What’s the Problem, Dr. Korman? by Laura Korman, DC
Q: What can I do to strengthen my immune system? A: A year and a half ago, I was answering many patient questions about how to prevent heart disease, diabetes or cognitive decline. But today, their concerns are predominately centered around another question: how to improve their immune health. My answer is that the same foundational principles apply, whether your goal is to prevent a chronic illness or an acute infection. It has been shown that having a chronic illness, such as obesity, hypertension, heart disease or diabetes, weakens immune resistance and puts you at a much greater risk for negative outcomes from COVID-19. Whether you are vaccinated or not, metabolic health should be the top priority. Therefore, my advice starts with improving metabolic health which I believe is under-emphasized, and even ignored, by healthcare leaders as a first-line defense against the COVID-19 virus. According to the CDC, 73.6% of American adults are overweight with a Body Mass Index (BMI) over 25, and 42.5%, are now obese with a Body Mass Index or over 30. Childhood obesity is also on the rise, affecting nearly one in five children between the ages of two and 19. This
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puts them at serious risk for a lifetime of poor health. In fact, obesity is the primary driver of heart disease, diabetes, and some forms of dementia and cancers.1 In addition, a recent study of COVID-19 cases suggests that risks of hospitalization, intensive care unit admission, invasive mechanical ventilation and even death are higher in those with an increasing BMI. The increased risk for hospitalization or death was particularly pronounced in those under the age of 65. More than 900,000 adult COVID-19 hospitalizations occurred in the United States between the start of this pandemic and November 18, 2020. Models estimate that 271,800 (30.2%) of these hospitalizations were attributed to obesity. Even more alarming, most people who are hospitalized with COVID-19 have more than one disease (comorbidity).2 Another study looked at 5,700 patients in New York City and found that 88% of them had more than one chronic condition. Only 6.3% had just one underlying condition, and 6.1% had no other coexisting conditions.3 The most common thread connecting these comorbidities is insulin resistance which is at the root of poor metabolic and immune health. This occurs when people consistently consume foods that raise blood sugar levels beyond what
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the body is burning or requires for energy. This excess blood glucose, stimulates higher levels of insulin which, over time causes, the cells to become less and less responsive to the effects of insulin. Insulin is there to drive blood sugar from food that was just consumed into the cells, both for immediate energy needs and to store it as fat for later energy reserves. Insulin resistance is also known as metabolic syndrome or pre-diabetes, and is the metabolic dysfunction of Type-2 Diabetes. It is estimated that 40% of Americans have pre-diabetes, and most of these individuals do not even realize it. The first recommendation I have for a patient who wants to strengthen immune health is to lower their BMI if it is above 25—which is the case for nearly three out of four adults. Then, order a HgA1c test along with a fasting insulin test. Optimal functional levels should be below 5.7ng/mL and 5.0ng/mL., respectively. I also instruct my patients to avoid foods that elevate blood glucose and insulin levels like sugary foods and beverages, processed carbohydrates, pre-packaged and fast foods. Sugar directly lowers the white blood cell defense against pathogens. Shop for whole, limited ingredient foods (found primarily around the perimeter of the grocery store) and focus on organic, non-GMO, pasture raised and local sources if possible. Avoid inflammatory vegetable and seed oils like canola, soybean, corn, sunflower and safflower oils (found in most dressings and condiments). Extra virgin olive oil and avocado oils are preferred. My second recommendation is that patients have their serum vitamin D levels checked, as there is overwhelming evidence of the correlation between low vitamin D levels and poor COVID-19 outcomes. Optimizing vitamin D could be the easiest and single most important strategy to minimize the risk of COVID-19. I advise my patients to take enough vitamin D3 to keep their serum levels optimally between 60-80 ng/ mL. Vitamin K2 should also be taken with vitamin D3 as these two vital nutrients work together to help absorb and divert calcium into the bones and away from the arteries.
