Evidence-based ways to decrease chance of Covid (other than mask/vax/ventilate)

[KSera]

7 minutes ago, mommyoffive said:

Have you had covid?  

I am struggling to decide what to do with things this year.  I like when places have masking rules in place so I don't have to decide things.  Mask indoors?  Only with a certain level?  Mask outdoors? I hate deciding. 

I don’t have to decide anything because we all (my family) just mask indoors always (outside the house, obviously). Something will have to change for us to stop, unfortunately—better vaccines, cases rare, good treatments that resolve long Covid and reverse increased post infection death risk, more information about long term sequelae in kids. I don’t see just deciding that getting it repeatedly is okay for us based on what we currently know, so something would need to change. Sucks, but it is what it is. Hopefully all the above improvements will happen and masks in public won’t be a permanent thing (other than flu season— i’m pretty sold we will use them in public places during flu season!)

[wathe]

1 hour ago, Hyacinth said:

It sounds, I don’t know…patronizing is maybe the word (?) to say losing weight is just too darn hard for anyone to do, so until sweeping societal changes come about, let’s not even suggest it when we’re discussing physical health. Don’t misunderstand. I agree with the list posted earlier in the thread. Losing weight IS hard. The challenges are REAL, particularly for people with fewer resources of time, money, and education. I get it. But still…is it so impossible that offering said education/tips in the context of a doctor’s appointment (or a friendly forum chat) is absurd? 

I don't think that anyone is saying that.

My agreement with @Farrar's statement (that follows) prompted the argument:  "I think most of these things are of really limited efficacy. The best thing you can do by FAR is to mask, vaccinate, and ventilate. That's really it. Being healthy in general helps, obviously, but it's not always in everyone's control, so making suggestions on that front is a little useless." 

Which prompted me being called out for not recommending weight loss.  (please note that I also didn't recommended against weight loss.  I didn't specifically mention weight loss at all.  Aside, there was no indication in OP's thread that weight is even an issue for her or her family).  

Which I felt was not what OP was looking for (a request for evidence-based, simple things, toolkit to decrease chance of covid, with example list of products).  Weight loss is not a simple thing.  Nor is there evidence to support that it decreases one's chance of getting covid or reduces viral load.  (Obesity does correlate with poor outcomes - no argument from me there)

Then back and forth.

I'm not against weight loss, or maintenance of a healthy weight.  It's wonderful that so many boardies have had success with weight management.  If boardies want to exchange weight-loss tips, they should have at it, there are thread for that.

I also don't believe that it's too hard for anyone to do.  But it probably is too hard for everyone to do in USA.   An obesity and overweight rate of 72% speaks volumes.

 I do think that it's very, very important to acknowledge that weight loss and weight maintemance is complex and very difficult for many people.  That it is a complex problem on a population basis.  That in many way it is a social problem, that needs societal level solutions .  @Corraleno's observation that Japan's obesity rate is minuscule compared to USA's is right on point.  The difference is not about human biology. The difference is the American obesogenic environment --culture, policy, economy, built environment, social inequality.  It's more than just individual diet choices of individual Japanese. Japanese walk more in daily life, have denser population centres, less car culture, better public transit, different food culture, different government intervention in food pricing, and many other DOH reasons that contribute.

I am irked by the I lost weight so other people should be able to too if they only ate properly tone in several previous posts.  But maybe that's just me mis-reading tone online.

 

Edited to fix awkward wording

Edited August 22, 2022 by wathe

[mommyoffive]

3 minutes ago, KSera said:

I don’t have to decide anything because we all (my family) just mask indoors always (outside the house, obviously). Something will have to change for us to stop, unfortunately—better vaccines, cases rare, good treatments that resolve long Covid and reverse increased post infection death risk, more information about long term sequelae in kids. I don’t see just deciding that getting it repeatedly is okay for us based on what we currently know, so something would need to change. Sucks, but it is what it is. Hopefully all the above improvements will happen and masks in public won’t be a permanent thing (other than flu season— i’m pretty sold we will use them in public places during flu season!)

That is where I have been.  Some of my family is getting tired, kind of wondering when they can stop because it is a rare thing to have others that mask unless forced.   

What are you doing for outdoor things? 

[wathe]

7 minutes ago, mommyoffive said:

That is where I have been.  Some of my family is getting tired, kind of wondering when they can stop because it is a rare thing to have others that mask unless forced.   

