Health & Fitness

Dietitian Melissa Meier shares the health perks of fasting while in iso, and three simple tips to help you stick to it at home.

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As reviewed in “Vitamin D Level Is Directly Correlated to COVID-19 Outcomes,” there’s compelling evidence to suggest optimizing your vitamin D level can reduce your risk of COVID-19 and other viral infections such as seasonal influenza.

A number of different scientists are calling for people and governments to prepare for a second wave of COVID-19 come fall, both in the U.S. and abroad.¹ Considering SARS-CoV-2 has been shown to be responsive to temperature and humidity, with infectiousness increasing with lower temperatures and humidity levels, we’re likely going to see a reemergence of COVID-19 infections in the fall, during normal influenza season.

REALLY IMPORTANT: Optimize Your Vitamin D Level Before Fall!

What this means is you now have a known “deadline” for optimizing your vitamin D level. To improve your immune function and lower your risk of viral infections, you’ll want to raise your vitamin D to a level between 60 nanograms per milliliter (ng/mL) and 80 ng/mL by fall. In Europe, the measurements you’re looking for are 150 nanomoles per liter (nmol/L) and 200 nmol/L.

Historically, December typically has highest flu activity in the U.S.,² but it would probably be good to aim for October, or maybe even earlier depending on your location. Optimizing your vitamin D is particularly important if you have darker skin, as darker skin places you at higher risk for vitamin D deficiency — and serious COVID-19 infection.

COVID-19 Racial Disparity Rooted in Vitamin D Deficiency

As reported by The Guardian,³ the COVID-19 mortality among black Americans is three times higher than that of whites, and researchers have long known that blacks cannot achieve optimal vitamin D levels from sun exposure at any time of the year in Northern America.⁴

Research⁵ posted April 28, 2020, points out that vitamin D insufficiency is prevalent in severe COVID-19 cases and that “Emerging health disparities data regarding African-American and homeless populations suggest that vitamin D insufficiency (VDI) may be an underlying driver of COVID-19 severity.” Importantly, this study⁶ found 100% of COVID-19 patients under the age of 75 admitted to intensive care units had vitamin D insufficiency.

A letter to the editor,⁷ published in the Irish Medical Journal, also points out the many links between vitamin D deficiency and factors known to play a role in COVID-19, such as male sex, acute respiratory distress syndrome (ARDS) and comorbidities like obesity, diabetes and heart disease, and presents data from an in-hospital review of 33 male COVID-19 patients’ vitamin D levels.

The 12 patients who progressed to ARDS had a mean vitamin D level of 27 nmol/L (10.8 ng/mL), whereas those who did not progress to ARDS had a mean level of 41 nmol/L (16.4 ng/mL).

It’s worth noting that 16.4 ng/mL is still grossly insufficient, as 40 ng/mL (100 nmol/L) has been established as a minimum level of sufficiency for general health and disease prevention by GrassrootsHealth.⁸ The same goes for the elderly, as you tend to lose the ability to convert vitamin D from sun exposure as you age.

Step 1: Measure Your Vitamin D

So, how do you go about optimizing your vitamin D level? First, you need to find out what your base level is, which is done using a simple blood test. An easy and cost-effective way of doing this is to order GrassrootsHealth’s vitamin D testing kit.

Once you know what your blood level is, you can assess the dose needed to maintain or improve your level. Again, the ideal level you’re looking for is above 40 ng/mL, and ideally between 60 ng/mL and 80 ng/mL (European measurement: 100 nmol/L or, ideally, 150 nmol/L to 200 nmol/L).

The easiest way to raise your level is by getting regular, safe sun exposure, but if you’re very dark-skinned, you may need to spend about 1.5 hours a day in the sun to have any noticeable effect.

Those with very light skin may only need 15 minutes a day, which is far easier to achieve. Still, they too will typically struggle to maintain ideal levels during the winter. So, depending on your situation, you may need to use an oral vitamin D3 supplement. The next question then becomes, how much do you need?

