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COVID-19 Update 2/9: How to Reduce Your Risk

February 9th, 2022 | 7 min. read

By Steve E. Bishop, M.D.

COVID-19 Update 2/9: How to Reduce Your Risk

On this week's COVID-19 update, Dr. Bishop had an honest conversation — it's time that we take improving our overall health seriously, both to reduce our risk of doing poorly with COVID-19 now and in the future, but also with future illnesses. Watch the update below and read on for a full recap. 

We need to talk about how to reduce your risk (in addition to getting vaccinated). 

I wanted to talk about what you can do to reduce your chance of getting sick with COVID, reduce your chance of going to the hospital, and reduce your chance of dying, should you wind up in the hospital.

And no, we're not going to talk about vaccines.

We have talked about that a lot and you know that it is my view is that pretty much every adult should get vaccinated to reduce their risk. This is what about what you can do in addition to getting vaccinated.

A great study came out of Israel this past week. it showed that people who had normal or slightly higher-than-normal vitamin D levels had a 14 times less chance of having severe or critical illness compared to people that had low vitamin D.

What does that mean?

How does your metabolic health affect your risk level? 

We've talked about this periodically the last couple of years, and you see it in the news here there a little bit. Our public health officials — our health departments, our CDC — other than a few comments here and there, they haven't made a big enough deal out of the fact that if you are overweight, if you have metabolic syndrome — meaning your cholesterol is bad, you have high blood pressure, or if you have abnormal blood sugar, even if you don't meet the definition of diabetes, pre-diabetes counts — your risk of getting COVID, getting severe COVID, and dying from COVID is hundreds of times higher than someone who doesn't have those conditions.

And that's why you've heard me say periodically, hey if you're super young and your labs are perfect, and you can run an eight-minute mile, your risk is pretty low. And that's true.

But you also heard me say most people don't fit in that category. And it's true. 88% to 90% of adult Americans fall into the category of having some metabolic abnormality in terms of abnormal labs — too much weight, too much around the middle, blood pressure is too high, etc. One of these things, okay?

And this is not just a COVID issue, right? Heart disease, strokes, and dementia are all driven by this same pathology, metabolic syndrome. That's all linked together.

All these things are also massive epidemics in our society, and it's what's killing most of us, COVID aside. We all really need to take a hard look at what's going on with our metabolic health.

There was a really nice article also in the Washington Post about this recently as well. The title is a little bit provocative, but I think it's appropriate. The title is "The US is losing more people than other nations to COVID-19. It's time for an honest talk about why."

And this is why. Let's just be honest for a minute. We weigh too much, and all of our labs are not normal. We have metabolic syndrome. Our blood pressure is too high.

It's because of what we eat, because of the type of food we eat, and how frequently we eat.

Europeans and other nations don't eat the way we do. They eat healthier food. They eat local food. They eat natural food. They weigh less. They don't have the trouble that we have with blood pressure, bad cholesterol, and blood sugar. They just don't have these problems at the same rates as we do.

And so they have done better in terms of their numbers, in terms of fatalities, hospital stays, and all of that. People have been sort of hesitant to talk about it.

I think at first, we needed to get the vaccines out there because we absolutely do. But as we move more into this idea of learning to live with COVID long term, yes, we've got to do the vaccines, but we've also got to figure out how to make ourselves as healthy as we can be when we get COVID.

Not if, but when, when you get COVID, because you will eventually get it, it may be a couple of years from now, but COVID's not going anywhere.

The idea here is we need to make you as healthy as we can so that when you get COVID, or frankly any other illness, you're going to do as well as you can. And you're not going to wind up in the hospital, and it's not going to kill you, because you're healthy.

What does that mean?

Let's take this back to the vitamin D study. What is it really telling us?

Vitamin D levels more than anything else are a marker of metabolic health. People who are overweight, people that have metabolic syndrome, tend to have low vitamin D.

So what this study is really telling us is that people that aren't metabolically well, they're more likely to have low vitamin D and they're more likely to wind up in the hospital and more likely to die from COVID. And that's almost regardless of vaccination status.

Having metabolic syndrome is going to increase your risk of death, even compared to someone else who doesn't have that, even if you're both vaccinated. So two people, one vaccinated, both vaccinated, one with metabolic syndrome, one without, the one with metabolic syndrome is going to do worse than the one who does not have it.

So what do we need to be paying attention to? We need to be paying attention to our triglycerides, that's lab tests, our LDL cholesterol, our blood sugar, our insulin levels, the fasting insulin level, our blood pressure, and our waistline. Dr. Pong covered that as it relates to heart health this week, but it's a good synopsis of those metrics. 

Those are the five criteria of metabolic syndrome. You need to with your doctor, if you're not a PartnerMD member, ask your doctor to check your labs, and assess you for metabolic syndrome.

