Healthy Eating & Nutrition Blog

Welcome to Health Takes Guts® Check back frequently for weight loss tips, advice for healthy nutrition and therapeutic diet plans, delicious recipes and other cutting-edge functional medicine nutrition news. Dianne Rishikof, MS, RDN, LDN, IFNCP, & CEO, has special programs for Registered Dietitians (RDs) with mentoring, resources and course offerings.

What is Black Seed Oil and How is it Used?

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Black seed oil is a supplement that comes from a plant native to Eastern Europe, Western Asia, and the Middle East. It is extracted from the seeds of the plant to produce an oil that can be used topically or ingested. The oil is also known as black cumin oil, Nigella sativa oil, and Kalonji oil. This oil has been used medicinally for a few thousand years.

The active ingredient in black seed oil is called thymoquinone, which is the main component of the oil responsible for the many health benefits it has.

This oil has several health benefits to our bodies when ingested. These benefits include help with better liver and kidney function, weight loss, heart health, digestive health, diabetes, antibacterial benefits, and antioxidant benefits.

Weight Loss

Black seed oil contains thymoquinone, the main active ingredient, which has shown to help with reducing body weight, lowering BMI, and waist circumference. Black seed oil may also help reduce risk of obesity in women, which has been shown in a few studies, especially in combination with a low calorie diet.
Liver and Kidneys
Some research shows that black seed oil has many protective effects on the liver because of the active ingredient thymoquinone. Thymoquinone works by reducing inflammatory responses, reducing the size of kidney stones, and increasing the chance of kidney stones going away altogether.

Heart Health

Some studies show that black seed oil has blood pressure-lowering effects, as well as cholesterol-lowering effects. This is true of total cholesterol and LDL cholesterol (the “bad” cholesterol), and can also help increase HDL cholesterol (our “good” cholesterol).
In the same study investigating weight loss with black seed oil use in women, the results showed that their triglycerides, or fat, were also lower. Lower blood pressure, lower cholesterol, and lower triglycerides all help lower the risk of heart disease.

Digestive Health

Black seed oil may have antimicrobial properties and promote healing of the gut. A few studies have also shown that black seed oil, taken with the common drug omeprazole which is used for heartburn and acid reflux, has therapeutic effects on bacterial activity. Some animal research has also shown inhibiting effects of candida growth in rats. Candida is a yeast that can grow too much in the gut, causing symptoms like gas, bloating, muscle aches, and even mood swings.

Diabetes

Black seed oil has been used for treatment of diabetes. A large amount of evidence has shown improvement in blood sugar levels, an increase in insulin, the hormone that regulates blood sugar, and a decrease in hemoglobin A1c, which is an indicator of diabetes.

Antibacterial Benefits

In animal research, thymoquinone decreased inflammation and improved gut barrier function in rats. Black seed oil, taken orally, has also been shown to have an antibacterial effect in the liver in mice, and antibacterial effects against MRSA in vitro.

Antioxidant Benefits

Thymoquinone is known to have antioxidant defense mechanisms through several different pathways. Some of these pathways include inhibiting fat production in liver cells, inhibiting enzymes that promote inflammation, enhancing natural killer cell activity, and stimulating immune cells. Thymoquinone also increases the right ratio of some immune cells, reduces the production of inflammatory indicators, overall decreasing oxidative stress in the body.

Usage and Dosage

This supplement can be ingested or used topically on the skin for healing purposes.
It may cause an allergic reaction when used topically, but it’s been reported to have healing effects for the skin including eczema and psoriasis.

Current evidence does not have an established recommended dosage, however, short-term use is recommended at around 1-3 months. There is limited research on long-term use of it, however, using the supplement for 3 months or less hasn’t shown any negative effects.

The dosages of black seed oil may vary from person to person, but they can range from 1000 mg per day to 2-3g per day in capsule or liquid form.
One study done in rats recommends an upward limit of 900 mg per day for humans, yet
500mg per day of isolated thymoquinone may be suitable for most.
Studies currently show no toxicity symptoms at doses as high as around 250mg of TQ in humans, granted this is much higher than the suggested 500mg/day.

Supplement Quality

When looking for quality black seed oil, consider the following content of the product:

Certified organic
Cold-pressed extraction of the oil; heat extraction can damage the composition.
Brands that name the origin country of the seeds.
Avoid brands that claim high concentrations of thymoquinone; this is an imbalanced ratio of compounds.

Side Effects of Black Seed Oil

This oil can interact with some medications, including warfarin and beta blockers. It’s important to consult with your doctor about taking this supplement.
No negative effects have been reported from use, aside from one study which showed side effects of nausea, bloating, and a burning sensation in patients with indigestion when taken orally.

