5. Basic first-aid kit. The joke in my household is that we have five doctors in the family plus one retired nurse, yet there are times when you can’t even find a Band-Aid in my home. That’s not a good idea. Cuts, falls, bug bites, and other accidents happen and can worsen without some simple first aid—which is why every office, restaurant, and public building usually has some kind of first-aid kit somewhere on the premises. Be sure your kit includes rubbing alcohol, hydrogen peroxide, gauze pads, medical tape, Band-Aids, an ice pack that can be kept in the refrigerator, sterile eye wash, scissors, tweezers, and disposable gloves, among other items.
6. Contact list. When there’s a medical emergency at home, don’t trust that you’ll remember who to call—or be physically well enough to find out. Keep a medical contacts list with your primary-care physician, local pharmacy, and other emergency contacts in your smartphone and on paper (in case your phone dies or you’re physically incapable of accessing it). It also helps to have a written and digital list of the medications you’re taking and their prescribed doses, along with any known drug allergies, that you or a loved one can bring to the ER or share with paramedics or other healthcare providers.
7. Medical emergency plan. Don’t wait until the unthinkable happens to consider where you or a loved one might want to go in the event of a medical emergency. Know which hospital is the closest or where you’d prefer to receive care and include the address in your medical contact list. Keep a “go bag” in your closet that includes a change of clothes, a day or two of extra medication, and anything else you might need for a short period of time if you suddenly have to go to the hospital.
Everything you’ve learned in this chapter isn’t designed to replace the insight, advice, and care that a doctor or other healthcare practitioner can provide. But you now have some of the strategies that we doctors use to assess risk and stay safe when we seek (or don’t seek) medical attention. If you can leverage these tools and start to think like a doctor, you can take some control over your own healthcare—because, ultimately, how effective and successful your healthcare will be is up to you. And in crisis times, knowing how to manage your healthcare can not only help you stay safe, but it may even save your life, as well.
Chapter 4
Food
When New York City first went into lockdown, I wasn’t caught off guard. We had planned for it at ABC, and the network quickly set up a studio in my apartment where I could broadcast up to thirteen hours per day. We had also planned for it as a family, and Alex, Chloe, and Chloe’s boyfriend, Billy, came home to live with me after their colleges abruptly closed and stay-at-home orders were issued.
Even though I was prepared to work and stay at home, I didn’t foresee the effects that the lockdown would have on other areas of my life, particularly my eating. Suddenly I was working from home, within steps of my kitchen, and living with three college kids who ate more than I’ve ever seen human beings consume. All this was also taking place in an apartment smaller than some people’s living rooms.
For those who don’t know New York City living, picture the apartment you saw on Friends and cut it into quarters. In most Manhattan apartments, you can walk from the bedroom to the kitchen in five seconds—it may take you a full two seconds to get from the living room to your refrigerator. My point: Small-apartment living makes it difficult to ever distance yourself from food—visually, physically, or mentally.
Before the pandemic, the close quarters of my apartment weren’t an issue. Like many New Yorkers, I spent morning to night out of the apartment, and when I came home, my cozy space was comforting after the immense hustle and bustle of the Big Apple.
But after stay-at-home orders were issued, we all became confined in our homes and within walking distance of our kitchens. But in my apartment, I was literally working, sleeping, and living on top of food.
It didn’t help that ABC set up my home studio within arm’s reach of the kitchen (not that there were any other options, by the way!). While the spot looked great on live TV—and I’m thankful for the crew’s expert eye—I could literally do a side bend and grab a cookie. Parked there for up to or more than thirteen hours a day, broadcasting for Good Morning America, Nightline, World News Tonight, breaking news, and special reports, I didn’t have to think about what or when I was eating: I simply had to reach and chew. I hardly left my chair—which means I hardly left my kitchen.
Like many Americans, I also didn’t have to make deliberate decisions about food anymore. Didn’t have to decide what to order for lunch from my office anymore or what to bring home for dinner at night. I wasn’t making decisions at the grocery store or area restaurants. The methodical routine of planning my meals, shopping for my meals, and going out for my meals was gone. Instead, food was there, next to me, around me, and available at all times. I felt like a lab rat in a cage: I just ate what was there.
The big X factor, however, was living with three kids in their early twenties—two who were college athletes and all three who were very fit and ate around the clock. Every two to three hours, they needed food. I’m not talking about some carrot sticks with hummus, either—a snack for these guys was a four-egg omelet with two different cheeses. Or they’d order pizza, tacos with chips and guac, or burritos the size of a football from my favorite Mexican restaurant. Since it was my apartment and I usually picked up the delivery tab, I often ate whatever they ordered, even though delicious New York pizza, chips, and burritos hardly fit into my usual low-carb lifestyle. But I was working so hard, it was a stressful time, and I felt like I deserved to eat whatever I wanted.
There was also the issue of my quarantine food. After the CDC recommended everyone stock up on enough groceries to stay at home for two weeks, I went online to buy canned sardines, crackers, and olive oil, along with an entire box of Lindt dark chocolate bars with salted caramel. If the world was coming to an end, I figured, I was at least going to enjoy it. But instead of savoring a square after dinner like I normally do, I began eating an entire bar nearly every day.
