Obesity – A Greater Risk of COVID-19 Severity?

As we all are aware of the current pandemic situation caused by Covid-19 has attracted worldwide attention. Usually, obesity has many side effects which complicates our physical and mental well-being. Obesity boosts the severity of respiratory diseases, but this is still not clear whether this plays a role in having a greater Covid-19 severity of illness.

For this purpose, a study was conducted in Asia where seventy-five patients diagnosed as ‘obese’ and seventy-five ‘non-obese’ took part, all of them having Covid-19. The severity of Covid-19 was assessed during hospitalization also, obesity was defined as BMI ≥25 kg/m2 in this Asian population. All patients denied a history of active cancer, chronic obstructive or restrictive pulmonary diseases, or other end-stage diseases.

The study has shown association between obesity and higher risk of having severe Covid-19. Each 1-unit increase in BMI was also associated with a 12% increase in the risk of severe COVID-19. To date, the virologic and physiological mechanisms underlying the strong relationship observed between obesity and COVID-19 severity are poorly understood.

It is reasonable to hypothesize that more severe COVID-19 in patients with obesity may be the consequence of underlying low-grade chronic inflammation and suppression of innate and adaptive immune responses.

Also, the mechanical dysfunction caused by obesity can increase the severity of lower respiratory tract infection and contribute to secondary infection. Health care professionals caring for Covid-19 patients should be aware of the likelihood of severe Covid-19 in obese people. Thus, the presence of obesity carries higher risk of severe illness roughly threefold with a consequent longer hospitalization.

On the other hand, the relationship between socioeconomic status and risk of obesity, and the political interventions such as lockdown against Covid-19 might translate into increased obesity occurrence and metabolic diseases in inactive groups and lower socio-economic status.

A reason for this increase is the availability of highly processed, energy-rich, cheap foods which boosts the calorie intake beyond energetic needs, which such foods are preferred and selected by individuals with a lower socioeconomic status who have limited income resources.

The use of lockdown to combat Covid-19 has been successful to a certain extent from an epidemiological perspective, but lockdowns have had negative effect on metabolic health. On the other hand, approaches designed to contain the spread of Covid-19 might promote obesity and associated metabolic diseases.

Accordingly, when considering the use of lockdowns in the future, the potential adverse consequence on metabolic health should be taken into consideration. Also, if potential lockdowns are to occur, the closure of Sporting facilities such as gyms should remain open with caution, which will potentially help people cope with inactivity.

References:

Clemmensen, C., Petersen, M. B., & Sørensen, T. I. (2020). Will the COVID-19 pandemic worsen the obesity epidemic?. Nature Reviews Endocrinology16(9), 469-470.

Dixon AE,  Peters U. The effect of obesity on lung function. Expert Rev Respir Med 2018;12:755–767 Saltiel AR, Olefsky JM. Inflammatory mechanisms linking obesity and metabolic disease 2017

Gao, F., Zheng, K. I., Wang, X. B., Sun, Q. F., Pan, K. H., Wang, T. Y., … & Zheng, M. H. (2020). Obesity is a risk factor for greater COVID-19 severity. Diabetes care, 43(7), e72-e74.

World Health Organization Rolling update on coronavirus disease (COVID-19): WHO characterizes COVID-19 as a pandemic. Published 11 March 2020.

COVID-19 and Body Mass

Unfortunately at this point the majority of scientists agree upon the fact that Covid-19 has become, and will be a part of, our reality for many months if not years to come. During this period, as a society we have been learning and adapting to new measures in our fight against the disease. Quarantines, social distancing, sanitizers in many shapes and forms, as well as some bogus anti-Covid ‘supplements’ are the first ones that come to mind in this long list.

However one of the more significant details that has been recently revealed in numerous research studies is the undeniable connection between an individual’s physical fitness and the severity of Covid-19 disease. To be more exact it is the connection between BMI (Body Mass Index) and the severity of Covid-19 symptoms an individual experiences. And outcomes of these studies indicate that the higher one’s BMI the stronger and fatal the disease becomes.

You might be asking what it is that is causing this adverse reaction to Covid-19 in overweight/obese populations. Stephen O’Rahilly, director of the Medical Research Council’s Metabolic Diseases Unit at the University of Cambridge says “Two things happen when obesity occurs: the amount of fat increases, but also you put fat in the wrong places. You put it in the liver and in skeletal muscle. And that disturbs metabolism. The key disturbance is that you get very high levels of insulin in the blood.”

