How Metabolic Disease Fuels Worst-Case Scenarios for COVID-19

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Every day we learn something new about the novel coronavirus, including an ever-expanding list of symptoms that indicate you are sick with COVID-19. (The CDC recently released six new ones that join the original trio of signs.)

Since the World Health Organization declared a pandemic on March 11, medical experts around the world have been diligently collecting data from hospitalized patients and threading together the common denominators of the most severe (and fatal) cases. One of the major themes that has emerged: Patients suffering from obesity and metabolic syndrome seem to have the most dire outcomes.

Metabolic syndrome refers to the presence of five risk factors that signal a higher likelihood of developing cardiovascular disease, diabetes and stroke: increased blood pressure (greater than 130/85 mmHg), high blood sugar levels (aka insulin resistance — a precursor of diabetes), excess fat around the waist, high triglyceride levels and low levels of HDL (the “good” cholesterol). 

Tragically, this cluster of symptoms is prevalent in our modern society. According to the American Heart Association, nearly one in four Americans — 23 percent — currently have metabolic syndrome. And the latest CDC stats indicate that nearly half of American adults are either prediabetic or diabetic.

Nearly half of American adults are either prediabetic or diabetic.

While the exact causes of metabolic syndrome are not fully understood, risk factors include older age, ethnicity, a body mass index greater than 25, personal or family history of diabetes, smoking, a history of heavy drinking, stress, a high-fat diet and sedentary lifestyle.

Here’s what preliminary data from some of the hardest hit countries around the world shows about the link between obesity, metabolic syndrome and COVID-19 experiences:

  • Research from a Chinese hospital published online on April 1 reported that obesity was associated with a 2.42-fold higher risk of developing severe pneumonia among the 383 COVID-19 patients. The finding held up even after adjusting for baseline cardiovascular risk factors including hypertension and diabetes.
  • In the UK, data from more than 2,000 patients admitted to the ICU with COVID- 19 reveals that 72.7 percent were overweight or obese, according to an article by Aseem Malhotra, MD, a leading cardiologist in Britain.
  • A study from the Italian national health authority found that among all reported fatalities from COVID-19, more than 75 percent had high blood pressure, about 35 percent had diabetes and a third suffered from heart disease. 
  • In France, doctors performed a retrospective review of 124 hospitalized patients. A report of their findings shows that the proportion of patients requiring mechanical ventilation was highest in patients with severe obesity (BMI > 35) — a sevenfold higher risk than in patients with a BMI less than 25.  
  • In the United States, early data shows similar links between obesity and more severe outcomes. A paper from doctors at NYU Langone Health analyzed data from 4,103 COVID-19 patients and found that the two strongest risk factors for hospitalization were being older than 65 and obesity.  
  • Also in the US, research from the Centers for Disease Control and Prevention (CDC) has found that patients with type-2 diabetes and metabolic syndrome might have up to 10 times greater risk of death when they contract COVID-19.

The takeaway from this early data: People with obesity and metabolic syndrome face a much tougher battle to survive when they get sick with COVID-19.

Experts don't know exactly why that is, but they are racing to figure it out. "The underlying mechanisms are complex and still being explored," says Frank Lipman, MD, Chief Medical Officer at THE WELL. “But in a very simplistic way, when you have these conditions, the body doesn’t have the building blocks to function properly when under stress.” Lipman goes on to explain that “obesity and metabolic syndrome also make the body more prone to inflammation, a precursor of almost all diseases, which can also impair the immune system.” 

What This Means For You

While this is still very much a developing story, the link between obesity, metabolic syndrome and COVID-19 is too important not to share, Lipman says. “We want to make people aware of this — that poor diet is a major contributing factor to poor outcomes of COVID-19 patients,” he explains. “People are eating too much processed food, which causes metabolic health problems that in turn lead to obesity, diabetes and heart disease.”

That said, we are not pointing fingers at individuals who suffer from these conditions, Lipman emphasizes. Instead, the problem is a more systemic issue with the food industry in our country — they employ scientists whose job it is to make unhealthy food tasty and addictive, causing people to eat more and more of it.

Coupled with genetic predispositions, a sedentary lifestyle and other risk factors, this can eventually cause people to develop metabolic syndrome — which puts them at greater risk of serious illness of death from COVID-19, as the data suggests. 

Lipman offers up one of his favorite quotes from the poet and environmentalist Wendell Berry to summarize the conundrum: "People are fed by the food industry which pays no attention to health, and are treated by the health industry which pays no attention to food."  

What You Can Do Right Now

While revolutionizing the food industry and the American healthcare system is a large and complex problem (to put it lightly), there are some factors within our control. The symptoms of metabolic syndrome can actually be reversed far more quickly than you might think, Lipman says. 

“While making lifestyle and dietary changes can help you start to feel better in just a few days, you can actually see metabolic syndrome start to reverse in about three months,” explains Lipman, who offers these tips as a starting point: 

  • Get moving. Any type of exercise — from HIIT workouts to yoga classes and even walking — can help. 
  • Reduce stress. Give meditation a try, and if you’re dealing with major stress and anxiety, seek help from a mental health professional.
  • Cook at home. This will almost always be healthier than eating out. Just make sure to avoid cooking with vegetable oils loaded with unhealthy polyunsaturated fat.  
  • Ditch the carbs. You’ll feel the difference almost instantly when you start avoiding sugary treats and processed foods. (Here are some of the immediate benefits.)
  • Try time-restricted eating. Intermittent fasting allows your body to enter a prolonged “fasting state” that keeps insulin levels low, reduces blood sugar and signals your body to burn fat stores. Aim to eat all your meals within an 8-10 hour period, eating dinner earlier and breakfast later.
  • Bring in some supplements. To promote metabolic health, Lipman recommends adding fish oil, alpha lipoic acid (ALA) and coenzyme Q10 (CoQ10) supplements to your routine. (Need a routine to begin with? Start with our Daily Complex supplement pack.)

Find more tips from Lipman to optimize your health and wellness in the fight against COVID-19 (and beyond) here.

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