Step 2: Assess Your Individualized Vitamin D3 Dosage

The reason you do not want to get fixated on arbitrary dosage recommendations is because the required dose can vary greatly depending on several factors, including skin color, weight and other nutritional deficiencies. As explained by GrassrootsHealth:⁹

“One of the main factors contributing to this variability is a person’s weight. Therefore, we also calculated a dose-response curve adjusted to an individual weighing 150 pounds (68 kg), shown below.

Indicated on the chart are supplemental dose amounts that ensure a specific proportion of the population achieves particular vitamin D levels. For example, 55% of participants achieved at least 40 ng/ml with 2000 IU/day and 94% of participants achieved at least 40 ng/ml with 8000 IU/day. This chart can be used as a guide to select your starting dose.”

While this chart provides a starting point, you can fine-tune your dosage further by taking into account your baseline vitamin D level. To do that, you can either use the chart below, or use GrassrootsHealth’s Vitamin D*calculator. To convert ng/mL into the European measurement (nmol/L), simply multiply the ng/mL measurement by 2.5.

How to Calculate Your Vitamin D From Sun Exposure

To calculate how much vitamin D you may be getting from regular sun exposure in addition to your supplemental intake, consider using the DMinder app,¹⁰ created by Dr. Michael Holick, author of “The Vitamin D Solution: A Three-Step Strategy to Cure Our Most Common Health Problems.” The free app is available for iPhone and android in the Apple store and Google play respectively. As explained by imedicalapps.com:¹¹

“The app attempts to calculate a patients’ vitamin D level based on demographics imputed when first opening the app and then updates the level based on either actual lab draws or data from the app. The app even uses the phone’s GPS and clock to determine the ‘best’ time of day for a patient to get the required sun exposure for vitamin D skin conversion.”

Step 3: Retest

Next, you’ll need to re-measure your vitamin D level in three to six months, to evaluate how your sun exposure and/or supplement dose is working for you. As explained by GrassrootsHealth:

“The only way to know how much supplemental intake you need is to test your levels. This will tell you whether the dose you are taking is the right dose for you to reach optimum nutrient levels. It is also important to check your nutrient levels at regular intervals because lifestyle changes may create a need for dosing adjustments.”

What Is the D*action Project?

Aside from the DMinder app, another helpful tool is the myData-myAnswers online tracker created by GrassrootsHealth. You automatically have access to this tool when you buy their vitamin D testing kit and enroll in the D*action project.

You can track any given supplement with this tracker (not just vitamin D). By tracking exactly how much you take and when, you can get a clearer picture of your personal requirement to reach and maintain an ideal level.

When you buy the GrassrootsHealth testing kit, you agree to enroll in the D*action project, an international field study aimed at solving the vitamin D deficiency epidemic.

By sharing your test results and anonymized personal health data with GrassrootsHealth researchers, you will enable them to determine the details of how vitamin D impacts health. As explained by GrassrootsHealth:

“You may choose to enroll 1-time to test your levels with an extended health questionnaire or you may participate for the full 5-year project where you provide your health information each 6 months for the 5-year period. The participation fees are based on the tests chosen; additional tests can be added to fit your individual needs.”

While I make these testing kits available in my online store, I do not make any profit from their sale. All proceeds go directly to GrassrootsHealth. If you prefer, you can also obtain the kit directly from their website. 

Share and Inform Your Community

I urge everyone to share this information with friends, family and community at large, so that we can minimize a second outbreak. For example, you could speak to pastors in churches with large congregations of people of color and help them start a program getting people on vitamin D. Doing so could help save many lives; far more than any vaccine program.

Additionally, if you have a family member or know anyone that is an assisted living facility, you could meet with the director of the program and encourage them to get everyone tested or at least start them on vitamin D.

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The unemployment caused by the coronavirus pandemic will soon exceed that of the Great Recession of 2007 to 2009 and represents the worst decline in jobs since the Great Depression in the 1930s.¹ It is difficult to overstate how many jobs have been lost — each Labor Department report adds to the grim statistics.

