Page 56 - IMCJ19s1

REVIEW OF EMERGING RESEARCH

The Functional Medicine Approach to COVID-19:

Nutrition and Lifestyle Practices for Strengthening Host
Defense

Minich DM ,Hanaway PJ 2
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1 Human Nutrition and Functional Medicine Graduate Program, University of Western States, Portland, OR
2 The Institute for Functional Medicine COVID-19 Task Force, Federal Way, WA

Abstract
The developing symptoms of COVID-19, as well as host defense, reduce the probability and mitigate the
the progression of illness and fatality, are a clearly a severity of viral infection. Lifestyle interventions, from a
function of the overall health status of the individual. Functional Medicine perspective, include nutrition,
Complex, chronic diseases such as obesity, hypertension, sleep, exercise, stress reduction, and connection. These
and diabetes are directly correlated with risk of disease factors, when in balance, provide a foundation for
severity and mortality. We explore lifestyle interventions optimal health and immune function.
that have specifically been demonstrated to strengthen

Food/Nutrition Balancing Inflammatory Pathways
Inflammation and immune responses often occur
Overall Recommendations: Research indicates that together in a viral infection. While inflammation is
plant-based foods such as those high in phytonutrients, required in the initial stages of an immune reaction to
water- and lipid-soluble vitamins, and other antioxidants, infection, prolonged release of inflammatory mediators
as well as dietary fiber, can help downregulate an overactive (e.g., interleukins, prostaglandins, tumor necrosis factor-
immune response. alpha [TNF-alpha]) may cause system-wide perturbations.
Low-level chronic inflammation and activation of the
Specific recommendations for patients: innate immune response are suggested mechanisms for
1. Eat plenty of fruits and vegetables. Aim for increased risk of lifestyle-induced diseases such as type 2
9-13 servings per day of a variety of types for a diabetes. Therefore, to lower inflammatory load, clinicians
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wide array of phytonutrients to enhance the gut suggest refraining from eating a Westernized diet and
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microbiome. shifting toward a balanced dietary pattern resembling the
2. Consume dietary fiber, a minimum of 28-35 grams well-studied Mediterranean diet. 3,4,5
daily, preferably from whole foods. Furthermore, data from the Nurses’ Health Study
3. Eat fermented vegetables or other probiotic- suggests that an inflammatory dietary pattern has been
containing foods to maintain epithelial health and identified as one that is high in “sugar-sweetened soft
gut barrier function. drinks, refined grains, diet soft drinks, and processed meat
4. Reduce or avoid immune offenders such as added but low in wine, coffee, cruciferous vegetables, and yellow
sugars and salt, high-glycemic foods (including vegetables.” Therefore, reducing or omitting foods that
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processed carbohydrates), and excessive saturated negatively impact the inflammatory cascade—such as
fat. those containing added sugars, salt, or trans fats, as well
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4
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as those that have a high glycemic index or excessive
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Food and nutrition are major daily input for health and amounts of saturated fats —would be helpful in lessening
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well-being. There are three mechanisms that may be the overall inflammatory burden. A systematic review has
involved in the ability of food-derived compounds to shown that a single, high-fat processed meal (e.g., a meal
reduce viral infection and severity: consisting of white bread, butter, cheese, and a milkshake)
leads to increases in the inflammatory cytokine
1. Balancing inflammatory pathways. interleukin-6 (IL-6) of around 100% relative to baseline
2. Reducing oxidative stress and increasing antioxidant within six hours of eating.9 Given that many pesticides are
levels. also known to impact immune function, increasing
3. Harmonizing the gut microbiome. consumption of organically grown produce may lower the
inflammatory burden and improve immune function. 10

54 Integrative Medicine • Vol. 19, No. S1 • Epub Ahead of Print Minich—Nutrition & Lifestyle Practices for Strengthening Host Defense