We are facing an unprecedented health crisis with COVID-19 classified as a pandemic.

Right now, there are no scientifically proven treatments or a vaccine available. To manage the situation, one can only follow the advice and guidelines recommended by the health authorities and try to maintain a healthy immune system to minimise the risk of infection.

Although for most people COVID-19 causes only mild illness, it can make some people very ill.

Evidence to date suggests that two groups of people are at a higher risk of getting severe COVID-19 disease. These are older people and those with underlying medical conditions such as cardiovascular disease, diabetes, chronic respiratory disease and cancer.

The reason why older adults and those with chronic illness are at a higher risk is because of the effects of chronic inflammation in the body and the consequent reduced functioning of the immune system.

It is well documented scientifically that diet and lifestyle choices have an anti-inflammatory effect on the body and this results in promoting and keeping the immune system healthy.

Lifestyle choices which can help in promoting a healthy immune system mainly involve maintaining a healthy body weight with proper nutrition and exercise and also managing stress and sleep.

Diet

Cutting down on refined and processed foods and dairy and animal proteins have been shown to be a major factor in maintaining good health and weight.

Fruits, vegetables (especially the green leafy types), beans and berries have anti-inflammatory compounds and nutrients which boost the immune system.

Another important factor in maintaining a healthy immune system is the health of microbes that live in the gut.

A diet full of fibre-rich foods promotes the growth of healthy gut bacteria. A plant- based diet consisting of fruits, vegetables, whole grains and beans helps in maintaining a healthy gut environment and data is emerging to support the role of the gut microbiome in strengthening and maintaining the immune system.

Vitamin D has been recently shown to affect the severity of COVID-19 infections. A daily recommended dose of 25mcg/ 1000IU has been suggested. Higher doses can have an adverse effect on health.

Vitamin D comes in two forms: vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D3 is more effective at raising blood levels. Vitamin C is an essential component of the diet and is only found in fruits and vegetables.

An adequate intake is required for the optimal functioning of the immune system. A recommended dose is 100-200mg a day. Main food sources of vitamin C include red and green peppers, oranges, kiwi fruit and broccoli.

Selenium and zinc are micronutrients important in maintaining a health immune system. One brazil nut a day will take care of your selenium needs.

Foods rich in zinc include wholegrains, beans and nuts. Herbs and spices in various forms have some of the highest concentrations of antioxidant compounds and many show anti-infective properties. Using a variety of herbs and spices in cooking every day would be beneficial.

Turmeric and its active component, curcumin, has an array of health-promoting effects. This includes anti-inflammatory, antioxidant and anti-infective properties.

A number of studies have shown that curcumin is active against a number of different viruses. The dose of a supplement is 1,000mg of curcumin combined with black pepper (piperine) to increase bioavailability.

Nutritional yeast is a species of yeast known as saccharomyces cerevisiae. It can be used in all sorts of dishes to add flavour and is also a great source of nutrients.

Beta-glucan, one of the nutrients within the yeast, has been associated with a number of immune-boosting effects. Nutritional yeast can be added to soups and sauces daily.

Green tea is high in polyphenolic catechins, which have a number of potential health benefits. Studies have also demonstrated antiviral properties, including efficacy against influenza. In general, two to five cups a day of green tea is needed. 

Sleep

This is essential for a healthy immune system. We should all be aiming to get between seven to nine hours of sleep per night.

To help ensure good quality sleep, the following can help: maintain a regular sleep schedule; avoid daytime naps and if you do nap, keep this to less than 30 minutes; make sure your bedroom is at a cool temperature around 15-19ºC; ensure a dark room without noise; minimise screen-time/use of electronic devices in the evenings and avoid it after 9pm; and avoid caffeinated drinks and alcohol after 3pm. 

Exercise

This has many benefits, including maintaining a healthy immune system and helping achieve good quality sleep. The recommended amount for adults is 150 minutes of moderate intensity physical activity a week and strength-building exercises twice per week. This, of course, depends on the age and fitness of each individual.

A consultation with a GP would be advisable before starting any type of strenuous activity. 

Stress

Chronic psychological stress promotes inflammation and reduces your defences against infection. Useful approaches for managing stress include mindfulness and meditation. Studies have shown loving relationships (within families and communities) to have beneficial effects on the immune system.

Be kind, look after your neighbours and those who are vulnerable in your communities. 

These recommendations, of course, do not guarantee freedom from infection or COVID-19, but they are all side-effect-free suggestions which are also in line with general recommendations for healthy living.

Pankaj Pandya is a general practitioner. For more information, send an e-mail to pankajpandya@btinternet.com.

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