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Wellness in the Time of Covid

While training for triathlon, it became rapidly important very early on to come across and maintain a routine that would help reduce stress to allow for recovery. When I correlated my recovery process to being a nurse in a busy ICU, it became a nightly routine that has helped me maintain 10 years of critical care nursing. Now, more than ever, it is just as important to find a method to help reduce stress so that the body can help fight inflammation and recover for the next day.

I've included 9 tips that are guaranteed to help.

1. Keeping your Physical Activity Level Up.

Exercise during the COVID outbreak is safe but symptoms should be taken into consideration. From Should, and how can, exercise be done during a coronavirus outbreak? An interview with Dr. Jeffrey A. Woods, J Sport Health Sci. 2020, Mar, 9(2): 105-107: "Typically, one can exercise moderately with mild upper respiratory tract symptoms (e.g., runny nose, sinus congestion, mild sore throat). However, I would recommend against exercising if you are experiencing any of these symptoms: severe sore throat, body aches, shortness of breath, general fatigue, chest cough, or fever. You should also seek medical care if you are experiencing those symptoms. Typically, recovery from respiratory viral infections takes 2–3 weeks, which corresponds with the time it takes your immune system to generate cytotoxic T cells necessary to clear the virus from infected cells."

My personal trainer and RYT-200, Sarah (@sarah_highpointyoga) and I have had many conversations related to sleep, metabolism and stress management. We've both had a lack of 'movability' during this time. Some strategies that we've found helpful include: going for walks around your neighborhood frequently during breaks away from the computer; finding free or low-cost Zoom classes with different workout topics will help diversify your workout and keep your mind activated; utilize gamified programs such as Zwift and TrainerRoad.

If you are a swimmer but do not have a pool, a great program to include in your daily mobilization also include dry land workouts direct from MySwimPro. They offer free, dryland workouts for swimmers! After using their customized swim programs, I can say nothing but great things about this app and the people behind the app. With joining, there is access to an online library of swim videos and also, group support with a Facebook community.

Additionally, Yoga has a profound impact on our mental and physical well-being. Here is an example of a simple Chaturanga.

2. Prevent the Slowing of Metabolism.

Due to the impact that less activity will have on our bodies, metabolism will most likely slow down, so being mindful of how much and what you are eating is important. Assuring your are getting enough, but not over-doing the amounts of protein, healthy fats and micro-nutrients during this time is vital. Below, I have included an article previously published for Penn State Health Fitness Center regarding protein intake.

Protein Myths vs. Facts What Active Individuals Need to Know About Protein Timing, Intake, and More By: Sarah Hartman, UFC Exercise Physiologist

#1: Americans eat too much protein - FALSE Actually, Americans eat at the low end of the recommended protein intake.  The myth may largely be due to the increasing body size and mass of Americans and the increase in total energy intake (calories). Berryman et al. AJCN, 2018 Fact: On a grams of protein per kilogram of body weight basis, and a percent of energy intake basis, Americans do not eat too much protein.  Obese individuals may fall below the RDA for protein intake.  Jo et al., Clinical Nutrition 2017 #2: A 20 gram dose is all you need and timing doesn’t matter - FALSE Fact: The optimal dose of protein changes based on age and goal.  Older adults need more protein to optimally stimulate muscle protein synthesis per meal.  Thus, protein intake and the daily recommendations need to change (increase) as we age. Fact: Anabolic Resistance exists as we age.  In older adults, there is a reduced increase in skeletal muscular protein synthesis (MPS) after the intake of protein as compared to younger adults.  Koopman et al., AJCN 2006; Symons et al., AJCN 2007, Fielding J. Nutr, 2013.  This anabolic resistance in older, healthy adults can be overcome with higher intake of dietary protein, especially when consumed along with carbohydrates.  In example, 40g protein (~16.8g essential amino acids) maximally stimulates muscle protein synthesis after resistance exercise in elderly men. Fact: Timing does have a small impact on muscle growth.  Furthermore, protein pacing (spacing protein consumptions out evenly throughout day/meals) enhanced total and abdominal body fat loss.  Arceiro et al.,Obesity 2013. #3: Eat a lot of protein = gain fat! - FALSE Fact: To further demonstrate the relation to protein distribution (pacing/timing), A clinical trial discovered that an increased protein intake and increased meal frequency reduced abdominal fat during energy balance and energy deficit without the presence of exercise. Clinical Trial: Paul J. Arciero, Michael J. Ormsbee, Christopher L. Gentile, Bradlet C Nindl, Jonathan R. Bestoff, and Maxwell Ruby. Obesity 2013. #4: For weight loss, reduce your protein intake - FALSE Fact: Increased total protein consumption per day and the implementation of protein timing/amount of protein (20 - 40g depending upon age) per meal enhanced total and abdominal body fat losses, with or without exercise.  Arceiro et al., Obesity 2013. Fact: Protein 6x/day increased metabolism (total calories burned in a day). Arceiro et al., Obesity 2013. Fact: Overeating protein increases lean mass (without physical activity) Bray et al., JAMA 2012 Fact: Increasing from 15% to 30% protein daily decreases kcal intake and increases satiety, meaning you’ll eat less and remain satisfied.  Eating 40% vs 15% protein plus exercise improves body composition.  Overeating protein does not appear to make you gain fat.  High protein diets help to reduce body fat and improve body composition, especially when paired with exercise.  J.Antonio., JISSN 2015 #5: Eating before bed will add body fat - depends on what you are eating and level of activity Fact: The overnight period is likely the longest period of muscle loss.  There is a window of opportunity during sleep.  In fact, timing protein pre-sleep may improve muscle recovery reconditioning and will not add body fat. Trommelen, 2016 Fact: Pre-sleep protein enhances muscle size and strength.  (Based off of a trial using a “pre-sleep drink consisting of 27.5g protein, 15g carbohydrates, and 0.1g fat while also consuming 1.3 - 1.9g protein/kg throughout the day.  Snijders et al., J Nutr, 2015

