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How Poor Diet Contributes to Coronavirus Risk How Poor Diet Contributes to Coronavirus Risk
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Of the many heartbreaking stories I’ve read or heard during this ghastly pandemic, one stands out as especially distressing, almost criminal. The headline, on Page 1 of The Times on April 12, read: “Empty Shelves, But Farms Put Food to Waste — Milk, Eggs and Produce Buried and Dumped.”Of the many heartbreaking stories I’ve read or heard during this ghastly pandemic, one stands out as especially distressing, almost criminal. The headline, on Page 1 of The Times on April 12, read: “Empty Shelves, But Farms Put Food to Waste — Milk, Eggs and Produce Buried and Dumped.”
That day I was researching food insecurity and soaring rates of metabolic disease as an often overlooked reason for the high risk of Covid-related illness and death among African-Americans, Hispanics and people in poor communities.That day I was researching food insecurity and soaring rates of metabolic disease as an often overlooked reason for the high risk of Covid-related illness and death among African-Americans, Hispanics and people in poor communities.
The article told of staggering food waste — tens of millions of pounds of fresh food, including 3.7 million gallons of milk a day, that farmers cannot sell because restaurants, hotels and schools were closed in a belated effort to squelch the pandemic. Some of the surplus food was donated to food banks and feeding programs that have been overwhelmed by demands to nourish the needy but have limited ability to store and distribute perishable food.The article told of staggering food waste — tens of millions of pounds of fresh food, including 3.7 million gallons of milk a day, that farmers cannot sell because restaurants, hotels and schools were closed in a belated effort to squelch the pandemic. Some of the surplus food was donated to food banks and feeding programs that have been overwhelmed by demands to nourish the needy but have limited ability to store and distribute perishable food.
Despite our nation’s ability to produce so much healthful food, fewer than one American adult in five is metabolically healthy, Dr. Dariush Mozaffarian, dean of the Freidman School of Nutrition Science and Policy at Tufts University, had told me the week before. He cited a recent national report describing poor diet as “now the leading cause of poor health in the U.S.” and the cause of more than half a million deaths per year.Despite our nation’s ability to produce so much healthful food, fewer than one American adult in five is metabolically healthy, Dr. Dariush Mozaffarian, dean of the Freidman School of Nutrition Science and Policy at Tufts University, had told me the week before. He cited a recent national report describing poor diet as “now the leading cause of poor health in the U.S.” and the cause of more than half a million deaths per year.
Dr. Mozaffarian explained that poor metabolic health was the immunity-impairing factor underlying cardiovascular disease, Type 2 diabetes and obesity-related cancers that left so many nutritionally compromised Americans especially vulnerable to the lethal coronavirus now all but paralyzing the country.Dr. Mozaffarian explained that poor metabolic health was the immunity-impairing factor underlying cardiovascular disease, Type 2 diabetes and obesity-related cancers that left so many nutritionally compromised Americans especially vulnerable to the lethal coronavirus now all but paralyzing the country.
“Only 12 percent of Americans are without high blood pressure, high cholesterol, diabetes or pre-diabetes,” he said in an interview last week. “The statistics are horrifying, but unlike Covid they happened gradually enough that people just shrugged their shoulders. However, beyond age, these are the biggest risk factors for illness and death from Covid-19.”“Only 12 percent of Americans are without high blood pressure, high cholesterol, diabetes or pre-diabetes,” he said in an interview last week. “The statistics are horrifying, but unlike Covid they happened gradually enough that people just shrugged their shoulders. However, beyond age, these are the biggest risk factors for illness and death from Covid-19.”
The characteristics of what doctors call the metabolic syndrome — excess fat around the middle, hypertension, high blood sugar, high triglycerides and a poor cholesterol profile — suppress the immune system and increase the risk of infections, pneumonia and cancers. They’re all associated with low-grade, body-wide inflammation, Dr. Mozaffarian explained, “and Covid kills by causing an overwhelming inflammatory response that disables the body’s ability to fight off pathogens.”The characteristics of what doctors call the metabolic syndrome — excess fat around the middle, hypertension, high blood sugar, high triglycerides and a poor cholesterol profile — suppress the immune system and increase the risk of infections, pneumonia and cancers. They’re all associated with low-grade, body-wide inflammation, Dr. Mozaffarian explained, “and Covid kills by causing an overwhelming inflammatory response that disables the body’s ability to fight off pathogens.”
