The COVID-19 pandemic is far from over, but the nation is far better equipped to fight it today than it was a year ago, thanks to improved methods of caring for patients, a host of therapeutics, and of course effective vaccines. But are there ways that we can take our health into our own hands and decrease our risk of falling prey to viral infections of all kinds – or at least lessen the severity of the attacks?
Lisa Wingrove, a registered dietitian with the Anschutz Health and Wellness Center, thinks so. Wingrove, a certified specialist in oncology nutrition and manager of Campus and Community Initiatives for the Wellness Center, spoke with UCHealth Today about the ways good nutrition can help people improve their health and in so doing bolster their defenses against COVID-19 and other infections.
What is your role as manager of Campus and Community Initiatives?
My role is to elevate and find opportunities for collaboration around nutrition, physical activity and mental well-being between the campus, the Wellness Center and our community. We did a needs assessment to see where there are gaps in services and that led us to develop programs to engage, for example, with public schools in developing complementary curricula and programs for healthy nutrition, mindfulness and exercise.
Can good nutrition provide immunity against COVID-19?
It’s important that we stipulate the difference between immune function in general and immunity against COVID-19 specifically. Nutrition can generally be seen as a mitigation strategy to support immune system function by reducing risk for underlying diseases that have worse outcomes with COVID. For a robust immune system response, we have to have specific types of nutrients to ensure our bodies are running at peak performance.
What are some examples of nutrients that bolster the immune system’s response?
Protein plays a significant role because it helps in antibody production. If we have limited or poor protein intake, it compromises our immune function. Also, very few people eat enough fiber. Having enough fiber is important for many different functions, but specifically, it helps to support our microbiome [the collection of microbes within and on the human body], which is also really important for a healthy immune system response. Finally, if you are deficient in vitamins and minerals, such as vitamin D and zinc, that affects the immune function. So having variety in your diet is super important.
How can poor nutrition increase our risk for COVID-19?
Poor diet is now the leading underlying cause of death in the United States. It surpassed tobacco some time ago. And when we think about obesity, certain cancers, cardiovascular disease, hypertension and diabetes – all of them conditions that lead to poor outcomes from COVID-19 – the underlying factor is nutrition and physical activity.
When we look at the older adult population, malnutrition may put them in a more vulnerable position to begin with. It’s the same with obesity, Type 2 diabetes, cardiovascular disease and so on. People with these chronic conditions may not have good nutrition to start with and that may put them at greater risk.
Help us further understand that risk.
People with chronic non-communicable diseases have a baseline low level of inflammation that is constant. It also means there is already some dysregulation of their systems. In others [without those conditions] who are exposed to a virus or other source of infection, their bodies mount an inflammatory response, which is what we want. Some inflammation is good. But in some people with these pre-existing chronic conditions, their bodies seem to go into a state of hyper-inflammation and get critically ill. Poor nutrition is often at the core of these diseases, and that, in turn, makes it more likely these people will have poor outcomes from COVID-19.
Can good nutrition mitigate these risks?
Yes. We can reduce our risk of developing the underlying conditions that lead to worse outcomes from COVID-19.
For example, the recommended daily intake of fiber is 25 to 38 grams, yet most people get between 15 and 20 grams a day. In one study, each daily 10-gram increase in dietary fiber decreased the mortality-relative risk from infectious and respiratory diseases by 34% and 18% in men and 39% and 34% in women, respectively. It is important to note that if you increase your fiber intake you need to increase your fluid intake accordingly.
Good nutrition relies on basic, budget-friendly foods. Helping people to eat healthily on a budget is really critical if we want to have a robust immune system and decrease our risk to these underlying conditions.
What are some practical ways to do that – to use food as medicine?
At the Wellness Center, we really focus on translational science – taking the science from a journal article and bringing it into your kitchen.