Two months into quarantine, I had gained almost five pounds. Moreover, I didn’t feel good. I was tired, low energy, and achy, and had difficulty focusing and concentrating. I knew the reason: I was consuming sugar and carbs in quantities I don’t normally ever do—and it was taking a toll on my physical and mental health.
When I started to feel terrible is when I woke up to what I was doing to my body. I literally sat myself down and talked to myself like I was one of my patients. I told myself that while it seemed like a good time to freak out about my diet, poor nutrition can be reversed by taking small steps, and those steps can add up to big results over time.
I looked at the two other aspects of my life—my physical activity levels and sleep hygiene—which, along with nutrition, make up what I call the three pillars of good health. My sleep was fine: I was averaging at least seven hours nightly because I knew I couldn’t deliver the news on any less. But I wasn’t moving because I wasn’t leaving my apartment, which I knew wasn’t helping my new diet. I immediately started to add a little exercise (more on how to do this during a pandemic in chapter 5).
At the same time, I went back to the way of eating I knew had helped my body in the past. This was based on facts, not fads or fear: I had followed a low-carb diet for years and had evidence from my own experience that it helps me lose weight and feel my best. I cut out the pizza, chips, and other processed carbs and focused on consuming more lean protein, veggies, dairy, and healthy fats.
But I couldn’t do it alone: Since my kids were part of the problem, I knew they also had to be part of the solution. I sat them down and explained I was changing my diet and needed their help—no more late-night pizza runs, quesadillas for dinner, or home-baked chocolate-chip cookies. I told them that this type of food wasn’t great for their health either, no matter how much they exercised.
Within two weeks, I had turned it all around. I lost two pounds and regained my energy, optimism, and focus. Since then, I h
aven’t gone back to stress eating or overeating, even as the crisis has continued and various stressful scenarios have developed. But I learned my lesson, and now I want to share with you how you can adapt and adopt that lesson, too, whether you have two or two hundred pounds to lose, or simply want to eat to optimize your health during a pandemic.
Here’s the thing that’s really important to recognize in our new normal: The pandemic has changed how we all eat. Everyone is cooking more, with surveys showing an unprecedented uptick in the percentage of Americans who now make their own meals. We’re also snacking more because we’re spending more time at home, whether we’re working from home or simply not going out as often. Many people, like I was during initial lockdown orders, are also stress eating or overeating—habits that are difficult to drop even after life began to settle down again.
What’s more, the pandemic has changed how we should eat. Some people may need to eat less in our new normal because they’re less active since they’re not going to the gym or getting out of the house as often. Others may need to adjust their nutrition because they’ve gained weight, whether during initial lockdown orders or due to all the stress of the ongoing pandemic. Finally, we should all be eating different foods now to make sure we’re doing everything possible to safeguard our health from the risk of an infectious virus or other contagious illness.
In this chapter, I’ll explain how the pandemic has changed how we all eat and what you can do about it to be healthier, avoid weight gain, or lose weight in our new normal. I’ll also detail how the pandemic should change how we all eat, with the truth about eating to boost immunity and which foods and diet plans could protect you the most against COVID-19.
Finally, I’ll explain how food can truly be thy medicine—or one of the contributing factors to the deterioration of your health. It’s why I went back to school a few years ago to get my master’s degree in nutrition. Since doctors aren’t really taught how food can help or harm health in medical school, I wanted to learn how to help my patients and viewers eat to optimize well-being. And there’s no time like a pandemic to view your refrigerator like a preview to your medicine cabinet. What you reach for in the fridge may very well determine what you eventually have to reach for in your pill closet.
How the Pandemic Has Changed America’s Diet
The coronavirus outbreak has changed what, how, or how much nearly every American eats. Before the pandemic, for example, restaurants made up 21 percent of our daily calories.1 We now eat out a lot less and cook at home more often, with 60 percent of Americans making more meals at home than they did before the outbreak.2 In fact, 85 percent of all Americans have changed either what type of foods they eat or how they prepare it, according to a survey by the International Food Information Council.3
Many of our pandemic-induced dietary changes haven’t been beneficial to our country’s collective health. With millions working from home and others unemployed, Americans are eating more frequently, with surveys showing up to 76 percent of people now snacking more often than they did before the outbreak.4 We’re also eating more in general, with overeating ranking as the third most common health concern caused by the pandemic, after lack of exercise and anxiety, according to one survey.5
What we’re eating has also changed. In the first few months of the pandemic, sales of flour, sugar, pasta, salty snacks, alcohol, and ice cream shot through the roof. While we started cooking more, we also started baking more, as bread recipes went viral,6 and we used our newfound kitchen habit to whip up dishes like pancake cereal, which dominated Instagram for weeks.7 We’re making fewer trips to the grocery store, where we find fewer choices on store shelves, as grocery stores look to avoid supply-chain problems.8 We’re also buying more frozen foods.
