Physical activity, nutrition tips to offer patients during COVID-19 pandemic

With most of the population in the United States living in areas under stay-at-home orders, many individuals may be turning to comfort foods and feeling limited in the amount of physical activity they can do.

In a White House press briefing, Deborah Birx, MD, U.S. Global AIDS Coordinator and U.S. Special Representative for Global Health, noted that it is critical now to “not be going to the grocery store, not be going to the pharmacy, but doing everything you can to keep your family and your friends safe.”

To help patients remain healthy, Healio Primary Care spoke with Brandon L. Alderman, PhD, an associate professor in the department of kinesiology and health at Rutgers, The State University of New Jersey, about physical activities, and Kristi L. King, MPH, RDN, LD, CNSC, senior pediatric dietitian at Texas Children's Hospital in Houston and a clinical instructor at Baylor College of Medicine, about nutritional tips that primary care physicians can share with their patients who are under stay-at-home orders.

Physical activity when stuck at home

Alderman noted that Americans are “acutely aware” of social distancing recommendations from the CDC and federal government; however, it is also essential to recognize that these same institutions recommend physical activity for 30 minutes per day in adults and 60 minutes per day in children.

“We also know from decades of research that physical activity is not only good for physical health but improves various aspects of mental health including stress, anxiety and depression,” Alderman said. “Therefore, as we think about our own self-care during these difficult times, it is critical that we incorporate physical activity into our daily routines.”

Evidence has shown physical activity can also strengthen the immune system, Alderman explained, “which may be critically important during this time of the COVID-19 pandemic.”

Therefore, it is particularly important for physicians to encourage patients who are immunocompromised to be physically active, according to Alderman.

He recommended that patients break up extended periods of sitting by engaging in physical activities — from walking and gardening to doing chores around the house — as well as other activities that they enjoy.

“As everyone is working on creating and settling into new schedules, I would recommend scheduling out time for physical activity every day,” Alderman said. “A short walk before and after ‘working hours’ may be a great way to separate our work life from our home life.”

Patients can use smartphone apps to encourage them to be physically active, Alderman said, adding that “it is also a great time to be creative about physical activity.”

“If regular gym-goers feel confined or unmotivated, it is a fantastic time to recreate some of favorite workouts using various objects around the home or just through bodyweight workouts, which can be quite demanding,” he said.

Alderman also suggested that people connect remotely and exercise together.

Eating healthy with limited options

King told Healio Primary Care that a healthy diet can also support the immune system and improve mental health, but “during the COVID-19 pandemic, there are many stressors and it can be extremely easy to mindlessly stress eat those high-calorie, high-fat comfort foods.”

King explained that gut flora can affect the brain. Although more research is needed to establish causation, evidence has shown that a healthy diet improves depression and anxiety, “which is something most people are experiencing to some degree on a daily basis right now,” she said.

It is particularly important for physicians to encourage those considered to be at high risk for severe illness from COVID-19 — including older adults, patients with underlying medical conditions and those who are immunocompromised — to maintain a healthy diet during the pandemic, King explained.

For instance, she noted that for patients with diabetes or heart disease, eating healthy will help support their immune system and manage their conditions, which in turn will help them “avoid trips to the doctor office or hospital for non-COVID-19 related issues, thus reducing your overall exposure.”

King recommends getting protein through beans, nuts, tofu and eggs if there is no meat left in the grocery store. High-sodium frozen meals should be limited to no more than one serving a day, and balanced with fruit and vegetables.

She stressed that physicians should remind their patients to try to make half their plate vegetables — whether they’re fresh, frozen or canned. This is because they “all give you the important nutrients you need, as well as antioxidants to help support your immune system,” she explained.

She also said that physicians can encourage their patients to “get creative and try new things.” – by Erin Michael

Reference:

White House. Remarks by President Trump, Vice President Pence, and members of the coronavirus task force in press briefing. https://www.whitehouse.gov/briefings-statements/remarks-president-trump-vice-president-pence-members-coronavirus-task-force-press-briefing-19/. Accessed Apr. 6, 2020.

Disclosures: Alderman and King report no relevant financial disclosures.