Exercise Intolerance

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Have you ever felt so tired during a workout, where you were unable to push through?
Maybe, what you’re experiencing is exercise intolerance.

Exercise intolerance is defined as the inability to maintain exercise at an expected level resulting in short workouts or easily fatigued muscle.

It is commonly associated with heart disease but can also present in people with mitochondrial dysfunction or metabolic disorders.

Signs and symptoms:

Excessive sweating
Shortness of breath
Chest pain and Muscle cramps
Inflammation
Weakness and shaking with exertion
Nausea

The “powerhouse of the cell”

Many of us are taught in high school biology that the mitochondria are the powerhouse of the cell. When there is mitochondrial dysfunction, the cell has a harder time making energy thus making fatigue more likely.

The Heart Disease Connection

When heart disease is present, the cardiovascular system has a harder time pumping oxygen into the blood and tissues. This can also cause exercise intolerance has the muscles and tissue are unable to receive the nutrients they need to optimally function.

Nutrition for Better Exercise Tolerance

Protein as well as nutrients such as thiamin, niacin, arginine, creatine, and carnitine all support healthy cells within the muscle. Great sources to pick up at your next grocery trip include grass-fed beef, wild caught fish, eggs, and beans.
Carbohydrates sources should be high in fiber to prevent large glucose spikes. Sweet potato, white potato, sprouted whole grains, quinoa, and brown rice all are high fiber sources that will fuel the body and slowly enter the blood stream.

It’s important to find your “sweet spot” when it comes to carbohydrates. Eating too little or too many carbohydrates can negatively affect your blood sugar, making you sleepy and not equipped for your workout.

Other nutrients to consider

Nitric oxide founds in beets, dark leafy greens, and dark chocolate help dilate the blood vessels so blood pumps more efficiently to the muscles.
Coenzyme Q10 aids in energy production and acts as an antioxidant to prevent cellular damage.
Glutathione aids in detoxify unwanted material in the body. The best sources of glutathione include spinach, avocado, asparagus and okra.
Selenium can help increase your glutathione production. Foods such as beef, chicken, fish, organ meats, cottage cheese, brown rice and Brazil nuts are great sources.

Find a Type of Exercise that Works for You!

Yoga
Tai chi
Walking

If you think you’re experiencing exercise intolerance, talk to your health care provider.

Sources:

Campagnolo, N., Johnston, S., Collatz, A., Staines, D., & Marshall-Gradisnik, S. (2017). Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic review. Journal of Human Nutrition and Dietetics: The Official Journal of the British Dietetic Association, 30(3), 247–259. https://doi.org/10.1111/jhn.12435

Dietary supplements for primary mitochondrial disorders. (n.d.). Nih.gov. Retrieved April 25, 2023, from https://ods.od.nih.gov/factsheets/PrimaryMitochondrialDisorders-HealthProfessional/

Finsterer, J. (2009). Mitochondrial myopathies. Fortschritte der Neurologie-Psychiatrie, 77(11), 631–638. https://doi.org/10.1055/s-0028-1109759

Holden, S., Maksoud, R., Eaton-Fitch, N., Cabanas, H., Staines, D., & Marshall-Gradisnik, S. (2020). A systematic review of mitochondrial abnormalities in myalgic encephalomyelitis/chronic fatigue syndrome/systemic exertion intolerance disease. Journal of Translational Medicine, 18(1), 290. https://doi.org/10.1186/s12967-020-02452-3

Khanpour Ardestani, S., Karkhaneh, M., Stein, E., Punja, S., Junqueira, D. R., Kuzmyn, T., Pearson, M., Smith, L., Olson, K., & Vohra, S. (2021). Systematic review of mind-body interventions to treat myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Medicina (Kaunas, Lithuania), 57(7), 652. https://doi.org/10.3390/medicina57070652

Colon Cancer

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When it comes to colon cancer, there are risk factors that can be modified through lifestyle and diet changes. This means you have the power to make that change and decrease your risk!

Of course… diet plays one of the BIGGEST roles in decreasing your risk of colon cancer.

Eat the rainbow.

The more colors you eat the more antioxidants, vitamins, and minerals your body is exposed to. These protect you from free radicals that promote cancer growth.

Cruciferous vegetables

Broccoli, kale, cauliflower, Swiss chard, and Brussel sprouts produce a compound call DIM which assists the body in detoxification.

High fiber foods:

These help feed good gut bacteria and keep the bowels moving. When there are more good bacteria within the gut, the bowels can eliminate waste better and fight of pathogens.

Omega-3 Fatty Acids:

These reduce inflammation and prevent harmful inflammatory compounds from damaging cells.

