evanengelstad

The situation with COVID-19, including the quarantines, shelter-in-place orders, and closings of many businesses and schools, is undoubtedly creating a lot of stress in people. People are losing employment. Parents are trying to juggle working from home and caring for children who aren’t at school. The economy is tanking, including retirement accounts and investments. There is massive uncertainty. When will this all end? And when we do go back to “normal life,” what will we do? Will the fear of The Virus just magically go away? Will businesses and schools reopen as if nothing happened? And how will we know when it is safe to go back in public and be in crowds? When can we start acting like humans again? 

 

I obviously want to protect our most vulnerable community members and do my part to prevent as much suffering and death as possible. I want to make sure I don’t contribute to overwhelming the medical system. But with such limited information and testing so far, it is hard to know the best strategy. The CDC recommends effective handwashing, covering coughs/sneezes, avoiding close contact with people who are sick, social distancing if COVID-19 is spreading in your community, staying home and wearing a facemask when you are sick, and disinfecting surfaces. I wonder if extensive quarantines will have unintended consequences, like enhancing negative emotions and exacerbating mental health issues, unwittingly enhancing viral transmission between asymptomatic children and older parents and grandparents, and/or delaying the acquisition of society-wide herd immunity which could prolong the amount of time our most vulnerable citizens are at high risk of infection. Obviously I do not know the answers. These are my current thoughts rolling around in my head. 

 

However, I want to reassure everyone with the facts that we do know:

• The vast majority of people that get The Virus will either have no symptoms or recover completely.
• The Virus itself may actively be working to become less virulent. The more it kills people, the less it can transmit between hosts. Viruses, therefore, often mutate and evolve to become less deadly.
• Viruses and bacteria, in general, are not the enemy. Much of our DNA is viral in origin and we rely on bacteria in our gut and elsewhere for our health. We most likely have more bacterial cells riding along in our body than human cells!
• Stress, anxiety, and powerlessness impair our immune function, so one of the most important ways to protect ourselves is to find ways to avoid constantly feeling these negative emotions. This is achievable with strategies that work! See below. 

 

I think the main way to feel empowered is to focus on what we ourselves can actually control and to let go of the things we cannot. 

 

God, grant me the serenity

to accept the things I cannot change,

the courage to change the things I can,

and the wisdom to know the difference.

 

You can’t control the news media fear mongering. You can’t control the panic all around you. You can’t control the blame, finger pointing, and fear of others that is smoldering in our society. But you can quit smoking. You can reduce stress. You can turn away from the TV and towards loving family and friends. You can eat healthy foods. You can help yourself and your family! In these difficult times (and always), rely on yourself, your family, your close friends, and your local community. Government officials and news pundits hundreds or thousands of miles away don’t know you personally and thus can’t help you personally. 

 

In my opinion, the primary goal of most of the large mainstream news media outlets is not to inform the public about the most important stories, but is rather to sell advertising and increase viewership. We have to resist buying into the sensationalism and panic! Be prepared and cautious, yes. But anxiety and fear will not help the situation. They will only cause more sickness and suffering. This is not the first, nor will it be the last, virus or disease that we will face. The best strategy is to build up resilience. Both bodily resilience in terms of your immune system but also resilience to the psychological virus that is spreading even faster than COVID-19. I personally am much more worried about the spread of despair and unrest than I am about any virus. 

 

In addition to focusing our attention on the things within our realm that we can control, how do we reduce these negative emotions? Meditation is a great tool to reduce anxiety. The app Waking Up by Sam Harris is a great guided meditation system that I have found to be very helpful. It is a subscription service, although he allows free accounts if you truly cannot afford the fee. Meditation reinforces the fact that we experience everything through our perceptions. Reality is what we perceive through the filter of our senses. So examining our minds and looking inward – observing the filter through which life is lived – can have a profound effect on how you think and how you feel. Reducing negative emotions does not just increase feelings of wellbeing. As Dr. Gabor Maté writes in his enlightening book When the Body Says No, “It is artificial to impose a separation between hormones and emotions.” He goes on to write:

 

“Psychological influences make a decisive biological contribution to the onset of malignant disease through the interconnections linking the components of the body’s stress apparatus: the nerves, the hormonal glands, the immune system and the brain centres where emotions are perceived and processed. Biologic and psychological activity are not independent; each represents the functioning of a super-system whose components can no longer be thought of as separate or autonomous mechanisms.”

 

Another way to balance out the fear, anxiety, and stress we are all feeling right now is to start writing a gratitude journal. At least once a day, pick out three unique things that you are grateful for and write them down. I do this before bed and it helps me calm my mind before sleep. Sometimes I find it hard to think of things, especially recently, and I have to fall back on the tried and true: “I am grateful for my wonderful wife Rosemary.” Or I think about simple, but profound, things like running water, a roof over my head, or friends to laugh and play virtual trivia with. But the more you do it, the better you get. And it is a constant reminder that there are good things to acknowledge. The world is not ending and we have a lot to be thankful for! 

 

The power of the mind is immense. For example, take the placebo effect – when a person has a reaction (either positive or negative) to an inert substance. It is usually referred to when discussing pharmaceutical drugs’ effectiveness. For example, if both a new blood pressure drug and a placebo lowered the average blood pressure of the study group by 6%, then the drug is considered ineffective. The placebo effect has long been considered a pesky variable to be controlled for. But instead of thinking of the placebo effect as a sign the drug doesn’t work, we need to realize that it is really saying that the mind does work! We have the power, with our beliefs and expectations, to change our health status! 