And he suggests that it is this disturbance that leads to a wide range of abnormalities such as increases in inflammatory cytokines as well as a reduction of adiponectin, a molecule that directly protects the lungs. Stephen O’Rahilly adds that it is also possible that fat could be increasing in the lung itself, which may lead to complications in how the lung handle the Covid-19 virus.

So far studies in the United States have indicated that having a BMI over 30 – a BMI above 30 indicates obesity- increases the risk of being admitted to hospital with Covid-19 by 113%; of being admitted to intensive care by 74%; while increasing the risk of death by 48%. On top of that Public Health England’s report suggests that the increase in risk of death rises by 90% in people with a BMI above 40.

What’s even worse is that these numbers are irrespective of age, as extra weight and obesity tend to affect younger populations just as bad. According to World Obesity Federation people under the age of 60 with a BMI between 30-34 are statistically twice as likely to be admitted to intensive care than those with a lower BMI.

Public Health England also warns that the risk of developing serious disease due to Covid-19 among people from black, Asian, and minority ethnic groups is 2.56 times higher than among white Europeans,. However at a BMI of 25 there is no such difference to be observed between ethnicities.

Considering that obesity is one of the biggest health problems that the UK is currently facing with two-third (63%) of its adult population being overweight and/or obese, this should be seen as a major concern as well as a call for action. We have to understand that avoiding contact with the virus is one part of the battle.

Being prepared for the infection is another part. And knowing that excess weight is a modifiable risk factor, improving your physical fitness is one of the smartest steps you could be taking right now. In addition to becoming more Covid-proof you will also be looking better!

Aydin Parmaksizoglu

BMI Formula: weight (lb) / [height (in)]2 x 703

References:

GOV.UK. 2021. Excess weight can increase risk of serious illness and death from COVID-19. [online] Available at: <https://www.gov.uk/government/news/excess-weight-can-increase-risk-of-serious-illness-and-death-from-covid-19&gt; [Accessed 8 June 2021].

Mahase, E., 2020. Covid-19: Why are age and obesity risk factors for serious disease?. BMJ, (371), p.m4130.

Senthilingam, M., 2021. Covid-19 has made the obesity epidemic worse, but failed to ignite enough action. BMJ, p.n411.

Williamson, E., Walker, A., Bhaskaran, K., Bacon, S., Bates, C., Morton, C., Curtis, H., Mehrkar, A., Evans, D., Inglesby, P., Cockburn, J., McDonald, H., MacKenna, B., Tomlinson, L., Douglas, I., Rentsch, C., Mathur, R., Wong, A., Grieve, R., Harrison, D., Forbes, H., Schultze, A., Croker, R., Parry, J., Hester, F., Harper, S., Perera, R., Evans, S., Smeeth, L. and Goldacre, B., 2020. Factors associated with COVID-19-related death using OpenSAFELY. Nature, 584(7821), pp.430-436.

World Obesity Federation. 2021. Obesity and COVID-19: Policy statement | World Obesity Federation. [online] Available at: <https://www.worldobesity.org/news/obesity-and-covid-19-policy-statement&gt; [Accessed 8 June 2021].

The Vegan Diet: An Introduction

The vegan diet is an entirely plant based diet, which in other words means that products that contain animal products such as meat, eggs and dairy are not consumed at all. Research suggests that people who are following vegan diet are tending to have a lower body mass index (BMI). This indicates that vegan diet aids with weight loss, also people who are vegan are more likely to make weight-conscious decisions.

Some studies have examined the effect of different diets such as vegan, vegetarian, semi-vegetarian, and omnivorous diet on weight loss. The results concluded that the group of people on vegan diet lost the more weight compared to other diets and also their saturated fats consumption has decreased.  Another study examined vegan and vegetarian diets, which has shown that plant-based diets were more effective for weight loss accompanied with health improvements such as lower cholesterol and decreased risk of cancer, compared to omnivorous diets.

Following the vegetarian or vegan type of diet has been shown to boost metabolism, which means that more calories could be burned while at rest, making weight loss more effective. Therefore, following vegan diets has shown to have many health benefits. This means that people consume less processed or pre-packed food that contain animal products, which eventually allows them to consume fresh and whole foods instead.

