Dunlap’s disease is deadlier than SARS-CoV-2.

What is Dunlap’s disease? It is where your belly done lap over your belt. Funny? Yes? No. In all the fighting over social distancing and mandates on mask wearing, we are hearing crickets from politicians and health professionals regarding the lifestyle changes one can make to mitigate the risks of contracting SARS-CoV-2 (i.e., COVID-19). Of course, we should be following social distancing recommendations and wear a mask. These can reduce the degree to which we are exposed or may expose others. There is more that we can do, however, and, truth be told, it will be more difficult than wearing a mask.

Many feel the shutdowns and the mandates are an affront to personal liberty. Perhaps, but freedom does come at a cost. True freedom also requires a level of personal responsibility.

If one really wants to get back to freedom, one must commit to doing what will make them a stronger and/or less desirable host. One can begin by: 1) reducing one’s body fat [to less than 20% body fat (men) or 30% body fat (women)], 2) change the diet–reduce total calories, eat much less sugar, cut your alcohol consumption, eat more anti-inflammatory fruits and vegetables, etc.; 3) commit to a regular exercise program and daily physical activity (these are not one in the same); 4) don’t smoke!!!, 5) establish a regular sleep-wake cycle, 6) and suck it up and wear a mask (it won’t kill you)!

Reduce body fat. Nearly one-third of Americans is obese. Nearly two-thirds are overfat. So, clearly most of us needs to lose some body fat. It is not a matter of appearance. I am not saying that everyone should have six-pack abs—far from it. I am saying that every American should seek to be in the “healthy” body fat range. While there are differences in the proposed guidelines, 8-19% for males and 21-33% is not unreasonable for most. Sure, it will require sacrifice and effort, but the benefits are immense.

Why care about body fat? Because obesity is at the center of many of our major health problems. For example, obesity is a central factor in metabolic syndrome (the coexistence of insulin resistance, elevated triglycerides, and hypertension). Thus, obesity dramatically increases the risk of diabetes, heart disease, stroke, etc. Known risk factors for metabolic syndrome include: abdominal obesity [waist circumference >102 cm (40 in) for men and >88 cm (34 in) for women; i.e., “Dunlap’s disease”], hypertriglyceridemia (≥150 mg/dl), low HDL cholesterol (<40 mg/dl for men and <50 mg/dl for women), elevated blood pressure (≥130/85 mmHg—note: this is considered “pre-hypertensive”), and high fasting blood glucose (≥110 mg/d). These are controllable risk factors and are affected by regular exercise/physical activity and genetics. We may not be able to control our genetics (“Choose your parents wisely”—Per Olof Åstrand), but we can affect our activity levels. We also tend to ignore the evidence that obesity and inactivity are risk factors for COVID-19.

Change the diet. Change need not be dramatic. Change should be sustainable (so refrain from fad dieting and short-term “fixes”). Small changes can add up quickly and have lasting effects. Just 100 kcal per day (via reduced consumption or increased physical activity) accumulates a loss of 10 lb over the course of a year. Alcohol is fine in moderation but can be a significant source of excess body fat. Small reductions in total consumption and/or the alcohol content of the drink can add up to significant fat loss. Given that the most significant damage with COVID-19 infection comes with the “cytokine storm”, it might behoove one to eat more “anti-inflammatory” foods, such as berries, fatty fish, cruciferous vegetables, avocados, olive oil, dark chocolate (yes, eating healthy doesn’t have to be painful), etc., and avoid inflammatory foods, such as fast foods, refined sugars, processed meats, trans fats, etc. These are rather simple lifestyle changes.

Exercise!!! Don’t use COVID-19 as an excuse for inactivity. Any activity is better than no activity, but exercise should be included, as well. Physical activity is simply any activity above resting. So, get moving! According to the “100-kcal Rule” one expends approximately 100 kcal per mile whether walking, jogging, or running. Physical activity is cumulative, so just move as much as you can. Exercise, however, will promote greater health benefits. It doesn’t take much to promote changes in body composition and health. It just takes getting started—and progressing. In times of pandemic, it is especially important to recognize the benefits of moderate exercise on the immune system response.

Don’t smoke!!! Smoking increases the risk of contracting COVID-19 (and a host of other medical conditions). I hope I don’t have to elaborate here. Just stop!!!

Establish a regular sleep-wake cycle. You may not have liked having a bedtime as a child but having one as an adult is equally important. Ideally, target 7-8 hours a night. If not, at least 6 hours. Get quality sleep. As Arnold Schwartzenegger said, “If you are sleeping more than 6 hours, sleep faster.” Excessive sleep is certainly less than beneficial—though tempting when we are working from home. Optimal sleep, though, is essential for recovery from exercise, as well as benefiting the immune system, memory, metabolism, and essential body functions.

Suck it up and wear a mask!!! Need I really say more here? Yes, wearing a mask is uncomfortable. Yes, mandated mask wearing is un-American. However, wearing a mask protects you and others from the spread of coronavirus, as well as other infectious diseases. So, let’s just get used to the fact that we should wear them in times such as this, as well as when we suspect we might be infected with even a common cold or influenza. Does it really hurt? It will not kill you!

Like it or not, this virus is here to stay and others (likely worse) will follow. We can’t shut down every time a novel virus hits. Thus, it is up to us to be healthy! Boosting our personal immune system against infectious disease is the best defense against continued and future shutdowns.

Be your best today; be better tomorrow.

Carpe momento!

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