Carvings                      January 15, 2021

The risk of COVID-19: it’s not just being old

            The pandemic has taken a dreadful toll among the senior population. The vast majority of deaths have occurred among persons over the age of 65. One estimate is that about ten percent of persons living in senior facilities have died, at least indirectly, from COVID-19. San Diego County is an example; 88 percent of deaths have occurred in persons over the age of 60. Those below the age of 40 account for only 1.1% of the fatalities.

            If age were the most important factor those over the age of 100 would surely have zero chance of survival. Yet as of the middle of January there have been at least two hundred people over the age of 105 (!!!!) who have tested positive for the virus and remain alive. The oldest confirmed survivor is a 113-year-old woman in Spain, a country that has suffered severely during the pandemic. Maria Morera is not obese or even overweight and thus has none of the diseases that are the consequences of having excess body fat and that play a major role in a morbid outcome. The oldest woman in Spain, she is bright-eyed and alert, noting that “I am old, very old, but not an idiot.” What an inspiration!

            Maria is fortunate in having an immune system that is strong enough to have overcome COVID-19. Not all seniors are so lucky; aging itself does take a toll on the immune system. However the stark truth is that most older persons are overweight or obese, triggering other comorbidities. Some have lost weight as they have aged but not the burden of their past: type 2 diabetes, heart disease, coronary artery disease and poor kidney function. These are the classic comorbidities of COVID-19. Another is chronic obstructive pulmonary disease (COPD) because nearly half of today’s seniors were smokers; smoking history accounts for nearly 90 percent of that lifestyle-destroying affliction.

            At the time of the last great pandemic, the influenza scourge of 1918-1919, about five percent of Americans were obese; that number is now an appalling 42.4 percent. In addition to contributing to the comorbidities mentioned, excess body fat adds fuel to the pandemic fire in two other ways. Fat tissue contains cells of the immune system and the more fat the more of these cells. During infection with SARS-CoV-2 these cells produce an overreaction, the cytokine storm that is almost always fatal.

            As noted in earlier blogs, COVID-19 victims who are deficient in vitamin D are several times more likely to be infected with the coronavirus, to require ICU care and to die. Vitamin D is critical for normal immune function but fat tissue acts as a vitamin D sink, preventing this hormone-like chemical from exerting its protective effect.

            Finally, what if the rate of obesity were the same today as it was during The Great Influenza of a century ago? Think about it.

Lifestyle

            Taking in less sodium isn’t going to do much for weight loss but it will certainly improve your overall health.  Americans take in about 5 times (!) as much sodium as they need, contributing to the current epidemics of high blood pressure, heart disease and osteoporosis.

            The sodium intake of hunter-gatherers in Africa is about 600 milligrams per day and the incidence of hypertension (high blood pressure) in that group is almost zero. The diet of their genetically identical cousins in the United States contains about 3500 milligrams of sodium each day, a major factor in the very high incidence of hypertension among blacks in this country.

            Most of our daily sodium intake comes from packaged, processed food. That’s why it’s so important to read the Nutrition Facts label on every package. If the sodium content is over 500 mg. (milligrams) per serving, take a pass.

            There are plenty of tasty substitutes for salt but potassium chloride isn’t one of them. Most users complain about the taste. However, there are plenty of spices that you can use to brighten up your menu. Just start experimenting.

            When you cut back on salt you’ll notice that you start losing your taste for salty foods in just a few weeks. If you are one of the 20 percent of Americans that are salt-sensitive you’ll also find that your blood pressure is coming down as well. That lowers your risk of heart attack and stroke, which together are the leading cause of death.