The following of plant-based diet or vegan diet is associated with lower risk of cancer, reduced risk of stroke, reduced inflammation, lower cholesterol, lower risk of diabetes and lower blood glucose. On the other hand, it may also have its cons when adhering to vegan diet. Animal products naturally contain vitamin-B12, which means that it has to be supplemented or find other sources. There is potential for vegans to become deficient in iron, vitamin C, calcium, vitamin D, protein, and omega 3, if foods containing all these are not consumed.

It is important to mention that for every diet, the key to successful weight loss is to consume lesser calories than are burned when exercising or doing daily activities. People that want to lose weight using vegan diet should consume mainly fibre-rich fruits e.g. berries, apples, citruses and others; also fibre rich and leafy vegetables such as broccoli, potatoes, sprouts, spinach, kale; fats coming from avocado, olive oil, nuts & seeds; protein sources should be mainly coming from tofu, soy, soy milk, beans, lentils, seitan, tempeh; whole grains such as oats, brown rice, quinoa, wholegrain bread.

On the other hand, people who want to be vegan and lose weight should avoid processed meat substitutes, vegan deserts, and processed snacks as some of them contain high amounts of sugar and saturated fats. Following plant-based diet has its positives from the perspective of consuming more plant foods, probiotics and fibres.

However, this can be healthy lifestyle diet and can be used for weight loss as well, but individuals taking this approach should be cautious of the deficits of some vitamins and minerals that are absent in vegan diet. Some nutritional deficits can be replenished by using vegan supplements, otherwise the lack of macronutrients and micronutrients may lead to disruptions in homeostasis.

Ibrahim

References:

Dinu, M., Abbate, R., Gensini, G. F., Casini, A., & Sofi, F. (2017). Vegetarian, vegan diets and multiple health outcomes: a systematic review with meta-analysis of observational studies. Critical reviews in food science and nutrition57(17), 3640-3649.

Turner-McGrievy, G. M., Davidson, C. R., Wingard, E. E., Wilcox, S., & Frongillo, E. A. (2015). Comparative effectiveness of plant-based diets for weight loss: a randomized controlled trial of five different diets. Nutrition31(2), 350-358.

Sweeteners: Friend or Foe?

Decades after their introduction to our diets there is still an ongoing debate whether sweeteners are harmful to our health or if they are simply a safe way to suppress your sweet cravings.

First things first we have to understand why it is considered beneficial for us to cut back on sugar, and before that we have to understand the big difference between various sources of sugar. Long story short when it comes to sugar it is all about how it is packaged. Sugars in the form of fruits come with a high fibre content (great for digestion), low glycemic index (meaning they do not cause sudden spikes in your blood sugar) and they provide you with lots of nutrients.

On the other hand the “evil sugars” come in processed forms such as chocolate bars, fizzy drinks, highly processed fruit juices, ice creams, and they are even added to products like soups, breads, etc. They have none of the beneficial stuff which we mentioned above, and they cause an unwanted spike in blood glucose which therefore raises your insulin levels (which eventually make it harder to burn off fat). They also increase triglycerides, cause inflammation in the body which then has the potential to lead to chronic illnesses such as diabetes and cardiovascular diseases.

How do sweeteners fair in comparison to sugar then? First of all I have to make it clear that most of the scaremongering claims root from animal studies where extremely high doses of these substances have been used. And believe it or not when it comes to human safety, animal studies are widely considered as a very poor source of information.

Also studies that claim a risk of obesity due to sweetener consumption tend to make the most common mistake of confusing correlation with causation. Most of the time it was not the sweetener that made the participants of these studies overweight but it was the overweight people consuming sweeteners with the aim of losing weight.

Whilst almost all the major health authorities in the world have agreed upon the safety of sweetener consumption, this should not “encourage” us to feast on sweeteners as they are still relatively new to our bodies, and there may still be more to discover over time. In the meantime I would not worry too much about an occasional can of a diet drink. At the end of the day it is usually the dose that makes the poison – you should consume what suits you in healthy moderation.