What are you doing for outdoor things? 

We are much like @KSera, similar reasons.  Masking with n95 in indoor spaces other than our own home with just us home.  My family are good sports about it. 

We aren't masking outdoors when able to maintain distance.  And for us, outdoors means fully outdoors - not in a tent or partial structure.  We haven't been in any crowded outdoor situations, but would mask if we did.

[Corraleno]

18 minutes ago, mommyoffive said:

I am struggling to decide what to do with things this year.  I like when places have masking rules in place so I don't have to decide things.  Mask indoors?  Only with a certain level?  Mask outdoors? I hate deciding. 

I'm continuing to mask (KN95) in all indoor spaces regardless of what anyone else is doing. I don't care if I'm the only one in the store with a mask on — I have not had covid and I would like to keep it that way. Even if I can't avoid it forever, I'd like to avoid it until there are better treatments for both acute and long covid, and a better understanding overall of long covid. I also generally try to shop at the least busy times (usually midweek and when stores first open), and I'm not traveling, eating in restaurants, or doing other higher risk things. 

[KSera]

13 minutes ago, wathe said:

Aside, there was no indication in OP's thread that weight is even an issue for her or her family

I can’t tell you how often it’s just assumed that that is part of someone’s health condition. I have a chronic condition that is often associated with being overweight, but I am not at all (below the mid range of healthy BMI for my height). It’s super frustrating to have the top thing on every information sheet say that the first thing I need to do is lose weight. Even at times in my life when I was underweight, my doctor would give me a standard hand out and it always started with “lose weight”. I totally get that it’s very helpful for people whose condition is due to excess weight, but totally unhelpful for those who it isn’t.

We’ve had these conversations here before, with people dividing into camps of those who think everyone can lose weight if they just do the right things and those who said they have tried everything and still can’t. I never really participated, but tended initially to have my thoughts lean in the directional of the first group. I’ve now been around long enough and known enough people who seem to do all the right things and still carry a lot of extra weight that now I think it’s far more complicated than that. I think there are many pieces of the puzzle, with microbiome being a huge one that we don’t fully know how to address yet. If a stool transplant can make a thin person fat or a fat person thin, then clearly there’s something more to it for some people than just eating right and exercising. 

[ktgrok]

18 hours ago, MissLemon said:

Um, this is exactly me. I was borderline morbidly obese prior to the pandemic and chose to lose the weight when covid came because the stats showed that obesity was linked to poor outcome.  I lost 75 lbs over about 18 months. Supposedly it is "impossible" for people like me to lose weight. I'm 50, perimenopausal, and have Hashimoto's disease. 

I knew what needed to be done to lose weight prior to the pandemic, but I straight up didn't feel like doing it. It was easier to maintain the status quo and tell myself that I wasn't that fat than to do something about it.

So ,yeah, I chose to sit around and keep excess weight and then chose to drop it when a pandemic came.

happy for you. Did you though not KNOW that losing weight would be a good idea before? Cause I'm thinking the issue is not that OP or any of us haven't KNOWN that losing weight is a good idea. Therefore, providing the suggestion isn't helpful. 

1 hour ago, Corraleno said:

 

If losing weight isn't "doable" for most people, for some physical or medical reason that is inherent in human biology, then why do countries with diets that are very different from the standard American diet have such different rates of obesity? In Japan, for example, only 25% of adults are overweight and 4% are obese, vs 67% overweight and 32% obese in the US. If maintaining a healthy weight is not "doable for most people," how do people in other countries manage it?  

Well, not gaining weight is VERY VERY different than losing and keeping weight off once someone is obese. Totally different biologically. It would be like comparing walking for someone who is never injured with relearning to walk after a spinal cord injury. Some can, some can't, and how hard it is will depend on a variety of factors, some of which we do not understand yet. 

[KSera]

18 minutes ago, mommyoffive said:

What are you doing for outdoor things? 

 

7 minutes ago, wathe said:

We aren't masking outdoors when able to maintain distance.  And for us, outdoors means fully outdoors - not in a tent or partial structure.  We haven't been in any crowded outdoor situations, but would mask if we did.

