COVID-19 and Obesity-A Link Too Dangerous To Ignore

Obesity and overweight

More than one-third of U.S. adults have obesity, which is defined as having a BMI > 30. According to the World Health Organization, obesity has nearly tripled worldwide since 1975. In 2016, > 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese. A staggering 38 million children under the age of 5 were overweight or obese in 2019. Most of the world’s population live in countries were overweight and obesity kills more people than underweight. Do I have your attention yet? If not, did you know that 39% of adults aged 18 years and over were overweight in 2016, and 13% were obese. Over 340 million children and adolescents aged 5-19 were overweight or obese in 2016. All the aforementioned facts are per the WHO . Obesity is preventable. We need to wake up and do better, not just for ourselves but the next generations to come. The COVID-19 pandemic has forever changed our lives and we must revisit our lifestyle choices in honor of health and disease prevention.

This article will highlight the association of obesity and Covid-19. First and foremost, for adults, the WHO defines overweight as BMI > or equal to 25; and obesity is a BMI > 30. BMI provides a rough measurement tool to correspond fatness in different individuals. It is not the best indicator of health as it is a population-level measure which is the same for both sexes and all ages and adults. BMI does not tell us bio-metrics, energy levels, sleep, relationship with food and other areas that predict health. However, it does provide a common way to classify

overweight or obesity in adults. BMI is defined as a person’s weight in kilograms divided by the square of his or her height in meters (kg/m2).

Causes of Obesity

  • Imbalance of calories from physical inactivity or surplus of calories consumed chronically over time
  • Family history and genetics
  • Medications: Some anti-seizure medications, antidepressants, steroids and beta blockers can lead to undesirable weight gain
  • Environment: Surrounding yourself with friends and family who may be overweight making poor food and beverage choices can lead to greater risk of obesity
  • Too little sleep which can increase appetite and desire to consume low nutrient foods

Why is obesity a risk factor for Covid-19?

Obesity is considered a large risk factor for risk of severe COVID-19 because of the respiratory dysfunction. Those with obesity have a greater likely hood of experiencing restricted airways, decreased lung volumes, and weaker respiratory muscles which are an essential defense against COVID-19. Such factors make an individual more susceptible to pneumonia, and experience additional cardiac stress. Furthermore, obesity is also linked with diabetes, heart disease, and kidney disease, which overall increase the risk of developing pneumonia. Other ailments like hypertension, hyperlipidemia, and pre-diabetes enhance the susceptibility to infection.

The current science:

  •  Data from 383 patients showed that having obesity was associated with a 142% higher risk of developing severe pneumonia associated with COVID-19.
  •  A larger study of over 4,000 patients with COVID-19 in New York City found that severe obesity was a major risk factor for hospitalization, second only to age.
  • Analysis of critically ill COVID-19 patients in Seattle found that 85% of patients with obesity required mechanical ventilation, compared to 64% of patients without the condition. Moreover, 62% of the patients with obesity died of COVID-19, compared with 36% of those without obesity.
  • Limitation: Study only assessed 24 patients, all of whom were critically ill, making it difficult to draw attention to the conclusions from the data.
    • Another analysis of 124 patients in Lille, France, found that patients with obesity were more likely to require invasive mechanical ventilation.

Collectively this evidence suggest that obesity may be a significant risk factor for COVID-19. Dr. Norbert Stefan, of the German Center for Diabetes Research stated that “obesity may put people infected with Covid-19 at more severe risk and possibly risk of death.” Many of the recent articles published in the last 2 months regarding comorbidities and the association with COVID-19 did not produce data surrounding body composition or metabolic health. The gap in data warrants further research to investigate how body composition, waist circumference, and blood glucose levels play a role in contraction and recovery from the virus, specifically metabolic syndrome.
Metabolic syndrome is a serious health condition that affects roughly 23 percent of adults and increases their risk of cardiovascular disease, type 2 diabetes, stroke and diseases related to fatty buildups in arterial walls according to the American Heart Association. The overall underlying cause of metabolic syndrome includes being overweight, obese, inactivity along with other genetic factors associated with aging.

However, given the limited studies there is not sufficient evidence to definitively say that those with obesity at higher risk for more severe COVID-19. The limited literature does suggest a connection and we can note that obesity is indeed a risk factor for worse outcomes in regard to health. Research does support the notion that those who are obese tend to experience more severe forms of infections according to a publication in the International Journal of Obesity .