Be Mindful of Certain Protein Sources:

Processed meats (ex. Bacon, sausage, hot dogs, deli meats) have been shown to favor cancer cell growth when eaten in excess. Studies regarding red meat and cancer are still inconsistent but, it’s important to consider how often you’re consuming red meat. Most people who eat red meat have limited vegetable intake. Therefore, it’s important to prioritize your fruits and vegetables with your red meat consumption. Also, opt for grass-fed protein sources as they are higher in anti-inflammatory compounds. As for poultry, there is no known associated risk with colon cancer.

Some Beverages can be helpful:

Green tea, matcha or coffee contain cancer fighting compounds. Just make sure to limit the added sugar.

It’s important to steer clear from:

Alcohol
Refined grains and sugar
Fried foods

These foods can promote inflammation in the body. When inflammation is present it can damage tissue and promote a cancerous environment as cells are damaged. Alcohol is estrogenic meaning it can cause your body to circulate excess estrogen throughout the body. Colon cancer thrives off estrogen, therefore it’s important to avoid alcohol all together. It is also classified as a carcinogen and damages your gut in the process. As for fried foods, refined grains, and sugar, they are known to be eaten in excess and can cause weight gain.

Maintain a Healthy Weight

When the body has more fat tissue around the belly-region, inflammation is more likely to occur. As already mentioned, inflammation can damage cells and if you’re chronically inflamed this can lead to more issues throughout the body.

Daily Bowel Movements & Decreased Colon Cancer Risk

Moving your bowels daily and eliminating stool will help avoid waste product from recirculating back into the body. Abnormal bowel habits and conditions such as IBS or IBD can negatively affect bowel health and consistent inflammation can influence a cancer growing environment.

If you are at risk for developing colon cancer (family history, poor diet or lifestyle, history of polyops), please get screened!

Heart Rate Variability (HRV)

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What is HRV and what does it say about your health?
To start, HRV stands for heart rate variability, and it represents the fluctuations of time (milliseconds) between each heartbeat.

How does heart rate variability work?

Your heart beats at a specific rate all throughout the day and never stops. That rate changes depending on what you’re doing at the time. When you are relaxed or resting, a slower heart rate is more likely than when in a stressed state, with a faster heart rate. There is variability in your heart rate based on the needs of your body and your respiratory patterns.

As research has looked further into HRV, many medical professionals are now using it as a biomarker to assess a person’s health status. The variability of the heart reflects how adaptable the body is. High variability means the body can adapt, while low HRV is associated with diabetes, cardiovascular disease, inflammation, obesity, and psychiatric disorders.

“Fight or flight” or Zen

Many of us have heard of fight or flight and how it causes both the heart and blood pressure to rise. In this situation, our sympathetic nervous system is triggered, and our heart rate variability has more extreme variations. After a period of stress, the parasympathetic nervous system kicks in and decreases heart rate cause HRV to has less intense variations.

Diet and HRV

A diet rich in omega-3 fatty acids, B vitamins, probiotics and polyphenols support a healthy HRV. This means incorporating more foods such as grass-fed beef, salmon, olive oil, yogurt, kefir, fruits and vegetables.

When it comes to foods that don’t support HRV, the main one is alcohol. Alcohol disrupts sleep and makes it hard for the heartbeat to stabilize adequately. Other things such as high intakes of saturated fat, trans fat, and high glycemic carbohydrates can favor stress and elevated heart rate in the body.

Low HRV can be caused from:

Hot sleeping environment
Eating too close to bedtime
Illness
Overtraining
Dehydration

Other ways to improve your HRV:

Exercise regularly to support your cardiovascular health.
Prioritize mental health as stress, anxiety and depression negatively affect your heart rate.
Adopt a meditation practice so you can master your breath and learn how to control your heart rate better.

Gut Feelings

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A study summary: Associations of emotions and emotion regulation with the gut microbiome in women.

Many of us know that bacteria in the gut can influence our health in so many ways. Research has been overwhelming recently about the connection between our emotions and various strains of bacteria within the gut.
A recent study looked at 206 women, examining if there was a connection between emotional health and gut microbiome. Emotional health was referred to as either positive or negative emotions. Emotional regulation was also assessed based on how well someone can process their feelings. The study used stool tests that measured the specific bacteria strains and their amounts.

The results showed:

Positive emotions were associated with fewer levels of Firmicutes bacterium CAG 94 and Ruminococcaceae bacterium D16.
Negative emotions resulted in lower capacity for the metabolism to process Pantothenate (Vitamin B5) and Coenzyme A.
Poor emotional regulation was tied to less bacterial diversity.

The Takeaway:

Emotional health and regulation can affect bacteria within the gut.

