Tips for reducing risk and coping with the future unknowns
Pete Williams – Founder of Functional Medicine Associates
Autumn is a time of change, even more so in these uncertain times of COVID-19 – now known as a disease not just of the lungs but a disease that affects the whole body. Researchers and medics alike admit that we need to throw out the traditional way we look at pandemics. Many scientists now suggest that we need an increasingly joined-up method, a systems approach to solving a very interconnected and whole-body problem.
This new systems approach is best demonstrated by the functional medicine model of healthcare. This unified thinking can help the brilliant emergency medicine model to come up with better answers over the longer term, once emergency treatment has finished.
“Your body functions as an integrated system and when attacked by a virus such as COVID-19 it responds in a whole-body way. This virus is a classic example of a multisystemic disorder and a highly individualised disease. One person’s COVID-19 infection is completely unique to them and therefore they may need a completely unique treatment. What we can be more clear about, however, is that some of the underlying mechanisms that drive the symptoms such as genetic predisposition, immune activation, oxidative stress, inflammatory pathways and mitochondrial damage may be common, underlying mechanisms in most affected people”
Pete Williams – Founder Functional Medicine Associates
With cases rising again, we move back into a time of heightened potential infection. It is a time in which we need to consider our health and current lifestyle and make the necessary changes so that we are Winter ready.
You can be the healthiest person out there, following best practice to reduce your chances of getting infected, but this might not stop you catching COVID-19. This has been demonstrated by one of our current COVID-19 long-haul patients who, despite being young and very fit, contracted COVID-19 and continues to present with severe health complications six months post-infection. Paying attention to lifestyle factors does play an important role; not only in reducing your risk of infection but in reducing the severity of any possible longer-term health consequences. Changing your lifestyle for the better has a significantly positive effect on your immune system.
We would like to share some useful information with you. This information comes from our experience in practice, recent scientific research on the virus and trusted sources in the industry. This information is designed to help keep our immunity and health in tip-top shape and is likely to be helpful in reducing risk alongside the excellent advice from NHS England.
Here is some key advice that you can implement in order to improve your health ready to face the uncertain Winter:
Optimise your sleep:
Aim for 8-9 hours every night. Just think of sleep as putting your car into the repair garage overnight to be fully checked out, repaired and cleaned up ready for the next day. Sleep does it all – provided you get enough of it. Optimal sleep primes parts of your immune system to do the best job of fighting off invaders (like viruses), so find that sleeping sweet spot of 8-9 hours per night.
In these difficult times it is more important than ever to engage in a good sleep regime.
Here are some tips (there are many) to get you started:
- Get some sun on your face in the morning. The light in the morning has a particular wavelength that helps the brain to set its daily circadian clock, helping you sleep better at night. Conversely, reducing tech time in the evening and avoiding taking screens to bed with you can assist with better sleep quality. The blue light emitted from screens stimulates your brain to think that it’s morning
- Avoid large meals 3 hours prior to going to sleep, if possible
- Reduce your alcohol intake. Alcohol can negatively affect our sleep, especially if consumed later in the day. It also affects our digestion and can alter our immune status.
- Avoid going to bed after 11pm, as late hour sleep is not as helpful as earlier sleep
- Make sure your bedroom is not too warm. 18c is an ideal temperature.
Improve your immunity by strengthening your digestive tract
Optimising your digestion can protect the bacterial balance in your digestive tract and help to optimise both arms of your immune system, innate and acquired As humans we are also made up of slightly more bacterial cells than human cells. The majority of the bacterial cells are friendly and reside in our digestive tract. They are key players in providing immune protection.
The digestive tract is the main border where our body communicates with the outside world; one which can be a very dangerous place. Its surface area is equivalent to the size of a tennis court and this amount of area takes a lot of controlling. You therefore won’t be surprised to hear that approximately 70% of your total immune system is located here, working hard to protect its largest border.
It has been quoted in scientific journals that your immune system in your gut does more work in one day than the whole of your immune system will do in its lifetime. If this border cannot patrol itself effectively (through friendly bacteria, protective proteins etc, then pathogens can slip through in abnormal numbers creating potential health issues elsewhere. I wrote of my concerns about this over the summer, the mechanisms at work and what we may see further down the road particularly with COVID-19 “Long Haulers”. Having followed the scientific evidence and having worked with several patients in this group I think those concerns are increasingly valid.
A great diet, moderate consistent exercise, stress reduction and sleep are cornerstones to protecting your bacteria and in turn your immunity. There are numerous tests that can be performed to explore bacterial friends and foes, immune soldiers on the borders and the structural integrity of those physical borders. If you currently have or have recently had significant digestive issues, then perhaps you should start investigating.
Eat a rainbow of colours:
For you and your bacteria to achieve optimal health, the best possible foods are needed. These can be obtained through a diet high in plant foods and fibre, adequate protein and healthy fats. Feed your bacteria well and they do a great job of effectively modulating your immune system ready to be both aggressive and calm, a mediator at the main battle front – your digestive tract. It is in the best interests of your bacteria to keep you fit and healthy – after all they need you to continue to carry them around and give them a nice home. It’s a partnership, they will work hard for you, but you need to work hard to provide the right environment and food for them.