Perhaps the biggest change inherent in our new normal is that we’re all eating more. The Quarantine 15 that many gained during initial lockdown orders has now turned into the Quarantine 30 for many. While reports vary, half of women and a quarter of all men say they gained weight during the pandemic, according to WebMD.9 Another survey conducted by Nutrisystem discovered that 76 percent of respondents have gained up to sixteen pounds during the pandemic.10 As reported in the New York Times, tailors in New York City say business is booming, with people bringing in pants, skirts, and dresses to be let out in order to accommodate expanding waist sizes.11
Weight gain and poor dietary habits prompted by the pandemic aren’t easy to change and can persist for years, even after stay-at-home orders end. If you’ve started to use stress eating or overeating as a way to deal with anxiety or other emotions, it may be difficult to simply erase that coping mechanism from your survival plan. But there are ways to combat stress eating and turn a bad habit into an advantage (see here).
When Eating Less Isn’t a Good Thing in Our New Normal
Not everyone has the luxury of eating all the salty snacks they want during a pandemic. The economic impact of the outbreak has caused or worsened food insecurity for millions of Americans. In New York City and other urban areas across the country, lines at food banks have stretched for blocks. Children who haven’t been able to attend school have lost their one daily meal. And 60 percent more older adults now face food insecurity than they did in pre-pandemic times.12
These facts belie what’s going on at many farms and food plants, where workers have destroyed crops, dumped milk, and smashed eggs. Without the same number of restaurants, hotels, schools, and stadiums to serve, suppliers say they’ve had no other choice but to toss perishable stock.
The pandemic has also exposed cracks in our food-supply chain. After outbreaks of COVID-19 hit several meat-packing plants, for example, the availability of meat shot down as the cost shot up. Panic buying, supplier disruption, and reduced transport options, among other problems, have also led to national shortages of dozens of food products.
The solutions to these issues are complex—and I certainly don’t have the answers. But I know that those who are lucky enough to have the problem of too much food should feel fortunate every day. Every meal I have, I am truly thankful to have food in the first place.
Six Rules to Eat Right in a Pandemic
Everything we do with our bodies during a pandemic can be critical to our overall health. But good nutrition may be one of the best protective measures we can take against the virus—and all other pathogens—short of wearing a mask and social distancing. Proper nutrition is not a guarantee you won’t get sick with COVID-19, but it can reduce your risk of severe complications.
Part of the reason diet matters so much is that what we eat affects our waistline, and we already know that being overweight or obese is the biggest chronic risk factor for severe COVID-19 illness. Good nutrition can also prevent or help treat type 2 diabetes and high blood pressure, both of which are risk factors for the disease. Our diet can also hurt or help our immunity, making us more or less vulnerable to infection and illness.
But before we detail the best ways to eat, I want to bust some myths about immunity: There is no food or group of foods that will protect you against getting sick with the coronavirus. While hokey headlines have appeared, like “Eat to Beat Covid-19,” these articles are based on fantasy, not fact. As a doctor who is also a nutritionist and believes in the power of food to prevent and treat disease, I haven’t seen any evidence that a certain food or food in general will protect you against this virus or any other virus.
What’s more, most research showing that specific foods may boost immunity are based on observation, not causation. What this means is that while scientists can observe that eating more oranges may improve immunity, most studies don’t actually prove that eating oranges causes increased immunity. In other words, correlation does not imply causation. Otherwise, we might all think that the sales of chicken wings cause snowstorms because wing sales go up around big football games, which occur in the winter.
Understanding these facts, here are my six rules to eat right during a pandemic:
1.
Cut down on added sugar already. If we’ve learned anything about diet, it’s that added sugar is terrible for our bodies and brains. Added sugar, found in nearly all processed foods, appears to increase inflammation, with multiple studies suggesting that the more sugar we consume, the more inflammation we have. And the more inflammation we have, the more it weakens our immune systems.
Sugar may be especially detrimental to those who contract COVID-19. While the data can change, current research shows that people with elevated blood-glucose levels are more prone to COVID-19 complications.13 Studies have also found that having COVID-19 may increase a patient’s blood-sugar levels, leading to worsening conditions.14 Either way, the virus appears to “thrive in an environment of elevated blood glucose,” according to the International Diabetes Federation.15
How much is too much sugar? The American Heart Association and the World Health Organization recommend capping daily added sugar intake at 6 teaspoons or 25 grams for women, and at 9 teaspoons and 36 grams for men.16 Since the average American consumes at least 18 teaspoons or 77 grams of sugar daily, almost everyone needs to make a significant adjustment.
I recommend that you start by reading nutrition labels—look for the line “added sugar” on all packaged foods—to get an idea of just how much sugar you’re currently consuming. Remember that surprising foods, even those considered “healthy,” can be loaded with sugar, like ketchup, bread, salad dressing, yogurt, spaghetti sauce, smoothies, instant oatmeal, protein bars, and frozen meals. Aim to cut out processed foods or substitute with low-sugar brands. Sugar is an addiction, so cutting down can be difficult at first, but I promise that the suffering is brief. As is true with any addiction, you’ll eventually find it easier to pass sugar up and you’ll need less to satisfy your cravings.
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