3. Schedule your day with highly detailed items.

Much like a check list. Many people struggle to figure out what their days should look like. I've always heavily relied on tailored schedules to help me meet my daily goals. Ever since I was a student-athlete at La Salle. Examples include workout time, movie time with specific movie of the day, planning out meals for the day, etc. Scheduling and creating a daily routine will help with decreasing stress levels and can help you feel a sense of accomplishment. Columbia News

4. 2500-5000 IU of Vitamin D3 per day.

This dose is recommended to keep your immune system in good shape. Some studies have pointed out the significance of reducing Influenza and Covid-19. More recently, scientists have found that low vitamin-d is found within 90% of patient's who develop acute respiratory distress syndrome in patients who contract COVID-19.

The following is from Dr. Gareth Davies, Dr. Joanna Byers and Dr. Attila R Garami and their research on Vitamin D along with COVID-19:

The researchers strongly recommend all hospital staff take daily D3 supplements (2,000iu to 4,000iu daily is considered safe short term) More detailed information visit: ​ 5. Protect your Gut Health.

From David Sinclair PhD: Eat your colors in plants. Either fresh or snap-frozen. They contain xenohormetic molecules that activate cell defenses. Also, include healthy fats of nuts, avocado, and olive oil in your diet. Oleic acid from these foods activates SIRT1, a defense enzyme, in your body. Newer research that has also come out has shown how gut bacteria is closely related to our brain health. You can read the recently published priorities for gut health here.

6. L-Glutamine for gut protection.

Glutamine is the most abundent free amino acid in the human body that is utilized by intestinal cells. Glutamine promotes enterocyte proliferation, regulates tight junction proteins and suppresses pro-inflammatory signaling pathways as well as protects against cellular stress during normal and pathologic conditions. You can read more about glutamine and it's roll here. In a recent study, enterocytes COVID-19 was found to be expressed in markers in the lung, but also within absorptive enterocytes from the ileum and colon. A good brand to purchase l-glutamine and the above mentioned vitamin d supplement include Thorne.

7. Keep the Humidity up in your home.

A dry environment can destroy your lung tissue and mucous lining leaving you susceptible to diseases. Drinking fluids as prevention of dehydration is very important. This tip isn't just good for this time, it is also helpful during times of seasonal threats such as other respiratory infections. Protect these guys:

8. Create Understanding through Education.

Turn off social media, breaking news channels and other distractions that may drive distraction as opposed to driving learning. I love the podcast, This Week in Virology (TWIV for short). They have many podcasts up and right now, as you could have guessed it, they are focusing on COVID19 and what is being done in terms of treatment. It is available on all podcast platforms. You can click the image below for their website.

9. Practice Mindfulness and Meditate.

There are several apps that can help guide your practice of both mindfulness and meditation. Headspace is one that offers both free and subscription services that I have personally used in the past. Ten Percent Happier is another app that has a free trial offered to new accounts. Meditation doesn't have to be done in a quiet space for you to be succesful, it can be done in as little as 5 minutes, and it teaches you to handle situations instead of burying the situation deep down. Mindfulness Based Stress Reduction is a well studied program that is significantly helpful and has personally helped me during nursing school. There are tons of programs available and are usually 8 weeks in length with an 8 hour silent retreat at the end. There is a free, do-at-your-own-pace, course where you fill out worksheets and send them in at the end. That course is available here.

There are many changes sure to come in the development of new research with COVID19. Utilization of these tips will help promote wellness but does not guarantee health. As always, speak to your health care provider to assure your health, especially before beginning any new exercise regimen. These statements have not been evaluated by the Food and Drug Administration. This blog is not intended to diagnose, treat, cure, or prevent any disease.

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