This is the same as what we are doing. Except my youngest  wears a mask outdoors when with friends, because it’s much easier than trying to maintain personal space between the kids. I’ll visit outdoors with family or friends without masks now though, whereas we didn’t used to. I do try to be positioned so we’re not directly facing each other and we aren’t too close together. I’m a little more wary about outdoors right now than I was, because I seem to be hearing about outdoor transmission more recently. But I think one on one outdoor visits with friends are pretty low risk.

[wathe]

Playing with @Corraleno's thought re human biology and obesity/overweight:  in a sense it really is about human biology.  If you put a population of humans in an obesogenic environment, a majority of them will become obese or overweight (USA, and Canada not that far behind).    If you put them in a non-obesogenic environment, they won't (Japan)

[ktgrok]

3 minutes ago, wathe said:

Playing with @Corraleno's thought re human biology and obesity/overweight:  in a sense it really is about human biology.  If you put a population of humans in an obesogenic environment, a majority of them will become obese or overweight (USA, and Canada not that far behind).    If you put them in a non-obesogenic environment, they won't (Japan)

And once they ARE obese certain factors kick in that make it a disease process that is progressive and complicates losing weight. Things like gut hormone levels, hormones that effect satiety, etc. So someone that would have been satiated and happy at a certain food level if they were never obese now feels hungry and deprived on that same level, and requires more and more food to feel satiated. (similar to addiction in that regard). 

AND their set point can change so that to be a healthy weight they need to eat LESS now, after having been obese, than if they'd never been obese at all. 

Together, those things can make it VERY VERY HARD. Then add in constantly being surrounded by food designed by super smart scientists to be addictive, and it is even harder. And yes, for many, potentially impossible given their life circumstances, biology, and other stressors. If it takes all their time and energy to focus on losing weight, and they have other competing things that require most of their time and brain power and energy, and their body is fighting them every step of the way, and their environment is purposely created to undermine any efforts and yeah....it's not a matter of, "oh! being obese is unhealthy? I'll just go lose weight then"

Edited August 22, 2022 by ktgrok

[Selkie]

32 minutes ago, wathe said:

I don't think that anyone is saying that.

My agreement with @Farrar's statement (that follows) prompted the argument:  "I think most of these things are of really limited efficacy. The best thing you can do by FAR is to mask, vaccinate, and ventilate. That's really it. Being healthy in general helps, obviously, but it's not always in everyone's control, so making suggestions on that front is a little useless." 

Which prompted me being called out for not recommending weight loss.  (please note that I also didn't recommended against weight loss.  I didn't specifically mention weight loss at all.  Aside, there was no indication in OP's thread that weight is even an issue for her or her family).  

Which I felt was not what OP was looking for (a request for evidence-based, simple things, toolkit to decrease chance of covid, with example list of products).  Weight loss is not a simple thing.  Nor is there evidence to support that it decreases one's chance of getting covid or reduces viral load.  (Obesity does correlate with poor outcomes - no argument from me there)

Then back and forth.

I'm not against weight loss, or maintenance of a healthy weight.  It's wonderful that so many boardies have had success with weight management.  If boardies want to exchange weight-loss tips, they should have at it, there are thread for that.

I also don't believe that it's too hard for anyone to do.  But it probably is too hard for everyone to do in USA.   An obesity and overweight rate of 72% speaks volumes.

 I do think that it's very, very important to acknowledge that weight loss and weight maintemance is complex and very difficult for many people.  That it is a complex problem on a population basis.  That in many way it is a social problem, that needs societal level solutions .  @Corraleno's observation that Japan's obesity rate is minuscule compared to USA's is right on point.  The difference is not about human biology. The difference is the American obesogenic environment --culture, policy, economy, built environment, social inequality.  It's more than just individual diet choices of individual Japanese. Japanese walk more in daily life, have denser population centres, less car culture, better public transit, different food culture, different government intervention in food pricing, and many other DOH reasons that contribute.

I am irked by the I lost weight so other people should be able to too if they only ate properly tone in several previous posts.  But maybe that's just me mis-reading tone online.

 

Edited to fix awkward wording

Nobody has said or implied that OP and her family are overweight. She asked what protective measures others have seen or tried, not for measures that are tailored for her family and their specific set of circumstances.

And nobody has said or implied that "I lost weight so other people should be able to too if they only ate properly". I haven't even seen any mention of food, other than the discussion about food prices and a brief mention of the Western diet compared to diets of other cultures.

