relationships may be an important step for your health.
Functional medicine focuses on restoring your health on a deep level in the least intrusive way. The lifestyle changes mentioned above - nutritional choices, handling stress, sleep, movement, social connections - are truly the foundation of healing your body and leading you to optimal health.
If you would like more information about supporting your immune system, check out the “Patient Education Tools: Lifestyle Practices for Strengthening Host Defense.”
Dr. Jamie
- Minch DM, Hanaway PJ. The Functional Medicine Approach to Covid-19: Nutrition and Lifestyle Practices for Strengthening Host Defense. Integrative Medicine Vol. 19, No. S1
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