Science currently suggests that we can achieve the above by eating a rainbow of colours. As wide a variety of different fruits and vegetables as possible is key and ideally more vegetables than fruits. Phytochemicals in fruits and vegetables not only provide an array of different colours, they also contain messages that talk to our genes encouraging them to express themselves in a healthy way. So, whilst eating broccoli every day is a great thing to do, you need to ensure a colourful and diverse plate at every meal.
Whilst the majority of us are probably already aware of the importance of exercise, the problem is that we have engineered a world and lifestyle that makes daily exercise difficult. Our busy, stressful lifestyles often leave us ‘no time to exercise’, but we know that many of our genes cannot work correctly if movement and exercise is not prescribed.
Exercise is also key to enhancing our immunity. Science shows that regular exercise trains the immune system to be more effective, priming immune cells to be better killers who are more efficient at their job. With the increased blood flow from physical movement this allows our immune soldiers to be carried off to far flung parts of the body where invading pathogens may be present. So, whether it’s a walk, jog, run, stairs, yoga or weights – just do it!
The only caveat to all of this is that when it comes to exercise you should avoid doing too much, too soon or too often as this can lead to your immune system being challenged and therefore not working at its best. To get the right balance we recommend using tech to track your activity. There are lots of great companies doing great, affordable tech that also track sleep and stress levels alongside exercise. In my opinion, well worth the investment.
Get your Vitamin D tested:
By November the amount of Vitamin D that can be made by the body through exposure to sunlight is minimal (in the UK at least). The sun just doesn’t get high enough in the sky at this time of the year and you will need to go as far south as Lisbon to get appreciable daily amounts in the winter months. We believe that Vitamin D (not really a vitamin but more like a hormone) is so important to overall health that we test all of our patients 2-3 times per year. Autumn is an optimal time to test as we can see how well stocked up your levels are following the Summer. Surprisingly many of our patients are deficient even at this time of the year. As far as reducing COVID-19 risk, a recent study on COVID-19 and Vitamin D levels has concluded that:
“Diagnosis of Vitamin D deficiency could be a helpful adjunct in assessing patients’ potential of developing severe COVID-19. Appropriate preventative and/or therapeutic intervention may improve COVID‐19 outcomes”
For those with less than optimal levels, using Vitamin D supplements through the winter months keeps these levels optimal. The good news is that both testing and supplements for Vitamin D are cheap and easy to do.
Appropriate supplementation can be helpful:
Supplements will never replace a great diet, but whether the population as a whole eat a balanced enough diet rich in fruits and in particular vegetables is highly debatable. In our experience of nearly 20 years we have never (on testing) seen a patient who hasn’t needed a little bit more help to achieve optimal levels of vitamins and minerals. As far as protection from COVID-19 and for the post COVID-19 long haulers, science has identified three key areas where diet, sleep, exercise, reduced stress and additional supplements, including pre and probiotics, can theoretically (most have not yet been tested in COVID-19) be beneficial:
- Balancing inflammatory pathways
- Reducing excessive oxidative stress.
- Harmonising the gut microbiome
We should also consider what we don’t eat to be of help. Going for longer periods without food has been shown to calm inflammatory pathways. This method can be very helpful in the most at risk groups, Type 2 Diabetics and the Obese. This echoes the advice by NHS England that losing weight is a very important strategy in these groups.
Don’t just buy any old supplements though! Quality is very important and that will come with an increased price tag. How do you know what you need, in what dose, for how long? Understanding this can only be achieved through direct testing of levels under an experienced professional.
Reduce Stress and Increase Positivity:
Whilst lockdown has been beneficial for some and resulted in reduced stress levels, this has of course, not been the case for everyone. For many there has, for one reason or another, been a huge increase in the levels of stress hormones. In serious hospitalised COVID-19 cases, the higher levels of the stress hormone Cortisol are predictive of poorer outcomes
We also know that long term stress causes our immune system to be less effective, so we need a plan in these uncertain times.
The uncertainty of what the future will bring – financial insecurity, job losses, pivoting work, managing home schooling with work demands, social restrictions etc – all put added stress on us. With mounting evidence of the mental health ramifications of our current situation growing weekly in the scientific literature, we need some help. Humans need to be with other humans, it’s part of our DNA to be connected to others and it’s a major part of our what keeps us healthy.
Based on the above, we currently advise our patients how important it is to look after one another in your immediate bubble, but also to practise self- care. Sharing hugs with your loved ones (within your bubble) stimulates the social hormone Oxytocin and is the Yin to the Yang (caused by stress). Lots of evidence shows that Oxytocin has a positive effect on reducing high blood pressure, another significant COVID-19 risk factor.
For the important people not in your immediate bubble, a phone call really does matter – letting people know that you’re there, that they can talk to someone and that they are still part of the tribe, acts as a wonderful safety net. So, make that call, it’s good to talk.
COVID-19 will not last forever, but it’s a wakeup call for us to get the basics of good health right. It has dramatically demonstrated what happens when you have a global Pandemic alongside health epidemics such as Obesity and Type 2 diabetes. It’s not a good combination and it’s an even worse outcome. You only have one body, so look after it as best you can.
For more information or to book a consultation, get in contact with us.
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