Metabolic Inflexibility Is Key Risk Factor for COVID-19

Analysis by Analysis by Dr. Joseph Mercola 

STORY AT-A-GLANCE

• While SARS-CoV-2 is a rampant virus that can cause severe problems in vulnerable individuals, the real pandemic — the underlying cause that makes people susceptible to complications from the infection in the first place — is poor metabolic health

• Aside from old age, obesity has been identified as one of the primary risk factors for being hospitalized with COVID-19 — doubling the risk of hospitalization in patients under the age of 60 in one study

• One hypothesis for why obesity is worsening COVID-19 has to do with the fact that obesity causes chronic inflammation. Having more proinflammatory cytokines in circulation increases your risk of experiencing a cytokine storm

• Insulin resistance is another top risk factor for COVID-19 that worsens outcomes and increases your risk of death

• There are five primary parameters of metabolic health: waist circumference, insulin sensitivity, blood pressure, and triglyceride and HDL levels. Having three or more abnormal parameters is indicative of metabolic syndrome

While SARS-CoV-2 is a rampant virus that can cause severe problems in vulnerable individuals, the real pandemic — meaning the underlying cause that makes people susceptible to complications from the infection in the first place — is metabolic inflexibility or insulin resistance.

In this interview, Dr. Aseem Malhotra, a British cardiologist and author of “The 21 Day Immunity Plan,” delves into the specifics and explains the role insulin resistance plays in the COVID-19 pandemic.

Obesity Is a Significant COVID-19 Risk Factor

Aside from old age, obesity has been identified as one of the primary risk factors for being hospitalized with COVID-19 — doubling the risk of hospitalization in patients under the age of 60 in one study1 — even if the individual has no other obesity-related health problems. A French study2,3 also found obese patients treated for COVID-19 were more likely to require mechanical ventilation.

One hypothesis for why obesity is worsening COVID-19 has to do with the fact that obesity causes chronic inflammation.4 Having more proinflammatory cytokines in circulation increases your risk of experiencing a cytokine storm.

A cytokine storm response is typically the reason why people die from infections, be it the seasonal flu, Ebola, urinary tract infection or COVID-19. Obesity also makes you more vulnerable to infectious diseases by lowering your immune function.5,6,7,8,9,10

Insulin Resistance Augments Infection Risks

Obesity is often rooted in insulin resistance, brought on by a flawed diet, and insulin resistance is another top risk factor for COVID-19 that worsens outcomes and increases your risk of death. An April 15, 2020, article11 in The Scientist reviews evidence12,13 showing how higher blood glucose levels impact viral replication and the development of cytokine storms.

While the research in question looked at influenza A-induced cytokine storms, these findings may well be applicable in COVID-19 as well. In a Science Advances press release, co-author Shi Liu stated:14

COVID-19 Risk Factors Can Be Rapidly Ameliorated

The good news, as Malhotra stresses, is that the lifestyle factors that make you more prone to severe COVID-19 infection and death can be modified and ameliorated in as little as 21 days, simply by changing your diet. Like me, Malhotra feels this has been sorely missing from pandemic response messaging.

To fill the information gap, Malhotra began writing. Initially, he wrote a series of articles for British newspapers. He also got the opportunity to speak about this on Sky News.

As more data became available, Malhotra’s writings turned into “The 21 Day Immunity Plan.” Malhotra also had the opportunity to share information with the U.K. Secretary of State for Health, Matt Hancock, and by the time the book was finished, Prime Minister Boris Johnson came out saying something needs to be done, on a policy level, about the obesity epidemic.

That said, we don’t have to have government policies in place to personally implement these lifestyle strategies. The information is available. It’s well-documented, noncontroversial and relatively simple to do. Surprisingly, Malhotra’s message has been largely well-received, and hasn’t been censored to the extent that many others have.

Unfortunately, we’re still fighting against a tsunami of dietary misinformation and false advertising on a daily basis, which makes it difficult to really get this message out and make it stick. “If every day the government was putting out a message saying, ‘Metabolic health is the key,’ then we would have a really big impact,” Malhotra says.

Most People Have Poor Metabolic Health

The central thesis of Malhotra’s book is that we have a pandemic of metabolic inflexibility or metabolic ill health. There are five primary parameters of metabolic ill health, which include having:

1. A large waist circumference

2. Prediabetes or Type 2 diabetes

3. Prehypertension or hypertension (high blood pressure)

4. High blood triglycerides

5. Low HDL cholesterol

If you have all of those five parameters within the normal ranges, you are in good metabolic health. Having three or more abnormal parameters is indicative of metabolic syndrome. Metabolic inflexibility can further be divided into two primary subsets, namely:

, signs of which typically include high blood pressure, high triglycerides, high cholesterol, obesity and other variables connected with that.

In the U.S., NHANES data15 published in 2016 reveal 87.8% of Americans are metabolically unhealthy, based on five parameters. That data is over four years old now, so the figure is likely greater than 90% of the population today.

According to a January 2019 update by the U.S. Centers for Disease Control and Prevention, more than 122 million American adults have diabetes or prediabetes16 — conditions which have been shown to increase your chances of contracting and even dying from COVID-1917,18,19,20,21,22

Metabolic Syndrome Triples COVID-19 Fatality Risk

Malhotra notes:

The bottom line is you need to have the five metabolic parameters listed above within the normal ranges, and you need an optimal blood level of vitamin D, which is now thought to be between 40 ng/mL and 60 ng/mL.

How to Improve Your Metabolic Health

So, just how do you improve those five metabolic parameters? Malhotra addresses this in his book, of course. In summary, to optimize your metabolic health and reverse metabolic syndrome, you’ll want to:

• Topping this list are processed foods high in industrial seed oils, added sugars and refined carbohydrates (i.e., bread, pasta and white rice).

As explained in my interview with Dr. Chris Knobbe, industrially processed seed oils such as canola, corn and soy oil (most of which are also genetically engineered) appear to be at the heart of most if not all chronic diseases of the modern world.

Evidence suggests they may be an even greater health threat than added sugar. Malhotra has also addressed this issue in his book, “The Pioppi Diet,”23 published in 2017. Aside from more direct harms, one of the ways in which these oils undermine your health is by skewing your omega-3 to omega-6 ratio, as they’re excessively high in omega-6 linoleic acid.

When used in cooking, they also produce toxic, carcinogenic aldehydes. In lieu of seed oils, use healthy saturated fats such as coconut oil, grassfed butter, organic ghee or lard.

• This too can ameliorate and reduce metabolic disease risk markers. Just be mindful not to go overboard, as excessive exercise will actually lower your immune function and put you at increased risk of respiratory infections.

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As noted by Malhotra:

Time-Restricted Eating Schedule Boosts Metabolic Health

In his book, Malhotra also recommends implementing a time-restricted eating schedule or intermittent fasting where you limit your eating to a window of, ideally, six to eight hours a day.

More Information

To learn more, be sure to pick up a copy of Malhotra’s book, “The 21 Day Immunity Plan.” It’s an easy read that emphasizes and summarizes the core lifestyle basics you need to understand and apply to improve your metabolic health, which in turn will reduce your risk of complications should you come down with symptomatic COVID-19 illness. Social Media info for Dr. Malhotra can be found on his site at doctoraseem.com.