When there are more negative emotions, there is a greater likelihood of bacterial imbalances within the gut.
Also, negative emotions can affect the body’s ability to metabolize important nutrients.
Less bacterial diversity caused from poor emotional regulation can increase the likelihood of negative health outcomes.
Greater microbial diversity is needed for an optimal microbiome and overall health.

Is it Really a Food Intolerance?

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Often, new clients will say to me: “I am here because I have a ton of food intolerances. I need to figure out a diet that avoids all these foods that I react to.”

If one food bothers you, maybe it is that food. But if 20 or 50 foods bother you, it isn’t the food, it is your gut. So while I believe that these foods are problematic, I am much more interested in getting to the root cause of their symptoms (which is usually something else) and not just eliminating a ton of good food. So what are the potential root causes?

Microbe imbalance:
- We have hundreds of trillions of microbes in our colons. We hope there is more good than bad, but oftentimes there is: too much bad, not enough good, or both. Sometimes there is a pathogenic overgrowth or they migrate up to our small intestine where they don’t belong and wreak havoc (SIBO).
- Dysbiosis is the word for any of these imbalances and it causes all types of reactions to all types of foods. It can be confusing because it isn’t clear which foods; it isn’t consistently a certain food. That is because it isn’t the food. It is the microbiome imbalance.
Digestive insufficiency:
- We need stomach acid, enzymes, and bile to digest our food. For a number of possible reasons (antacid medication, aging, digestive dysfunction, microbe interference) we often don’t have enough of one or more of these. And that causes indigestion, heartburn, bloating… all in reaction to food.
Motility issues:
- Food moves through our digestive tract. It needs to move not too fast that we don’t digest and absorb, but not so slow that we feel sick or have trouble processing. We need our stomach to empty at the right rate, our food to move through our small intestine at the right rate and so on. Many people have trouble in this area for a variety of reasons.
Leaky Gut:
- This is a buzz word for a real thing: increased intestinal permeability. The integrity of the lining of our intestinal wall makes all the difference in whether we feel good or whether we react to foods.
Immune imbalance or dysregulation:
- If our immune system is overactive (perhaps because of leaky gut) we will react to foods that should otherwise be safe.
Food sensitivities:
- Sometimes it is food. Gluten and dairy are the most common food sensitivities. A sensitivity is similar in some ways to an allergy (and different in other ways), in that the immune system sees and responds to the protein of a food as if it is a threat. Sometimes this is temporary in the case of some of the bullets above.
- Other times we truly can’t eat gluten anymore (like an allergy).

These are all things we dive into with clients here at Health Takes Guts, Inc. Schedule an appointment here!
Additionally, these topics are all explained at length in my ebook: Health Takes Guts® Your Comprehensive Guide to Eliminating Digestive Issues, Anxiety, and Fatigue.

Magnesium is good for your brain.

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A new study recently came out about Magnesium.
You can read it here: Dietary magnesium intake is related to larger brain volumes and lower white matter lesions with notable sex differences
550mg of Magnesium a day reduces brain shrinkage and prevents cognitive decline (like dementia).

This is not the first, in fact there are many studies showing Magnesium’s positive effect on the brain and cognition. Often times the benefits of Magnesium are compounded with Vitamin D or other nutrients. This is why I recommend everyone take a Magnesium in addition to a multivitamin.

You should make sure your Magnesium is in the forms of Magnesium Glycinate or Magnesium Threonate and that it is from a professional grade company (clean and quality assured), such as these in my Full Script store.

Anti Inflammatory – What’s the hype?

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For over a decade, scientific research investigating noncommunicable diseases have demonstrated a commonality among seemingly disparate pathologies. What could heart disease, Alzheimer’s, autoimmune disorders, depression, arthritis, and irritable bowel syndrome all have in common? Despite the many differences between each condition, the evidence continues to suggest a key marker appearing in each: biochemical signs of inflammation.

In the human body, the inflammatory process is the natural immune activation that occurs when there is a potential threat–whether that be a wound that needs clotting, a bone that needs healing, or a potential invader that needs to be neutralized. These states of inflammation are healthy and necessary to life. But they also, importantly, are temporary. In fact, there are key cellular signals, including a class of molecules called pro-resolving mediators–that initiate the resolution of inflammation so that the immune response not only brings its heightened activity to a close, but also returns to normal function. However, what science now shows is that sustained states of inflammation are not as functional or benign as naturally occurring inflammation that arises and resolves. The continually elevated immune activity is causing what’s now often deemed “chronic low-grade inflammation,” and markers of its existence are showing themselves to be a risk factor, or component of, many conditions that were previously thought to be unrelated.

The inflammatory process itself is a cascade of biochemical activity involving an array of cell types and molecules, and it can unfold in regions all around the body.

