By Karen Koffler, M.D.
Medical Director, Osher Center for Integrative Medicine
University of Miami Health System
There is an opportunity to learn and grow from every crisis.
Now more than ever, the coronavirus challenges us to become our own best health advocates. Based on the people I see that are most affected by serious illness, I’m convinced that addressing our lifestyle really shores up our health. In doing so, we protect ourselves so that if we become exposed to the virus, we may only develop a mild case. It all begins with a healthy immune system, and that’s created by how we live, eat, sleep, and move.
How does stress affect my immune response?
One thing I notice in my practice is that stressed people tend to eat poorly, skip exercise, have disrupted sleep, and tend to not follow practices that create greater resilience against stress. Stress upsets our microbiome and digestive function. It also alters hormonal communication within our body. Stress interferes with the ability of our cells to deliver sufficient oxygen and nutrients and to carry away waste. All of this makes immune system less functional. On an emotional level, stress really undermines our ability to think through a situation. It makes us less creative and less grateful.
How can I stick to a good diet during stressful times?
Food is not an ideal stress mitigating strategy. When people are tired and vulnerable, especially at the end of the day, they tend to reach for sweets or carbohydrates. Plan around this vulnerable time. Have a healthy late afternoon snack so you're not starving right before dinner or take a walk while someone else makes dinner.
Also, many people eat dinner and continue to snack until bedtime. My patients frequently tell me that if they stop eating after dinner, they sleep better, have a more restorative sleep, more energy and less brain fog the next day. So, just by deciding to close the kitchen after dinner, people often do really well.
People who are successful at not gaining weight during stressful times have a plan. They stock their home with foods that support their health goals. They don't shop for foods that undermine their health, and never shop when they're hungry. It also helps if the whole family practices healthy habits, especially when it comes to food.
Not everyone is consistent, so follow the 80/20 rule. If you maintain a good, nourishing diet 80% of the time, you can let go of the 20%.
Does weight gain affect my immune system response?
Many people joke about the “Quarantine 15”, but when we gain weight, our body secretes inflammatory cytokines, molecules that mediate and regulate immunity. One of the main things I do to protect patients is minimize inflammation. This makes the immune system much more appropriately responsive to health threats.
What supplements strengthen my immunity?
A healthy, varied diet with lots of fruits and vegetables, whole grains, plant-based proteins and limited red meat is the foundation of a strong immune system. Specific supplements also strengthen immune system function.
Vitamin D plays a key role in how well your immune system responds to invading marauders. Get a blood test to make sure your vitamin D3 level is at least 50. Even though we live in South Florida and should all be making plenty of vitamin D, I consistently check these levels in patients and find them low. Anything lower than 50 is probably too low, especially at this time. In addition to D, vitamin A and zinc are critical nutrients for an appropriate immune response.
Another supplement I like is quercetin. This is a bioflavonoid nutrient most commonly found in apples, goji berries, capers, onions and kale. At the Osher Center, we also recommend elderberry. Its effect on several viruses, including MERS and SARS, has been studied and shown to be effective.
Lastly, melatonin is protective against damage done to the lungs. Especially if patients have an issue with sleep, melatonin is useful during this time of COVID-15. It is critical that one get a high quality supplement.
If anxiety interferes with my sleep, is it okay to take a sleeping medicine?
How you prepare for sleep, how you create an evening that allows you to succumb to sleep is part of the sleep process. I hear about people binge-watching dramas or listening to the news before bed. Not texting, scrolling through social media or doing things that create tension or anxiety before sleep is really important. If you watch TV before bed (a habit you may want to reconsider), it can only be comedy. The state that is invoked when you laugh is very relaxing and healing.
I do like melatonin as a sleep aid, but it does create very vivid dreams. For some people, that's a wonderful adventure; for others it's not fun.
Also, many of my patients find chamomile tea relaxing. You could also try supplements such as L-theanine, lemon balm, kava, valerian, or passionflower. CBD oil from a reliable company also works well for many patients.
Another thing to remember is that alcohol disrupts sleep. Many of my patients did not realize that, but were waking up at 3 a.m. because alcohol impacted their blood sugar. When they stopped having a glass of wine, they slept better. Speaking of sugar, eating a sweet before bed tends to awaken people during the night.
Pharmaceutical sleep medicines don’t engender a deep, restorative sleep, so I would hold off on those and try natural remedies, such as the previously mentioned supplements or melatonin. Melatonin actually helps people attain deeper stages of sleep. Guided imagery, meditation, and breathing techniques are all known to be very effective at inducing sleep.
How can I motivate myself to exercise?
Exercise has so many benefits, it’s a wonder more people don’t embrace it. However, this pandemic has disrupted everyone’s routine, even those who regularly exercise at the gym, in fitness classes, or with friends.
First of all, we know that people who exercise moderately and regularly generally sleep better, as long as they work out early in the day, not at night, because that may disrupt sleep. We know that exercise improves our outer appearance, but it also enhances our body’s inner functions. It lowers cholesterol, blood pressure and stress and releases endorphins, which improve mood.
For right now, the great outdoors is a great substitute for the gym or Zumba class. Run, jog or walk through your neighborhood or along the beach, while maintaining social distancing. If you have children, include them if possible, so that everyone experiences the benefits of exercise. Ask a friend to be your accountability buddy and do weekly check-ins during a zoom call.
Redirect the energy you might use worrying to working out. Start small, maybe 10 minutes a day or 10-minute intervals of exercise three times a day. Add a few minutes each day. As you begin to reap benefits, you’ll be motivated to stick with it.
If not now, when?
The world is upside down right now, so be compassionate with yourself and take small steps. Now is the time to take your health more seriously and develop habits that will sustain you past this pandemic and shore you up for another potential pandemic, while protecting you from heart disease, dementia, diabetes and other diseases.
It's not just about this virus, it's about your overall health. The same health habits that protect you from a serious infection protect you from age-related diseases.
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