Obesity linked to dangerous COVID-19 outcome: health experts

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COVID-19 cases are surging nationwide and public health experts are worried that the upcoming holidays, starting with Thanksgiving, will cause cases to spike even more in Miami-Dade County, which reported more than 2,100 new cases on Wednesday.

But Arlette Perry, chairwoman of the University of Miami’s Kinesiology and Sport Sciences Department, is worried that as talks have focused on vaccines and the politicization of wearing a mask, one major health factor has been overlooked: Obesity.

America is contending with an obesity epidemic, and obesity — defined as a body mass index figure of 30 or greater in most people — can contribute to significantly worse outcomes from COVID-19.

Obesity’s role in the COVID problem

“I believe there are certain aspects of the COVID-19 virus that have not been explored. This information would explain why certain segments of the population are at greater risk. We talk about masks, gloves, social distancing and the vaccine, but in my lecture on COVID at UM, I send a different public health message — it’s all about ‘metabolic health and fitness,’ ” said Perry.

For decades, Perry has worked with local YMCAs and Miami-Dade Public Schools to run after-school programs on UM’s Coral Gables campus. Her work is dedicated to help youngsters stay in shape — or get in shape — before obesity becomes a lifelong health issue.

Perry’s THINK program, for instance, partnered with the YMCA’s after-school program to teach children at predominantly Black and Hispanic schools in South Florida how to make better health choices.

Higher risk of dying from COVID if you’re obese

“Statistics show that if your BMI is above 35, you have a 40{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22} greater risk of dying from COVID. Even if you are mildly obese, the chances are five times greater that COVID will land you in the intensive care unit,” Perry said.

People with visceral fat, those who carry excess weight around the belly and have fat deposits on their heart, kidneys and liver appear to be at higher risk for COVID complications, added Dr. Gianluca Iacobellis, a researcher at the Diabetes Research Institute at the University of Miami Health System.

UM researchers found that once the novel coronavirus gets into the body, fat tissue may be used as a reservoir for the virus. The more visceral fat a patient has, the more the virus is amplified, Iacobellis believes.

“Preliminary data have indicated that the new COVID-19 cases are increasing among younger adults with obesity,” Iacobellis said in a paper he co-authored for Obesity, the journal of The Obesity Society.

“Based on my studies, when it comes to COVID-19, it’s worse to be obese than diabetic,” said Iacobellis.

Losing excess weight can improve your health

Miami Hurricanes football players KC McDermott, Sunny Odogwu and Nick Linder spoke to elementary school students April 19 about the importance of staying active and eating healthily. MARCUS LIM For the Miami Herald

Reducing obesity, and this obesity-COVID correlation, takes effort, patience and persistence, health experts note. But it can be done,.

Shedding the weight can improve a series of health issues beyond COVID complications, including type 2 diabetes, hypertension, high cholesterol, heart disease, sleep apnea and other ailments.

“If you improve your cardiorespiratory fitness, you can improve your immune response, reduce your inflammatory response and better handle the virus,” Perry said. “Just by increasing your muscle-to-fat ratio, you can improve immune response. Unfortunately, no one talks very much about these types of issues.

“Not a lot of information is disseminated about the increase in high fat, processed, calorie dense, comfort foods that are so much greater now with COVID. Hispanic and Black Americans are at the highest risk and there are reasons for this,” Perry said.

“We see a lower level of physical activity participation and higher rates of obesity and obesity-related problems in the minority students,” Perry added. “It is important to us to go into minority schools to make sure that they know the importance of living a healthy, active lifestyle.”

From Bill Maher in L.A. to Miami

Perry is not alone in sounding the obesity-COVID alarm.

Since March, “Real Time” host Bill Maher has devoted numerous panel discussions and closing monologues on his HBO talk show to Americans’ obesity problem and its role in complicating the COVID battle. He cited the same grim figures Perry cites in a “New Rules” segment on “Real Time” in July when cases were soaring after Independence Day.