I guarantee most of you, almost all of you, probably have at least one of these things that's not normal that needs to be dealt with. If you're a PartnerMD member, talk to someone in our wellness department. Our health coaches can help you out. Our physicians can help you out.

You need to get these labs checked, and you need to work on your diet and your exercise. And that's going to be the most important thing you can do for yourself long term to improve your overall health, your overall quality of life, but specifically to reduce your risk for COVID.

Small steps lead to progress. 

And I'm not saying everybody needs to look like a runway model. That's not what we're going for. Just losing 10% of your body weight is enough usually to reverse most of the abnormalities of metabolic syndrome.

If you weigh 200 lbs, losing 10 to 20 pounds, it's usually enough. You don't have to be stick thin. You don't have to look like you're about to go on the catwalk. You don't have to look like an Instagram model.

You just need to be healthy and you can do that without making drastic changes. Often, it just means making some small adjustments in the type of food we're eating or how frequently we're eating. Focusing on fresh foods that are local, as much as possible.

This means healthy, organic meats, healthy organic seafood, chicken, green vegetables, non-starchy foods. Eating foods that have been around for hundreds of years and don't come in a bag or a package or a box.

For the most part, farm-to-table eating. All these things are really just a way to get us back to eating the way our grandparents and our great-grandparents ate.

Diabetes and obesity are a product of the last 30 to 40 years. Go back more than 50 years or so, you rarely saw people with diabetes or with obesity. Very few people had this problem.

It's because we changed our food, right? We changed the way we eat.

And we need to get moving. 

Yes, we also need to exercise more as well. People 50 years ago were just more active than we are. We need to be in the gym a couple of times a week. We don't have to be a body-builder, but just start somewhere. All of this is to say we have to get our health in order.

This is kind of a wake-up call with COVID never really disappearing on the horizon. You need to be as healthy as you can so that when you get COVID, hopefully it will be a mild illness for you.

If you're a PartnerMD member, we've got a lot of really excellent resources with our health coaches who can help you out with making progress.

You don't have to make all changes overnight. It's about making progress. It's not about being perfect.

So just start somewhere. Start reevaluating what you're eating. Start reevaluating your exercise routine. Start reevaluating your health in general, your priorities for your own health and wellness, in addition to getting vaccinated for COVID.

Check out the study. It's super interesting. I think you will like it. I'll also link a Forbes article here. The takeaway is, again, the patients with vitamin D deficiency, meaning your levels are less than 20, are 14 times more likely to have a severe or critical case of COVID than those with a value more than 40.

The mortality rate of patients who had normal vitamin D but were in the hospital was 2.3% compared to a 25% mortality rate for those who did not have a normal vitamin D level.

And, you know, I think people are tempted to say, oh, well, this just means I need to take vitamin D and that's fine. You can and probably should take a vitamin D supplement every day, especially during the winter. Nothing wrong with that. That will keep your levels up, but remember you can't just fix this by popping a pill.

Your vitamin D level is yes reflected partially by supplementation, but it's also a general reflection on your overall metabolic health. If you're metabolically healthy, your vitamin D level is going to be closer to normal without supplements.

Stress reduction is important, too. 

Lindsay says "Stress reduction mitigation is super important."

You are 100% correct. We talk about this a lot in our metabolic health class at PartnerMD called MetabolizePMD.

We talk about stress and sleep a whole lot. And both of those things are major drivers of excess hunger and excess weight gain because they do a number of things to your hormone levels.

They increase hormone levels, cortisol, which is the body's version of prednisone or steroids, and they increase your hunger hormone called ghrelin.

And both of those things make you eat more. So sleeping better and reducing stress will absolutely help with your metabolic health. No question about it. 

Wrapping Up

It's a big topic, and every once in a while, I like to bring us back to the foray, especially as we get down the line here, and we see that really we need be making some long-term investments in our health as a nation. And it starts at the individual level, but that's where we can make the difference long term, not just for COVID, but for whatever comes next, right?

This won't be our last pandemic, folks. We'll have another one, maybe 5-10 years from now. There will be another one. H1N1 flu wasn't that long ago, right? Another one will come.

The idea here is we got to be as healthy as we can be throughout our lifespan, both to increase our lifespan but to also increase our healthspan. You want to be as healthy as you can for as long as you can. And that really comes down to what we eat and how we move, and what we do with ourselves in the meantime.

When is the next update? 

We are going to take next week off as we work on developing exciting new wellness content. The next update will be on Wednesday, February 23 at 1:00 pm on our Facebook page. For those without Facebook, we will post our written recap on Thursday. 

Steve E. Bishop, M.D.

As a board-certified internist and concierge doctor in Richmond, VA, Dr. Steven Bishop is passionate about helping his patients improve their lives through better health. He helps healthy adults adjust their lifestyles as they age and helps patients with complex medical diseases manage and improve their health.