It has been really inspiring to read how our members of our nation have been coming together across varying industry’s to lessen the surge of COVID-19 on our health care system. Workers on the front-line are sacrificing their own safety tending to the sick everyday, companies like NIKE are changing manufacturing lines to create face masks, and small bio-tech startups are coming together to navigate expediting a vaccine solution.
Vaccine or not, and PPE’s aside (which I hope everyone is wielding in public unabashedly!) we should all be aware of other risk reduction strategies to keep ourselves and loved ones healthy. Thus, we’re sending out some ideas for Risk Reduction for COVID-19 that aren't our immune boosting mushrooms. The content comes from an extremely well cited peer-reviewed compilation from Andrew Weil’s Center for Integrative Health.
- Adequate sleep: Shorter sleep duration increases the risk of infectious illness. One study found that less than 5 hours of sleep (monitored over 7 consecutive days) increased the risk of developing rhinovirus associated cold by 350% when compared to individuals who slept at least 7 hours per night.(1)
- Adequate sleep also ensures the secretion of melatonin, a molecule which may play a role in reducing coronavirus virulence (see Melatonin below).
- Melatonin: Melatonin has been shown to inhibit NFkB activation and NLRP3 inflammasome activation.(8) In fact, the age-related decline in melatonin production is one proposed mechanism to explain why children do not appear to have severe symptoms and older adults do.
- Melatonin also reduces oxidative lung injury and inflammatory cell recruitment during viral infections.(9)Typical dosing of melatonin varies widely from 0.3mg to 20mg (the latter used in the oncological setting).
- Zinc: Coronavirus appear to be susceptible to the viral inhibitory actions of zinc. Zinc may prevent coronavirus entry into cells2and appears to reduce coronavirus virulence.3 Typical daily dosing of zinc is 15mg – 30mg daily with lozenges potentially providing direct protective effects in the upper respiratory tract.
- Vegetables and Fruits +/- isolated Flavonoids: Many flavonoids have been found, in vitro, to reduce NLRP3 inflammasome signaling, and consequently NFkB, TNF-a, IL-6, IL1B and IL-18 expression.10 Some of the specific flavonoids which have been shown to have this effect, and which can be found in the diet and/or dietary supplements include licorice, Chinese skullcap, onions, apples, tomatoes, nuts, berries, parsley, and celery: (4)(5)
- At least 5 – 7 servings of vegetables and 2-3 servings of fruit daily provide a repository of flavonoids and are considered a cornerstone of an anti-inflammatory diet.
- Vitamin C: Like flavonoids, ascorbic acid inhibits NLRP3 inflammasome activation.(6)Clinical trials have found that vitamin C shortens the frequency, duration and severity of the common cold and the incidence of pneumonia.(7)Typical daily dosing of vitamin C ranges from 500mg to 3000mg daily with even higher doses utilized during times of acute infection.
1 Prather AA, et al. Behaviorally Assessed Sleep and Susceptibility to the Common Cold. Sleep. 2015;38(9):1353-9.
2 Phillips JM, et al. Neurovirulent Murine Coronavirus JHM.SD Uses Cellular Zinc Metalloproteases for Virus Entry and Cell-Cell Fusion. J Virol. 2017;91(8).
3 Han Y-S, et al. Papain-like Protease 2 (PLP2) From Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV): Expression, Purification, Characterization, and Inhibition. Biochemistry. 2005;44(30):10349.
4 Lim H, et al. Flavonoids Interfere with NLRP3 Inflammasome Activation. Toxicol Appl Pharmacol. 2018;355:93.
5 Yamagata K, et al. Dietary Apigenin Reduces Induction of LOX-1 and NLRP3 Expression, Leukocyte Adhesion, and Acetylated Low-Density Lipoprotein Uptake in Human Endothelial Cells Exposed to Trimethylamine-N-Oxide. J Cardiovasc Pharmacol. 2019;74(6):558.
6 Choe J-Y, et al. Quercetin and Ascorbic Acid Suppress Fructose-Induced NLRP3 Inflammasome Activation by Blocking Intracellular Shuttling of TXNIP in Human Macrophage Cell Lines. Inflammation. 2017;40(3):980. 1
7 Hemila, H. Vitamin C Supplementation and Respiratory Infections: A Systematic Review. Mil Med. 2004;169(11):90.
8 Hardeland, R. Melatonin and inflammation – Story of a Double-Edged Blade. J Pineal Res. 2018;65(4):e12525
9 Silvestri M and Rossi GA. Melatonin: its possible role in the management of viral infections – a brief review. Ital J Pediatr. 2013;39:61..