 

I will leave you with this final thought. We evolved over eons (or were designed by an omnipotent all-intelligent creator) to have an immune system capable of responding to anything that we might encounter. Yes, humans are the smartest species on the planet, but are we smarter than millions of years of trial and error and survival experience? We need to trust the innate intelligence of our bodies and immune systems. We need to get out of the way – stop smoking and avoid other forms of toxic exposure like pesticides and endocrine-disrupting chemicals – and give our bodies what they need: a good diet, enough sleep, and freedom from chronic psychological distress. We can do this! Be well, my friends!

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Check out my previous post about Coronavirus here. It has tips on nutrition, supplements, sleep, and other thoughts on COVID-19.

[UPDATE AS OF 3/20/2020]: Dr. Chris Masterjohn, a respected nutrition researcher, recently came out with the excellent and well-researched “Food and Supplement Guide to the Coronavirus” (available here). He undertook an extremely in-depth look at the scientific research surrounding effective treatments and preventative measures that have been studied in relation to viruses similar to SARS-CoV2. For example, the SARS Coronavirus that caused an outbreak in 2003 is genetically 87% similar to SARS-CoV2. He also looks at the unique known pathology of The Virus and how it interacts with ACE2 and interferons in our bodies, as well as taking into account that it is a lipid-enveloped virus. For all the rest of the gory details, as well as comprehensive science-backed food and supplement recommendations, I highly recommend purchasing it here. With all that said, I’ve slightly updated my recommendations below, especially with regards to Vitamins A, C, and D, Zinc, Elderberry, Garlic, and smoking. I have also learned a lot about the natural history and pathology of COVID-19 from Peter Attia, MD and his Podcast and Show Notes, available here.  

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According to the CDC, “at this time [March 13, 2020], there is no vaccine to protect against COVID-19 and no medications approved to treat it. Nonpharmaceutical interventions (NPIs) would be the most important response strategy.” NPIs include handwashing, staying home when sick, covering coughs and sneezes, avoiding crowds, and cleaning surfaces. Basically, avoid all other humans and sanitize everything. These recommendations are making me want to lock the door and cower alone at home clutching a bottle of Purell. I wonder, is there anything else I can do besides feel paranoid, afraid, and helpless?

 

The first thing I have to remind myself is that we can choose what to worry about. We can be rational beings. We can look at the facts. We don’t have to freak out just because the news media tells us to freak out. This is not to say we shouldn’t take reasonable precautions and be vigilant about hand washing and other ways of limiting the spread of The Virus. But there is a big difference between taking reasonable precautions and panic-buying ridiculous amounts of hand sanitizer and surgical masks thereby preventing medical professionals and those at high risk from having access to those items. There is a big difference between avoiding large crowds and treating anyone who coughs as a leper to be feared. 

 

Did you know that around 20,000 people have died this season from influenza or influenza like illness in the United States? Did you know that nearly 40,000 people die each year of sepsis (bacterial blood poisoning)? And that’s just infections. Even with the uncertainty of The Virus, I feel confident saying that the average American adult trying to avoid the grim reaper this year should concern themselves more with cancer (111,040 deaths in 2018), accidents (96,287 deaths), heart disease (89,613 deaths), and suicide (34,474 deaths). [https://wonder.cdc.gov/]

 

Again, I don’t mean to minimize those who have died. It is a tragedy for sure, and I feel terrible for the family members of those who have lost someone. And I do think we should take The Virus seriously so that we limit its spread and don’t carelessly expose those at risk. But I also think we should connect our level of worry and panic with the actual statistics and risk level. And I think that when we do choose to be concerned about something that we rationally think is a threat to our well-being, that we should try our best to find ways to take action to protect ourselves. Because, believe it or not, feeling scared, stressed, helpless, and disempowered is bad for our immune systems [1]. So anytime we can be proactive and feel that we are empowered and taking charge, our stress level goes down and our immune function goes up.

 

In fact, any other stress-reducing activities will help you as well since stress is such a drain on the immune system. This whole global pandemic situation has really made me want to start meditating again. There are apps available like Headspace, Calm, Waking Up, and 10% Happier. Or just take 5 to 10 minutes, close your eyes, and focus on your breathing. That’s all it takes sometimes to get out of fight or flight mode and into a more relaxed state [2,3]. If you have access to a sauna, that is a great stress reduction activity with additional benefits (cardiovascular, exercise recovery, metabolic) [5,6]. Exercise is another multifunctional health activity. It reduces stress but also boosts your immune system [3,4]. Finally, take hot baths, laugh, connect with loved ones [8], or better yet do all three at the same time! Whatever reduces your stress will make more resources available to your immune defenses. 

 

Related to stress, sleep is essential for a highly functioning immune system to defend you from not just The Virus, but from anything that is trying to invade your system. Sleep expert and researcher Dr. Matthew Walker writes in Why We Sleep, “Downstairs in the body, sleep restocks the armory of our immune system, helping fight malignancy, preventing infection, and warding off all manner of sickness.” He also describes the research of Dr. Aric Prather [9]: “The less sleep an individual was getting in the week before facing the active common cold virus, the more likely it was that they would be infected and catch a cold.” So getting enough sleep is a very important tool to protect ourselves from The Virus and other infections. If you are having trouble sleeping, make sure to try the following tips for improving your sleep hygiene before resorting to sleeping pills (which unfortunately tend to only produce unconsciousness and not the deep sleep important for healing and immune enhancement). This list is adapted from Why We Sleep and https://medlineplus.gov/healthysleep.html.