[Shoeless]

28 minutes ago, ktgrok said:

happy for you. Did you though not KNOW that losing weight would be a good idea before? Cause I'm thinking the issue is not that OP or any of us haven't KNOWN that losing weight is a good idea. Therefore, providing the suggestion isn't helpful.

For Covid? Of course not. I knew in the abstract it was good for a variety of health related issues. When the data came back that said obese patients landed in the ICU, on a ventilator, or dead more often than normal weight patients, I found my motivation to lose weight right quick.

The op asked their question in regard to Covid. They asked for evidence based things they could do, and there's data to back up the advice to lose excess weight. It's not a personal attack.

https://www.nature.com/articles/s41366-021-01054-3

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685947/

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253640

https://www.nytimes.com/2021/12/08/health/covid-fat-obesity.html

[Corraleno]

Here's an evidence-based change people can make: a plant-based diet was associated with a 73% reduction in the risk of moderate to severe covid symptoms. From a study published in the BMJ based on data from nearly 3000 HCWs in 6 countries:

"Results There were 568 COVID-19 cases and 2316 controls. Among the 568 cases, 138 individuals had moderate-to-severe COVID-19 severity whereas 430 individuals had very mild to mild COVID-19 severity. After adjusting for important confounders, participants who reported following ‘plant-based diets’ and ‘plant-based diets or pescatarian diets’ had 73% (OR 0.27, 95% CI 0.10 to 0.81) and 59% (OR 0.41, 95% CI 0.17 to 0.99) lower odds of moderate-to-severe COVID-19 severity, respectively, compared with participants who did not follow these diets. Compared with participants who reported following ‘plant-based diets’, those who reported following ‘low carbohydrate, high protein diets’ had greater odds of moderate-to-severe COVID-19 (OR 3.86, 95% CI 1.13 to 13.24). No association was observed between self-reported diets and COVID-19 infection or duration.

https://nutrition.bmj.com/content/4/1/257

 

Edited August 22, 2022 by Corraleno

[Shoeless]

1 hour ago, wathe said:

I am irked by the I lost weight so other people should be able to too if they only ate properly tone in several previous posts.  But maybe that's just me mis-reading tone online.

If you are referencing my post, then yes, you are misreading my tone.

For the last several years, I have seen so many ads and online posts from people insisting it's impossible for women "of a certain age" to lose weight, and there's simply no avoiding putting on weight, so just give up on trying.  And that's just not true.  "Obese" isn't the default setting for all women over 45.

Saying "I lost weight" isn't me going "Neener, neener!" and thumbing my nose at anyone. I am actually very sympathetic to how hard it is to lose weight. It took me 18 months, for crying out loud, after several failed attempts over the years. I'm very much aware of how hard it is to do.

Edited August 22, 2022 by MissLemon

[Melissa in Australia]

9 hours ago, Selkie said:

 

And yes, Australia is different than most of the rest of the world when it comes to food prices. I hope that situation gets better soon. I wish I could send you some cheap beans from the US.

When you mean most of the rest if the world do you mean USA  or does the rest of the world encompass all of North America? 

Food prices have always been a problem for most of Africa. And the food prices and /or availability  are currently a problem for Europe,  all Middle East countries and swathes of Asia. 

[KSera]

9 minutes ago, Corraleno said:

Here's an evidence-based change people can make: a plant-based diet was associated with a 73% reduction in the risk of moderate to severe covid symptoms, and low-carb diets had the worst outcomes. From a study published in the BMJ based on data from nearly 3000 HCWs in 6 countries:

"Results There were 568 COVID-19 cases and 2316 controls. Among the 568 cases, 138 individuals had moderate-to-severe COVID-19 severity whereas 430 individuals had very mild to mild COVID-19 severity. After adjusting for important confounders, participants who reported following ‘plant-based diets’ and ‘plant-based diets or pescatarian diets’ had 73% (OR 0.27, 95% CI 0.10 to 0.81) and 59% (OR 0.41, 95% CI 0.17 to 0.99) lower odds of moderate-to-severe COVID-19 severity, respectively, compared with participants who did not follow these diets. Compared with participants who reported following ‘plant-based diets’, those who reported following ‘low carbohydrate, high protein diets’ had greater odds of moderate-to-severe COVID-19 (OR 3.86, 95% CI 1.13 to 13.24). No association was observed between self-reported diets and COVID-19 infection or duration.

https://nutrition.bmj.com/content/4/1/257

 

There are several super interesting things about that study, including that adjusting for BMI did not make a difference--the difference appeared to be due to the diet itself, and not the resulting impact on BMI. That's actually helpful info for people who are trying to do all the right things to lose weight and are eating healthy, plant based diets, but still can't get their weight down. According to this study, their risk may not be any higher than for someone with a lower bmi eating the same diet. I was surprised to see a pescatarian diet was not as low risk as a plant-based diet (though I noticed that a plant based diet could include fish as well in this study).

