While most mainstream media pundits and American health authorities remain mum about the influence of nutrition and lifestyle on the risks of COVID-19 and its prognosis, more than a dozen states in Mexico have decided to combat the pandemic by banning the sale of junk food to minors.
Mexico Bans Junk Food to Curtail COVID-19 Death Toll
As reported by NPR, September 14, 2020:1
â€œFirst Oaxaca’s state legislature passed a ban on selling or giving out high-calorie packaged foods and sugar-sweetened drinks to minors on Aug. 5. Less than two weeks later, Tabasco state approved a prohibition, too. Now at least a dozen other states are considering similar legislation.
â€˜I know it can sound a bit drastic but we had to take action now,â€™ says Magaly LÃ³pez, a lawmaker in Oaxaca’s Congress who spearheaded the ban. More than 70,000 Mexicans have died from COVID-19, the world’s fourth-highest recorded death toll, according to tracking by Johns Hopkins University.
Two-thirds of those who died in Mexico had an underlying medical condition such as obesity, diabetes, hypertension and cardiovascular problems, according to Health Department officials. That has led to a new urgency to change diets so that the younger generation doesn’t suffer those ailments.â€�
Adults are also urged to cut back their consumption of junk food to curtail their risk of COVID-19 and other health issues. This includes the consumption of soda, which assistant health secretary Hugo LÃ³pez-Gatell has referred to as “bottled poison.”2,3
Legislators are still pondering how to enforce the ban, but according to NPR, punishment for sale of junk food to minors could potentially include fines or even jail time.
LÃ³pez-Gatell is reportedly considering making the ban a permanent law in order to protect the health and well-being of Mexican youth moving forward. This would be no easy task, he admits, considering the powerful commercial interests at play. Critics also point out that, in all likelihood, the ban will simply shift business from grocery stores to unregulated street vendors.
Interestingly, when NPR interviewed teenagers around Mexico City and Oaxaca state, they found most â€œknew about health problems related to junk foodâ€� and seemed receptive to the ban. One 16-year-old girl said, â€œI’d be frustrated at first if I couldn’t buy a Coke, but I’d adapt. And maybe I’d think twice and buy fruit or something healthy instead.”
Nutrition Plays an Important Role in COVID-19 Susceptibility
As reported in â€œJunk Food Companies Responsible for COVID-19 Susceptibility,â€� underlying health conditions such as obesity, heart disease and diabetes have emerged as key factors in COVID-19 fatalities.
In one study,4,5 more than 99% of people who died from COVID-19-related complications had underlying medical conditions. Among those fatalities, 76.1% had high blood pressure, 35.5% had diabetes and 33% had heart disease.
Another study6 revealed that among 18- to 49-year-olds hospitalized due to COVID-19, obesity was the most prevalent underlying condition, just ahead of hypertension. Processed foods, junk foods and soft drinks are key culprits in the development of these chronic diseases, and therefore have a key role to play in COVID-19 hospitalizations and deaths.
London-based cardiologist Dr. Aseem Malhotra has been among those warning that poor diet can increase your risk of dying from COVID-19. He told BBC that ultraprocessed foods make up more than half the calories consumed by the British, and if you suffer from obesity, Type 2 diabetes and high blood pressure â€” all of which are linked to poor diet â€” your risk of mortality from COVID-19 increases tenfold.7
Malhotra also noted8 that eating nutritious foods for even one month could help you lose weight, put Type 2 diabetes into remission and improve your health considerably, thereby improving your chance of survival should you contract COVID-19.
Dr. Robert Lustig, Emeritus Professor of pediatrics in the division of endocrinology at the University of California, San Francisco, has also been outspoken about the connection between diet and COVID-19 risks, stating:9
“I’ve heard COVID-19 referred to a beast, because it doesn’t distinguish. In point of fact, it doesn’t distinguish who it infects. But it does distinguish who it kills.
Other than the elderly, it’s those who are Black, obese, and/or have pre-existing conditions. What distinguished these three demographics? Ultra-processed food. Because ultra-processed food sets you up for inflammation, which COVID-19 is happy to exploit … Time to rethink your menu.”
Even Mild Obesity Increases Risk for COVID-19 Complications
Importantly, even mild obesity can have significant implications for COVID-19. According to Italian researchers who analyzed10 data from 482 COVID-19 patients, â€œObesity is a strong, independent risk factor for respiratory failure, admission to the ICU and death among COVID-19 patients,â€� and the extent of risk is dependent on your level of obesity. In a press release, lead author Dr. Matteo Rottoli stated:11
“Health care practitioners should be aware that people with any grade of obesity, not just the severely obese, are a population at risk. Extra caution should be used for hospitalized COVID-19 patients with obesity, as they are likely to experience a quick deterioration towards respiratory failure, and to require intensive care admission.”
Specifically, patients with mild obesity had a 2.5 times greater risk of respiratory failure and a five times greater risk of being admitted to an ICU compared to nonobese patients. Those with a BMI of 35 and over were also 12 times more likely to die from COVID-19.12
British Report Links Obesity to COVID-19 Severity and Death
Similarly, a July 2020 report13 by Public Health England described the results of two systematic reviews,14 one of which showed that excess weight worsened COVID-19 severity, and the other that obese patients were more likely to die from the disease compared to nonobese patients. Here too, the risk of hospitalization, intensive care treatment and death all progressively increased along with BMI. Compared to healthy weight patients, patients with a BMI above 25 kg/m2 were:
- 2.03 times more likely to suffer critical illness
- 6.98 times more likely to need respiratory support
- 3.68 times more likely to die
Yet another study15,16 published May 2, 2020, on the preprint server medRxiv found obesity doubles your risk of being hospitalized for COVID-19. According to the authors:17
â€œThese findings suggest that modification of lifestyle may help to reduce the risk of COVID-19 and could be a useful adjunct to other interventions, such as social distancing and shielding of high risk.â€�
Pandemic Has Highlighted Role of Junk Food in Health
In an editorial18 published in the BMJ, three researchers cited the role of the food industry in driving up rates of obesity and ultimately causing more COVID-19 deaths. According to the authors, â€œIt is now clear that the food industry shares the blame not only for the obesity pandemic but also for the severity of COVID-19 disease and its devastating consequences.â€�
They not only called on the food industry to stop promoting unhealthy food and drinks immediately, but also called on governments to force reformulation of junk foods to better support health.