Aydin

Coffee or No Thanks? A Look Into Caffeine and Sporting Performance

Caffeine is one of the most well known and studied supplement on the planet. It has many physiological effects although it has no nutritional value. However, its effects are associated with stimulating the nervous system and hence improving exercise capacity.  This ‘stimulant’ has been consumed worldwide for centuries and its effects are recognised by many nations. On the other hand athletes are among the groups of people who are interested in the effects of caffeine in endurance exercises and other physical activities.

The available literature suggests that the benefits of caffeine on performance athletes can be seen when moderate amounts of caffeine is consumed (~3mgkg1 body mass).  Also, these benefits are potential for many sports such as in endurance, high intensity activities, and stop-and-go events, there is not much evidence on its direct effect on strength and power activities.

Many studies using moderate to high doses of caffeine (5-9 mg/kg BM) have found ergogenic effects in endurance activities and recognised the effects on the physiological responses to exercise; this include increased heart rate, a doubling of blood catecholamine levels, higher blood lactate levels and also increased blood free fatty acid and glycerol levels in some subjects. On the other hand there are some side effects that could occur such as gastrointestinal upset, mental confusion, nervousness, impaired focus and sleep disturbances. Recent studies have shown that lower doses of caffeine can stimulate an ergogenic effect when consumed prior to exercise in short or long endurance events.

Some practical applications for athletes using caffeine can aid athletes in their performance goals. When considering whether to use caffeine as stimulant, it is recommended athletes to begin with low caffeine doses ~100-200mg, and if higher dose is consumed it does not appear to give additional advantage. However, the response to caffeine is strongly individual, and professional athletes need to see its effect in training before moving to competitions.

Caffeine’s ergogenic effect is independent of habitual caffeine use, training status, diet, gender, hydration status, and exercise modality, but results in the heat are less clear (see Burke et. al., 2013; Spriet, 2014). Also, caffeine can be found and consumed in the form of capsules, coffee, sports and energy drinks, gums, gels, and bars, but mouth rinsing with caffeine is less likely to produce an ergogenic effect. Even not so active individuals use caffeine containing substances in their everyday lives in order to improve their mental alertness or other uses such as pain killers.

Caffeine works by stimulating the central nervous system (CNS), heart, muscles, and the centres that control blood pressure. Caffeine can raise blood pressure, but might not have this effect in people who use it all the time. Caffeine can also act like a “water pill” that increases urine flow. But again, it may not have this effect in people who use caffeine regularly. Also, drinking caffeine during moderate exercise is not likely to cause dehydration.

Additionally, the research on caffeine have determined that lower dose of caffeine ~200mg is ergogenic in different exercise and sport scenarios in recreationally and well-trained individuals men and women. On the other hand, high caffeine doses are associated with unpleasant physiological responses to exercise and additional side effects and do not bring more benefits. The mechanism which explains the ergogenic effect of caffeine is shown from adenosine receptor antagonism in the central nervous system and the peripheral nervous system. However, the administration of caffeine in the form of capsules, tablets and coffee used in research, caffeine can be delivered in many different forms with similar ergogenic effects.

So, to wrap it up, caffeine consumption in normal quantity brings physiological benefits that could aid physically active individuals in their performance as well as not as active individuals in their everyday lives, but higher dose will not boost its effects and contrariwise it may cause adverse effects.

Ibrahim

References:

Burke, L., B. Desbrow, and L. Spriet (2013). Caffeine for sports performance. Human Kinetics, Champaign, Illinois, USA.

Spriet, L.L. (2014). Exercise and sport performance with low doses of caffeine. Sports Med. 44:S175-S184.

Exercising On An Empty Stomach

Exercising early in the morning can be hard and this can be due to many reasons such as waking up earlier than you’d have liked to or due to the lack of energy that is coming from food in your system. However, it is debatable whether it is a good idea to workout on an empty stomach or if this fasted state is going to cause you adverse effects such as metabolic disbalance.

Let’s take for instance waking up in the morning after 6-12 hour overnight fast. This state will cause your body to somewhat deplete its glycogen and therefore activate the fat burning process by mobilizing the usage of fat as energy to compensate the low glycogen levels. However, as we know when we eat food, our body starts to produce insulin which interferes with the mobilization of body fat.