[Selkie]

14 minutes ago, Melissa in Australia said:

When you mean most of the rest if the world do you mean USA  or does the rest of the world encompass all of North America? 

Food prices have always been a problem for most of Africa. And the food prices and /or availability  are currently a problem for Europe,  all Middle East countries and swathes of Asia. 

I was talking about the expensive beans and lettuce that were mentioned. In most parts of the world (the entire world, not just North America), plant foods like produce, legumes, and grains are among the cheapest foods. Hence the fact that richer countries have much higher meat consumption than poorer countries.

[ktgrok]

36 minutes ago, KSera said:

There are several super interesting things about that study, including that adjusting for BMI did not make a difference--the difference appeared to be due to the diet itself, and not the resulting impact on BMI. That's actually helpful info for people who are trying to do all the right things to lose weight and are eating healthy, plant based diets, but still can't get their weight down. According to this study, their risk may not be any higher than for someone with a lower bmi eating the same diet. I was surprised to see a pescatarian diet was not as low risk as a plant-based diet (though I noticed that a plant based diet could include fish as well in this study).

I admit I'm being super lazy and not reading the whole thing, but can you clarify? I've been off my ADHD meds for over a week, and my brain is NOT understanding this, lol. Did the study show that a plant based diet that also included fish (which to me IS a pescatarian diet) was helpful to prevent Covid complications? Or? 

Sorry, I really am slightly in brain fog mode, between my first nap in years, stormy rainy weather giving me a headache, and no vyvanse (rules changed the week I went to fill my script and now if the doctor doesn't write your ENTIRE address on the script they won't fill it, finally got it handled today and will be back on them tomorow, praise Jesus) I am trying to parse what you meant. 

[KSera]

4 minutes ago, ktgrok said:

 Did the study show that a plant based diet that also included fish (which to me IS a pescatarian diet) was helpful to prevent Covid complications? Or? 

Yes, including fish was still helpful to reduce severity of illness: "After adjusting for important confounders, participants who reported following ‘plant-based diets’ and ‘plant-based diets or pescatarian diets’ had 73% (OR 0.27, 95% CI 0.10 to 0.81) and 59% (OR 0.41, 95% CI 0.17 to 0.99) lower odds of moderate-to-severe COVID-19 severity, respectively"

So, I read that as plant-based being 72% reduced odds of moderate to severe Covid and Plant-based or pescatarian as 59% reduced odds of moderate to severe covid compared to those who did not eat those diets. (It's odd to me how they grouped those, but I didn't do a deep dive on my read through, so can't say why they did it that way).

[Ausmumof3]

10 hours ago, Selkie said:

About the bolded - it made me laugh. I have lost 70 pounds - 40 before the pandemic, 30 during the pandemic. So yeah, I have a complete understanding of what is involved in losing weight. 

And yes, Australia is different than most of the rest of the world when it comes to food prices. I hope that situation gets better soon. I wish I could send you some cheap beans from the US.

I have also lost that amount of weight and regained it. It was not a mentally healthy place for me when I was losing weight it took most of my mental energy and took me away from my kids/family. Focusing on numbers on the scale is less helpful than focusing on eating delicious healthy food and finding time for movement for me. On days I don’t work, I always exercise and I usually eat vegetables etc for lunch. On days when my whole day is full of homeschooling and care tasks that doesn’t happen.

On the plus side I saw some beans on sale for $16kg last night! Yay. Still more than the $5-6 we usually allocate to greens but hey.

[Ausmumof3]

Just now, Ausmumof3 said:

I have also lost that amount of weight and regained it. It was not a mentally healthy place for me when I was losing weight it took most of my mental energy and took me away from my kids/family. Focusing on numbers on the scale is less helpful than focusing on eating delicious healthy food and finding time for movement for me. On days I don’t work, I always exercise and I usually eat vegetables etc for lunch. On days when my whole day is full of homeschooling and care tasks that doesn’t happen.

