The Best Diet for COVID and Long COVID

Did you know that healthy plant-based diets appear not onliy reduce the risk of severe COVID-19 and the risk of getting infected in the first place, even independent of comorbidities. Here’s our first story.

What’s the role of nutrition for both preventing and beating COVID-19? Nutrition-related myths on protection and treatment have been widely prevalent in this pandemic, and while there is no diet that completely prevents infection, there are certainly dietary steps we can take to minimize risk. Those with healthier diets in general seem to suffer less serious courses, but this appears to be an indirect benefit of lower rates of obesity and pre-existing medical conditions. That’s great, but is there any diet that may have direct effects on the course of disease, or susceptibility to infection in the first place?

Well, plant-based diets have been shown to decrease the risk of suffering from other respiratory infections—in fact, plant-based seminaries during the pandemic of 1918 appeared to have been relatively spared. Why might a plant-based diet help? Vegetable nitrates concentrated in dark green leafy vegetables can be used to make nitric oxide, which is part of our lungs’ first line of defense against infection. There are also polyphenol phytonutrients in plants that may directly inhibit viral infection. Then, there are beneficial effects on our microbiome, which plays a key role in our system-wide immune function. Fiber-containing foods facilitate more of a symbiotic relationship with our gut bugs, whereas processed junk and animal foods can have the opposite, dysbiotic effect.

Fiber, concentrated in whole plant foods, is the single most anti-inflammatory food component, whereas saturated fat, concentrated in meat, dairy, and junk, is the most pro-inflammatory food component. And so, it’s no surprise those consuming more pro-inflammatory diets were at greater risk of suffering a severe course, and of getting COVID-19 in the first place––up to nearly 12 times the odds, even after taking into account body weight, diabetes, and blood pressure. But this study only covered 60 COVID-19 patients. How about 11,000 COVID-19 patients?

Diet-associated inflammation increased the risk of getting COVID-19 infection, suffering a severe course, and dying from the disease. Might this help explain why the COVID death rates were a hundred times lower in Africa? Can a plant-based diet help mitigate COVID-19? Let’s find out.

In this study of COVID-19 illness severity in the elderly in relation to vegetarian versus non-vegetarian diets, statistically, the nonvegetarians had up to like 20 times the odds of suffering a critically severe course of COVID-19, but that was based on only nine vegetarians. A study of thousands of front-line healthcare workers across six countries found that those eating plant-based diets had 73 percent lower odds of suffering a moderate or severe course of COVID-19, and even combined with pescatarians (who eat fish but no other meat), still had significantly lower odds. The biggest spread was between those eating plant-based versus low-carb. Compared to plant-based healthcare workers, those eating low carb, high-protein diets had nearly four times greater odds of suffering a serious infection.

This may not seem surprising, given that many of the underlying risk factors for COVID-19 mortality—obesity, heart disease, high blood pressure, and type 2 diabetes—can be controlled or even reversed with a healthy enough plant-based diet and lifestyle. But the apparent plant-based protection went above and beyond. The greatly reduced risk was independent of all those conditions. The researchers suggest that a “healthy diet rich in nutrient-dense foods may be considered for protection against severe COVID-19.” The one food group most associated with lower symptom severity in one outpatient study was legumes, followed by grains, the top sources of dietary fiber. The investigators suggest that the anti-inflammatory effects of the short-chain fatty acids released by our fiber-feeding good gut bugs may explain the connection.

The healthcare worker study enrolled a few thousand people, but Harvard researchers collected data from nearly 600,000 participants, using a plant-based diet scoring system where you get points for eating healthy plant foods, but points deducted for meat, eggs, junk, and dairy. And indeed, those scoring higher not only had a significantly lower risk of suffering a severe course of COVID-19, but also a significantly lower risk of getting infected in the first place. And again, this was after taking comorbidities into account, alongside nondietary risk factors such as exercise and smoking.

The bottom line: “the best available evidence suggests that plant-based diets are beneficial in directly reducing the risk of severe COVID-19 symptoms and the risk of infection,” even independent of other health-related factors. A more Mediterranean-style diet may reduce the risk of infection by 22 percent, while an even more plant-based diet may cut infection risk in half.

For dealing with long-COVID, a plant-based diet has been suggested based on the abundance of data showing positive associations of plant-based diets with improved immune function, neurotransmitter balance, pain and inflammation reduction, improved sleep, and mental health. So, in terms of lifestyle adjustments in long-COVID management, “large-scale promotion of plant-based eating” may have the potential to improve physical and mental impacts. But this has yet to be put to the test.

There was a study that suggested that those who eat more vegetables are less likely to end up depressed, and those who eat more nuts, beans, and whole grains may end up less depressed, anxious, and stressed after COVID, whereas stress levels were correlated with higher meat intake. But the only interventional studies are showing a detrimental impact on high-fat, high-sugar diets. But that’s in Syrian hamsters, though there are definitely some unhappy hamster lungs on the crappy diet.

