Can Dietary Habits Impact COVID-19 Outcomes?

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JOHN WHYTE: Welcome, everyone. I’m Dr. John Whyte, the chief medical officer at WebMD. And you’re watching Coronavirus in Context. What’s the role of what we eat in terms of either getting COVID or protecting us when we do get COVID? What is the role of food and immunity?

To help provide guidance and give us some insights, I’ve asked my good friend, Dr. Dean Ornish, the founder of the Preventive Medicine Research Institute in Sausalito, California. Dean, it’s great to see you.

DEAN ORNISH: Always good to see you, John.

JOHN WHYTE: Dean, you and I have talked about several times these two studies that recently came out that talked about the role of dietary habits in COVID. And I want to start off with the first one from BMJ Nutrition Prevention and Health, where they followed 3,000 frontline doctors and nurses across six countries. Can you tell us what they found?

DEAN ORNISH: Sure. And I think it’s a particularly compelling study. With the Omicron variant, as you’ve talked about on your previous shows, even if you’re triple vaccinated, there’s still a number of people who break through because it’s so infectious. And so I think people are really looking for, what else can I do besides getting vaccinated, of course, wearing masks, social distancing, all the usual things, that might also help me to stay well, or if I do get sick to get a milder version of it?

And this was one of two, I thought, particularly compelling studies that just came out a few weeks ago. And as you said, they looked at almost 3,000 frontline health care workers who get exposed to COVID every day. And they found that those that were eating a healthy plant-based diet were 73% less likely to get moderate to severe COVID. Those following a pescatarian diet, a healthy plant-based diet with some fish, were 59% less likely.

And equally amazing, those following a high animal protein, high fat– Atkins, paleo, Keto-type diets– were 400% more likely to get moderate to severe COVID. So we already know that a healthy plant-based diet has so many beneficial effects beyond COVID. But I think this is just the latest example of things that we can do ourselves to help enhance our immunity.

JOHN WHYTE: A similar study you mentioned in Gut that followed 600,000 people in the US and London. And what did they find?

DEAN ORNISH: Yeah, these were scientists at Harvard School of Public Health, people like Dr. Walter Willett, and the King’s College in London. And they looked at almost 600,000 people. And they found something similar, that those eating a healthy plant-based diet were 41% less likely to develop moderate to severe COVID.

There are other studies that have looked at and found that when you get vaccinated, those who are smokers, who are overweight, or who are hypertensive, they don’t nearly develop as much of an immune response. So it’s just seeing it from both perspectives.

And also, as you know, people who have chronic diseases, who are overweight, who are hypertensive are more likely to be hospitalized and more likely to die from COVID. Just being obese, for example, can raise your risk of mortality by 300%.

It’s part of an overall thing that I’ve written about for years that, why is it that these simple, simple lifestyle changes can make such a powerful difference? And I think it’s because they affect so many different parts of our underlying–the biological mechanisms that affect our underlying health– chronic inflammation, oxidative stress, changes in immune function, as we’ve been talking about, with the microbiome and telomeres and gene expression, angiogenesis, and so on.

And these mechanisms, in turn, are directly influenced by what we eat, how we respond to stress, how much exercise we get, and how much love and support we have. And I think this is just the latest version of that.

JOHN WHYTE: I do want to turn back to these two studies. A criticism has been, Dean, that those were done at a time when we didn’t have the ability to do a lot of testing. So the presence of COVID was largely determined by symptomatology– not completely, but that was a measure. Does that take away from what these studies seem to be showing?

DEAN ORNISH: Well, not at all. Because, again, we’re talking about moderate to severe COVID. So even if you’re not able to test for it as accurately as we can now, when people get to that degree of symptomatology, it’s pretty clear what they have. So I don’t think it really takes away.

Now, there’s another point of view that maybe it’s not such a bad thing if a lot of people get the Omicron because the symptoms seem to be less severe, and maybe that’s part of how we’ll get to herd immunity. And certainly you can make a case for that. What concerns me about that is the long COVID and that even the more mild versions of the Omicron variant still don’t necessarily reduce the long COVID, which can cause brain fog and myocarditis and other things like that.

JOHN WHYTE: Let’s break it down for folks. Because you and I are familiar with these terms. You’ve been an expert in this from the very beginning, when it wasn’t popular to talk about these things. People forget that, the role of stress, the role of diet. But people are going to say, mm, OK, what do you mean, Dr. Ornish, by plant-based diet?