On the plus side I saw some beans on sale for $16kg last night! Yay. Still more than the $5-6 we usually allocate to greens but hey.

Also just as an aside, the two people I know who have actually dealt with longer term covid symptoms are both thin and healthy. On the other hand the guy from our church who is morbidly obese said it was nothing and less than a normal cold. I realise those are just anecdotes but I actually know a ton of people who have had covid now and not many have had more serious cases requiring hospitalisation but the ones who were worse hit were all healthy weight males between 20-45. One who needed hospitalisation has MS. I have one kid I tutor who may be dealing with some ongoing issues and she’s actually very thin and has almost stopped eating some days.

[Ausmumof3]

https://www.nature.com/articles/s41598-022-17197-w
 

Heres a study on the link between covid and obesity. Interestingly it’s not as straightforward as lose weight equals better outcomes. In some age groups mild overweight is protective and being underweight is linked to more severe outcomes as well. But no one is telling the underweight people here to put on a few pounds to protect themselves from covid. Because the narrative that obese people are to blame for all their health issues is a strong one.
 

I realise this is kind of hijacking the original thread at this point though, sorry OP.

“After adjusting for confounders, those in the younger group with severe obesity had an increased risk of COVID-19 mortality compared to those with normal/overweight (HR 1.27; 95% CI 1.01–1.61). An increased risk of death was also observed for patients with underweight (HR 3.74; 95% CI 1.39–10.07). For patients aged ≥ 60 year, mild/moderate obesity was associated with reduced mortality risk (HR 0.87; 95% CI 0.78–0.97). For the age group < 60 year, the length of stay in ICU for those patients with severe obesity was 35% higher compared to the normal/overweight category (e^β 1.35; 95% CI 1.21–1.51). Conversely, for the survivors in the underweight category, the length of stay in ICU was 51% lower compared to the normal/overweight group (e^β 0.49; 95% CI 0.31–0.78). In the age group ≥ 60 year, mild/moderate obesity was associated with an increased length of stay in the ICU (e^β 1.10; 95% CI 1.01–1.21), adjusting for confounders. These findings could be helpful for health professionals to identify subgroups at higher risk for worse outcomes.”

 

[BeachGal]

3 hours ago, mommyoffive said:

Have you had covid?  

I am struggling to decide what to do with things this year.  I like when places have masking rules in place so I don't have to decide things.  Mask indoors?  Only with a certain level?  Mask outdoors? I hate deciding. 

I did this past winter when omicron was rampant.

I read a paper about a month ago that discussed immunity, including having two doses of mrna vaccine and an omicron infection (which is me), and at this point, I'm okay with the risk of not masking. Another paper came out recently saying something similar. If cases skyrocket in fall/winter, I'll probably mask again. I've been going into restaurants, stores, etc and have not gotten sick. I do use Xlear, though, and if a person or business asks me to mask, I will.

 

[Selkie]

27 minutes ago, Ausmumof3 said:

https://www.nature.com/articles/s41598-022-17197-w
 

Heres a study on the link between covid and obesity. Interestingly it’s not as straightforward as lose weight equals better outcomes. In some age groups mild overweight is protective and being underweight is linked to more severe outcomes as well. But no one is telling the underweight people here to put on a few pounds to protect themselves from covid. Because the narrative that obese people are to blame for all their health issues is a strong one.
 

I realise this is kind of hijacking the original thread at this point though, sorry OP.

“After adjusting for confounders, those in the younger group with severe obesity had an increased risk of COVID-19 mortality compared to those with normal/overweight (HR 1.27; 95% CI 1.01–1.61). An increased risk of death was also observed for patients with underweight (HR 3.74; 95% CI 1.39–10.07). For patients aged ≥ 60 year, mild/moderate obesity was associated with reduced mortality risk (HR 0.87; 95% CI 0.78–0.97). For the age group < 60 year, the length of stay in ICU for those patients with severe obesity was 35% higher compared to the normal/overweight category (e^β 1.35; 95% CI 1.21–1.51). Conversely, for the survivors in the underweight category, the length of stay in ICU was 51% lower compared to the normal/overweight group (e^β 0.49; 95% CI 0.31–0.78). In the age group ≥ 60 year, mild/moderate obesity was associated with an increased length of stay in the ICU (e^β 1.10; 95% CI 1.01–1.21), adjusting for confounders. These findings could be helpful for health professionals to identify subgroups at higher risk for worse outcomes.”