• Stick to a sleep schedule and go to bed and get up at the same times every day (even weekends!)
• Avoid caffeine (especially later in the day) and nicotine. Caffeine has a halflife in your body of around 6 hours and as Dr. Walker says, drinking a cup of coffee at 4:00pm is the same as chugging a half cup of coffee at 10:00pm and then expecting to go to sleep without problem! 
• Avoid alcohol before bed, since it tends to rob you of REM sleep, impair your breathing, and cause disruptive excessive urination.
• Exercise regularly but not too close to bedtime.
• Don’t eat a large meal too close to bedtime. Try to stop eating three hours before you go to sleep. 
• Investigate if any prescription drugs you are taking might disrupt your sleep. 
• Try to avoid napping after 3:00pm.
• Relax before bedtime – meditate, listen to calming music, read, but for God’s sake don’t check your email one last time – it can wait!
• Take a hot bath/shower before bed. The cooling of your body after you get out can help induce sleepiness.
• Make sure your bedroom is very dark and free of any electronics or anything else that could distract you from sleep. Keep a cool room and avoid bright clocks facing you as you try to sleep.
• Try to get enough sunlight exposure during the day (an hour or more if you are having sleep problems) and then turn down the lights an hour before bed (or wear blue-blocking glasses).
• Don’t lie in bed awake for hours. If you can’t sleep, get up and do something relaxing until you get sleepy. This helps to avoid setting up an association between being in bed and not being able to sleep. 

 

As a Nutritional Therapy Practitioner, I tend to think what we eat is very important to our health. Adopting a nutrient dense, whole foods diet and avoiding processed foods, excessive sugar, and industrial seed oils can go a long way in making sure your immune system is strong [18-19].

 

The gut is home to around 70% of the immune system, so making sure digestion is in good shape is the number one priority for healthy immunity. The stomach needs to be full of acid that not only helps digest food, but also kills pathogenic material we might swallow, like viruses and bacteria. We need to keep our stomach acidic enough by avoiding things that inhibit acid production: chronic stress, too much alcohol, and a processed-food diet lacking in zinc, calcium, iodine, and vitamin C. We also need to get enough water throughout the day, be in a calm state when we eat, and chew our food thoroughly. If undigested chunks of food make it to the small intestine they can cause inflammation that interferes with the healthy functioning of Peyer’s patches, which are an important part of our immune system that prevents bacterial overgrowth in the gut. Blood sugar imbalance is a stressor to the body and takes energy away from our immune systems, so a good strategy is to eat a low glycemic diet that keeps blood glucose levels even throughout the day rather than spiking and crashing. Finally, the immune system requires the correct balance of dietary fats to function properly with its inflammation and anti-inflammation healing processes, so it is important to eat a good mix of wild-caught fish, pasture-raised animal fats, and plant fats like those found in avocados and walnuts. For more specific dietary recommendations, click here. https://evanengelstad.com/wp-content/uploads/2019/04/Healthy-Food-Choices.pdf

 

Specific foods and supplements have shown promise in preventing or reducing the severity of colds, flu, or other respiratory infections. Vitamin C, in particular, has been studied for its antiviral properties [10-12]. Studies are currently underway with high-dose intravenous Vitamin C as a COVID-19 treatment and a group of doctors in the discipline known as orthomolecular medicine claim that it is the only effective treatment so far [13]. However, for prevention, nutrition researcher Dr. Chris Masterjohn recommends against high-dose Vitamin C for COVID-19 because of the potential for it to enhance interferon production which could actually be used against the body and cause more damage from the virus [23]. Therefore, I also recommend against high-dose Vitamin C supplements as a preventative measure for COVID-19. But I do recommend getting a sufficient amount for general health by eating Vitamin C-rich foods like citrus fruits, cantaloupe, kiwi, mango, papaya, pineapple, berries, watermelon, broccoli, Brussel sprouts, cabbage, peppers, potatoes, spinach, other leafy greens, tomatoes, and winter squash.

 

Vitamins A and D are also extremely important for immune function. But like Vitamin C, I recommend not taking high doses of these supplements due to the potential to increase the substance ACE2 in our bodies that is used by COVID-19 to gain entrance to our cells [23]. But I still recommend getting enough of each to maintain health and avoid deficiency. To get optimal vitamin D status you’ll need to get enough sun daily (spending as much time as possible outside without getting sunburned). Liver is a wonderful superfood for both of these nutrients (as well as Zinc and a host of others). If you do not like the taste, you can try soaking it in lemon juice before cooking, grinding it up as a portion of chili meat, or eating it as braunschweiger or liverwurst. You can also take cod liver oil or liver powder supplements. Just do not eat more than 3-4 ounces of liver per week to avoid getting high doses of Vitamin A while you are at risk of contracting SARS-CoV2. 

 

Zinc is another nutrient essential to your immune system and that has shown promise in interfering with other coronaviruses like SARS. Dr. Masterjohn recommends getting enough Zinc by eating one or two oysters three to four times a day [23]. Zinc is also found in beef, lamb, and dark meat chicken, certain cheeses, and soaked, sprouted, or fermented grains, legumes, nuts, and seeds. Zinc lozenges can also be an effective way to reduce viral colonization in the throat [14-16].