Alas, the metabolic well-being of many Americans is now further endangered by currently advised limits on shopping trips, an increased reliance on canned and packaged foods high in fat, sugar and salt, and emotional distress that prompts some people to turn to nutritionally questionable “comfort foods.”Alas, the metabolic well-being of many Americans is now further endangered by currently advised limits on shopping trips, an increased reliance on canned and packaged foods high in fat, sugar and salt, and emotional distress that prompts some people to turn to nutritionally questionable “comfort foods.”
The Covid pandemic has cast a glaring light on longstanding costly and life-threatening inequities in American society. Those living in economically challenged communities, and especially people of color, are bearing the heaviest burden of Covid-19 infections. But while diet-related disorders increase vulnerability to the virus, limited national attention has been paid to lack of access to nutritionally wholesome foods that can sustain metabolic health and support a vigorous immune system.The Covid pandemic has cast a glaring light on longstanding costly and life-threatening inequities in American society. Those living in economically challenged communities, and especially people of color, are bearing the heaviest burden of Covid-19 infections. But while diet-related disorders increase vulnerability to the virus, limited national attention has been paid to lack of access to nutritionally wholesome foods that can sustain metabolic health and support a vigorous immune system.
Clearly, when this pandemic subsides, a lot more attention to the American diet will be needed to ward off future medical, economic and social calamities from whatever pathogen next comes down the pike.Clearly, when this pandemic subsides, a lot more attention to the American diet will be needed to ward off future medical, economic and social calamities from whatever pathogen next comes down the pike.
The report Dr. Mozaffarian cited, issued in March in honor of the 50th anniversary of the White House Conference on Food, Nutrition and Health, was unexpectedly timely. It pointed out that “severe malnutrition has largely been replaced with food insecurity — the limited or uncertain availability of nutritionally adequate and safe foods and beverages,” a circumstance that in 2018 affected 14.3 million American households.The report Dr. Mozaffarian cited, issued in March in honor of the 50th anniversary of the White House Conference on Food, Nutrition and Health, was unexpectedly timely. It pointed out that “severe malnutrition has largely been replaced with food insecurity — the limited or uncertain availability of nutritionally adequate and safe foods and beverages,” a circumstance that in 2018 affected 14.3 million American households.
The government spends about $70 billion a year to support food insecure individuals and families through the Supplemental Nutrition Assistance Program (SNAP, formerly called food stamps). But other than disallowing purchases of alcohol, tobacco, pet foods, hot prepared foods and foods eaten in the store, SNAP does not restrict the kinds of foods people can buy with their state-issued allowance.The government spends about $70 billion a year to support food insecure individuals and families through the Supplemental Nutrition Assistance Program (SNAP, formerly called food stamps). But other than disallowing purchases of alcohol, tobacco, pet foods, hot prepared foods and foods eaten in the store, SNAP does not restrict the kinds of foods people can buy with their state-issued allowance.
Rather than limiting peoples’ food choices with SNAP dollars, experts are devising programs that can prompt people to choose foods and beverages that can enhance, rather than impair, their health. For example, under an expanded version of SNAP, in some states recipients who use the supplement to buy foods like fruits, vegetables and whole grains get $1.30 on the dollar. But under a proposed disincentive, if the benefit were spent on sodas and snacks, they would get only 70 cents on the dollar.Rather than limiting peoples’ food choices with SNAP dollars, experts are devising programs that can prompt people to choose foods and beverages that can enhance, rather than impair, their health. For example, under an expanded version of SNAP, in some states recipients who use the supplement to buy foods like fruits, vegetables and whole grains get $1.30 on the dollar. But under a proposed disincentive, if the benefit were spent on sodas and snacks, they would get only 70 cents on the dollar.