 

Not sure if it's the case with this study (haven't read it), but other studies that are non-Covid-related have shown that people in the overweight BMI category are healthier than people in the normal category. But the reason for that is because so many people in the normal BMI category are smokers, alcoholics, drug addicts, or have a medical condition that causes them to lose weight. Dr. Joel Fuhrman talks about this in his book Eat For Life, and Dr. Greger discusses it on his site nutritionfacts.org.

https://nutritionfacts.org/video/is-the-obesity-paradox-real-or-a-myth/

"To put the obesity paradox issue to the test once and for all, the Global BMI Mortality Collaboration was formed, reviewing data from more than 10 million people from hundreds of studies in dozens of countries—the largest evaluation of BMI and mortality in history. To help eliminate bias, they omitted smokers and those with known chronic disease, and then excluded the first five years of follow-up to try to remove from the analysis those with undiagnosed conditions who lost weight due to an impending death. And…the results were clear: being overweight, and all grades of obesity, were associated with a significantly greater risk of dying prematurely. So, adjusting for these biases leads to “eliminating the obesity paradox altogether.” In other words, the so-called obesity paradox appears to be just a myth."

[Ausmumof3]

17 minutes ago, Selkie said:

Not sure if it's the case with this study (haven't read it), but other studies that are non-Covid-related have shown that people in the overweight BMI category are healthier than people in the normal category. But the reason for that is because so many people in the normal BMI category are smokers, alcoholics, drug addicts, or have a medical condition that causes them to lose weight. Dr. Joel Fuhrman talks about this in his book Eat For Life, and Dr. Greger discusses it on his site nutritionfacts.org.

https://nutritionfacts.org/video/is-the-obesity-paradox-real-or-a-myth/

"To put the obesity paradox issue to the test once and for all, the Global BMI Mortality Collaboration was formed, reviewing data from more than 10 million people from hundreds of studies in dozens of countries—the largest evaluation of BMI and mortality in history. To help eliminate bias, they omitted smokers and those with known chronic disease, and then excluded the first five years of follow-up to try to remove from the analysis those with undiagnosed conditions who lost weight due to an impending death. And…the results were clear: being overweight, and all grades of obesity, were associated with a significantly greater risk of dying prematurely. So, adjusting for these biases leads to “eliminating the obesity paradox altogether.” In other words, the so-called obesity paradox appears to be just a myth."

Did they also do the same in those with obesity? Control for other factors that may be causing the obesity etc? To prove that obesity was a causal factor versus a result of underlying conditions that also accelerated death? 
 

It makes no difference to me at this point. I know what I can and can’t manage in terms of health and my sanity.

[Selkie]

18 minutes ago, Ausmumof3 said:

Did they also do the same in those with obesity? Control for other factors that may be causing the obesity etc? To prove that obesity was a causal factor versus a result of underlying conditions that also accelerated death? 
 

It makes no difference to me at this point. I know what I can and can’t manage in terms of health and my sanity.

I believe that the meta-analysis only included people who did not have a chronic disease and had never smoked.

[PronghornD]

7 hours ago, Corraleno said:

If you want sources, just pull up any of the thousands of RCTs on weight loss, and you'll see that nearly 100% of the subjects in every study lost weight while following the diet and/or exercise protocol in the study, regardless of age, starting weight, weight loss method being studied, etc. Losing weight is clearly "hard but doable" for the vast majority of people (although obviously there can be issues, like thyroid conditions, autoimmune disease, medications that lead to weight gain, etc., that can make it difficult or impossible for some people to lose weight). But for most people, the problem is that they see "dieting" as a temporary period of "deprivation" that they have to suffer through to achieve a specific goal, and then they go back to eating the way they did before and gain it all back.

If losing weight isn't "doable" for most people, for some physical or medical reason that is inherent in human biology, then why do countries with diets that are very different from the standard American diet have such different rates of obesity? In Japan, for example, only 25% of adults are overweight and 4% are obese, vs 67% overweight and 32% obese in the US. If maintaining a healthy weight is not "doable for most people," how do people in other countries manage it?  