Break it down for them. What does that mean? That doesn’t just mean they’re eating lettuce and kale. Help them understand what that means.

DEAN ORNISH: A plant-based diet is the way that most people ate worldwide until they had the prosperity to be able to eat animal protein as often as we do, and processed foods, and concentrated sweeteners, and so on. So it’s mainly fruits, vegetables, whole grains, legumes, soy products, as close as possible to how they come in nature.

And I think there’s a growing consensus that this is really the optimal way for most people to eat. Not only is it low in the disease-causing substances, but there are literally hundreds of thousands of protective substances in fruits and vegetables that– phytochemicals, bioflavonoids, carotenoids, retinols, isoflavones, genistein, lycopene, on and on and on that have anti-cancer, anti-heart disease, and anti-aging properties.

JOHN WHYTE: Well, let’s talk about the barriers. And you’ve heard all of these before. I’ve been in many meetings with you. But let’s just go over them for our audience. So people will say, it’s too expensive. The food spoils if I don’t eat it soon. Or they’ll say, as you know, I don’t like that. I don’t like the taste of plant-based food.

DEAN ORNISH: Am I going to live longer or is it just going to seem longer?

JOHN WHYTE: Right, exactly. Exactly. I need to– I’m a steak and potatoes kind of person. What’s your response to them when they’re saying food is really something that’s– they view– is designed to give them pleasure. And there’s a role of food in that, and community. But at the same time, we’re trying to talk about food as medicine, the properties that it has to help our immune systems, particularly when we’re talking about COVID. How do you reconcile that with patients?

DEAN ORNISH: Yeah, well, it’s an important question. First of all, this is a third-world diet. This is the way people ate before they had the funding to eat animal protein as often as they do, or saturated fats, or concentrated sweeteners, or processed foods. This is the least expensive way to eat, number one. In fact, I– one of my colleagues and I–

JOHN WHYTE: People push back on that, Dean. They’ll say, you know what? The dollar meal at a fast food restaurant is much cheaper and keep my kids fuller longer.

DEAN ORNISH: Well, a colleague of mine and I trained the St. Vincent de Paul homeless shelter in our program 20 years ago. Over 30,000 homeless people went through it. So you can buy food at food co-ops. It’s actually less– obviously, you can spend more money if you want to eat truffles and really expensive things. But you can eat a very healthy plant-based diet for less than it costs you to get meat, especially now with inflation and the price of meat is soaring. Number two, you can eat food that’s delicious and nutritious.

JOHN WHYTE: Now, in fairness, Dean, people are going to wonder, right? OK, I’ll switch to a plant-based diet. Let’s assume folks can do that. Am I going to reduce my risk of heart disease? Am I not going to have a heart attack now till I’m much older in life? Am I going to reduce my chances of COVID? Will I not get COVID? What do you say to them? They’re willing to switch. What–

DEAN ORNISH: Yeah, you will reduce your risk. But risk reducing– or fear is another way to put it– is not a sustainable motivator. After someone’s had a heart attack or a friends got COVID or something, they’ll do pretty much anything their doctor tells them or their nurse tells them to do for maybe a month or two, and that’s about it.

JOHN WHYTE: Max.

DEAN ORNISH: What is sustainable– because we all know we’re going to die. The rate of birth is still 100%. It’s one per person. We don’t think about it most of the time because it’s too scary. So when the denial breaks down after someone’s had an event, then there’s a motivational moment. But even then, it doesn’t last that long because the denial comes back. We don’t want to think about the fact that we’re mortal, so we don’t.

But what I’ve found, actually, what is sustainable is not fear of dying but joy of living, that joy and pleasure and love and feeling good ultimately are much more sustainable.

JOHN WHYTE: Well, Dr. Ornish, as always, I want to thank you for giving us a fresh perspective and a renewed perspective on how what we eat, our dietary habits, impacts our health.

DEAN ORNISH: Thank you for having me. Our new paperback is Ornish.com. It’s all in there. And I feel so passionate about doing this work because I’ve seen what a powerful difference it can make in people’s lives. And to me, awareness is always the first step in healing, so thank you for helping to raise awareness today. I’m really grateful. And it’s always great to see you.

JOHN WHYTE: Absolutely. If you have questions for me or Dr. Ornish, feel free to drop us a line. You can email me at drjohn@webmd.net. Thanks for watching.

This interview originally appeared on WebMD on February 3, 2022

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