Dr. Sanjay Gupta: Pandemic proofing your life is not what you think (CNN)

 

Editor's Note: CNN Chief Medical Correspondent Dr. Sanjay Gupta is a practicing neurosurgeon and the author of the new book "World War C: Lessons from the Covid-19 Pandemic and How to Prepare for the Next One."

I have bad news for you: We're stuck with this novel coronavirus in our environment perhaps indefinitely. And there might be another, more deadly and contagious pathogen right behind it that's poised to dart around the world and stir yet another pandemic. But here's the good news: Pandemic proofing your life is easier than you think, and it's not about building a bunker or mega-dosing on supplements and waiting white-knuckled for the next booster shot. A remarkable suit of armor is already within you.

In the midst of a global pandemic, we've all changed. I joke that you've either become a chunk, monk, hunk or drunk. But seriously, what surprised me in my research into how we can prevent serious illness and death -- and prepare for the next globetrotting scourge -- is the key role diets play in our immune system and response to any infection, not just Covid. 

As we all know, Covid has shined a big light on the difference between people who contract the virus with underlying conditions already and those who are otherwise healthy. But the conversation often unfairly revolves around obesity, which has the unfortunate result of objectifying and stigmatizing people. The recent uproar over comments made by the CEO of the salad chain Sweetgreen is a testament to how divisive this conversation can become. More importantly, it does a disservice to it because the connection between obesity and Covid mortality is complicated. 

To be clear, suggesting that stamping out obesity will somehow be easier than mass vaccination, which the Sweetgreen CEO seemed to do, is patently false. But a deeper dive into nearly two years' worth of data tells an important story that does not need to focus on weight or body size; and this one that doesn't get enough attention. 

More than a third of Americans have what's called metabolic syndrome, and that number increases to nearly half of those age 60 and over. That's a lot of vulnerable hosts for a stealthy pathogen. You don't even have to be a single pound overweight to have metabolic syndrome, which refers to a cluster of common conditions that increase the risk of heart disease, stroke, diabetes, sleep apnea, liver and kidney disease, cancer, Alzheimer's, and dying from an infection. 

In addition to excess body mass, these conditions include high blood pressure, abnormal cholesterol levels, and high blood sugar -- the invisible signs of an unhealthy body. And if you can check these three boxes regardless of weight, you qualify as having the syndrome, which is easily stoked and perpetuated by diet. Many medical experts say that metabolic syndrome may be the most common and serious condition you've never heard of, and yet it's playing mightily into people's outcomes from Covid. 

So, how does your diet adversely affect immune function? Some of it is direct. Food can spark or, conversely, subdue levels of inflammation. Our daily sustenance also constantly serves and regulates your intestinal microbiome -- the gut's internal "friendly" germ factory that plays mightily into immunity. 

Studies in the past year alone have highlighted the significance of the microbiome in people's prognosis with Covid. Associations found between gut microbiota composition (that is, strains and volume of species) and levels of inflammatory markers in patients with Covid suggest that the gut microbiome is involved in determining the magnitude of the infection. In other words, a significant predictor of just how ill you are likely to become is the status of your gut microbiome at the time you are infected. And, there is little question that metabolic dysfunction is associated with an imbalanced gut flora. 

That also seems to be true for what happens to people after Covid-19 has cleared the body. The health of the gut's biome could be a major cause of long-hauler or post-Covid symptoms -- brain fog, fatigue, and other persistent symptoms that remain after the initial infection runs its course. All of this means one of the easiest, most effective hacks to boost your immunity and protect yourself against disease in general is to eat healthier to keep weight in check, nurture your microbiome, and support a humming metabolism. No, salads won't replace vaccines or masks, but they are a terrific complement to all the other preventive measures we can take to stay out of harm's way. Pretty painless for a significant payoff.

I know that deep down, you already understand that eating muffins or doughnuts with a mochaccino every morning for breakfast probably isn't going to get you where you really need to go. Diets may seem confusing, but food isn't. The key to remaking your metabolism involves changing how you think about food in the first place. Food is at the center of a grand intersection: it can hurt, and it can heal. For most of my life, I simply thought of food as fuel, just calories for energy, made up of micronutrients and macronutrients ("building blocks"). 

Over the past decade, though, I have come to understand and appreciate food as a tool for epigenetic expression, or how my diet and genome interact. Because food is the one piece of information we all have to give our body every day, we have to be sure we send the right information that works with it and supports healthy pathways -- not harmful or self-destructive ones.

It should come as no surprise that the typical Western diet -- high in salt, sugar, calories, and saturated fats -- is not friendly to our physiology. As the research concludes, a plant-based diet that is rich in a variety of fresh whole fruits and vegetables, particularly berries and green leafy vegetables, is associated with better health. I know you have heard this countless times, and you may be numb to it. I am too. 

But there are a few simple statistics I often share with my patients to make the point. For instance, if you increase your fruit intake by just one serving a day, this can reduce your risk of dying from a cardiovascular event by 8%, the equivalent of 60,000 fewer deaths annually in the United States and 1.6 million fewer deaths globally. There are few medications that offer that much impact so easily. And, now you can be sure that a regular handful of berries or a juicy apple can also reduce your risk of experiencing a severe illness from an infection like Covid and its future siblings. 

I realize that changing your diet in an effort to optimize your health will take some time -- and it should. I kept a food journal a few years ago to figure out new foods I could add to my diet to diversify my microbiome. I learned that fermented foods like pickles are my secret weapon. I now regularly snack on them to boost my productivity and energy. Find something similar for you. 

Don't start by trying to break a bad habit and deprive yourself of the foods you love even though they don't wear health halos; instead, simply begin by introducing a good new habit like choosing more nutrient-dense, minimally processed foods with less refined sugars and flours. This will automatically move you away from ultra-processed food full of preservatives and additives that carpet bomb the good bacteria in your gut, while allowing harmful bacteria to thrive. Find a new food, something different, and make it part of your routine. (And you'll also likely have an easier time heading up the stairs, waking up with more energy, and just feeling better).

For too long, we have been lulled into the false belief that wealth can buy health. It is why we wait for the vaccine instead of more fully adopting simple strategies to best protect ourselves every day. In the wake of this pandemic, we will need to analyze how we nourish ourselves at a deeper level than we have ever done in the past. Think about it. The food you eat can lay the groundwork for pandemic proofing your body in the future.