In these days of COVID-19 we hear that people with poor metabolic health usually suffer a much worse outcome from getting infected with the virus. In 99% of the deaths in Italy from COVID-19, poor metabolic health was identified. Prateek Lohia, MD, MHA, assistant professor of internal medicine at Wayne State University, said. “Patients with metabolic syndrome had a 40% increase in all-cause mortality, 68% increase in the need for critical care services and a 90% increase in the need for mechanical ventilation compared to the patients without metabolic syndrome.”
But what is poor metabolic health?
If we look at crowd photos from the 1950’s and 1960’s, we are fascinated at the number of slim people. It can often be difficult to spot a person in the crowd who looks fat. The people look positively skinny in comparison with crowd photos taken these days. In most cases, that difference is metabolic syndrome, or poor metabolic health.
When a person has metabolic syndrome, a major indicator is excess fat around their middle. They might be called apple shaped, sometimes referred to in males, as having a beer belly. Often the major indication is a belly that hangs over the belt.
The excess fat accumulated around the center of a body is adipose fat, and it packs all around the body’s critical organs such as the heart, pancreas, stomach, liver etc. It can make bending over to tie shoelaces difficult, and can compress the lungs requiring more effort for breathing. To know if this is a concern for you, just take your waist measurement in the morning and compare it with your height. The waist measurement should be less than half your height measurement.
Not all people who have poor metabolic health are apple shaped. Some can be very thin and we refer to these people as TOFI’s. Thin outside, fat inside. They can still have excess adipose fat around their organs impacting their health.
What has happened to these people?
When their body has too much energy usually from eating excess carbohydrates, it could become toxic in the blood, so it has to go somewhere else. Their body converts this energy into a storable form and deposits it in the central area. This can be stored in the liver which can result in non-alcoholic fatty liver disease (NAFLD) which over time, expands the liver putting more bulk into the central area and can eventually lead to cirrhosis or permanent scarring damage to the liver. Sometimes this excess energy is converted into Triglycerides (fat) and stored in the central area, increasing adipose fat around the organs, and pushing out the belly.
A major driver for this, is eating food that has too high energy but a low level of nutrients. It is common to think this is a result of a person just over eating, but it often comes from their body reacting to the type of food they are eating and continuing to send “hungry” messages. So, the wrong food can make you feel hungry, even if you have just eaten. For example, many processed foods and sweetened beverages are full of calories, have almost zero protein, but zero nutrition. If these are dominant in your diet, your body will keep you feeling hungry until you have satisfied your protein or nutrition requirements.
What are the health impacts of this condition?
This central adipose fat releases hormones such as leptin, some cytokines and others, to such an extent that it is now considered a major endocrine organ influencing a number of internal processes. These can help drive up obesity which is now known to increase cancer risk. The high glucose levels driving metabolic syndrome also increase insulin levels ultimately creating insulin resistance and this drives a wide range of diseases. Some examples of these diseases are Type 2 diabetes, PCOS, macular degeneration, kidney disease, liver diseases, heart disease, obesity and many other diseases that are only just being recognized as caused by insulin resistance.
Why is a person with metabolic syndrome more susceptible to a poor COVID-19 outcome? It seems that their immune system is compromised, that nutrition levels are lower, that these people have a delayed response by the immune system. Chronic inflammation seems to be a factor, as it is common in obese people. It seems that COVID-19 can create an excessive inflammatory response called a cytokine storm. This can cause severe lung damage and multi organ failure.
Is there anything that can be done?
Yes, there is and you can get results quite quickly. The really good news is that when you focus on this problem, the body seems to reduce the worst adipose fat level first. In just one week with a significantly reduced dietary glucose level, research has found that liver function can recover by as much as 30%. In just three weeks, the adipose tissue can begin to shrink and health markers can begin to improve.
For many people, the route to improved health involves heavily reducing dietary carbohydrates which lowers insulin, reduces sugars in the blood and switches the body to consume stored fat. When this is done, the first fat store that is targeted is the central area adipose fat. Great news.
A paleo diet can help and even a vegan diet may help. Grains, sugar sweetened drinks, HFCS, starchy vegetables and sugar must be eliminated. This means no corn, rice, potatoes, parsnips, almost no fruit and no flour or corn-based products like pasta, cereals, bread, pretzels, cakes buns etc. So very difficult but not impossible for a vegan to still get all their required nutrition.
A keto or low carbohydrate style diet is my easy way to do this because it mostly eliminates any feeling of hunger. Increase the level of meat, eggs, dairy, and eat lots of green vegetables every day. You are replacing most carbohydrates with additional protein, and fat. If the overall calories are kept just a little under daily requirements, then the body will begin to use stored fat to make up the energy shortfall. Intermittent fasting can also help.
Take a look at this report from Dr. Maryanne Demasi for more detailed medical information: http://dx.doi.org/10.1136/bmjebm-2020-111451
For more information, I invite you to download my e-book.George Elder, Author, “Take Back Your Health”, Available on Amazonwww.takebackyrhealth.com