For example, cannellini beans [sometimes called white kidney beans] are a high-value protein that is anti-inflammatory, high in fiber, and will help you maintain a healthy weight. When we’re eating plant-based proteins that are relatively unprocessed, we’re also not getting all the saturated fats and sodium that come with those processed products. So we’re actually giving our bodies the best fuel.
Another way of getting more nutrients into your diet is just having a piece of fruit a day. That’s not a big ask. Or have a bowl of carrots and celery as a snack. If you want to pair them with a protein, do some string cheese or hummus.
You mentioned the benefits of fiber in reducing infection and respiratory disease risk. Are there other benefits?
Yes. Fiber slows down nutrient absorption in your GI tract and that leads to lower post-eating glucose levels, which can keep your blood glucose modulated and in turn help with your appetite and energy levels.
We know that there are significant health disparities in the U.S. What is the role of nutrition in that?
More vulnerable populations tend to live in areas of food deserts. When we look at the rates of poverty in those communities, the food that people have most readily available is highly processed, high-calorie and high-fat, with very low nutritional content.
When we think about the social determinants of health, it’s about food access, education and affordability. Yet when we look at a bag of carrots or a bag of celery as being relatively inexpensive, if you are living on SNAP [Supplemental Nutrition Assistance Program] benefits, or you have low income, every meal counts. If you don’t have access to education or community social resources to support your wanting to learn more about [good nutrition], it can be a very vicious little circle. It’s an insidious situation.
How can we address that?
A lot of communities are working hard on developing urban farms and getting out education on a grassroots level. At the Anschutz Health and Wellness Center, we offer virtual cooking classes every Tuesday that focus on chronic disease conditions. Every class is taught by a registered dietitian with a different focus. So if someone has diabetes or pre-diabetes, we have a specialty diabetes dietitian who teaches a recipe and cooks it so you can either cook along or just observe and ask questions.
We also have virtual cooking classes on cardiovascular health, weight loss and weight management, oncology and GI health. The cost is $6, but if someone can’t afford it, we give it for free. Our goal is more people participating and sharing the knowledge. [For free recipes, visit the Anschutz Health and Wellness Center blog.]
Has COVID-19 helped to raise the importance of good nutrition in maintaining a healthy immune system?
I think it has, and part of that is being homebound. We’ve had to be creative. With restaurants being closed, if you’re someone who relied on eating out on a regular basis, all of a sudden that’s been taken away, and you’ve had to find ways to feed yourself. People have had to learn to cook and we’ve seen an increase in participation in our virtual cooking program.
Certainly, some people have gained weight during the COVID-19 pandemic, and part of that is stress. A lot of people have coped through emotional eating. But many people have really had to consider what they are actually putting in their bodies because the choices they were making before aren’t available or maybe they realize they weren’t the best choices in the first place.
People have also noticed that going out to eat is expensive. We know when you cook at home it is going to cost you less and aside from that, [the food] is going to be lower in fat and sodium and just better for you. You’re also likely to choose a portion size that is appropriate. I think people in general have learned a lot about food, eating and nutrition during the pandemic.
What if I’ve had COVID-19? Can nutrition help my recovery?
We don’t have a lot of hard evidence about that. But [regardless of the illness], if you’ve been on a regimen of medications for an extended period of time, we know that your microbiome might be depleted. If you are trying to regain muscle mass, you have to have a proper protein intake. So I think that it is fair to say with any illness that the recovery phase takes time and your body will need to be rebuilt. Buying whole foods and eating healthily is something that can help anyone recover from a critical illness.
What are some final tips for managing nutrition, during and after the pandemic?
Ensure that you have some healthy food choices that don’t require a lot of preparation. Having healthy snacks on hand is also important. I find ways to have half an avocado a day because it’s great for brain health, it’s high in fiber and high in healthy fats.
Another thing that is great for satisfying a sweet tooth is making some chia pudding. Chia is high in omega-3 fatty acids and also high in fiber. You can make the pudding with frozen fruit. If you’re hankering for something sweet, a couple of spoonfuls are really good for you, rather than breaking into a bag of Tootsie Rolls or something like that.