 

Consuming bone broth is another way to not only help your immune system, but your health in general [21]. While it is quite expensive to buy quality bone broth, it is fairly straightforward to make it at home yourself using leftover chicken bones from roasting a whole chicken or getting cheap soup bones from a local butcher. Dr. Masterjohn lists Elderberry extract (found in lozenges, syrups, or capsules) as his first line of defense against COVID-19 due to its possible ability to block viral attachment to ACE2 [23]. Echinacea has also been studied extensively and shows promise in promoting positive outcomes with the common cold (caused by various types of rhinoviruses or coronaviruses) [22]. Unfortunately, excessive alcohol consumption is a sure way to depress your immune system and make you more susceptible to The Virus [20]. My advice is to make some tea and pretend it is booze! You’ll have just as much fun, I promise. And finally, now would be an excellent time to quit smoking since that is turning out to be a significant risk factor for COVID-19. 

 

Functional medicine doctor Chris Kresser listed several other foods and supplements to boost your immune system in his recent podcast with infectious disease specialist Dr. Ramzi Asfour [17]:

• Garlic (here is a delicious recipe that is high in garlic, it uses 44 cloves! https://smittenkitchen.com/2006/08/a-44-clove-ticket-to-a-happier-place/)
  • To get the benefit of the antiviral component of garlic called allicin, Dr. Masterjohn recommends crushing or dicing garlic, leaving it for 10 minutes at room temperature to let oxidation happen to enhance the amount of allicin, and eating it raw [23]. It takes a strong stomach, but it might be worth it to protect yourself from The Virus!
• Ginger
• Fermented foods like sauerkraut and kimchi
• Cordyceps medicinal mushroom
• Astragalus
• Chinese medicinal herbs: Shuang-Huang-Lian, lian qiao (Forsythia suspensa), jin yin hua (Lonicera japonica), huang qin (Scutellaria baicalensis)

 

The commonality with all the above recommendations is that they are all extremely low risk (with the possible exception of sauna therapy and certain foods/supplements if you are allergic). In fact, most of them have no risk at all. And aside from a few of the more rare supplements/herbs, they are also all very inexpensive, if not free (which is, perhaps, why they get no attention in the media). But they are all backed by varying degrees of scientific evidence listed below. Some of the recommendations have also been practiced by traditional cultures for hundreds if not thousands of years. So why not try to incorporate some of them into your life to protect yourself from infection with The Virus? It sure beats feeling helpless and scared! Be well, my friends! 

 

References

Mindset, Stress Reduction, Exercise, Sauna, Sleep

[1] Wallerstein N. Powerlessness, empowerment, and health: implications for health promotion programs. Am J Health Promot. 1992 Jan-Feb;6(3):197-205. Review. PubMed PMID: 10146784.

• “Powerlessness, or lack of control over destiny, emerges as a broad-based risk factor for disease. Empowerment, though more difficult to evaluate, can also be demonstrated as an important promoter of health.”

 

[2] Black DS, Slavich GM. Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Ann N Y Acad Sci. 2016;1373(1):13–24. doi:10.1111/nyas.12998

• “In conclusion, across 20 RCTs and more than 1600 participants, we found tentative evidence that mindfulness meditation modulates some select immune parameters in a manner that suggests a more salutogenic immune profile. Specifically, mindfulness meditation appears to be associated with reductions in proinflammatory processes, increases in cell-mediated defense parameters, and increases in enzyme activity that guards against cell aging.”

 

[3] Obasi CN, Brown R, Ewers T, Barlow S, Gassman M, Zgierska A, Coe CL, Barrett B. Advantage of meditation over exercise in reducing cold and flu illness is related to improved function and quality of life. Influenza Other Respir Viruses. 2013 Nov;7(6):938-44. doi: 10.1111/irv.12053. Epub 2012 Nov 21. PMID: 23170828; PMCID: PMC3582749.

• “The MEPARI trial suggests that both moderate-intensity exercise and mindfulness meditation may prevent ARIs [acute respiratory infections] and reduce the impact and that mindfulness meditation may be the more potent of the two interventions.”

 

[4] Davison G, Kehaya C, Wyn Jones A. Nutritional and Physical Activity Interventions to Improve Immunity. Am J Lifestyle Med. 2014 Nov 25;10(3):152-169. doi: 10.1177/1559827614557773. eCollection 2016 May-Jun. PubMed PMID: 30202268; PubMed Central PMCID: PMC6124954.

• “The available evidence suggests that regular moderate activity is particularly beneficial for immune enhancement and reducing the risk of infection, especially URTI, in the general populations.”

 

[5] Tomiyama C, Watanabe M, Honma T, Inada A, Hayakawa T, Ryufuku M, Abo T. The effect of repetitive mild hyperthermia on body temperature, the autonomic nervous system, and innate and adaptive immunity. Biomed Res. 2015;36(2):135-42. doi: 10.2220/biomedres.36.135. PubMed PMID: 25876664.

• “…repeated mild hyperthermia by MNS may induce suppression of the sympathetic nervous system. Acquired immunity by T and B cells as well as innate immunity by NK cells was also enhanced.”

 

[6] Ernst E, Pecho E, Wirz P, Saradeth T. Regular sauna bathing and the incidence of common colds. Ann Med. 1990;22(4):225-7. PubMed PMID: 2248758.

• “There were significantly fewer episodes of common cold in the sauna group. This was found particularly during the last three months of the study period when the incidence was roughly halved compared to controls.”

 

[7] Cohen S, Doyle WJ, Alper CM, Janicki-Deverts D, Turner RB. Sleep habits and susceptibility to the common cold. Arch Intern Med. 2009 Jan 12;169(1):62-7. doi: 10.1001/archinternmed.2008.505. PMID: 19139325; PMCID: PMC2629403.

• “Poorer sleep efficiency and shorter sleep duration in the weeks preceding an exposure to a rhinovirus were associated with lower resistance to illness.”