All in all, adopting a healthful plant-based diet may be a powerful tool to decrease the risk of severe COVID-19, and should be promoted as a public health safety measure. And what are the side effects? A delay in aging and decreased disease. Maybe this is the booster we need. After all, if real effort had gone into encouraging and incentivizing healthier diets and lifestyles, we would not only have saved many more lives from COVID-19, but we would also reduce future mortality from all major causes of death.

Finally, today, I share with you some research about how to reform the food system before it’s too late.

Infectious diseases are emerging globally at an unprecedented rate. Literally hundreds of new pathogens have emerged and re-emerged over the last few decades, and what we eat is responsible for most of the new diseases that have jumped from animals to humans.

In response to the torrent of emerging zoonotic (animal-to-human) diseases, three of the world’s leading authorities—the World Health Organization, the Food and Agriculture Organization of the United Nations, and the World Organization for Animal Health (OIE)—held a joint consultation to determine the key underlying causes. First on their list was the “Increasing demand for animal protein.”

The greatest swords of Damocles dangling are the H5 and H7 bird flu viruses blanketing much of the earth. A bird flu pandemic could be devastating, given their current upwards of Ebola-like flip-of-the-coin death rates. Given that the emergence of these deadly bird flu viruses, H5N1 and H7N9, are “linked to intensification of the poultry sector,” there have been calls for the “de-industrialization of animal production”––for example, as suggested here in the Annals of the New York Academy of Sciences, “replacing large industrial units with smaller farms with lower stocking densities,” potentially resulting in less stress, less disease susceptibility, less intense infectious contact, and smaller infectious loads. Maybe they’re the ones that could use a little social distancing.

The American Public Health Association, the largest and oldest association of public health professionals in the world, has called for a moratorium on factory farming for nearly two decades now. Maybe COVID-19 is the dry run we needed, the fire drill to awake us from our complacency and reform the food system before it’s too late.

But if, as the Food and Agriculture Organization of the United Nations visualized it, the next pandemic starts with “increased demand for poultry products,” before ending up with human-to-human transmission, maybe we need to move beyond just giving these animals some more breathing room. “It is curious, therefore [given the pandemic threat], that changing the way humans treat animals—most basically, ceasing to eat them or, at the very least, radically limiting the quantity of them that are eaten—is largely off the radar as a significant preventive measure. Such a change, if sufficiently adopted or imposed, could still reduce the chances of the much-feared influenza epidemic. It would be even more likely to prevent unknown future diseases that, in the absence of this change, may result from farming animals intensively and killing them for food. Yet, humanity [doesn’t even] consider this option.”

However, thanks to food innovations, this may be changing. Have you looked in the dairy case at the supermarket lately? Some of America’s largest dairy producers have recently filed for bankruptcy due to the constellation of new consumer choices.

I was peripherally involved in the largest meat recall in human history. Remember the footage of the cows getting forklifted? A hidden-camera investigation at a California slaughter plant for “spent” dairy cows led to a recall of nearly 150 million pounds of beef for violations of food safety rules meant to protect the public from mad cow disease. Downed dairy cows—too sick to even walk—were being dragged to slaughter with chains into the federal school lunch program. You don’t have to worry about contaminated cattle brains in your oat milk, though.

Plant-based milks are a no-brainer.

But, you can see what I’m saying. Yes, you can pass public health regulations to stop the cannibalistic feeding of slaughterhouse waste to dairy cows—or, you can just provide the public better alternatives, and let the market eliminate the risk entirely, because there’s no prions in plants.

HIV/AIDS likely arose from people slaughtering primates. Thirty million people wouldn’t be dead right now if we were eating meals from bushes instead of bushmeat. We can’t get coronaviruses from cauliflower. There is no flu in falafel production, no matter how tightly you crowd the balls together. What I am saying is our food choices don’t just affect our personal health, but our global health. Not just in terms of climate change, but in terms of stifling pandemic risk.

There has been a tremendous surge in interest in diversified protein sources, given the increasing consensus that reduced meat consumption is critical for addressing both the climate crisis and our burgeoning epidemics of lifestyle diseases. Eating less meat may not only help save the world, but could help prevent the loss of more than ten million human lives a year. To their credit, in 2016, the Chinese government recommended its citizens cut their meat consumption in half, in part to reduce their growing rates of chronic disease. A completely plant-based diet might reap $30 trillion from the health benefits alone, and that would be just from the lowered rates of chronic diseases like cancer, heart disease, and type 2 diabetes––not even factoring in the decreased catastrophic pandemic risk. What we eat doesn’t just affect our personal health, but our global health in more ways than one.