Cardinal signs of inflammation include:

Redness
Swelling
Pain
Heat

This is easy to visualize when we think of a burn that we might incur on our finger while cooking dinner, or as a dramatic example, the shocking sight of our own knee after an orthopedic surgery. What’s more challenging to visualize, and research, is the inflammation that can occur within the body over long periods of time.

Yet, the same biochemical processes have been detected in these less visible regions.

The redness associated with inflammation is due to dilated arteries allowing increased blood flow to the site of damage.
Swelling arises once endothelial cells (flat cells that line the continuous sheet of tissue wrapping around blood vessels and body compartments) have leaked protein and water at the site.
Immune cells are activated to inflame the site.

Modern research investigating these processes have detected specific signals–molecules, that can communicate to the immune cells–that are secreted at these sites and then promote the inflammatory cascade. As it turns out, these cascades can unfold anywhere in the body because immune cells not only circulate in the blood, but also take residency in tissues and organs themselves. Evolutionarily, these abilities are incredibly beneficial. Modern humans evolved to have hyper-active immune systems, an ability to store surplus energy (fat tissue), and blood that’s quick to coagulate upon insult.

With these ancient processes underpinning much of human immune activity, the inflammatory connection between modern noncommunicable diseases makes sense. But what’s triggering these unrelenting inflammatory cascades?

Part of the answer to that question is a second question: what is even older than the immune system?

Metabolism.

As it turns out, protecting the cell (immunity) is an ancient system. But using energy to fuel cellular activity (metabolism) is even older.

One of the major biological stressors of modern life is the frequent onslaught of nutrition into the gastrointestinal tract. Food, and all of the compounds that arrive with it, is the outside world. Every time a human being eats, it’s a stimulating process not only for the organs involved in digestion and absorption, but also for the immune system. Importantly, approximately 70% of the immune system is housed within the gastrointestinal tract, and it must conduct surveillance at each meal of all food consumed. At every eating opportunity there is a complex interaction between the host immune system and the environment.

Not only is frequent eating associated with increased immune activity, but the food itself is dramatically different from what humans evolved to consume. One of the signatures of the modern food environment is the processed, hyper-palatable meals and food products that are now cornerstones of daily living.

Modern human G.I. tracts are coping with:

Refined grains
Alcohol
Sugar
Hydrogenated oils
Emulsifiers
Preservatives

These not only can cause acute damage during the digestive process, but it perpetuates the low-grade immune activity that can’t resolve–because the offending agent appears three, four, or even five times a day.

Fortunately, there is an antidote to this prevalent issue. As it turns out, one of the most powerful tools to reduce inflammation is also food. Recent evidence has found there to be strong associations between a healthy diet–like the Mediterranean diet–and reduced systemic inflammation. A healthy, anti-inflammatory diet can promote a reduction in fat mass, which has some anti-inflammatory effects on its own, help calm inflammation from powerful molecules in the food itself, and reduce inflammation because the meals contain few irritants.

Benefits from an anti-inflammatory diet include:

Whole food sources like leafy greens, vegetables, fruits, lean proteins, and healthy fats all have properties that provide the body with amino acids, antioxidants, polyphenols, and other phytonutrient compounds that can neutralize free radicals, quell inflammation, and promote healing.
Complex carbohydrates like fruits, potatoes, vegetables, and winter squashes are wrapped in a fiber matrix that has been shown to feed the microbiome–the microbial environment in the human colon.
Feeding these colonies with diverse fuel sources has been associated with increased diversity in the microbiome, which tends to have systemic anti-inflammatory and immune-supportive effects.

When paired with lean proteins and healthy fats like avocado and olive oil, the entire meal provides an array of benefits that help support healthy immune function in the G.I. tract as well as intestinal integrity, fullness, and satisfaction. Additional functional foods, such as probiotic items like kefir and sauerkraut, can also be included to support diversity in the microbiome plus offer beneficial compounds they contain called postbiotics. These bioactive chemicals, like polyphenols, short chain fatty acids, and enzymes, appear to help support the immune system and decrease inflammatory responses.

In contrast to the processed foods that can impair tight junctions, trigger immune responses, and promote potential leaking in the gut, these whole food sources are an example of the natural relationship between environment and host. Thoughtfully tailoring the diet to include predominantly anti-inflammatory, whole foods is a critical component of promoting long-term health not only in the gastrointestinal tract but in the whole body.

Coronavirus – Part 2 – Long-term effect of COVID-19

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Back in March, when the pandemic was new, I posted a comprehensive article on what we knew about the novel coronavirus and the disease it causes, Covid-19. A lot has happened since March, and we know a lot more. So here is part 2.