Perhaps the question should be is it hard but doable to lose weight long term rather than to simply lose weight temporarily.

The Japan example has some weaknesses. You are ignoring the variable of dietary history and its impact on a person's ability to lose weight. If a person is sixty years old and has been continually obese since they were five, that person may be metabolically very different from someone who first became obese at menopause. If that is the case, what is doable for our population and other country's populations might be quite different. Our metabolisms may have been harmed throughout lifetimes of poor diet.

[Laura Corin]

I don't know if this counts as simple, but regular exercise may reduce likelihood of infection a bit, as well as improve outcomes of infection more.

https://www.theguardian.com/world/2022/aug/22/regular-physical-activity-may-lessen-covid-risks-study-finds?CMP=Share_AndroidApp_Other

[Corraleno]

6 hours ago, Ausmumof3 said:

https://www.nature.com/articles/s41598-022-17197-w
 

Heres a study on the link between covid and obesity. Interestingly it’s not as straightforward as lose weight equals better outcomes. In some age groups mild overweight is protective and being underweight is linked to more severe outcomes as well. But no one is telling the underweight people here to put on a few pounds to protect themselves from covid. Because the narrative that obese people are to blame for all their health issues is a strong one.
 

I realise this is kind of hijacking the original thread at this point though, sorry OP.

“After adjusting for confounders, those in the younger group with severe obesity had an increased risk of COVID-19 mortality compared to those with normal/overweight (HR 1.27; 95% CI 1.01–1.61). An increased risk of death was also observed for patients with underweight (HR 3.74; 95% CI 1.39–10.07). For patients aged ≥ 60 year, mild/moderate obesity was associated with reduced mortality risk (HR 0.87; 95% CI 0.78–0.97). For the age group < 60 year, the length of stay in ICU for those patients with severe obesity was 35% higher compared to the normal/overweight category (e^β 1.35; 95% CI 1.21–1.51). Conversely, for the survivors in the underweight category, the length of stay in ICU was 51% lower compared to the normal/overweight group (e^β 0.49; 95% CI 0.31–0.78). In the age group ≥ 60 year, mild/moderate obesity was associated with an increased length of stay in the ICU (e^β 1.10; 95% CI 1.01–1.21), adjusting for confounders. These findings could be helpful for health professionals to identify subgroups at higher risk for worse outcomes.”

 

But that study was specifically limited to ICU patients, it's not referring to the general population — and we know from many other studies that obesity greatly increases the risk of ending up in ICU to begin with. The fact that underweight people in ICU had higher mortality than overweight people does not mean that underweight people in the general population have a higher rate of mortality from covid. It just means that if you are sick enough to end up in ICU, then being overweight may be slightly better than being underweight, because you have more reserves. And the reason an ICU patient is underweight could also be a factor — for example, someone who is underweight at the point of admission may have been sicker for longer before becoming critical, while obese people might be admitted and treated sooner due to their perceived higher risk.

[Shoeless]

22 hours ago, Laura Corin said:

I don't know if this counts as simple, but regular exercise may reduce likelihood of infection a bit, as well as improve outcomes of infection more.

https://www.theguardian.com/world/2022/aug/22/regular-physical-activity-may-lessen-covid-risks-study-finds?CMP=Share_AndroidApp_Other

Ah, maybe because of the nitric oxide production from exercise?

https://pubmed.ncbi.nlm.nih.gov/33472351/

[Ausmumof3]

21 hours ago, Corraleno said:

But that study was specifically limited to ICU patients, it's not referring to the general population — and we know from many other studies that obesity greatly increases the risk of ending up in ICU to begin with. The fact that underweight people in ICU had higher mortality than overweight people does not mean that underweight people in the general population have a higher rate of mortality from covid. It just means that if you are sick enough to end up in ICU, then being overweight may be slightly better than being underweight, because you have more reserves. And the reason an ICU patient is underweight could also be a factor — for example, someone who is underweight at the point of admission may have been sicker for longer before becoming critical, while obese people might be admitted and treated sooner due to their perceived higher risk.

Yes but it’s not the only one. Either way my point is less about the risk and more about the ease or otherwise of long term weight loss for those with serious struggles. For me I think advice like eat more plant foods or get some more movement in your day is more helpful than focusing on a number on the scale and applies to everyone not just the overweight (plenty of people have a “healthy bmi” but still make poor food choices and don’t exercise.)