With the looming third wave of Covid-19 in South Africa, we once again need to focus on what we can do to minimise the effect of this dreadful disease on us and our loved ones.  The frightening thing about Covid is its unpredictable nature. 

Some people who are infected have significant co-morbidities and we would expect them to have poor outcomes, yet they sail through the infection with little consequences, and others that seem pretty healthy die. There is still so much we don’t understand about the virus and its pathophysiology.  

Multiple studies have shown a strong link to non-communicable diseases like obesity, high blood pressure, diabetes and kidney disease.  Other co-morbidities include cancer, chronic lung disease and auto-immune diseases.  The common thread with all these diseases is chronic inflammation as evidenced by high levels of inflammatory markers in the blood of affected individuals. 

One of the most serious consequences of Covid is an excessive inflammatory immune response to the virus and its damaging effects on the endothelium of blood vessels – called a cytokine storm. Thus a hyperactive immune system lends itself to a cytokine storm. The damaged endothelium also contributes to excessive coagulation with multiple small blood clots throughout the body including lungs, brain, heart, peripheral veins and arteries  and other vital organs.  

Here is a useful article about the risk factors associated with Covid-19:   Some people think it is too late to make any lifestyle changes now that the numbers of infections are rising in so many parts of the country. But it is astounding how rapidly the body can respond to positive interventions.  For instance it has been shown that insulin resistance can start reversing in as little as 24 hours after adopting a diet low in saturated fats and refined carbohydrates.  

This process can be accelerated by adding daily moderate to vigorous physical activity.  There are many stories of people suffering from angina, or peripheral vascular disease whose symptoms of pain on exertion disappeared in just a few weeks after adopting a healthy diet. 

See for example.  So what can we do to positively reduce chronic inflammation:

• Increase the daily ingestion of fruit, especially the red, yellow and purple fruits and berries. They are so rich in anti-oxidants and anti-inflammatory properties
• Increase daily ingestion of vegetables, particularly the green and leafy vegetables such as kale, spinach, broccoli, Brussels sprouts, bok-choy, cabbage, cauliflower, mustard spinach, Chinese cabbage, rocket – all rich in isothiacyanates, like sulforaphane which reduce inflammation (probably through boosting the growth of intestinal bacteria that produce short-chain fatty acids – which moderate the body’s inflammatory response). Sulforaphane is one of nature’s powerhouses of healing chemicals
• Ingestion of whole grains like oats, brown rice, barley, quinoa, whole wheat – which have many vitamins and minerals necessary for a healthy immune system – and their fibre promotes the growth of healthy gut micro-organisms
• Daily ingestion of legumes such as beans, peas, lentils, soybeans, chick-peas – which are rich in dietary fibre, healthy proteins, and numerous vitamins and minerals
• Ingestion of some seeds (linseeds and chia seeds) and nuts – good sources of selenium and omega 3 fats
• Mushrooms eaten on a regular basis reduce excess hormones and limit angiogenesis – a process that accelerates growth of blood vessels to feed cancer growth.
• Green tea, and herbal teas like Rooibos, Jasmine, Hibiscus, Lemon verbena
• Spices and herbs – like turmeric, ginger, cinnamon, garlic, onions, pepper containing capsaicin

  What are some foods we should avoid to reduce inflammation:

• Cut refined carbs – white bread, sugar-rich foods like cakes, donuts, sweets, sugary drinks, ice-cream, chocolates (except dark chocolate in moderation)
• Cut out processed meats – polony, salami, sausages,
• Cut out or drastically reduce fast foods and snack foods – deficient in fibre, and loaded with salt, sugar, preservatives, and refined carbohydrates.
• Cut down saturated fats – as found in all animal products – chicken, fish, red meat, eggs, cheese, full-fat milk, cream. These have all been found to increase inflammatory markers.
• Cut out or reduce alcohol – recent large multi-centre studies have shown an increase in all-cause mortality from any ingestion of alcohol.
• Most processed foods are loaded with saturated tropical fats – like palm and coconut oil. This is done to replace the now-banned trans fats.  I believe the jury is still out on whether consuming a lot of palm oil is safe in the long term.  I suspect it is not.

So you can do a lot to mitigate your risk of severe Covid by your diet. Next week we will look at how exercise can protect you from the ravages of this disease.

Until then, socially distance, wear a mask all the time in public places and make sure there is good ventilation in public places.

Dave Glass

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