COVID-19 Lifestyle Interventions for Optimal Health

Substantial research indicates that certain dietary and lifestyle patterns offer viable options for improving overall health, especially by reducing inflammation. The anti-inflammatory effects of foods and aspects of how one chooses to live may, in turn, favorably influence and support immune system function as a preventative measure for reducing the risk of illness. Furthermore, in the case of (viral) infection, implementing these changes could significantly offset the severity and sequelae incurred from illness.

While this unprecedented COVID-19 pandemic may be stressful and have mental-emotional ramifications both short- and long-term for individuals, Integrative Nurse Coaches can effectively use this time as an opportunity to redirect patients efforts into an assessment of their current lifestyle and motivate changes that will reduce the immediate risk from acute viral infection, as well as the long term risk of chronic disease. Since lifestyle factors have a large effect on immune function, when working with patients in the era of COVID-19, the modifiable lifestyle factors below are excellent first steps in our coaching relationship with clients and patients.

Overall Recommendations: Research indicates that plant-based foods high in phytonutrients, water- and lipid-soluble vitamins, and other antioxidants, as well as dietary fiber, can help downregulate an overactive immune response.

Specific recommendations for patients:

  1. Eat plenty of fruits and vegetables for a wide array of phytonutrients to enhance the gut microbiome.
  2. Consume dietary fiber,  28-35 grams daily, preferably from whole foods.
  3. Reduce or avoid immune offenders such as added sugars and salt, high-glycemic foods (including processed carbohydrates), and excessive saturated fat.

Food and nutrition are major daily input for health and well-being. There are three mechanisms that may be involved in the ability of food-derived compounds to reduce viral infection and severity:

  1. Balancing inflammatory pathways.
  2. Reducing oxidative stress and increasing antioxidant levels.
  3. Harmonizing the gut microbiome.

 

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Overall Recommendations: Both acute and chronic stress can result in dysregulated, suppressed immune function. Under these conditions, susceptibility to illness is more likely. Monitoring stress levels through biofeedback markers such as heart rate variability (HRV) may assist in knowing when to implement stress management strategies and in having a means to assess their efficacy, as well in helping to track resilience-building approaches. Practicing stress-modifying techniques on a regular basis using HRV and other modalities can result in greater resilience when confronted with stressors.

Overall Recommendations: Due to its restorative and regulatory abilities, sleep has a major influence on immune function and inflammatory signals. Therefore, getting good quality, sufficient quantity (seven to eight hours) and adequate deep phasic bouts of sleep is of utmost importance as part of immune maintenance, as well as during times of recovery from illness. It is advised to have patients practice good sleep hygiene and maintain consistent sleep hours by turning off screens, ensuring the room is cool, quiet, and dark, and setting reminders to go to bed on time.

Moderate, regular physical activity helps immune system function by raising levels of infection-fighting white blood cells and antibodies, increasing circulation, and decreasing stress hormones. A personalized exercise program can be designed even during homestay by utilizing features in one’s home environment, including apps, the internet, and technology, or by taking the opportunity to experience the calming, immune-supportive effects of being in nature (while, at the same time, social distancing).

Physical activity provides the movement the body needs to oxygenate, circulate blood and nutrients, and eliminate waste from cells, all of which are essential to the function of the immune system. In addition to the blood vessels delivering blood to organ systems, the lymphatic system, present largely in the neck, armpits, and groin, plays a big role in the transport of immune factors. Indeed, the social distancing and homestay that has been recommended by many states and nations may invariably disrupt people’s activity schedules and lead to more sedentary behavior, such as more screen time or sitting, reclining, or being stationary, which could further negatively impact immune activity.[106]

Social relationships and connections are a significant determinant of immune health. The absence of these essential relationships, collectively referred to as social isolation, loneliness, bereavement, and/or conflict, has been implicated in the upregulation of proinflammatory processes and reduced immune functionality (e.g., NK cell activity. Furthermore, those who are socially isolated have heightened response to stressors. Older individuals may be particularly at risk for the effects of loneliness if their immune system is already compromised.[127],[128]

The sum of the research on connection and the immune-inflammatory response is mixed as this connection appears to be influenced by several factors, including the response of the individual and their preferences, personality, and health state, as well as whether or not there is conflict or stress in the interactions. However, if there is a sense of supportive connection through the social network, it appears that immune markers can be favorably influenced.