Long-term effect of COVID-19

Early on in the pandemic, we learned that COVID-19 was a short-term illness only fatal to the most vulnerable population — the elderly and those with pre-existing medical conditions. And all the actions were taken to protect those who came to be known as ‘the most vulnerable.’ While for younger and healthy people, this virus would just make them feel like catching a bad flu, which could be got through by self-quarantine.

In recent months, research and data have shown that the original beliefs were mistaken and that the younger and healthy population is still at great risk of severe complications from COVID-19 even without significant risk of death. Only till now, more attention has been given to the group of people called the “long-hauler” who have tested negative after recovery from COVID-19 in theory. But the truth is that they still suffer from various symptoms, which seems to have no consistent reason for this to happen.

It is much clearer now that besides the respiratory system, COVID-19 affects many different parts of the patients, including the energy level, heart, brain, gut, and even their mental status in a more extended period than expected.

Fatigue

As a common symptom in those presenting with symptomatic COVID-19 infection, fatigue has also been reported by over 50% of people who recover from COVID-19 even 10 weeks later, regardless of the seriousness of their initial infection, according to newly-released research published in November. Female gender and pre-existing depression/anxiety diagnosis are both the most common characteristics among people who experience prolonged fatigue after recovery.

Brain

A recent study found that one-third of hospitalized patients with COVID-19 seem to have impaired neurological, psychological, and cognitive functions, ranging from confusion to “brain fogs.” Hallucinations, delirium, short-term memory loss, strange touching sensations of the hands, or high sensitivity to light and sounds are typical symptoms that many “long-haulers” experienced after their recovery. Many others also have problems with their sympathetic nervous system that directs the body’s rapid involuntary actions or responses like heartbeats and breathing, which lead to erratic heartbeat and shortness of breath.

Heart

Besides the symptoms of irregular heartbeat caused by the impaired nervous system due to COVID-19, heart damage has been observed among many people who had recovered from COVID-19 no matter if they had underlying heart diseases or not. One JAMA Cardiology study used cardiac MRIs on 100 people who just recovered from COVID-19 found abnormalities in the hearts of 78% of research participants and “ongoing myocardial inflammation” in 60% of them. This observation has worried health care experts about a potential increase in heart failure incidence in the near future.

Gut

You may be surprised to see that COVID-19 can influence the gut. In fact, studies found that abdominal symptoms are a common presentation for COVID-19. Patients with COVID-19 had significant alterations in their gut biota through fecal testing characterized by the increase of opportunistic pathogens and the reduction of beneficial bacteria even after clearance of the SARS-CoV-2 and all COVID-related respiratory symptoms. This situation has also been observed among patients naïve to COVID-19 antibiotic therapy. The loss of beneficial bacteria species in the gut persisted in most patients despite clearance of the coronavirus, suggesting that the exposure to the coronavirus or hospitalization could be linked with a more long-lasting damaging effect on the gut microbiome.

Mental health

This pandemic has caused much mental stress in its disruption to social, work, and exercise routines. However, the feelings of stress, anxiety, and depression are often worse among current COVID-19 patients and the “long-haulers.” Recent studies show that many COVID-19 survivors are likely to be at greater risk of developing mental illness, and 20% of them are actually diagnosed with a psychiatric disorder within 90 days.

Their mental state has suffered because of the disease in consideration of their discomfort, disease status, and the difficulties of accessing medical services besides all the physical-isolation disruptions.

Then, the mental health status is further exacerbated because some of them cut themselves off from the community due to discomfort and the aim to protect others. Due to their self-isolation and physical discomfort, they are unable to do activities that they usually rely on to relieve stress, such as exercise, go out with friends, or meet family members.

According to the National Alliance on Mental Illness, being unable to work and feeling unproductive can also hinder mental health. Many patients have lost income and health insurance due to their disease status, which brings its own form of anxiety and insecurity.

Moreover, “medical gaslighting,” whereby physiological suffering is downplayed as a psychological problem such as stress or anxiety, has influenced many “long-haulers” due to the disbelief coming from people around them. Employers, Friends, and family members cannot believe they are sick for that long and accuse them of just being lazy. Even many doctors refused to believe that a “mild: COVID-19 can last for more than 2 weeks. Thus, mental health has become a severe issue that will affect the coronavirus-infected population in the long run.

It’s still not clear what happens to the “long-haulers” that lead to the reoccurring symptoms. It could be that infectious viruses can hide in some reservoir organs, which is missed by tests that use nasal swabs. The persistent fragments of viral genes may be triggering a violent immune overreaction. Or the immune system is stuck in the overactive state by COVID-19 even when the virus is gone.

The recovery from COVID-19 could be tentative, variable, and not guaranteed. Thus, it is crucial for us to protect ourselves well from the beginning by understanding how the virus spread and effective protections.

How does the coronavirus spread?