As the carbohydrates (in the form of glucose) levels are low in the blood stream caused by the overnight fast, more calories from stored fat are burned when exercising to compensate the low glucose levels. Therefore in fasted state less insulin is present which ultimately links to burn more calories that come from stored fats when you do cardio in such fasted state.

Doing cardio in the morning will allow your metabolism to remain high for a period of time after the workout is done and take advantage of the after-burn effect. Of course, you will benefit from doing cardio in the evening, but you will impair the effect of the after burn effect because your metabolic rate drops drastically as soon as you go to sleep. Some researches support this theory, where it has been tested on subjects who burned 1kg of fat faster when exercised in fasted state in the morning, compared to individuals who had few meals throughout the day exercised later.

A study on respiratory gas exchange, caloric expenditure, and carbohydrate/fatty acid metabolism in individuals who exercised after 12 hours of fast has shown 67% of the energy expenditure that came from fat, compared to 50% expenditure achieved when individuals who did the same exercise later in the day or after having food. Also, another study supports the hypothesis that endurance training enhances lipid oxidation in men after a 12 hour overnight fast.

Of course both methods of exercising either in fasted or fed state has their own pros and cons. This highly depends on the individual and their goals. Some other benefits of training on empty stomach can be improved performance and helps avoid stomach upsets. On the other hand there are negatives as well which could be decreased ability to work at higher intensity for longer, lower stamina, and can lead to muscle loss.

As previously mentioned both methods have their benefits and its side effects, this depends all on the individual and its goals. At the end, it is very important to follow your body and find what works and feels best for it. 

Ibrahim

Reference:

Read, F. C. M. F. cardio on an empty stomach.

Aceto, Chris. Everything you need to know about fat loss. Club Creavalle, Inc. (1997)

Bergman, BC, Brooks, GA. Respiratory gas-exchange ratios during graded exercise in fed and fasted trained and untrained men. Journal of Applied Physiology. (1999) 86: 2.

Brehm, B.A., and Gutin, B. Recovery energy expenditure for steady state exercise in runners and non-exercisers. Medicine and Science in Sports and Exercise. (1986) 18: 205,

Staying Active in Cold Weather

The change of seasons causes the ambient temperature changes as well. As we are currently in the winter season, the temperatures drop. When it comes to physical activity, some individuals choose to take exercising indoors and some choose to workout outside in the cold.

However as the temperatures are low outside, the temperature of our muscles can also drop, which makes this a huge aspect for the sporting performance.

One of the biggest considerations for training in the cold is the warm up. It is very important to warm up before any type of physical activity especially cold weather, as the cold temperatures can significantly reduce muscle function. The decline of muscle temperature may result in reduced force up to 20% studies suggest, and they can take longer to build force.

As we know that the brain sends signals to the muscles via nerves, the rate of nerve conduction slows down in cold circumstances. On the other hand, muscles produce heat when they are activated, which therefore provides a protection from the cold.

Warm up before exercise is crucial in such low temperatures, and can decrease the risk of injury up to 40%. Additionally, warm ups that consist of strengthening, jumping, balance, and agility exercises potentially reduce the risk of non-contact injuries such as ACL-tear. However, exercise form is of a huge importance in such circumstances.

Some people rush the warm up section of the workout and neglect its importance, so take some quality time and put effort in to doing correct and effective warm up with good form. This will also make you feel better and ready for exercising in the cold.

Most physical activities outdoor include running, rope skipping, jumping, and others. Studies suggest that dynamic stretching during warm up could be more effective than static stretching.

Examples of dynamic stretch can be forward lunges with a twist, knees to chest, high knees, and side shuffle. Static stretches on the other hand include stretch holds for 5-30 seconds, such examples are standing hamstring stretch, shoulder, chest, back, calf, and adductor stretches.

It is suggested that dynamic stretches can help with the warm-up of muscles and improve performance more than prolonged holds of stretches. Now that we know the importance of warm up, another benefit of it is the improved muscle flexibility and readiness for the upcoming exercises.

A simple jog for 5 minutes can improve flexibility and warm up the muscles, and can help preventing muscle strains which is a quick stretch of the muscle beyond its flexibility limit. Most of the exercise specialists recommend that warm up and stretching is essential, as studies suggests that it’s a way of injury prevention.

However, the effect of warm up doesn’t last forever. It is also recommended the warm up and stretching to last at least 15 minutes prior physical activity to gain most of its benefits.

