Eating healthy during a pandemic

This current pandemic has proved to really test our mental, emotional, and physical mettle. As a practicing family doctor, I receive a lot of questions about how to improve immunity and what kinds of foods to eat or what kind of supplements I should take. Our current data suggest that the Covid-19 virus is affecting people who are chronically ill and the elderly. Examples would be those who have immunocompromised, diabetes, obesity, and chronic respiratory illnesses. At the same time, we’re all facing Covid-19, there’s another war going on. That war is maintaining our health. What does it mean to be healthy? What does it mean to practice wellness? I would argue that health IS wealth.

Healthful foods are essential not just in terms of protecting us during a pandemic, but also continuing to help protect and optimize our overall health. As of yet, we do not know how nutritional/lifestyle measures stack up against Covid-19, but we do know that eating a lower fat, plant-based diet can enhance our immune system. Vegetarians have been shown to have more effective white blood cells when compared to non-vegetarians, due to a higher intake of vitamins and lower fat intake¹. Maintaining weight is important for sustaining our health but can also benefit our immune system too. One of the reasons why a plant-based diet is effective at weight loss is due to increased satiety by eating nutrient dense fiber and consuming less calories. This added fiber can also lower your body mass index which has been linked towards improved immunity².

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During a pandemic, you need to stock up more than just toilet paper. A whole-food plant-based diet is rich in vegetables, fruits, beans, legumes and whole grains. So, how do you reduce cost and stock up healthfully? Look no further than whole grains, beans, legumes, bulk food, dry foods, and healthy frozen foods. Making use of grocery store delivery services and using wholesale club memberships such as Costco or Sam's Club allow you to stock up and create more time between store visits. Also utilizing local ethnic stores could be more budget-friendly especially for dry herbs and spices and less common ingredients such as Mexican chilis to make mole or ginger, turmeric, and lemongrass for Indian and Asian foods.  

During these anxious and tense times, it’s easy to opt for more comfort foods or emotionally eat. Often, you can even make these meals healthier. For example, in mac and cheese, we can substitute regular pasta with whole grain, quinoa, or bean pasta. You also might try making your own vegan cheese with cashews. Chocolate chip cookies and other desserts use a lot of eggs. An easy egg substitute is replacing each egg for one tablespoon of ground flaxseeds or chia seeds and three tablespoons of water. Eggs are used to bind, add structure, stabilize, and help thicken in baking, which makes it a powerful versatile ingredient. However, a recent study found that among US adults, higher consumption of eggs was significantly associated with a higher risk of incident cardiovascular death and all-cause mortality in a dose-response manner. Therefore, minimizing or avoiding eggs would be best for overall health.

Going back to emotional eating, whether you have a sweet tooth or not, it's hard to avoid something sweet every once in a while. This is where practicing moderation is important. I do want to emphasize that "sweetness" can come from artificial ingredients or more wholesome ingredients. The former can lead to the body creating more inflammation in the body, sweeteners like high fructose corn syrup are especially hard on the body and I would recommend avoiding it as much as possible. If you have to use more processed sweeteners, I recommend using molasses and date sugar. I personally would use more whole, intact food ingredients that are more naturally sweet such as sweet potatoes, bananas, and berries. 

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Alcohol is another “food” we often turn to in times of stress. It has long been believed that moderate consumption leads to more beneficial health benefits. However, contrary to popular belief, this has not been actually shown to be true due to more recent Mendelian randomization tools used in studies³. So, my recommendation would be to avoid alcohol if you are seeking to be more health-conscious, especially during a pandemic

My biggest tip to shifting your health towards overall wellness rather than creating more disease is cooking food in your own kitchen. It is more cost-effective and knowing what actually goes into your food helps you to make healthier decisions. Due to our pandemic, we may find we are doing more emotional eating and reducing physical activity. Thus, my second tip would be to decrease grazing and actually shift toward eating less, even eating just twice a day would be more beneficial to your overall health. My third tip has always been advocating a whole-food, plant-based diet; for those who still consume animal products, increasing your daily intake of antioxidants, fiber, vitamins, and minerals is paramount. You can do this by doubling or tripling your portions of plant foods. This would be an amazing help towards your overall well-being. I find that during an unprecedented time like ours, we can take the opportunity to understand and learn that physical health is just as important as our emotional health. Finally, let’s remember to please be kind to our bodies but also be kind to each other.

Colin Zhu, DO, is a traveling physician who is board certified in family practice and lifestyle medicine. He has practiced as a CompHealth locum tenens physician for the past four years. Zhu is the author of "Thrive Medicine: How To Cultivate Your Desires and Elevate Your Life” and is a podcast host of Thrive Bites.

References:

Malter M, Schriever G, Eilber U. Natural killer cells, vitamins, and other blood components of vegetarian and omnivorous men. Nutr Cancer. 1989;12:271-278; Carddock JC, Neale EP, People GE, Probst YC. Vegetarian-based dietary patterns and their relation with inflammatory and immune biomarkers: a systematic review and meta-analysis. Adv Nutr. 2019;10:433-451.)

Haddad EH, Berk LS, Kettering JD, Hubbard RW, Peters WR. Dietary intake and biochemical, hematologic, and immune status of vegans compared with nonvegetarians. Am J Clin Nutr. 1999;70(3 Suppl):586S-593S

Goulden R. Moderate alcohol consumption is not associated with reduced all-cause mortality. Am J Med. 2016;129(2):180-186.e4. and Holmes MV, Dale CE, Zuccolo L, et al. Association between alcohol and cardiovascular disease: Mendelian randomisation analysis based on individual participant data. BMJ. 2014;349:g4164.