We are living through the biggest pandemic of our generation and, as we say goodbye to 2020, we sadly do not bid farewell to the coronavirus. One year on, the news continues to be dominated by rising case numbers, hospitals full to capacity and, more recently, emerging new strains. People following the daily news reports are understandably feeling anxious and helpless as they worry about the health impact on themselves, their family and their friends. Added to this concern are the financial implications for many as small businesses close their doors for good and the number of unemployed rises.

One silver lining, however, is that this virus has been around over a year and more evidence-based data is emerging on what each and every one of us can do to strengthen our own immune systems so that, should we become infected, symptoms will be less severe and the duration of the illness shorter.

Dispelling the fear

Despite the reference to this virus as ‘the deadly coronavirus,’ how deadly is it in fact? Over 98% of the people worldwide who have tested positive and who have had the virus, have survived. The symptoms range from asymptomatic, to mild, to moderate, to severe. According to the accumulated data and the resultant advice from the Institute of Functional Medicine (IFM) (as well as other medical institutions worldwide), the severity of the virus is determined, in part, by the function of the host immune system, putting those with pre-existing co-morbidities (cardio-metabolic dysregulation, obesity, type-2 diabetes, hypertension, and hyperlipidaemia), excess inflammation and compromised immunity at higher risk of more severe COVID-19 infection. What does this mean for you if you fall in the category of ‘more vulnerable? The good news is the large extent to which diet and lifestyle changes can help strengthen your immune system to be more resistant to severe infection. It is important to remember:

• We are amazing human beings who come fully loaded with an immune system capable of combatting bacteria, viruses, cancer cells, fungi, mould etc on a moment-to-moment basis, which is why we have survived as a species for so long.
• Our immune system is divided into 2 main parts:
  • the innate, which is the first line of defence acting like security guards patrolling the streets.
  • the adaptive, more akin to an army which is called in when the first line of defence fails. It is the adaptive immune system that is responsible for making antibodies.
• If we expect our immune systems to protect us, we have to supply them with the tools they need to do the job (vitamins, minerals, phytonutrients and energy in the form of carbs, proteins and fats). At the same time, we need to address underlying health issues which are keeping our ‘army’ fighting battles on other fronts and thus not united and strong enough to deal with the virus when we become sick.

Time to be proactive

To date there is still no universal, pharmacological treatment for COVID-19, and although a vaccine is now rolling out, it is still early days. The good news is the evidence-based diet, lifestyle and supplement plan recommended by the IFM (and many other health institutes) has been formulated by studying viruses that have behaved similarly to SARS-CoV-2 (i.e., SARS-CoV-1 and MERS) as well as by understanding the mechanism of action of other RNA viruses. Rather than worrying and feeling helpless, starting to learn what steps you can take, big or small, to help you and those around you will make you feel more in control, less anxious and stressed and will have a more positive effect on your immune system.

How to avoid viruses

• Wash your hands thoroughly every time you go outside and come into contact with a person or surface that could have virus particles. You should spend at least 20 seconds each time, preferably with soap and water, to ensure you remove all germs. This free poster provides a simple outline of proper hand washing technique.
• Keep a small bottle of hand sanitiser or HOCL (hypochlorous acid) spray in your pocket or handbag for times soap and water are not available. The benefit of HOCL is that it has been shown to inactivate a variety of viruses, including coronaviruses, in less than a minute. More importantly it does not kill the ‘good’ microbiome responsible for numerous physiological processes of the human body. We do not want to be using products that kill the ‘good’ with the ‘bad.’
• Get out of the habit of touching your face. It’s not easy to do but the main points of entry for a virus are all on your face and if you can train yourself to keep your hands below your shoulders, this will drastically reduce the odds of an infection.
• While many carriers may be asymptomatic, try to avoid contact with anyone who does show flu-like symptoms, such as coughing, sneezing or blowing their nose.
• Avoid busy spaces, especially poorly ventilated indoor spaces.
• Always cover your nose and mouth when sneezing or coughing to prevent the spread of any viruses you might be carrying.
• Follow government guidelines for wearing a mask and social distancing.

How to build and support a strong immune system

Eliminate lifestyle factors that drive inflammation and impact immune function:

• Sleep: Good quality and sufficient quantity of sleep help reduce inflammation and increase immune system function.
• Exercise: Engage in moderate, regular, physical activity that you enjoy in order for it to be consistent. Physical activity is known to be critical for proper function of virtually all physiological systems, including the immune system. However, to reduce inflammation, moderate levels of exercise are more effective than intense exercise, which in itself can be stressful for the body.
• Stress reduction: Stress chemistry is inherently inflammatory and can lead to a dysregulated immune system. When the body is under stress, it activates its ‘fight or flight’ response, which suppresses many functions, including that of the immune system. The stress response can be very useful in short bursts but, over the long term, it can be devastating to your health. There are many coping mechanisms you can implement to help you regulate your stress response. Most importantly do not become ‘stressed’ and ‘panicky’ as you read and hear the news surrounding this virus, as this will activate your stress response and weaken your immune system. Rather stay calm knowing that the more steps you take to strengthen your own immune system the more chance it will have to fight off this, and other, infections. Please read this in-depth article for lots of stress-lowering tips and suggestions, as well as for more information on exactly how stress affects your immune system.