 

[8] Umberson, D., & Karas Montez, J. (2010). Social Relationships and Health: A Flashpoint for Health Policy. Journal of Health and Social Behavior, 51(1_suppl), S54–S66. https://doi.org/10.1177/0022146510383501

• “Poor quality and low quantity of social ties have also been associated with inflammatory biomarkers and impaired immune function, factors associated with adverse health outcomes and mortality.”

 

[9] Prather AA, Janicki-Deverts D, Hall MH, Cohen S. Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep. 2015 Sep 1;38(9):1353-9. doi: 10.5665/sleep.4968. PMID: 26118561; PMCID: PMC4531403.

• “Shorter sleep duration, measured behaviorally using actigraphy prior to viral exposure, was associated with increased susceptibility to the common cold.”

 

Vitamin C

[10] Vorilhon P, Arpajou B, Vaillant Roussel H, Merlin É, Pereira B, Cabaillot A (2019) Efficacy of vitamin C for the prevention and treatment of upper respiratory tract infection: a meta-analysis in children. Eur J Clin Pharmacol 75:303–311. https://doi.org/10.1007/s00228-018-2601-7

• “Although no preventive effects were found, vitamin C intake reduced the duration of URTI. Considering the frequency of URTI, the inappropriate prescription of antibiotics, and the safe nature of vitamin C, its supplementation is justified, especially in children under 6 years of age and those who present a high frequency of URTI. There is a sound rationale for further trials with greater statistical power among children of this age.”

 

[11] Ran L, Zhao W, Wang J, Wang H, Zhao Y, Tseng Y, Bu H. Extra Dose of Vitamin C Based on a Daily Supplementation Shortens the Common Cold: A Meta-Analysis of 9 Randomized Controlled Trials. Biomed Res Int. 2018 Jul 5;2018:1837634. doi: https://doi.org/10.1155/2018/1837634. eCollection 2018. PubMed PMID: 30069463; PubMed Central PMCID: PMC6057395.

• “In the evaluation of vitamin C, administration of extra therapeutic doses at the onset of cold despite routine supplementation was found to help reduce its duration (mean difference (MD) = -0.56, 95% confidence interval (CI) [-1.03, -0.10], and P = 0.02), shorten the time of confinement indoors (MD = -0.41, 95% CI [-0.62, -0.19], and P = 0.0002), and relieve the symptoms associated with it, including chest pain (MD = -0.40, 95% CI [-0.77, -0.03], and P = 0.03), fever (MD = -0.45, 95% CI [-0.78, -0.11], and P = 0.009), and chills (MD = -0.36, 95% CI [-0.65, -0.07], and P = 0.01).”
• “Extra doses of vitamin C could benefit some patients who contract the common cold despite taking daily vitamin C supplements.”

 

[12] Hemilä H. Vitamin C and Infections. Nutrients. 2017 Mar 29;9(4). pii: E339. doi: 10.3390/nu9040339. Review. PubMed PMID: 28353648; PubMed Central PMCID: PMC5409678.

• “In the early literature, vitamin C deficiency was associated with pneumonia. After its identification, a number of studies investigated the effects of vitamin C on diverse infections. A total of 148 animal studies indicated that vitamin C may alleviate or prevent infections caused by bacteria, viruses, and protozoa.”

 

[13] http://orthomolecular.org/resources/omns/v16n04.shtml

• “The coronavirus pandemic can be dramatically slowed, or stopped, with the immediate widespread use of high doses of vitamin C. Physicians have demonstrated the powerful antiviral action of vitamin C for decades.”

 

Vitamin A and D and Zinc

[14] https://www.foundmyfitness.com/vitamin-d

• Low vitamin D leads to impaired immune function.

 

[15] Huang Z, Liu Y, Qi G, Brand D, Zheng SG. Role of Vitamin A in the Immune System. J Clin Med. 2018;7(9):258. Published 2018 Sep 6. doi:10.3390/jcm7090258

• “Vit. A has both promoting and regulatory roles in both the innate immune system and adaptive immunity; therefore, it can enhance the organism’s immune function and provide an enhanced defense against multiple infectious diseases.”

 

[16] Singh M, Das RR. Zinc for the common cold. Cochrane Database Syst Rev. 2011 Feb 16;(2):CD001364. doi: 10.1002/14651858.CD001364.pub3. Review. Update in: Cochrane Database Syst Rev. 2013;6:CD001364. PubMed PMID: 21328251.

• “Zinc administered within 24 hours of onset of symptoms reduces the duration and severity of the common cold in healthy people. When supplemented for at least five months, it reduces cold incidence, school absenteeism and prescription of antibiotics in children.”

 

Chris Kresser Podcast

[17] https://chriskresser.com/everything-you-need-to-know-about-coronavirus-with-dr-ramzi-asfour/

 

Sugar and Industrial Seed Oils

[18] Albert Sanchez, J. L. Reeser, H. S. Lau, P. Y. Yahiku, R. E. Willard, P. J. McMillan, S. Y. Cho, A. R. Magie, U. D. Register, Role of sugars in human neutrophilic phagocytosis, The American Journal of Clinical Nutrition, Volume 26, Issue 11, November 1973, Pages 1180–1184, https://doi.org/10.1093/ajcn/26.11.1180

• “Oral 100-g portions of carbohydrate from glucose, fructose, sucrose, honey, or orange juice all significantly decreased the capacity of neutrophils to engulf bacteria as measured by the slide technique.”
• “This implicates glucose and other simple carbohydrates in the control of phagocytosis and shows that the effects last for at least 5 hr.”

