Life in the Time of Coronavirus - Brought to you by Dr. TZ
Healthy Living during COVID-19 Lockdown
In a recent interview about why we are practicing physical distancing, Anthony Fauci said “The enemy of R naught is physical distancing.” R naught is the mathematical expression of the number of susceptible people a single infected person can infect. When we physically distance, we cause the R naught to fall. Our job in fighting this disease is to stop infections from occurring. This means we have to stay at home, avoiding contact with others outside our immediate family, but attacking the R naught should not come at the expense of our health. The stress of this isolation can produce bad habits; we become increasingly sedentary and are tempted to eat and drink too much to assuage the anxiety and fear we all feel. Our health will suffer if we succumb to these temptations.
Margan and I made a New Year Resolution to try intermittent fasting (IF) during 2020. While some believe IF is nothing more than a fad, there is true science behind the salutary effects it has on metabolism and health. Monique Tello, MD, MPH from Harvard writes in the Harvard Health Blog about the many benefits of IF, including decreased insulin levels, lowered blood pressure, and weight loss. While I am not a fan of anecdotes, on a time-restricted eating regimen (described here) for three months, I lost 9 pounds. A recent paper in the New England Journal of Medicine described the multiple beneficial effects of intermittent fasting in both animal and human studies. We adopted the time restricted eating regimen of IF, eating only between noon and 6 P.M. One can ease into this regimen by beginning with a wider eating window and progressively shortening it over 4 to 6 weeks. The feeling of being irritable and hungry when missing breakfast goes away in about a month. After that you really don’t miss that meal. As the articles in the links point out, it is important to eat during daylight hours, allowing the body to flip from metabolizing sugars to metabolizing fat. IF takes us back to our evolutionary roots; our ancestors evolved with long periods of fasting interspersed with food to eat. One important caveat: if you have a significant metabolic condition such as Type 1 or Type 2 diabetes, consult your physician before embarking on intermittent fasting.
Fortunately for those of us who enjoy coffee or tea, black coffee or plain tea (no sugar or milk) doesn’t break your fast when you get up in the morning. Yet another side benefit is two meals per day rather than three. Two meals are cheaper than three and involve less meal preparation. Remember that three meals a day is only a cultural habit, not a metabolic requirement. Drinking a lot of alcohol during COVID 19 imprisonment isn’t a great idea either. It adds a lot of calories and harms one’s liver.
It’s way too easy to be sedentary at home. While it might be an exaggeration to suggest that sitting is the new smoking, multiple studies show improvements in metabolism when comparing people who sit for prolonged periods with people who sit less and move more. When I worked at Emmes in Rockville, Maryland, I began wearing a pedometer to help me quantitate how many steps I took per day. For two years I entered the data into a spreadsheet. After a baseline period, I began adding to the time I walked. It adds up surprisingly fast. I parked my car at the far end of the parking garage and took “garage walks” for 15-20 minutes before starting work. When we moved to Bethesda, my daily steps increased going to and from the Metro. On average, I walked 12,000 steps daily.
What to do home? First, even a modest increase in daily steps has a real impact on health. For example, in older women, even 4400 steps daily diminished the risk of death. Newer research shows that the step intensity (running vs. walking vs pacing) is less important than the total number of steps daily. What to do? Pacing about the apartment adds steps to the daily count. If you use a pedometer or a Fitbit, you can quantitate that or use time — 30 minutes of pacing (broken up into 5- or 10-minute segments) — as a useful metric. While pacing, I have found that listening to TED talks on my smartphone helps immensely — and I learn at the same time! Music is also a great balm for the spirit. Whatever floats your boat. The message to take to heart is, watch how you eat, don’t drink too much, and keep moving. This necessary craziness of physical distancing will come to an end. Each of us is the enemy of COVID-19’s R naught.
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Dr. Thad Zajdowicz is the Co-Chair of the League of Women Voters-Pasadena Area Healthcare Committee and a retired infectious diseases physician who spent many years in clinical practice, emergency preparedness, and pandemic planning for the US Navy. He holds a Doctor of Medicine degree from the Temple University School of Medicine and a Master of Public Health degree from Old Dominion University/Eastern Virginia School of Medicine.