In two short months, the leisure and hospitality industry, which includes travel, tourism, lodging and recreation, shed almost half its jobs.² Most of the lost jobs were related to eating and drinking establishments, work that depends on disposable income and the ability of people to move around freely.³

Bureau of Labor Statistics data, cited by Charles Gascon, regional economist for the Federal Reserve Bank of St. Louis suggest that more than 66.7 million people working in food preparation, sales, production and services are now at high risk of layoffs.⁴

Conventional food production and delivery have been severely disrupted, but what about natural foods? I am a founding member of an exciting plan to keep organic farmers and natural product businesses up and running during this difficult time.

Are We Facing a Second Great Depression?

During the Great Recession, the greatest economic downturn in recent times, unemployment peaked at 10% in October 2009.⁵ During the Great Depression of the 1930s, that figure was 24.9%, which included people in work relief jobs.⁶ When you compare those figures with estimates of unemployment rates that may come from the COVID-19 pandemic that are between 10.5% and 40.6%, you see how serious this is.⁷

Many of us did not live through the Great Depression, but we have seen pictures of the devastating poverty and heard stories from our older relatives. People lacked both food and money, and bread lines and soup kitchens were how many survived. According to U.S. History.com, the food offerings began as charity operations:⁸

"When soup kitchens first appeared, they were run by churches or private charities. The Capuchin Services Center in southeast Detroit, for example, served 1,500 to 3,000 people a day. That center opened on November 2, 1929.

Volunteers of America also was important in setting up soup kitchens all over America. By the mid-1930s, state and federal governments also were operating them."

Today, charities are still feeding the growing number of hungry people. A few weeks into the COVID-19 pandemic, U.S. food banks were swamped. At an Omaha food pantry that before the pandemic normally served 100 people a day, 900 people a day show up now.⁹ In Las Vegas, the Three Square Food Bank, which anticipated 200 to 250 cars a day through the pandemic, is getting up to a 4-mile-long caravan of 500 to 600 cars, according to The New York Times.¹⁰

Today's pandemic food shortages also have parallels to World War II. During the war, the cost of munitions and war-related items caused the producer price index to rise by 17% and consumer price index by 10%, which raised the price of everyday staples.¹¹ This led to passage of the Emergency Price Control Act of 1942, which authorized the U.S. government to ration food and set prices.¹²

In addition to stabilizing prices, the Emergency Price Control Act was meant to prevent hoarding and price gouging and ensure that scarce resources could reach everyone evenly.¹³ Among the rationed items that Americans could buy only with coupon books were sugar, coffee, processed foods, meats, fats, canned fish, cheese and canned milk.¹⁴

Flash forward to today's pandemic and food is again being rationed, as well as paper products and hand sanitizers.¹⁵ Store shelves are sometimes bare and people wait in long lines outside of grocery stores. During World War II, there were few fast food restaurants and people usually ate at home. During this pandemic, while many fast food restaurants are seeing long lines, home cooked meals are again becoming the norm, creating more demand for dry good items like pasta.

Big Food's Business Models Have Made Things Worse

Big Food's large dairies, packing plants and concentrated animal feeding operations (CAFOs) are struggling during the pandemic as consumer demand wanes and their nonregenerative business models abysmally fail. Milk is being dumped and edible livestock euthanized even as people are struggling with hunger and food insecurity.¹⁶ It is a thorough indictment of conventional agriculture.

According to Tim Gibbons, communications director at the Missouri Rural Crisis Center, COVID-19 is "shining a spotlight on the rigidity and lack of resilience for the corporate model of [farm production], which does not pay farmers fairly and is not good for consumers."¹⁷

It is ironic that despite the many systems' failures and even as Americans lose their livelihoods and face poverty, food insecurity and mental health crises, financial markets continue to rally. Ill-conceived government policies have clearly created a bubble that will crash in the future.