Strategies to Overcome Obesity: Tips for a Healthier Tomorrow

Now that we are aware of the connection obesity has with disease and infection let’s talk about practical strategies and tips to improve body composition and overall health! First and foremost, obesity prevention begins at a young age. It’s important to help young growing adolescents maintain a healthy weight without a focus on the scale.

Obesity prevention for children

  • Help your toddlers learn appropriate portion sizes. The American Academy of Pediatrics states children from the ages of 1 to 3, every inch of height should equate to approximately 40 calories. As children age you can teach them what appropriate portion sizes look like.
  • Eat healthy foods as a family and create a healthy experience with eating at the table with no distractions like tablets, computes, phones and other games.
  • Encourage eating slowly and eating only when hungry. Eating out of boredom can lead to excess calorie consumption. If you find yourself eating out of boredom be sure to have healthy snacks like fresh cut fruits and veggies available to snack on.
  • Limit unhealthy foods that lack nutrients in the household. If it ends up in your cart at the store, it will end up in your mouth and eventually your tummy. Stock the fridge and pantry with healthy foods, and limit low nutrient foods as a “treat” that is not consumed daily.
  • Establish a healthy sleep routine and focus on managing stress. Those that tend to sleep more heave a healthier weight and crave less unhealthy foods that are often low in nutrition. Higher stress is also associated with weight gain due to poor coping mechanisms.
  • Incorporate regular physical activity which includes at least 60 minutes per day. A byproduct of being more active is less time in front of the screen.

Obesity prevention for adults
It is no secret obesity prevention tips are the same for losing or maintaining a healthy weight. Consuming a healthy diet, sufficient sleep and participating in regular physical activity can help prevent obesity.

  • Consume plenty of healthy fats. A study published in the Nutrition Journal illustrated that intake of healthy fats, such as polyunsaturated fats, can attenuate cholesterol levels and decrease obesity risk.
  •  Eat regular meals on a schedule. Eat a proper breakfast, lunch and dinner that has appropriate portion sizes. Make half your plate fruits and vegetables. Adults should consume five to nine servings of fruits and veggies each day.
  • Granola, oats, yogurt and fruit with coffeeFruits and veggies are low in calories, high in nutrients, water and full of dietary fiber that supports satiety. Research shows dietary fiber plays a key role in maintaining a healthy weight. A 2019 trial published in Journal of Nutrition found that dietary fiber intake promotes weight loss and dietary adherence in adults with overweight or obesity consuming a calorie-restricted diet.
  • Consume less processed and high sugar foods. According to a study published in the American Journal of Clinical Nutrition, processed and ultra-processed foods are linked to increased risk for obesity. Most processed foods are high in fat, sodium, and refined sugar which can promote over-eating.
  • High calorie, high sugar foods often contain limited nutrients and tend to promote over-eating. Processed foods that should be limited to avoided include cereals, white bread, potato chips, cookies, ice cream, granola bars, crackers and other snack foods. Be mindful of marketing claims for certain snack foods that may list “low-fat” or ‘low-carb” but still contain a significant amount of sugar and limited nutrients. Should you choose granola bars or grains ensure they are whole-grain.
  • Participating in regular activity that includes both strength training and aerobic activity. Regular physical activity of 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity is encouraged per week according to the CDC . Find a movement that you enjoy doing and set a goal to complete it each week with the family. Establish smart goals and hire a coach that can assist you in completing appropriate exercise safely to prevent injury. If you’re new to exercise, begin by walking, stretching and strive to improve your time spent exercising each week.
  • Focus on meal prep and have a plan. It is much easier to shop for healthy foods when you have a list that meets your budget. If you walk into a store with a list you are less likely to be tempted by unhealthy foods. Avoid walking down the aisles looking for items that are not on your list. A good grocery list should contain plenty of fruits, vegetables, fish,  healthy whole-grains, lean proteins, healthy fats and spices. Be sure to make a regular list and post it on the fridge for items as you run out.
  • Eat more protein and veggies as snacks. Higher protein intake is associated with better weight management, glycemic index and bone health according to several studies.  A review published in the Journal of Food Science specifically illustrates the metabolic advantages of higher protein diet and benefits of dairy. Higher protein intake is associated with greater satiety and healthier better composition. Some great high-protein options include eggs, Greek yogurt, beef, chicken, fish, lentils, wild game and other dairy products. A study published in the European Journal of Obesity examining the effect of a high-protein diet versus a standard protein diet on weight loss and biomarkers of metabolic syndrome found significantly greater weight loss with higher protein diet.