On the other hand, this means physical activity should be constantly maintained in cold weather while the muscles are still warm and loose, but if you stop and rest for prolonged time muscles gradually cool down and become less flexible which is a thing that we have to avoid. Depending on the exercise or sport, some exercise specific warm-ups may be required.

Reference:

PAY, B. Great Facts And Tips For Warming Up In Cold Weather.

The importance of Vitamin D

Why do I need vitamin D?

Vitamin D is important to your body to help absorb calcium and promote bone growth  and keeping teeth strong. Vitamin D helps regulate the amount of calcium and phosphate in the body. Too little vitamin D results in soft bones in children (rickets) and fragile, misshapen bones in adults (osteomalacia). Vitamin D plays an important role for other important body functions such as regulate the immune system and the neuromuscular system. Vitamin D also plays major roles in the life cycle of human cells. Vitamin D is so important that your body makes it by itself but only after skin exposure to sufficient sunlight. This is a problem for people in northern climates.

Here are possible 8 signs and symptoms of vitamin D deficiency:

  • Getting Sick or Infected Often
  • Fatigue and Tiredness
  • Bone and Back Pain
  • Depression
  • Impaired Wound Healing
  • Bone Loss
  • Hair Loss
  • Muscle Pain

Good sources of vitamin D

From about late March/early April to the end of September, most people should be able to get all the vitamin D they need from sunlight. The body creates vitamin D from direct sunlight on the skin when outdoors. But between October and early March we don’t get enough vitamin D from sunlight. Vitamin D is also found in a small number of foods

Sources include:

  • oily fish (such as salmon, sardines, herring and mackerel)
  • red meat
  • liver
  • egg yolks
  • fortified foods
  • or dietary supplements.

Your body doesn’t make too much vitamin D from sun exposure, but always remember to cover up or protect your skin if you’re out in the sun for long periods to reduce the risk of skin damage and skin cancer.

If you have any questions about vitamin D, please speak to out Fitness Professionals at SportsDock.

 

written by Jelena

 

What is the scale telling us?

In this day and age, many people are concerned with the concept of weight. Many see having high weight on the scales or gaining weight as a bad thing, but what if it didn’t have to be.

Getting in shape doesn’t always mean losing weight when looking at a scale. Some people feel disheartened when they start going to the gym or attending exercise classes regularly and get on the scale only to see they are still the same weight. But this does not mean that you aren’t getting results; it’s all about knowing the difference between losing fat and losing weight.

Recently, I have seen posts on social media of people documenting how they managed to stay the same weight whilst achieving a body that they are happy with and this was by working hard to reduce body fat whilst gaining muscle which led to overall body toning. A lot of them also made conscious decisions to stop stepping on the scales and instead use transformation pictures to document their progress. The average scale cannot tell you which percentage of your body weight is fat or muscle and therefore you could be losing fat and gaining muscle and a scale would be unable to tell you that. That’s why transformation pictures are great concept because they allow you to compare your body to previous states and allow you to recognise they physical changes your body has undergone which can help highlight that your progress.

So if your next scale weigh-in has you feeling down, consider using transformation pictures to help minimise the effect the scale has on how you view your progress.

by Beverley Osei-Henewaa

More sleep please

The importance of sleep in you training routine

The majority of us live very busy lives with work and family keeping us busy throughout the day. It a challenge just getting into the gym to training with a busy lifestyle! However please keep in mind the importance of sleep in your training routine.

A paper completed by endurancedoc.com show how athletes bodies, whilst asleep, secretes human growth hormone (GH) from the Pituitary gland whilst we are at rest. Growth Hormone is needed to help repair the body’s muscles through protein synthesis and also helps to break down fat in the body. Lack of sleep deprives the body of enough time to secrete GH to adequately build or repair the body and therefore can lead to injury or stop exercise progress.

The recommended amount of sleep for moderate to heavy exercisers is between 7 to 10 hours (Cheri Mah Stanford Sleep Disorders Clinic) However Researchers from University of Pennsylvania suggest that you are unable to catch up on sleep. Therefore please bear in mind that an extra sleep at the weekend does not make up for lost sleep over the week.

Keep in mind that a good night’s sleep is an important part of anyone’s exercise programme!