Image by PIRO4D from Pixabay 

There are things you can do now to reduce your risk.

COVID-19 has helped to lay bare what we in the African American community have always known: there is systemic inequality (injustice) in all aspects of living for black people in the US.  The disparity (difference) that exists among African Americans and their white counterparts exists in income (9% whites vs 22% blacks live in poverty) ($61,000 vs 38,000 median income) education quality and attainment , employment, home/land ownership (71.9% vs 41.8%), incarceration (5x the rate of whites), quality healthcare access, and measures of health such as obesity, cancer, heart disease, diabetes, stroke, and end-stage kidney disease – more likely to have it earlier and more often, more likely to have complications, and lower survival rates. 

Image by Alexandra_Koch from Pixabay 

Of course institutional racism is the main cause – but that is not my specialty, so I am not going to comment on its out-sized role.  Others who are studying the effects of racial inequality are much better at explaining it than me.  There will be lots of commentary about all the ways America has failed its African American population.  However, I am a clinical dietitian so I can speak about disparity in health.  Unless you have been hiding out without any communication to the outside world, the killing of George Floyd helped to energize white (and others) Americans to fight for racial injustice.  The organizations I belong and my places of employment have all put out statements stating they support Black Lives Matter and intend to support more diversity though I have yet to see concrete results that improve the lives of black folks.  I received an email recently from my professional organization inviting African American dietitians to submit articles to their publication explaining how racism has impacted their ability to practice nutrition.  But when I looked at the actual publication, there is no diversity on their editorial board or among their writers.  African American dietitians were encouraged to submit an article (for free) but were not represented as a working member of the publication who gets to decide what is printed and is distributed to its members.  My point is it is going to take a very long time before changes occur which will significantly improve the plight of black people in this country.  African Americans living right now will unlikely see the stark disparity improve in access quality healthcare or chronic disease.  My message can be summed up by something attributed to an unknown fellow named Bill Widener, “Do what you can with what you have, where you are.” 

So, what can blacks do to improve their odds of surviving COVID-19 and increase both their health span and lifespan?  Obviously, the first thing is not to get it in the first place – wear a mask, social distance from others, avoid crowds and indoor activities with little ventilation for long periods.  What if you get it or any viral or bacterial infection?  The number two action anyone can take today is to decrease inflammation in your body.

  • Turn away from ultra-processed foods.  These are foods whose ingredients are processed, e.g. cookies, cakes, soda, refined flour, deli meats, etc., with little to no nutritive value.  Processed foods increase blood markers of inflammation such as C-reactive protein and Interluken-6. 
  • Lose weight – obesity leads to inflammation.  Fat cells regulate our immune response.  As they enlarge, the body sees this as an injury and puts the immune system in overdrive. 
  • Increase exercise – African American participation in regular physical activity is lower than other population groups and declines as people age. Skeletal muscle makes myokine, a protein which decreases pro-inflammatory compounds and increases killer T cells which are key to a strong immune system and fighting COVID-19.  It can also reduce body fat, a major producer of pro-inflammatory compounds. 
  • Ensure you consume enough Vitamin D.  Vitamin D plays a role in immunity and decreases markers of inflammation.  Obesity decreases vitamin D so does lack of sunlight, living a smoggy and/or northern city, and inflammatory bowel disease such as Crohn’s Disease or IBS.   Exercise increases vitamin D.  The recommended dietary allowance for vitamin D is 600 international units but be careful about consuming too much as it can harm health. There is no way to know if you have low levels of vitamin D, so do not self-medicate.  See your doctor for a blood test to determine if you have low vitamin D levels.
  • Zinc may protect against COVID-19 infection, but the research is not definitive.  We do know that zinc deficiency is associated with higher infection rates. Typically, zinc deficiency is not a problem in the US and only seen among older people, alcoholics, breastfeeding infants, and pregnant women.  Zinc is toxic in high doses so eating more food that naturally contain zinc is recommended if you want to get more in the diet.
  • Gut health – prebiotics such dietary fiber from fruits, vegetables, and whole grains feed the kind of bacteria you want in your gut so consume plenty of them.  A healthy gut is associated with decreased markers of inflammation.
  • Diet – consume foods such as oily fish (for omega-3 fatty acids), vegetables, fruits, olive oil, and whole grains – features of the Mediterranean diet but other healthy diets work as well.  These foods reduce markers of inflammation.
  • Drugs such as metformin and rapamycin, used for certain health conditions, are also considered geo-therapeutics – they decrease chronic inflammation and appear to increase life and health span.  Metformin is prescribed for diabetes, but you should ask your doctor about it if you have pre-diabetes or polycystic ovarian disease combined with obesity as metformin has been shown to help these conditions.  Metformin also helps people lose weight which itself leads to lower markers of inflammation.  Rapamycin, originally used to prevent renal transplant rejection in patients, appears to be a very effective antiaging drug reducing the risk for cancer, diabetes, and CAD.  These drugs are not approved by the FDA as off-label at this time. 

African Americans can not wait for someone to come along and fix the problem of health.  There are steps to can take now which can move the needle without any assistance for anyone else.