For those relying on their own funds to buy food, tax strategies could be used to increase the cost of foods and beverages that are less healthful, with the resulting tax revenues used to lower prices for healthy foods.For those relying on their own funds to buy food, tax strategies could be used to increase the cost of foods and beverages that are less healthful, with the resulting tax revenues used to lower prices for healthy foods.
There have also been several successful pilot programs demonstrating the cost savings and health benefits of actually providing healthy foods to people with diet-related disease.There have also been several successful pilot programs demonstrating the cost savings and health benefits of actually providing healthy foods to people with diet-related disease.
The Pennsylvania-based Geisinger Health System began a program in 2016 called Fresh Food Farmacy to give free nutritious food to food-insecure people with Type 2 diabetes and their families.The Pennsylvania-based Geisinger Health System began a program in 2016 called Fresh Food Farmacy to give free nutritious food to food-insecure people with Type 2 diabetes and their families.
The organization created a food pantry in its Shamokin, Pa., clinical center that provides enough fresh fruits and vegetables, whole grains, and lean proteins to feed each family two healthy meals a day five days a week, along with weekly menus and recipes.The organization created a food pantry in its Shamokin, Pa., clinical center that provides enough fresh fruits and vegetables, whole grains, and lean proteins to feed each family two healthy meals a day five days a week, along with weekly menus and recipes.
Updated June 2, 2020 Updated May 28, 2020
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said.
There is an uptick in people reporting symptoms of chilblains, which are painful red or purple lesions that typically appear in the winter on fingers or toes. The lesions are emerging as yet another symptom of infection with the new coronavirus. Chilblains are caused by inflammation in small blood vessels in reaction to cold or damp conditions, but they are usually common in the coldest winter months. Federal health officials do not include toe lesions in the list of coronavirus symptoms, but some dermatologists are pushing for a change, saying so-called Covid toe should be sufficient grounds for testing.
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities.
Among the first 95 members enrolled, there was a 40 percent decrease in the risk of death or serious complications and an 80 percent drop in medical costs per year, Dr. Andrea T. Feinberg and colleagues reported.Among the first 95 members enrolled, there was a 40 percent decrease in the risk of death or serious complications and an 80 percent drop in medical costs per year, Dr. Andrea T. Feinberg and colleagues reported.
In 2018, John Hancock replaced its usual life insurance policies with John Hancock Vitality providing financial incentives to foster healthier lifestyles, including up to $600 per year to purchase healthier foods.In 2018, John Hancock replaced its usual life insurance policies with John Hancock Vitality providing financial incentives to foster healthier lifestyles, including up to $600 per year to purchase healthier foods.
Last October, Kaiser Permanente launched Food for Life to enhance access to affordable, healthy food, which the organization estimates could reduce medical care costs by about 45 percent. As a first step, residents eligible for California’s SNAP benefits will be offered medically tailored meal delivery options for patients and their families.Last October, Kaiser Permanente launched Food for Life to enhance access to affordable, healthy food, which the organization estimates could reduce medical care costs by about 45 percent. As a first step, residents eligible for California’s SNAP benefits will be offered medically tailored meal delivery options for patients and their families.
Last spring, Dr. Mozaffarian and colleagues published a brief report headlined “Food Is Medicine — The Promise and Challenges of Integrating Food and Nutrition Into Health Care” in JAMA Internal Medicine.Last spring, Dr. Mozaffarian and colleagues published a brief report headlined “Food Is Medicine — The Promise and Challenges of Integrating Food and Nutrition Into Health Care” in JAMA Internal Medicine.
Touting the benefits of providing free medically tailored meals to food-insecure patients and their families, they noted that diet-related diseases lead to “suboptimal school and work performance, increased health costs and lower productivity and wages.”Touting the benefits of providing free medically tailored meals to food-insecure patients and their families, they noted that diet-related diseases lead to “suboptimal school and work performance, increased health costs and lower productivity and wages.”
In other words, consuming a more wholesome diet is a win-win investment. And there’s no better time to make it than now, as the country begins the struggle to get back on a healthful footing.In other words, consuming a more wholesome diet is a win-win investment. And there’s no better time to make it than now, as the country begins the struggle to get back on a healthful footing.