Many are looking for ways to stay calm during one of the most unprecedented health crises our country has ever seen. Shift your focus to these 3 areas to improve your health during the pandemic.

Establish a routine:

Which includes regular wake, bedtime, movement, mealtimes, schoolwork, work projects and “leisure time” built in to create stability. Eat breakfast every day! Those that consume the majority of their calories early on are less likely to be overweight and obese. Be sure to incorporate a high-quality protein, fiber and fluids. By getting into the habit of completing tasks on a regular basis along with mealtimes you set yourself up for a new normal.

Nutrition 101

Be mindful of fluids, what you are eating at meals and snacking on. High-stress situations can lead to an impact on our ability to make healthy choices. By stress eating high-calorie and low nutrient foods you are more likely to put on undesirable weight. By creating a schedule of mealtimes and having a calendar of meals you are less likely to eat out of boredom.

  • Have fruits and veggies cut and prepared in the fridge should you be hungry and snack on nutrient dense foods versus processed food.Grocery shopping is critical, be sure to have a list prepared ahead of time and stock up on plenty of frozen along with fresh fruits and veggies.
  • Eat the rainbow and incorporate as many whole foods as possible. By eating colorful fruits and vegetables you can support a healthy immune system. Vitamins and minerals support a healthy immune system which are found in pigment rich foods (color!).
  • Be sure to also incorporate unsalted, nuts, seeds, lean proteins and healthy fats can truly help optimize your immune function land even support good sleep. What we eat has a direct impact on our sleep which can also help keep unwanted pounds at bay!

Supporting positive mental health with movement and meditation!

Getting plenty of regular movement, aerobic activities like walking, biking, hiking, swimming along with resistance training with household items or weights at home. Exercise boosts physical, mental and emotional health which can help reduce stress overall. By reducing stress, you are also fighting off the risk of disease and illness. 30-40 minutes a day of yoga, meditation, walking, running or biking is a great way to stay healthy! Many apps, videos and programs are available on demand online.

Work with a Dietitian to Fight Off Obesity and Establish Healthy Habits

Many find great success working with a registered dietitian nutritionist. Research indicates that a few sessions with an RDN can lead to healthier habits, optimal food choices and successful weight loss. As an RDN I personally work with many on improving their relationship with food, eating more fruits and veggies, selecting high-quality proteins, and preparing foods at home. RDN’s can assist in developing a calorie-controlled plan and calculating out energy needs that support appropriate weight loss, weight maintenance goals. Additionally, a personal trainer or fitness coach can also assist you in setting goals for routine physical activity. I work with several individuals on creating a periodized program for appropriate progression of physical activity. The goal is to move more and to feel good about the exercise you are doing. The journey to 100 miles begins with taking that first step. I am here to help you and support you, join me and take that first step to a healthier tomorrow!

In good health,

Wendi Irlbeck, MS, RDN

 

Wendi Irlbeck, MS, RDN is a registered dietitian, nutritionist, and fitness coach. Wendi utilizes evidence-based science to tailor nutrition programs for those looking to improve their health and energy. Along with supporting athletes desiring to optimize performance, minimize health risks, and enhance recovery from training while focusing on injury prevention. Wendi partners with parents, sports performance staff, special needs and recreational athletes to offer nutritional guidance and optimal athletic performance & lifestyle plans. Wendi is based in East Lansing, Michigan and is very active on social media platforms such as facebook , twitter and Instagram.

Overindulge on Thanksgiving? Damage Control Tips for the Weekend After

A delicious left-over pumpkin pie taunts you from the kitchen counter alongside the heaps of leftovers in the fridge, saying, “eat me!” Or those sugar cookies and assorted desserts your guests conveniently forgot to take home? Eh, what’s one more going to do? The weekend after Thanksgiving can be toughest for many hoping to maintain their weight and health goals. Holiday weight gain is quite common for many adults. So, you’re feeling guilty from too much pie and turkey. The best thing you can do now is let the past exist in the past. Say “goodbye” to the guilt, shame or any negative feelings you may have because you have a new day in front of you and an opportunity to take control moving forward.

Many of my clients have expressed that “it’s inevitable to gain weight and I might as well just start over on January 1st.” While I honor those, who desire to start off a new year with health as a priority, this is not the best mentality for life-long health. As a registered dietitian and trainer who has been where you currently are, I encourage you to work smarter, not harder. Let me throw out an analogy for you – if you sign up for a 5k, which is roughly 3.10 miles, would you start your race 2 miles before the starting line, expecting the same time and competition as if you started at the starting line with the other runners? Raise your hand if you want to work harder and put yourself at a disadvantage? I wouldn’t put my hand up either, so what I am getting at here is if you know you want to lose weight or improve your lifestyle, start the process now.

