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Lewis Kaplan, a critical care doctor for Veterans Affairs at the University of Pennsylvania recently said “We have an obesity epidemic in the midst of a pandemic.” Businesses and humans in general have spent the last 3 decades plus producing fake food. These food products are engineered, full of stabilizers and chemicals to keep them shelve worthy. None of this has anything to do with nutrition or the proper function of our collective (herd) immune system. It's phenomenal that in the year 2020 having technology, data, and knowledge that a healthy diet full of whole and real food is the answer to a healthy functioning body of a human being, we are still consuming and offering space to box food. In the early 1900's grandma ate better than you, she was physically more active than you and if she had known the information we have available at our fingers tips today do you think she'd be eating twinkies. We had the correct platform for healthy eating; backyard, locally and community grown food, fresh food, partly because the capabilities to extend the life of these foods to the extend we can today was not available then. Then we fucked it up with money, I'll get to that in a second.
A little history on how we moved away from fresh food healthy to eating convenience food and specifically in North America. Modern convenience food had its beginnings in the period after World War II in the United States. Many of these products had their origins in military developed foods designed for storage longevity and simplify of preparation. After the war, many food companies were left with surplus manufacturing facilities. These companies developed new lines of canned and freeze dried foods products that were designed for use in the home. Fun fact: In 1965, non-working women spent more than two hours per day cooking and by 1995, this time had been reduced by more than half. This can be attributed to a shift in food preparation from individuals to food manufacturers. Convenience has lowered the cost of time associated with food consumption and increased the quantity and variety of foods consumed. Which is great for the manufacturers but not public health. Interestingly the strong reaction we have taken to "combat" Covid-19 should have been deployed decades ago to fight obesity.
Let's put this into perspective; in a 2004 Globe and Mail article - that's 16 years ago!- it was stated that 1 in 10 Canadian deaths among adults aged 20 to 64 was directly attributable to excess weight. The number of obesity-related deaths in this relatively healthy age group doubled between 1985 and 2000. Fast forward to 2018 and staggeringly the one and only have sex with a mask on Dr. Theresa Tam acknowledged that in 2017 64% of Canadians were overweight or obese and said that "this is a problem." My question for Tam is knowing this as a medical professional and while planning for possible pandemic scenarios, which we are to understand the government had done, this little issue of obesity and immunity never connected hard enough for the doctor to take a stronger stance and recommend the government implement legislation to aid in controlling a possible future pandemic. She is excellent with bandaid solutions not so great it seems with hard core preventative health policies.
Peter Katzmarzyk, a professor in the school of physical and health education at Queen's University in Kingston told the Globe in 2004 that "immediate and sweeping public-health campaigns and interventions are required to slow or reverse the recent trends." So where have these sweeping public health campaigns been given that swift mandatory campaigns can be rolled out within days and implemented. Even given the emergency state of Covid you would think that if the ability to legislate such swift changes exists why have we not been able to accomplish this within almost 4 decades under various governments. The answer is simple - money. Money which the manufacturers of box food add to the overall economy and then Pharma to aid people following years of a box food diet. For decades between food and pharma corporations we have allowed money to dictate the state of our public health and now the chickens have come home to roost.
The Washington Post recently wrote that more "than 42% of U.S. residents are obese, defined as a body mass index of 30 or greater, and more than 9 % are severely obese, with BMIs of 40 or more. Eight months into the pandemic, obesity has turned out to be one of the clearest predictors of a difficult battle against covid-19, for reasons that may vary from person to person. Some experts say they consider obesity to have contributed to the stunning coronavirus death and morbidity rate in the United States, which has one of the highest obesity rates in the world. And there is some evidence it is particularly harmful for people under 60, who generally fare better than the elderly against the disease caused by the novel coronavirus."
So while a large number of deaths from Covid in the US is attributed to obesity it's interesting to compare Italy's numbers, a country which was drowning in cases and at one point had the highest amount of infected after China. Europeans overall including Italian's eat more local, homemade food than North Americans. Of the 36,000 coronavirus deaths in Italy more than 80% were patients aged 70 years and older. While in the US data released on June 16th by the CDC shows that the country’s death toll skews significantly younger. There, people in their 80s account for less than half of all covid-19 deaths; people in their 40s, 50s and 60s, meanwhile, account for a significantly larger share of those who die. The median covid-19 sufferer in America is a 48-year-old; in Italy it is a 63-year-old.
It will be interesting to see if the top bureaucrats including Dr. Tam and other public health officials will connect these dots and focus more on legislating restrictions on convenience food or possibly higher taxes on those foods to accommodate for the education of preventing obesity as well as resources to aid in the reduction of obesity and further funding for healthcare to continue care of obese individuals.
So why exactly are you more prone to this virus if you're obese - suppression of immunity.
Karger is the multidisciplinary online journal for obesity research and therapy and in a recent paper researchers and doctors describe why obese Covid-19 patients have a higher morbidity rate.
The paper states that "emerging data suggest that adults with obesity may be at risk for a more serious and complicated course of COVID-19, the severity of the disease being exacerbated by biological and social factors associated with obesity. Obesity has been shown to alter immune function and increase the susceptibility to infection from different pathogens. Elevated circulating pro-inflammatory cytokines, as well as reduced adiponectin levels, may impair the immunological response to infection. This entails disruption in the lymphoid tissue structure and shifts in leukocyte populations and inflammatory phenotypes. Also, B and T cell responses are impaired, and this causes an increased susceptibility and delay of resolution of viral infections. Finally, reduced vaccine efficacy has been observed. Obesity is related to comorbidities such as type 2 diabetes, hypertension, and cardiovascular and renal diseases, which may deteriorate during COVID-19 and affect the overall health of patients. Among individuals under the age of 60 affected by COVID-19, adults with obesity are almost twice as likely to need treatment in the ICU than those without obesity. Severe obesity increases the risk of acute respiratory distress syndrome, which is a major complication of COVID-19. Several studies demonstrated an association of obesity with ICU admission and mortality among individuals with COVID-19."
The most fascinating part of this paper is that as the world is furiously trying to outdo each other with Covid vaccine development the sad fact is that for a large number of Americans and Canadians a vaccine won't be a cure. The paper states that "vaccination efficacy in adults with obesity may be compromised. Obesity-related metabolic dysregulation has been proposed as the driver of poor effector T cell and helper T cell function, and in impaired memory T cell responses and vaccine efficacy. This may be due to alterations in T cell metabolism. In obese mice, the protectiveness of the 2009 A/H1N1 vaccine was reduced."
It's clear that obesity needs to be addressed, not stigmatized or ignored. Individual responsibility of health needs to take front and centre. Be aware of your health choices and their consequences. Your immunity doesn't come from a vile but from a healthy lifestyle, yes that takes work but isn't quality of life worth the effort. Public health officials and governments need to aid in taking back our food chain and the way we grow and produce our food in order to continue sustaining life on earth without astronomical costs to our healthcare system. Really, what is it going to take?