Maher has returned to the obesity topic frequently despite charges by some that he’s “fat-shaming.”

“Bill Maher has nailed the issue, hasn’t he?” Perry said. “He also lives in L.A., where there seems to be a certain community awareness about weight, fitness and personal health, which makes it easier for consumers. I hope we can improve that mindset in Miami. … It appears COVID has generated more interest in health and fitness from many of our students and faculty at UM.”

Now, health officials fret that Thanksgiving travel and gatherings could send dozens of Florida counties to a COVID ‘tipping point’ before the holiday, in which consuming calorie-laden meals is as much a part of the festivities as heading out for Black Friday sales.

Obesity rates among ethnic groups

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The 2019 CDC Adult Obesity Prevalence Maps report shows that among non-Hispanic Black adults, the majority of the country — 34 states and the District of Columbia — had an obesity prevalence of 35{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22} percent or higher — including Florida. Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention has tried to get the word out, too.

“Everyone has a role to play in turning the tide against obesity and its disproportionate impact on racial and ethnic minority groups,” the CDC warns on its website.

Even being overweight, defined as a body mass index (BMI) between 25 and less than 30, might increase the risk of severe illness from COVID-19, according to the CDC.

The 2019 CDC Adult Obesity Prevalence Maps report shows that obesity remains high — 12 states now have an adult obesity prevalence at or above 35{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22}: Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, Tennessee and West Virginia. This is up from nine states in 2018.

Florida, overall, is at 25{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22}-30{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22}, or in the overweight range. Florida, which reported 961,676 total COVID cases on Wednesday, is third behind California and Texas in the total number of confirmed COVID cases, according to the New York Times’ database.

The 2019 maps show that obesity notably impacts some groups more than others.

Six states had an obesity prevalence of 35{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22} percent or higher among non-Hispanic white adults. Florida was in the overweight range of 25{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22}-30{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22} here.

Among Hispanic adults, 15 states had an obesity prevalence of 35{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22} or higher. Florida was in the obese range among this group at 30{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22}-35{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22}.

And among non-Hispanic Black adults, the majority of the country — 34 states and the District of Columbia — had an obesity prevalence of 35{d9cf345e272ccae06ddf47bdd1d417e7fd8f81a9d196cc6ace4cb20fad8f4c22} percent or higher — including Florida.

What can you do

Getting physically active is a start, the CDC suggests. You can exercise even while practicing social distancing.

Take a walk outdoors, ride a bike. Move around the house more.

Watching more TV? If you can stream exercise videos, great. If not, why not jog in place while watching TV or doing push-ups or some other cardiovascular activity during the commercials?

Good nutrition can help support optimal immune function,” the CDC says. Try to add more fruits and vegetables, lean protein and whole grains to your daily diet and avoid processed foods, which tend to have high caloric counts and high sodium levels.

A healthy diet can also help prevent or better manage heart disease and type 2 diabetes — both of which are exacerbated by obesity.

Get enough sleep. According to the CDC, a third of U.S. adults report that they usually get less than the recommended amount of sleep — about nine to 12 hours for school age children, 6-12 years of age; eight to 10 hours for teens; and seven to eight hours for adults.

Lack of sleep is linked with many chronic diseases and conditions, including type 2 diabetes, heart disease, obesity and depression.

Pandemics are stressful. We know that what you have to do to manage life in a pandemic — like social distancing and wearing a mask — can make you feel even more stressed. Stress can affect sleep and eating habits, which then can lead to obesity. Try to manage stress with an exercise program or other calming techniques rather than turning to alcohol or smoking, the CDC says.

Mimi Whitefield, a former Miami Herald reporter, contributed to this story. She can be reached at [email protected] or on Twitter @heraldmimi.

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Miami Herald Real Time/Breaking News reporter Howard Cohen, a 2017 Media Excellence Awards winner, has covered pop music, theater, health and fitness, obituaries, municipal government and general assignment. He started his career in the Features department at the Miami Herald in 1991.
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