SUMMARY OF CLINICIAN RECOMMENDATIONS FOR OPTIMIZING HEALTH DURING THE COVID-19 PANDEMIC

NUTRITION:

  • Eat plenty of fruits and vegetables. Aim for 9-13 servings per day of a variety of types for a wide array of phytonutrients to enhance the gut microbiome.
  • Consume dietary fiber, a minimum of 28-35 grams daily, preferably from whole foods.
  • Eat fermented vegetables or other probiotic-containing foods to maintain epithelial health and gut barrier function.
  • Reduce or avoid immune offenders such as added sugars and salt, high-glycemic foods (including processed carbohydrates), and excessive saturated fat.

STRESS REDUCTION/MANAGEMENT:

  • Monitoring stress levels through biofeedback markers such as heart rate variability (HRV) may assist in knowing when to implement stress management strategies and in having a means to assess their efficacy, as well in helping to track resilience-building approaches.
  • Practicing stress-modifying techniques on a regular basis using HRV and other modalities can result in greater resilience when confronted with stressors.

SLEEP:

  • Good quality, sufficient quantity (seven to eight hours) and adequate deep phasic bouts of sleep is of utmost importance as part of immune maintenance, as well as during times of recovery from illness.
  • It is advised to have patients practice good sleep hygiene and maintain consistent sleep hours by turning off screens, ensuring the room is cool, quiet, and dark, and setting reminders to go to bed on time.

EXERCISE:

  • A personalized exercise program can be designed even during homestay by utilizing features in one’s home environment, including apps, the internet, and technology, or by taking the opportunity to experience the calming, immune-supportive effects of being in nature (while, at the same time, social distancing).

SOCIAL FACTORS/CONNECTION:

  • Encourage reduced exposure to interactions perceived as hostile and non-supportive and, at the same time, emphasize and encourage spending time with people who are positive or affirming.
  • For those people who may be lonely or isolated, as well as those who may be at increased risk of immune compromise, recommend regular social connection as a routine. Ideas might include participating virtually in local community events or in a religious or spiritual group.
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Co-Founder || Personal Website

As Co-Founder of the International Nurse Coach Association for over a decade, Susan has been teaching and developing coaching program and currently through the Integrative Nurse Coach Academy. She is Board Certified in Health and Wellness Coaching, Holistic Nursing, and Clinical Nutrition. Susan has authored several chapters on Nutrition and Environmental Health for Holistic Nursing, Integrative Nursing, and Nurse Leadership textbooks. She has co-authored Nurse Coaching and Self-Assessment chapters in; Holistic Nursing: A Handbook for Practice, 7th edition (2015-2020) and is co-author of the award winning book (ANA Gold Seal, 2015) Nurse Coaching: Integrative Approaches for Health and Wellbeing (2015) and The Art and Science of Nurse Coaching, an ANA Publication (2013), that led the way to establishing the standards for practice in the emerging Nurse Coach role. For the past 20 years, she has been the Nurse Coach and Nutrition consultant for Special Immunology Services at Mercy Hospital in Miami and is currently the Director of Nurse Coaching at Rezilir Health in Hollywood, Florida. Susan continues to integrate lifestyle health and wellness education into diverse communities, bringing her expertise and passion as a nurse, clinical nutritionist, and medical anthropologist. She has developed and implemented integrative health initiatives for diverse community organizations including the Yellow Courtyard, Integrative Health Symposium, Urban Zen, New York Open Center, The Lower East Side Girls Club, Kripalu, Omega Institute, and the University of Miami and Florida Atlantic University. As a concerned global citizen, Susan is the founder and education director of the Earthrose Institute, a not-for-profit organization dedicated to environmental health education and advocacy. She maintains a private practice as an Integrative Nurse Coach with a focus on nutrition and the environment.

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