Weight management, comorbidities and COVID-19

COVID-19. Initially an outbreak of pneumonia of unknown cause.

It has had a significant impact on our livelihoods, we share a communal longing to see family and friends again and we strive for that long-lost feeling of ‘normal’.

It wouldn’t come as a shock to know that our desire to lead a healthy lifestyle has fallen down the priority list and I hope I’m not alone when I say 3 areas of my lifestyle have arguably faltered. My diet, my activity levels and my alcohol consumption.

It has proven to some, myself included, that all those years where we cursed our busy lives and said, ‘I’d get to my ideal weight if I just had the time to cook from scratch’, is not necessarily true.

Even though we’ve had opportune time to do this, self-isolation has prompted a reliance on readily available processed/canned foods which boast a longer shelf-life. More poignantly,

high sugar and high fat foods provide a comfort to many, meaning giving them a miss is even more of a challenge than normal.

Not only this, but the impact lockdown measures have had on our mobility has enforced higher levels of physical inactivity and don’t get me started on the lockdown alcohol, where it’s no surprise that recent data shows alcohol sales have skyrocketed.

In response to COVID-19, the media have jumped on the bandwagon and started pointing the finger that ‘everyone should lead a healthy lifestyle’. At times I question how much this really calls people to action, but the truth is they’re right. Our health is now more important than ever…

But what really is the link with COVID-19?

With 64% of the UK population overweight or obese, even my poor maths brain can work out that a high percentage of the population who will contract coronavirus will also have a Body Mass Index (BMI) over 25.

Now before I lose you over the BMI debate, I hear you, but it is the simplest and quickest way to determine whether our weight is healthy for our height. That coupled with taking our waist circumference, can give us a good indication of whether we are a at risk of lifestyle mediated diseases.

It is well-known that being overweight or obese puts us at risk for other health conditions such as diabetes, heart disease and high blood pressure. You can check if you’re at risk at using our ‘know your diabetes risk’ calculator.

One study found nearly half of patients with COVID-19 had a comorbidity, with hypertension (high blood pressure) being the most common, followed by diabetes and coronary heart disease.

These conditions can have a negative impact on respiratory disease and have shown to be predictors of poor outcomes in COVID-19.

The good news

The good news is there are steps we can take to change our lifestyle and improve our health. These changes won’t just help with one health condition, but all of them, but more on that later…

Research can normally take years to publish, however, in the face of a global pandemic scientists have frantically researched risk-factors which has uncovered some initial findings.

What does the research say?

In short, overweight and obese individuals have shown to be more likely to require invasive mechanical ventilation, with one UK study showing as much as 73% of critically ill patients in intensive care units falling into this category. In comparison, only 26% of those with a healthy BMI required invasive mechanical ventilation.

Studies also found that obese patients (with a BMI of 30kg/m2 or more) with COVID-19 have a greater risk of dying than those who weren’t, with some studies showing up to double the chance of death.

So, why is this?

Getting oxygen round the body

The more weight we carry, the more oxygen our body needs.  To get oxygen pumping around a larger body our heart and lungs have to work significantly harder, putting our system under pressure. As COVID-19 is a respiratory illness which affects the lungs and airways, it can increase the pressure even more.

This is a reason why, when in intensive care, individuals with a BMI over 25kg/m2 will likely need more assistance to support breathing..

The immune system

The second explanation of why being overweight and having comorbidities puts us more at risk is the effect it has on our immune system.

Our immune system helps us fight off viruses like COVID-19. However, being obese can cause inflammation within the body, affecting how our cells respond to infection and inhibiting our immune system.

This is also important when considering comorbidities such as diabetes. Those with diabetes are more susceptible to developing infections due to high blood glucose (sugar) levels weakening their immune system defences; again, dampening the ability to control the spread of any invading pathogens.

For comorbidities such as a heart condition, issues arise once the virus enters the body. COVID-19 causes direct damage to the lungs and places stress on the cardiovascular system by requiring the heart to beat faster and harder to supply oxygen to major organs, which is problematic for those with high blood pressure too.

The enzyme ACE2

Lastly, a more technical cause is an enzyme called ACE2, which attaches to the outer surface of cells in the lungs, arteries, heart, kidney and intestines. Research suggests this enzyme serves as the entry point into cells for COVID-19 and having higher levels of fatty tissue correlates with greater amounts of the enzyme ACE2 making an infection with COVID-19 more likely. The same has also been found in patients with Type 2 Diabetes and hypertension.

So, now we’re past the doom and gloom what can you do with all this information?

COVID-19 doesn’t look like it’s going away any time soon but taking control of our lifestyle is something we have the power to do now. When it comes to our health, we can become more active (unlimited exercise as BoJo says!), be more mindful about our drinking habits or start making changes in the kitchen. The time is now and there is support available in your area.

The Healthier You: NHS Diabetes Prevention Programme

Xyla Health & Wellbeing are accepting referrals onto the NHS Healthier You: Diabetes Prevention Programme.

The programme is founded on behavioural insights and has been designed by our multi-disciplinary team, including clinical and health psychologists, dietitians, and sports/exercise specialists.
The 9-month programme consists of 6 fortnightly sessions and 7 x monthly sessions comprising of nutrition, physical activity and behaviour change sessions. You can read more about the Healthier You: NHS Diabetes Prevention Programme here.

In the current climate, we are still able to support patients remotely and can also refer patients to our digital provider, Oviva.

As we face the current crisis, we are finding that Service Users are very receptive of the information given during the remote sessions and has even helped their mental health:

“Well done Xyla Health & Wellbeing for organising conference calls in place of our meetings. I thoroughly enjoyed mine this morning with Rob our trainer in Newbury. Thank you!”

“Thank you, I now have something to focus on whilst on lockdown.”

“Thank you, the weigh-in may be different but it’s good to keep in touch!”

During the remote sessions, using education, interaction and peer support we aim to consolidate learning, promote self-monitoring and support discussions around personal challenges and achievements.
Service Users will get access to:

• The Xyla Health & Wellbeing mobile app
• Email reminders
• E-learning Physical activity videos
• Online versions of our Eating Well Handbook, Moving More Handbook, In the Kitchen Recipe Handbook and Taking Charge Handbook
• Lifelong access to our e-learning platform.
• Plus much more…

Find out more by visiting our website.