 

[19] Turley AE, Zagorski JW, Rockwell CE. The Nrf2 activator tBHQ inhibits T cell activation of primary human CD4 T cells. Cytokine. 2015 Feb;71(2):289-95. doi: 10.1016/j.cyto.2014.11.006. Epub 2014 Dec 5. PubMed PMID: 25484350; PubMed Central PMCID: PMC4297602.

• “Collectively, these data suggest that tBHQ inhibits activation of primary human CD4 T cells, which correlates with activation of Nrf2 and inhibition of NFκB DNA binding. Although these studies suggest the food additive tBHQ negatively impacts T cell activation, further studies will be needed to fully elucidate the effect of tBHQ on human immune responses.”

 

Alcohol

[20] Sarkar D, Jung MK, Wang HJ. Alcohol and the Immune System. Alcohol Res. 2015;37(2):153–5. PMCID: PMC4590612.

• “Clinicians have long observed an association between excessive alcohol consumption and adverse immune-related health effects such as susceptibility to pneumonia. In recent decades, this association has been expanded to a greater likelihood of acute respiratory stress syndromes (ARDS), sepsis, alcoholic liver disease (ALD), and certain cancers; a higher incidence of postoperative complications; and slower and less complete recovery from infection and physical trauma, including poor wound healing.”

 

Bone Broth

[21] Wheeler MD, Rose ML, Yamashima S, Enomoto N, Seabra V, Madren J, Thurman RG. Dietary glycine blunts lung inflammatory cell influx following acute endotoxin. Am J Physiol Lung Cell Mol Physiol. 2000 Aug;279(2):L390-8. PubMed PMID: 10926563.

• “Chronic glycine improves survival by unknown mechanisms, but reduction of lung inflammation is likely involved.”

 

Echinacea

[22] Melchart D, Linde K, Fischer P, Kaesmayr J. Echinacea for preventing and treating the common cold. Cochrane Database Syst Rev. 2000;(2):CD000530. Review.  Update in: Cochrane Database Syst Rev. 2006;(1):CD000530. PubMed PMID: 10796553.

• “The majority of the available studies report positive results. However there is not enough evidence to recommend a specific Echinacea product, or Echinacea preparations for the treatment or prevention of common colds.”

 

Chris Masterjohn, PhD and Peter Attia, MD

[23] “Food and Supplement Guide for the Coronavirus”

• Available here.

[24] PODCAST #98 – Peter Attia, M.D. and Paul Grewal, M.D.: Coronavirus (COVID-19) FAQ

• Available here.

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I am not diagnosing or treating any disease, nor am I giving medical advice of any kind.

Consult your doctor before starting any exercise program, meditating, going outside, trying to improve your sleep,

taking any supplements, starting a sauna routine, changing your diet, making more friends, or doing anything at all.

This article introduces an upcoming ten-part series on the immune system. Here is the main thesis of the series: Problems relating to our immune systems, such as infection, allergies, autoimmune disease, and cancer, are mostly caused by our lifestyle and the environment we create for ourselves. We have considerable control over both of these factors, and we should therefore feel empowered to take action to improve our health and that of our immune system. 

Introduction

Consider the following two paradigms of disease causation and health. One, the germ theory of disease commonly associated with Louis Pasteur and Robert Koch, posits that specific germs cause specific diseases. For example, the bacteria Mycobacterium tuberculosis causes the disease tuberculosis and poliovirus causes poliomyelitis. The foundation of germ theory, and the way scientists tried to rigorously prove a particular germ caused a particular disease, was a set of criteria known as Koch’s postulates:

1. The microorganism must be found in all organisms suffering from the disease, but not in healthy organisms.
2. The microorganism must be isolated from a diseased organism and grown in pure culture.
3. The cultured microorganism should cause disease when introduced into a healthy organism.
4. The microorganism must be reisolated from the inoculated, diseased experimental host and identified as being identical to the original specific causative agent.

Even though these benchmarks are now outdated and somewhat inaccurate since our understanding of disease has advanced, they still continue to greatly influence the way doctors and researchers think about infectious disease. The germ theory paradigm focuses on pathology and illness, and thus seeks to remove whatever is causing problems in the system so that it can be healthy again. Germ theory is the dominant paradigm in medicine today, and modern physicians use antibiotics, antifungals, antivirals, tumor removal surgery, radiation and chemotherapy to kill cancer cells, and other methods to destroy or eradicate substances from the body. 

Another paradigm of disease causation and health is the terrain theory of Pierre Jacques Antoine Béchamp, which posits that germs can only cause disease when one’s internal environment provides the right conditions for that germ to flourish. It focuses on trying to create a bodily environment inhospitable to opportunistic pathogens. It assumes that given optimal conditions, humans tend towards health and vitality. 

In the debate between Pasteur and Béchamp during the mid-19th century, germ theory won decisively and Béchamp has been relegated to the scientific dustbin. Germ theory has the benefit that it makes sense and is intuitive. It is easy to imagine certain tiny organisms infiltrating your lungs, multiplying, and causing irritation that makes you cough, for example. Since the mid-1850s, scientists have poured huge amounts of money, time, and effort into conducting vast numbers of experiments trying to find disease-causing pathogens and ways to destroy them. Germ theory became the dominant paradigm of disease causation for a reason. It is supported by common sense, scientific studies, and the fact that antibiotics are mostly effective in treating acute infections. This path has obviously helped many people survive otherwise gruesome diseases in the last two centuries.