We now know a lot more about how we catch this thing. The coronavirus that causes COVID-19 is known to spread from person-to-person by respiratory droplets from coughing, sneezing, or respiratory secretions. However, health authorities have recognized that this virus can also be transmitted through tiny aerosols in the air exhaled by an infected person. Aerosols and droplets are different in sizes that aerosols are smaller-sized respiratory droplets with a diameter of smaller than 100 micrometers, while droplets are larger than 300 micrometers.

Due to the smaller size and lighter weight, aerosols can concentrate and stay in the air for a long time after an infected person breathes, speaks, shouting, singing, coughing, or sneezing indoors or in poorly ventilated spaces with the increased risk of contagion. People infected with coronavirus can spread the illness to others as much as 48 hours before they have symptoms. That is why effective protection against virus transmission is the key to COVID-19 prevention. For more information about the differences between aerosols and droplets, please see this article for more details.

What are the effective ways of protection?

Social distancing

Social distancing is also called “physical distancing,” which means keeping a safe space of at least 6 feet (about 2 arms’ length) between yourself and other people who are not from your household to reduce close contact between people. It is considered as an important part of measures to control COVID-19.
When possible, please avoid public places with too many people as possible such as restaurants, bars, gyms, and public transportations where social distancing can be hard to apply and follow.

Wash hands frequently

Hand washing is one of the best ways to protect yourself and your family from getting COVID-19 or any other transmissible diseases and prevent the spread of germs to others. The coronavirus can spread from other people or surfaces when you touch your eyes, nose, and mouth with unwashed hands. The virus can also be transmitted to you through food and drinks handled with unwashed hands. If you touched a contaminated surface, the virus could stick to your hands and live for up to 9 hours.
Thus, you should wash your hands anytime before touching your face, preparing meals, and eating, as well as anytime after blowing your nose, coughing, or sneezing, using the bathroom, handling garbage or pet waste, or touching anything from outside your house. The length of hand-washing should be long enough with a 20-second scrub each time. When soap and water are not readily available, alcohol-based hand sanitizer that contains at least 60% alcohol can be used as an alternative, which is not as effective as hand-washing .

Mask

According to the CDC, anyone age 2 and older should wear a mask in public settings and when meeting people from outside of their household. By properly covering the mouth and nose, masks can help block the release of exhaled respiratory particles into the air, along with the virus these particles carry. The correct and consistent way of wearing a mask for the best protection is to avoid touching the mask and choose the correct fit and types of masks. Studies have suggested that some masks are much better than others due to their ability to block droplets in different sizes.

Differences in Masks

Surgical Masks

A surgical mask is also known as the “medical mask,” disposable and made with polypropylene non-woven fabric. It can protect the wearer’s nose and mouth from contact with droplets, splashes, and sprays and filter out large particles in the air. Surgical masks can also protect others by reducing exposure to the mask wearer’s saliva and respiratory secretions.

N95 Masks

The N95 mask, as one kind of respirator, can offer more protection than a surgical mask, which is commonly used by healthcare providers. It is designed to filter 95% of particles from large to very tiny sizes when the wearer inhales. Some N95 masks have valves that make them easier to breathe through. However, the one-way valves release unfiltered air when the wearer breathes out. Thus, this type of mask can’t prevent the wearer from spreading the virus.

Cloth Masks

A cloth mask is designed to trap droplets that are released when the wearer talks, coughs, or sneezes help reduce the spread of the virus by people who have COVID-19 but don’t realize it. Cloth Masks should be washed regularly and dried completely dry at the highest temperature of a dryer after using. However, the choice of material and the number of layers can significantly influence the mask’s ability to filter the virus.

According to the recent study on the number of droplets emerging from the mouth during a speech, the fit, material, and layer of the mask decide its ability to prevent virus transmission. The results show that properly fitted N95, surgical, and polypropylene masks are the best, and layered cotton masks are a good alternative without access to any multi-layered polypropylene masks. In contrast, a bandana is not a great choice, and neck gaiters may be even worse than wearing no masks. For more information about the differences between masks, please see this article for more details.

COVID-19 Transmission

Maybe you think these 3 methods are all you need to watch out for to protect yourself from COVID-19. However, the truth is that a few other factors are crucial to transmitting the virus, including ventilation, contact time, activity, and environment. Those factors are the primary determinants of the risk of COVID-19 transmission based on the formula by Jones et al. in their recent published paper: volume of exposure + length of exposure = risk of COVID-19 transmission.
In the same article, Jones et al. also include a table that shows the risk of coronavirus transmission from asymptomatic people in different settings and for different occupation times, venting, and crowding levels. Besides, viral load of the infected person as well as people’s susceptibility to infection should also be taken into consideration of the virus transmission rate. For more information about factors that influence virus transmission rate, please see this article for more details.

