Aaron Hartman, MD (YouTube video, Aug 17, 2020) discusses two modifiable risk factors for severe COVID-19: obesity and alcohol consumption. He cites UK data showing increased alcohol sales (~14% since lockdown) and that ~10% of calories in the UK come from alcohol; notes US obesity prevalence (~40% overall; ~50% in African Americans; ~33% of children); explains biological mechanisms (alcohol depleting glutathione, obesity as an inflammatory driver) and cites a French study reporting increased ICU/ventilation risks for higher BMI (BMI 30–34: 1.8x critical care admission and 3.6x complications; BMI >35: ~7x risk of mechanical ventilation). He also points viewers to dietary resources (elimination diet, paleo/renewed food plan, detox plan) and general lifestyle guidance to reduce inflammation and weight.
Questions this video answers
August 17, 2020
14% increase in alcohol sales
About 10% of all calories
About 40% of Americans overweight; about 50% of African Americans overweight; about one-third of US children overweight
BMI 30–34: 1.8× likelihood of critical care admission and 3.6× likelihood of complications if admitted; BMI >35: ~7× increased risk for mechanical ventilation
Chapters
The last thing I'd like to talk about on this series of videos is actually two big risk factors for severe COVID 19 disease and that is obesity and actually alcohol consumption. The reason I want to focus on these is because we're getting a lot of information out of the UK about how much increase in alcohol consumption they're having there and some of the effects it's having on disease there as well as some of the data with the United States with a obesity patients that I'm seeing that are quote unquote young and healthy, that are having severe COVID 19 disease are actually people that are overweight or have some other obesity related disease like heart disease, diabetes, sleep apnea is a big, big one. I'm seeing patients that are having bigger issues with getting of this infection and alcohol consumption or VCR modifiable risk factors, meaning we can start working on those now to get those down for the fall. So where we see in the UK, well about 10% of all calories right now in the UK are actually being consumed via alcohol. They've had a 14% increase in sales in alcohol since the lockdown. Now for those of you who've been in the UK, pubs are really popular, drinking beer is really popular. So 14 increase in on already elevated consumption of alcohol is quite, quite significant. We've had a lot of increase in alcohol consumption here. I've not seen national data. I do know locally in the state of Virginia, ABC sales have skyrocketed. A lot of patients have been gaining weight during this time as well. In America, about 40% of Americans overweight compared to 20% England. African Americans, about 50% African Americans in the United States are overweight and about a third of kids overweight in United States. So automatically we have an increased susceptibility based on that alone. The alcohol increases our risks. We're seeing the calories and sugar spikes from alcohol being associated with increased inflammation as well as weight. Alcohol actually depletes our glutathione levels. So if you've heard me talking about taking NAC to help prevent this. Will NAC helps your body make glutathione? That's how it works. Alcohol consumption depletes glutathione, so there's probably an association with alcohol and depletion of some of your body's antioxidants and increased susceptibility to this disease. There's been a French study looking at seven fold increased risk for mechanical ventilation on those with a BMI over 35. So if your BMI is over 35, you have a much, much, you know, seven fold increased risk for actually needing to have a ventilator. If you get this. If your BMI is 30 to 34, you're 1.8 times more likely to to be admitted to the critical care unit and you're 3.6 more times likely to have complications from that if you're admitted and your BMI is over 35. So it appears that this is from that study was actually from France. So obesity is appearing to be one of the major risk factors which is modifiable for this disease. So I didn't want to say a whole lot more than that. I guess these two articles actually will be post published or posted below the video. I will continue to put out information about modifiable risk factors. Things we can actually change because appearing in addition to vitamin D status, nutrition status, there are things like we already know about diabetes, but obesity appears to be a driving inflammatory factor. Not the diabetes itself per se, but the the combination of obesity and diabetes. Obesity and heart, heart disease, obesity and sleep apnea. Even some of the younger kids have been getting severe disease. I mean obesity and trisomy 21 or down syndrome. Obesity and other psychological issues appears to be a big risk factor. If you want some help on trying to lose weight, we do have a lot of resources on our website. We have multiple food guide resources. One of the ones a lot of people will start with when they're trying to lose weight is actually the elimination diet which you can feel free to download that resource. Remove inflammatory foods, foods people react with. One of the causes for big causes for obesity in our country is inflammatory foods and food chemicals. The elimination diet actually has you remove those. So if you actually want to think about starting something the next four weeks, six weeks before school starts, whatnot, that's a great starting point. The guide's there for your for free download. It gives you a seven day meal planning guide. It also gives you a sheet you can take to the grocery store to pick food out. Gives you some meals if you if you're kind of more paleo esque. The renewed food plan is a guy that actually has paleo concepts. Low grain, low inflammatory foods. It also the meals actually are pretty good unlike the recipes. If you're someone who has more straight up inflammation, there's a detox food plan there as well. But if you want to pick one to start with, the elimination diet is probably the best one to start with. If you're trying to decrease inflammation, lose weight and get your sugars under control Obviously you should work with a healthcare provider or professional to work through this. Individualize it for yourself. If you want more information about this as well as more resources on our website, I have a podcast actually on diet lifestyle and we are continuing to roll out new podcasts. Hopefully we'll be putting out one or two in the next week. Anyway, hopefully this information is helpful. I'm just trying to educate people, get people to realize there's things you can do to relieve your anxiety, to get a little more control over this and be safe and be well. You all take care of.