But I do not believe all aspects of terrain theory need to be cast away and ridiculed. Germ theory is not perfect. It does not describe the whole story and I think that many of Béchamp’s ideas also make intuitive sense and fill in the gaps left by germ theory. For example, antibiotics are losing their effectiveness and antibiotic resistant bacteria is on the rise, creating dangerous hospital environments that are breeding grounds for these dangerous superbugs. Antibiotic use also damages one’s microbiome, which, given the ever-increasing recent understanding of its many functions, seems likely to cause unintended health problems. Germ theory also does not explain why infection with poliovirus is asymptomatic for the vast majority of cases, why there are around two billion people worldwide infected with M. tuberculosis that never present with active tuberculosis, and why your friend never gets sick when the rest of the office is coming down with the flu.

Germ theory has one other important disadvantage compared with terrain theory: it tends to promote a feeling of individual powerlessness and fear. We are at the mercy of the dangerous outside environment. We desperately sanitize our hands, wear SARS masks, and avoid shaking hands with sick people because if we come into contact with the pathogen, then we believe we will get sick. Terrain theory, on the other hand, assumes that germs have always been out there and that they will always be out there. But it gives us power. If we can create an environment inside our bodies that is more inhospitable to illness, then we have less of a chance of catching that cold or flu, and a greater chance at a speedy recovery if we do. And this feeling of empowerment helps our cause, because feeling powerless actually harms our health. 

So how do we cultivate a healthy internal environment and an immune system that reacts properly to outside and inside germs? How do we avoid the minor signs of immune dysfunction like frequent colds and flu or mild seasonal/food allergies? And the more severe issues that appear as the vast array of autoimmune diseases like rheumatoid arthritis, lupus, Crohn’s disease, multiple sclerosis, type I diabetes, psoriasis, or Hashimoto’s thyroiditis? And can we avoid the most severe immune problem of all, cancer? The statistics are horrific: 32 million Americans suffer from food allergies, 50 million suffer from autoimmune diseases, 40% will get a cancer diagnosis in their lifetimes, and 20% of Americans will die of cancer. 

But you don’t have to become a statistic. I write this series to empower you to take action for your health. You have the power to support your immune system! You are not at the mercy of your genetics or environment exposures! 

Modern science still has much to discover about the intricacies of the immune system; a magic pill to optimize or heal one’s immune system seems unlikely to be developed in the near future (or ever). But we do have scientific studies that offer glimpses of what lifestyle choices and environmental factors seem to help or hurt our immunity. We can also look back to the lifestyles of our ancestors who did not experience any autoimmune diseases, allergies, or cancer. And we can draw from our own common sense and intuition about our bodies. From this perspective, I offer these ten ways to support our immune systems. Each topic will be a separate article in this ten-part series. Check back for links to each article. 

1. Food

2. Sleep

3. Exercise

4. Friends and Family

5. Vitamin D and Sun Exposure

6. Meditation and Mindset

7. Other Nutrients and Supplements 

8. Time-Restricted-Eating

9. Childbirth and Breastfeeding

10. Sauna Use

 

References and Further Reading:

Zumla A, Maeurer M. Host-Directed Therapies for Tackling Multi-Drug Resistant Tuberculosis: Learning From the Pasteur-Bechamp Debates. Clin Infect Dis 2015 Nov 1, 61(9):1432-8. doi: 10.1093/cid/civ631.

Harvard Health Publishing. How to boost your immune system. Harvard Med. Sch. Sept 2014. https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system.

Teng MWL, et al. Immune-mediated dormancy: an equilibrium with cancer. J. Leukoc Biol 2008, 84: 988-993. https://doi.org/10.1189/jlb.1107774.

Seeman M, Lewis S. Powerlessness, health and mortality: a longitudinal study of older men and mature women. Soc Sci Med 1995 Aug;41(4):517-25.

Wallerstein N. Powerlessness, empowerment, and health: implications for health promotion programs. Am J Health Promot 1992 Jan-Feb;6(3):197-205.

https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance

Langdon A, Crook N, Dantas G. The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation. Genome Med 2016; 8(1):39. doi:10.1186/s13073-016-0294-z

Struelens MJ. The epidemiology of antimicrobial resistance in hospital acquired infections: problems and possible solutions. BMJ 1998, 317 (7159):652–654. doi:10.1136/bmj.317.7159.652.

Stewardson AJ, Huttner B, Harbarth S. At least it won’t hurt: the personal risks of antibiotic exposure. Curr Opin Pharmacol 2011 Oct;11(5):446-52. doi: 10.1016/j.coph.2011.06.011.

Mehndiratta MM, Mehndiratta P, Pande R. Poliomyelitis: historical facts, epidemiology, and current challenges in eradication. Neurohospitalist 2014;4(4):223–229. doi:10.1177/1941874414533352.

https://www.wired.com/story/the-19th-century-crank-who-tried-to-tell-us-about-the-microbiome/

 

I am a 31-year-old married man. I do not have mature mammary glands. (Yet.) I do not have a thirsty newborn. But I do have an insatiable interest in breastfeeding after reading a fascinating article in The Stranger entitled “The More I Learn About Breast Milk, the More Amazed I Am.” I fell deep into the rabbit hole and this blog post attempts to scratch the surface of the amazing topics of breastfeeding and breast milk. It is our first food source, fully customized and full of specialized elements. Perhaps we can learn more about adult nutrition by examining its composition. Researching breast milk has decidedly strengthened my appreciation of the human body and everything it does without our even thinking or knowing about it. I hope you enjoy the following remarkable aspects of breast milk.