Meanwhile, Harvard T.H. Chan School of Public Health has found that flying on an airplane has a much lower risk of catching COVID-19 than going to the grocery store or eating out. This is because of the volume of exposure to COVID-19 such as high-performing ventilation systems, mandatory face mask policies, disinfection of high-touch surfaces, health attestations from passengers and crew before flying, and education and awareness of COVID-19 are effectively controlled and limited.

Vitamin D and COVID-19.

Although there is inadequate evidence to recommend the use of vitamin D to prevent or cure COVID-19, more research has suggested that vitamin D may play a role in determining the disease severity of COVID-19.

According to Weir et al. that “the severity of COVID-19 can be determined by the presence of pneumonia, severe acute respiratory distress syndrome, myocarditis, microvascular thrombosis and/or cytokine storms, all of which involve underlying inflammation.” In order to fight against inflammation and viral infection, the human body will produce lymphocytes called Tregs, which have been reported to be low in many COVID-19 patients. Research also found that the level of Tregs can be elevated by vitamin D supplementation. Besides, low serum vitamin D level is closely related to an increased risk of pneumonia, severe acute respiratory distress syndrome, myocarditis, microvascular thrombosis, and cytokine storms.

What is an adequate level of vitamin D?

In order to prepare your body with its ability to fight inflammation, it is better to have enough vitamin D, especially during the current and upcoming seasons that lack adequate sun exposure (vitamin D can be synthesized by the skin under sun exposure). Although the adequate vitamin D level remains controversial, many studies suggest a level between 30 ng/mL to 60 ng/mL.

I hope this blog can help you understand the actual risks of COVID-19 and encourage you to avoid getting and spreading the virus.

Sources:

Zuo, T., Zhang, F., Lui, G., Yeoh, Y. K., Li, A., Zhan, H., Wan, Y., Chung, A., Cheung, C. P., Chen, N., Lai, C., Chen, Z., Tso, E., Fung, K., Chan, V., Ling, L., Joynt, G., Hui, D., Chan, F., Chan, P., … Ng, S. C. (2020). Alterations in Gut Microbiota of Patients With COVID-19 During Time of Hospitalization. Gastroenterology, 159(3), 944–955.e8. https://doi.org/10.1053/j.gastro.2020.05.048

Townsend L, Dyer AH, Jones K, Dunne J, Mooney A, et al. (2020) Persistent fatigue following SARS-CoV-2 infection is common and independent of severity of initial infection. PLOS ONE 15(11): e0240784. https://doi.org/10.1371/journal.pone.0240784

Weir, E. K., Thenappan, T., Bhargava, M., & Chen, Y. (2020). Does vitamin D deficiency increase the severity of COVID-19?. Clinical medicine (London, England), 20(4), e107–e108. https://doi.org/10.7861/clinmed.2020-0301

https://www.theatlantic.com/health/archive/2020/08/long-haulers-covid-19-recognition-support-groups-symptoms/615382/

https://www.theatlantic.com/health/archive/2020/06/covid-19-coronavirus-longterm-symptoms-months/612679/

https://montrealmom.com/lifestyle/health-wellness/covid-19/covid-19-needs-a-re-brand/

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https://www.heart.org/en/news/2020/09/03/what-covid-19-is-doing-to-the-heart-even-after-recovery

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https://kottke.org/20/08/study-shows-that-some-masks-are-much-better-than-others

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The best tip for not overeating at the holidays!

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Every year, the holidays present a myriad of problems and challenges. The one I hear about most is: how to indulge without overindulging. In other words, how to eat healthy through the holidays; how to enjoy and participate but not blow your health and weight goals.

This year, 2020 presents even more stress and challenges. Although perhaps due to social distancing regulations, you will have less parties and gathering centered around eating!

Either way, here is a tip for this year or any year or every single day of your life.

Take a sip or small bite. First.

By ingesting a small small taste, you can assess if you need this or want this. If this is your favorite, then you shall continue with a full portion. But if it is just ok (or terrible), you can leave it, and not have any more.

For instance, you might like pumpkin pie but feel neutral about pecan pie. So eat the pumpkin pie (and enjoy!) and leave the pecan. Most people just eat it all, and it isn’t worth it. If it doesn’t contribute to your enjoyment, leave it. In that case, it is all down side.

This tip can be used for the main meal as well. Love sweet potatoes but not stuffing? Eat the sweet potatoes and leave the stuffing! You don’t have to eat it all. Where we get into trouble is the foods we aren’t passionate about, but eat anyway.

You want to balance enjoyment with health. The way to do that is to indulge in what is worth it and leave what isn’t.