Let’s begin by being mindful of our health and fitness goals by minimizing the empty calories and overindulgence that takes place between today and January 1st. Would you not feel better if you started today and not January first like everyone else? The truth is you don’t have to start two miles behind the starting line and then end up running a 7k when you’re only training for a 5k. Let’s CHOOSE to make it easier for ourselves, limiting the shame and guilt, because holiday weight gain is not inevitable! I believe in you – you should too – and I promise you can do this!

Here are 5 tips to help you focus on gaining more memories this holiday season than lbs.:

  1. Repeat after me, “resume normal eating immediately”

The worst thing you can do today is continue with the oversized portions of foods that you don’t normally consume. Get back on track with your normal intake of balanced meals containing a lean protein, fruit, vegetable and healthy fat. It’s important not to consume meals that are both high in fat and high in carbohydrates to offset blood sugar levels. You likely consumed an overabundance of carbohydrates on Thanksgiving so it may be wise to CHOOSE to limit carbs and even calories in these immediate days after to re-stabilize your hormones. Don’t make the mistake of skipping meals now to try and off-set the over-eating you did on Thanksgiving. Unless you practice intermittent fasting in your normal routine, you shouldn’t skip meals. Skipping meals can lead to feeling overly hungry later, which will make matters worse.

  1. Get active with family & friends

Sitting on the couch watching Netflix may be your family’s holiday tradition. However, inactivity contributes to weight gain, especially during times of overeating. Make a new tradition with your family spending time moving with your loved ones! Races are popular this time of year – go sign up as a family and gain memories! If you can’t run, walking can be just as beneficial. Movement is movement! Look at gym memberships that are likely currently available at a lower to no joining fee cost!

  1. Drink up!
    • I’m not talking about the eggnog. Although it’s delicious, it won’t help you with your health and fitness goals. I am talking about water. It is so important to increase your water intake during the holidays due to the different foods you’ve been consuming which can disrupt regular digestion. Your gut and waistline will thank you for greaterImage result for water glass" water intake after eating new foods.
    • Water consumption is also a great way to curb cravings and stay hydrated. Often when we are “hungry” or have a craving it is because we are thirsty and dehydrated. Be sure to drink 20 oz. of water every couple of hours throughout the day to stay hydrated and ward off unnecessary snacking. Research exists indicating increased hydration can be associated with weight loss.
    • According to the study, higher protein and water intake is associated with weight loss. If you’re having difficulty losing weight and finding yourself overly hungry all the time, you may want to reevaluate your water intake. Drinking water before meals can help you feel fuller and can also assist with digestion during meals.
  2. Control portions
    • Controlling portions supports getting back into a routine of normal eating. Keep in mind the portions you may or may not have learned –
      • A portion of protein is the size of your palm which is roughly equivalent to 3 oz.
      • A serving of veggies is 1 cup and fruits is 0.5 cup
      • A fat is approximately 1 Tbsp. nuts and seeds should be limited to a serving of 0.5 oz.
      • Should you choose to include a carbohydrate, a serving is 1 slice of bread, 0.5 cup of pasta or 1 cup of a whole grain.
    • In instances of weight loss and management it may be more helpful to increase protein, fruits and vegetables. I recommend working with a dietitian to ensure you’re hitting appropriate portions and getting adequate nutrition.
  3. Focus on quality sleep and managing stress levels
    • Sleep deprivation during the holidays is quite common and can further lead to poor nutrition and physical activity habits. Those that tend to sleep less tend to be hungrier and a result can over consume calories leading to an increase on the scale. Additionally, less hours slept is also associated with a disruption in the circadian rhythm, which is our biological clock controlling many important physiological functions. Aim for 7-9 hours of quality sleep per night. This will also help prevent your risk of getting sick and missing out on the true enjoyment of the holiday festivities.

These five simple tips will enable you to focus on progress through the holiday season! Should you over-eat or have something outside of your “plan,” tell yourself “it’s okay,” dust the cookie crumbs off and keep moving forward. “When a child learns to walk and falls down 50 times, the child never thinks to himself maybe this isn’t for me.” Always get back up and keep moving!

Your health and fitness coach,
Wendi Irlbeck, MS, RDN