Making healthier choices could also help mediate the next coronavirus epidemic, not only at the source by sidestepping wet markets, but by also decreasing the rates of co-morbidities found to increase the risk in all the deadly coronaviruses: SARS, MERS, and COVID-19. Consider the underlying risk factors for COVID-19 severity and death: obesity, heart disease, hypertension, type 2 diabetes, and chronic pulmonary disease. “In virtually all studies, vegetable protein is superior to animal protein [in terms of] lower rates of heart disease and type 2 diabetes and lower blood pressure than animal protein.”

The same diet that can help you survive this pandemic can also help prevent the next. So, instead of propping up the meat industry to the tune of a 100 million taxpayer dollars a month, and forcing meat plants to stay open, pandemic proof your diet. Thankfully, expanded options are now hitting the meat case as well. No longer a niche market for vegetarians, major meat producers have started blending in vegetable proteins to make hybrid meat products, like Perdue’s “Chicken Plus Nuggets,” or Tyson’s “Whole Blends” sausage links. Smithfield, the world’s largest pork producer, recently debuted an entire line of plant-based products. Hormel has a new plant-based line too; the purveyors of SPAM now believe in the power of plants. Check out this headline from a few weeks ago: “KFC to roll out Cargill’s plant‐based chicken across China.” Talk about a Cultural Revolution. And, we’re not talking about Tofurkey. Cargill is America’s largest private corporation and one of the biggest meat packers in the world.

How many fewer curly-tailed viral mixing vessels are there now that Dunkin’ Donuts has a meat-free breakfast sausage? How many fewer hens are packed beak-to-beak now that egg-free mayo has taken the sandwich spread sector by storm? Quorn, a brand of meat-free meat made from the mushroom kingdom, opened a single facility that can produce the meat equivalent of twenty million chickens per year. These products may not be the healthiest from a personal standpoint— a doughnut sandwich without pork is still a doughnut sandwich—but hey, swap in an egg-free omelette from Tim Hortons and from a pandemic standpoint? Zero risk.

Doesn’t necessarily have to be plants, though. “Researchers are seeking alternative protein sources everywhere.” Can’t think of any possible alternative to cow’s milk? How about cockroach milk? Could be healthier than cow’s milk, and hey, no lactose, no dairy allergy problems. An important alternative. I mean I can’t imagine anything else you can make milk out of. And gluten-free too! The only downside, evidently, was the flavor, but the researchers—perhaps funded by Big Bug?—chalked this up to fact that the judges knew there were cockroaches in the bread; and so, they were all just biased. Hmmm, I think I’ll stick with the plants.

But if you’re like: “you’ll have to pry that pork chop from my cold, dead hands,” we may be able to have our meat and eat it too. An even more innovative approach to pandemic prevention was suggested by Winston Churchill in 1932. In an article in Popular Mechanics entitled “Fifty Years Hence,” he predicted that “[w]e shall escape the absurdity of growing a whole chicken in order to eat the breast or wing, by growing these parts separately under a suitable medium.”

And indeed, the prediction is becoming a reality. Instead of taking a cutting from a plant and growing vegetables, you’re taking a sample from an animal, and growing meat. Potentially lots of meat––like maybe a billion pounds from a single sample. Indeed, in terms of efficiency, growing meat straight from muscle cells could reduce greenhouse gas emissions and water use by as much as 96 percent, and lower land use by as much as 99 percent. But when you factor in pandemic risk, the benefits to human health of a slaughter-free harvest could arguably rival those to planetary health.

Food safety has been considered the primary human health benefit of such an approach. There has been a six-fold increase in food poisoning over the last few decades, sickening tens of millions of Americans every year, and contaminated meats and animal products are the most common cause. So, when the cultivated meat industry calls its product “clean meat,” that’s not just a nod to clean energy. Food-poisoning pathogens like E. coli, Campylobacter, and Salmonella are due to fecal residue––traces of which are found on most poultry sampled in the United States, and about half of retail ground beef and pork chops. They’re intestinal bugs, so you don’t have to worry about them if you’re producing meat without intestines. You don’t have to cook the crap out of meat if there’s no crap to begin with, just like you don’t have to worry about brewing up new respiratory viruses that could kill millions of people if you’re making meat without the lungs.

“A culinary choice in south China led to a fatal infection in Hong Kong, and subsequently to 8000 cases of severe acute respiratory syndrome (SARS) and nearly 1000 deaths in 30 countries on six continents.” If only we had learned our lesson then. We may be one bushmeat meal away from the next HIV, one pangolin plate away from the next killer coronavirus, and one factory farm away from the next deadly flu. Tragically, it may take a pandemic with a virus like H5N1 before the world realizes the true cost of cheap chicken.