As noted by Bill Maher in the video above, obesity has always killed us, albeit slowly. â€œMixed with COVID, it kills you fast,â€� he says. So far, Mexico appears to be the only nation that has taken the matter seriously enough to actually implement an all-out ban on junk food for children and teens.
Other noteworthy exceptions include the town of Huntington, New York, where town officials have urged residents to â€œgo on a diet because [with] COVID-19, youâ€™re twice as likely to have a poor outcome if youâ€™re obese.â€�
The U.K. is also targeting obesity as part of the countryâ€™s coronavirus prevention strategy by restricting junk food ads.19 July 23, 2020, Prime Minister Boris Johnson announced he intends to ban TV junk food advertising before 9 p.m. and limit in-store promotions. Online ads for unhealthy foods may also be banned.20
Studies Stress Nutrition in Fight Against COVID-19
Two additional studies are worthy of note. The first, published in the May 2020 issue of Pakistan Journal of Medical Sciences,21 points out that â€œOptimal nutrition and dietary nutrient intake impact the immune system, therefore the only sustainable way to survive in current context is to strengthen the immune system,â€� and that â€œA proper diet can ensure that the body is in proper state to defeat the virus.â€�
To optimize your chances of surviving COVID-19 and minimizing its symptoms, the authors provide both dietary guidelines and good food practices to minimize the risk of food contaminants. Included in the dietary guidelines are recommendations to:
- Eat four servings of fruit such as guava, apple, banana, strawberry, cantaloupe melon, grapefruit, pineapple, papaya, orange, Longman fruit, blackcurrant and pummelo daily
- Eat five servings of fresh vegetables daily and avoid overcooking them to prevent loss of nutrients
- Include nuts and coconut in your diet
- Include animal foods such as red meat, poultry, fish, eggs and milk
- Avoid soda and other sweetened beverages and drink pure water instead
Unfortunately, the guidelines include the recommendation to avoid healthy saturated fats such as butter, coconut oil, cheese, ghee and cream, and to use unsaturated fats only. While some unsaturated fat sources are perfectly healthy, such as avocados, fish and nuts, others really should be avoided.
Industrially processed seed oils are fats to be diligently avoided and this includes oils like soybean oil, canola oil and corn oil. The second study, published in the July 2020 issue of Brain, Behavior and Immunity, notes that:22
â€œThe high rate of consumption of diets high in saturated fats, sugars, and refined carbohydrates (collectively called Western diet, WD) worldwide, contribute to the prevalence of obesity and type 2 diabetes, and could place these populations at an increased risk for severe COVID-19 pathology and mortality.
WD consumption activates the innate immune system and impairs adaptive immunity, leading to chronic inflammation and impaired host defense against viruses.
Furthermore, peripheral inflammation caused by COVID-19 may have long-term consequences in those that recover, leading to chronic medical conditions such as dementia and neurodegenerative disease, likely through neuroinflammatory mechanisms that can be compounded by an unhealthy diet.
Thus, now more than ever, wider access to healthy foods should be a top priority and individuals should be mindful of healthy eating habits to reduce susceptibility to and long-term complications from COVID-19.â€�
My Dietary Recommendations
It really did not take long before it became apparent that the COVID-19 pandemic was illustrative of a far more widespread pandemic, namely that of insulin resistance.
All of the comorbidities that dramatically increase your COVID-19 risks (including your risk of symptomatic COVID-19 illness, hospitalization and complications resulting in death) are rooted in insulin resistance. Remove the insulin resistance, along with vitamin D deficiency, and very few people â€” except for very old and frail individuals â€” would be at significant risk from SARS-CoV-2 infection.
So, it really is high time to start looking at how we can improve our health in general, and avoid insulin resistance in particular. A healthy population simply isnâ€™t going to be as vulnerable to infectious diseases like COVID-19.
Aside from the general dietary recommendations listed above (with the exception of the recommendation to replace saturated fats with soy, canola and corn oils), I recommend:
â€¢ Adopting a cyclical ketogenic diet, which involves radically limiting carbs (replacing them with healthy fats and moderate amounts of protein) until you’re close to or at your ideal weight.
This includes avoiding all ultraprocessed foods and also limiting added sugars to a maximum of 25 grams per day (15 grams a day if you’re insulin resistant or diabetic). This will allow your body to start burning fat rather than carbohydrates as its primary fuel and increase the sensitivity of your insulin receptors.
Once you have regained your ideal body weight, then you can cycle carbs back in a few times a week. One of the best books written on this subject is my classic â€œFat for Fuel.â€�
â€¢ Restricting your eating window to six to eight hours each day, making sure to eat your last meal at least three hours before bedtime. This is known as time-restricted eating or intermittent fasting, and is a powerful intervention to reduce insulin resistance and restore metabolic flexibility.
Additionally, get regular exercise each week and increase physical movement throughout your waking hours, with the goal of sitting less than three hours a day. Making sure youâ€™re getting sufficient sleep (typically eight hours for most adults) and tending to your emotional health are also important factors that can influence your weight, general health and immune function.