Eliminate dietary factors that drive inflammation and impact immune function:

• Eat less sugar – sugar is incredibly detrimental to your immune system and actually creates a friendly environment for viruses to thrive in. Sugar addiction is very real and widespread. Please get in touch with a qualified nutritional therapist if you feel that you are unable to cut sugar from your diet.
• Eat more fruit and veg – Try to get a wide variety of fruit and veg into your diet. Different colours indicate different nutritional properties, hence the phrase, ‘eat the rainbow’. Eating more plant-based foods lowers inflammation, increases antioxidants and nourishes a healthier gut microbiome which in turn improves immune status (70%-80% of immune cells are found in the digestive tract).
• Cut processed foods – The chemicals, preservatives and additives that go into processed foods such as ready meals are detrimental to your immune system and have a much lower nutritional content than clean, whole foods. Wherever budget allows, opt for organic products.
• Drink more water – Water helps to flush out the toxins that build up in your body and damage immunity. Aim for 1.5 to 2 litres a day.
• Eat garlic – Garlic makes a delicious flavouring for healthy meals, but it also has potent anti-viral properties. Garlic is more potent raw than cooked; however, the raw form can be challenging to eat due to its strong flavour. As with all thing’s nutrition, doing a little is better than doing nothing so if cooked garlic is all you can stomach, try to work it into as many meals as possible.
• Balance blood sugar levels – Insulin resistance, obesity and impaired glucose tolerance have all been shown to be associated with inflammation.
• Address food intolerances / sensitivities – If you are suffering from gut related symptoms such as bloating, acid reflux, excessive gas, pain, constipation, diarrhoea etc, the underlying cause should be investigated and addressed. A good place to start is to eliminate the biggest inflammatory culprits which are refined sugar, gluten and dairy. Keeping a food diary often helps pinpoint which foods correlate with symptoms. These symptoms can also be caused by a dysregulation of the balance of your GI microbiome which has been shown to be a source of systemic inflammation.

Supplementing – Evidence-based dietary supplements for immune support and prevention of viral infections (including COVID-19).

The Functional Medicine approach to COVID-19 recommends the following supplement regimen:

• Vitamin D3: 3000-5000 IUs daily. Vitamin D has been implicated in mitigating the severity of COVID symptoms.
• Zinc picolinate: 30-60 mg daily in divided doses
  • Suppresses viral attachment and replication
  • Evidence it both prevents viral infections and reduces their severity and duration
  • Reduces the risk of lower respiratory infection
  • Must be taken with quercetin
  • Advisable to consider 1mg of copper daily as zinc depletes copper
• Quercetin: 500mgs 2x daily, increased to 1000mgs 2x daily if infected
  • In order for zinc to stop the virus replicating it needs entry into the cells. One of the most important roles of quercetin is as a zinc ionophore, transporting zinc across lipid membranes and into the cells.
  • Quercetin has also been shown to inhibit viral replication and promote viral inactivation and eradication.
• Vitamin C: 1000 – 3000 mg daily (taken in increments of 1000mgs)
  • Contributes to immune defence by supporting various cellular functions of both the innate and the adaptive immune systems
  • Supplementation with Vitamin C appears to be able to both prevent and treat respiratory and systemic infections
  • Our adrenal glands require Vitamin C. It is thus more important in these times of stress to make sure you are getting sufficient vitamin C in your diet or by supplementing.
• Curcumin: 500-1000 mg per day
  • Curcumin is a well-known anti-inflammatory
  • Potential inhibitor of COVID-19 by reducing viral replication
• EGCG: 4 cups of green tea daily or 220 mg per day
  • Potentially targets SARS-CoV-2 main protease to reduce viral replication
  • Has been shown to prevent influenza
• NAC: 600 mg a day could function as a preventative measure.
  • Favourably modulates cellular defence and repair mechanisms
  • Repletion of the antioxidant glutathione and cysteine, particularly important for those who have the inflammatory cytokine storm
  • An important supplement for the so called ‘long haulers’ who suffer symptoms such as chronic fatigue weeks after the acute phase has resolved
• Potassium: 99mgs a day if infected
  • Studies of COVID-positive patients have identified low levels of serum potassium. Since potassium deficiency is extremely common, it is suggested that we all need to be ingesting loads of potassium-containing foods (asparagus, artichokes, broccoli, cauliflower, dark leafy greens, celery, parsnips, pumpkin, potatoes, sweet potato, avocado, banana etc) as part of our COVID prevention protocol. However, with active COVID infection supplementation is most likely necessary.
• Magnesium: 400mgs daily
  • 70% of us are thought to be deficient in this mineral, despite the vital role it plays in immune health and hundreds of other chemical processes taking place daily.

Conclusion

Four main phases of COVID-19 require their own focus. They are:

• Prevention: During this time the focus is on reducing inflammation for those with co-morbidities and supporting the immune system to improve outcomes if infected.
• Early infection: Support focuses on supporting the immune system to fight the virus.
• Escalating inflammation: It is important to note that 2 clinical patterns are emerging after the 1^st two weeks since exposure – either the patient starts to recover or progresses to more severe infection. It is the so-called inflammatory cytokine storm that causes more damage to tissue and at this stage it is very important to focus on anti-inflammatory measures.
• Recovery: This is a very important stage when focus is on resolving inflammation, tissue damage and losses of function that occurred as a result of the virus. It is these unresolved issues that can lead to a person becoming a ‘long hauler,’ with continuing debilitating health issues.

As we move into 2021, the focus for us all should be on making important changes to support our body’s own ability to defend itself when called upon to do so. It is not about making huge fundamental changes to diet and lifestyle, but more about tweaking in the right places that can make all the difference. Since this virus is now understood to behave similarly to other coronaviruses, implementing the tools mentioned above can reduce your chances of getting the virus and, in the case of infection, reduce your symptoms and the length of time you are sick.

Disclaimer

Supplements should not be taken without the advice of a healthcare practitioner to ascertain your personal requirements and possible interactions with other medications. In addition, none of the advice in this article is intended to supersede the medical advice of your doctor. This article is intended to advise you on how to protect yourself as best as possible, while understanding that there is much you can do to support your own immune system by implementing healthier diet and lifestyle measures.