 

Composition of Breast Milk

If you sold human milk in stores, could you put an accurate nutrition facts label on it? What are the ingredients of breast milk, anyway? Well, “it depends.” It depends on the age of the infant. It depends on if the baby was born preterm or not. It depends on the diet of the mother. It depends on the immune status of mother and child. It even depends on the gender of the baby! All of these factors (and more) can change the composition of human milk.

 

Stages of Development

The composition of breast milk is constantly changing depending on the needs of the baby. In terms of macronutrients, for example, the protein composition of breast milk tends to go down gradually as the infant gets older. The first milk a mother produces – colostrum – is full of immune factors that help build a baby’s immune system and prebiotics to help grow the baby’s microbiome. As the infant grows, the composition of milk shifts to become richer in calories (fat and carbohydrates) and less rich in immune proteins. And in premature babies, mothers tend to produce higher protein and fat milk (perhaps to help them catch up and grow quicker).

 

Diet of Mother

The fatty acid composition of breast milk is much more dependent on the mother’s diet than the carbohydrate or protein composition. Drawing from Milligan and Bazinet’s research, Katie Hinde summarizes in her fascinating blog post “How Special is Human Breast Milk? Part II”

Women consuming a “Western” diet have 0.32% DHA (omega-3) in milk, whereas women consuming a lot of fish have 0.93% DHA, but vegetarian and vegan women have 0.22% and 0.14% DHA respectively.

DHA stands for docosahexaenoic acid, a conditionally essential fatty acid. In order to be optimally healthy, humans need to consume two types of essential fatty acids: linoleic acid (LA) and alpha-linolenic acid (ALA). ALA is converted to DHA in the human body so that it can be used in brain and retina tissue, as well as to create anti-inflammatory prostaglandins. Most people do not efficiently convert ALA to DHA and thus need to consume more preformed DHA in their diet. Due to DHA’s importance in the neurodevelopment of growing infants, it is important for nursing mothers to have sufficient levels of DHA in their breast milk. Eating fish is one proven way to accomplish that. An excellent article by Arthur Haines entitled “Why You Should Consume Seafood Despite the Warnings” might help you decide whether or not to eat fish in the face of warnings about mercury and other pollutants in fish. And DHA status does not just affect infant brain and retina development. Analysis of two clinical trials showed that pregnant women are less likely to have preterm births if they have sufficient DHA status.

The mother’s diet not only affects the macronutrient composition of breast milk, but also its taste! Leave it to Canadians to use a trained panel of adults to taste test breast milk from different mothers. Elizabeth Barker noted in the abstract of her dissertation entitled “Sensory Characterization of Human Milk”

Off-flavours noted in fresh human milk were described as metallic, fruity, sour and spicy. Frozen milk, subject to more frequent and more intense off-flavours, was described as metallic, cardboardy and soapy.

More recent research looking at differences between bottle fed and breastfed infants shows that babies can indeed taste differences in flavor and that it can influence their later experience of food. For example, mothers who recently ate spicy food create more “peppery” breast milk which in turn conditions their babies to develop a taste for the flavor that appears to continue into adulthood.

 

Gender

It turns out that in some cases, mothers make more energy-dense and fat-rich breast milk for baby boys than for baby girls. However, it may be that baby girls get a higher volume of breast milk from mothers so that the energy density is the same regardless of gender. The research is fairly sparse and has limitations, but it brings up an important question: if an infant does not have access to breast milk, do we need to have separate formula options depending on gender?

 

Immune Status of Infant

In another amazing blog post by Katie Hinde, she lays out the scientific plausibility of how the composition of mother’s milk can rapidly adapt to the immune needs of the infant. Here is how it basically works. While suckling, negative pressure is created around the nipple that takes a mixture of baby saliva and breast milk back into the milk ducts. This explains how a mother can then create breast milk with specific immunofactors to help the infant fight off an infection that the mother does not have. The combination of breast milk and baby saliva also creates a chemical reaction resulting in the formation of hydrogen peroxide that helps prevent harmful bacteria from growing and encourages the growth of helpful bacteria. Breast milk is an amazing mixture of not only lactose, fatty acids, and proteins, but of micronutrients, growth factors, hormones, immune factors, bacteria, and even stem cells!

 

In Part II of this blog post, I will compare breastfeeding to bottle feeding and how it can affect infant mortality, intelligence, and even the structure of the jaw. I will also dive into the Nestle controversy and boycott. Stay tuned!

 

References and Further Reading:

The entire blog Mammals Suck… Milk! by Katie Hinde is great. I consulted these articles for my post:

http://mammalssuck.blogspot.com/2017/02/no-country-for-colostrum.html

http://mammalssuck.blogspot.com/2016/01/breast-milk-baby-spit.html

http://mammalssuck.blogspot.com/2012/08/boy-milk-vs-girl-milk.html

 

Human Milk Composition: Nutrients and Bioactive Factors by Olivia Ballard and Ardythe L. Morrow

 

https://blog.theralogix.com/dha-during-pregnancy/

 

“Nutritional supplement could prevent thousands of early preterm births”

https://www.sciencedaily.com/releases/2016/10/161013130104.htm

 

The role of nutrition in children’s neurocognitive development, from pregnancy through childhood by Anett Nyaradi et al.

 

Flavor Perception in Human Infants: Development and Functional Significance by Gary K. Beauchamp and Julie A. Mennella

 

The sensory world of formula-fed infants: differences among artificial milk feedings in flavor learning and satiation by Mennella, Trabulsi, and Inamdar

 

Evolutionary modifications of human milk composition: evidence from long-chain polyunsaturated fatty acid composition of anthropoid milks by Milligan and Bazinet