Conventional, nonregenerative farming is responsible for virtually every major environmental and health problem we now have, including:

Food insecurity and malnutrition amid mounting food waste	Promotion of foodborne illnesses and drug-resistant bacterial infections
Rising obesity and chronic disease rates despite growing health care outlays	Rapidly dwindling fresh water supplies
Toxic agricultural chemicals polluting air, soil and waterways, thereby threatening the entire food chain from top to bottom	Disruption of normal climate and rainfall patterns due to the destruction of ecosystems by pollution

Job Losses Worsen Poor Countries' Plights

In poor countries, COVID-19 presents even more dire consequences. People are not just at risk of illness and death with weak health care systems to treat them; they are also losing jobs because of the slowdown in Western countries' economies and less demand for the goods they manufacture and export.

A half-billion people who were not living this way before the pandemic may be catapulted into poverty, says Oxfam, a conglomerate of 19 organizations working to end global poverty.¹⁸ That is a 6% to 8% rise in poverty for the entire global population. According to Oxfam:¹⁹

"Existing inequalities dictate the economic impact of this crisis. The poorest workers in rich and poor nations are less likely to be in formal employment, enjoy labor protections such as sick pay, or be able to work from home.

Globally, just one out of every five unemployed people have access to unemployment benefits. Two billion people work in the informal sector with no access to sick pay — the majority in poor countries where 90 percent of jobs are informal compared to just 18 percent in rich nations."

In Bangladesh, more than 1 million garment workers, most of whom are women, have been laid off without pay because of cancellations of orders from Western clothing brands.²⁰

In Africa, it is estimated that as many as half of all jobs could disappear. A taxi driver and father told Oxfam he had not had passengers since the lockdown closed the airport and restaurants, and added "This virus will starve us before it makes us sick."²¹

In India, as many as half a million people who had been working outside their cities of origin literally walked back home after their jobs disappeared with the COVID-19 pandemic.²² Amitabh Behar, chief executive of Oxfam India, called the exodus the "largest mass migration since independence."²³

In Delhi, throngs of displaced workers coalesce at food lines set up by the government to feed them, but the amount of food is not always sufficient. "Instead of coronavirus, the hunger will kill us," said Nihal Singh, a migrant worker hoping to be fed at one of the food lines,²⁴ echoing the sentiments of the African taxi driver who spoke to Oxfam. Clearly, famine is following on the footsteps of COVID-19.

The clustered food distribution in India and elsewhere also increases the risk of COVID-19 infections spreading, since the crowding and desperation of hungry people makes social distancing nearly impossible.

Introducing ‘The Nourish Mint’ — A New Way Forward

Even though natural products have rarely been in greater demand from consumers, COVID-19 has prevented natural products’ industry conferences that were normally scheduled from occurring. Such meetings, like the Natural Products Expo West, usually held the first week of March, facilitate connections and allow raw ingredient companies to pitch to brands, and brands, in turn, to pitch to independent retailers. Until now.

Luckily there is some good news when it comes to keeping the supply chain of natural foods and supplements flowing amid the temporary shutdown of such natural products’ industry conferences.

The Organic & Natural Health Association has created a new way for farmers and natural product businesses to interface called "The Nourish Mint."²⁵ The online events, the first to take place June 18 and 25, 2020, at 4 p.m. to 5 p.m. Eastern time, will allow:²⁶

"… brands, raw ingredient suppliers, distributors and independent retailers of SENPA, INFRA [Independent Natural Food Retailers Association], Positively Natural and MAHO [Mid-American Health Organization] to network and exchange new innovations and opportunities …

'Retailers are very interested in knowing not just about the product, but what goes into the product, where those ingredients come from and how they ultimately help the person buying it,' said Debra Short, executive director of SENPA. ‘The Nourish Mint’ is a great opportunity for them to do that while we wait for industry conferences to resume."

How does The Nourish Mint work? It will operate just like an in-person event in which raw ingredient companies and brands can present their products to an audience of independent retailers and other interested companies in the industry — except that it will be online. The presenters will have three minutes to showcase their products and three minutes to answer questions from the virtual audience.²⁷

Flexibility is built into The Nourish Mint sessions. After the formal, live presentations of ingredients, products and brands, there will be an open social with attendees. Members of the audience will also be able to schedule individual or private meetings with the presenting companies for a future date.

The Nourish Mint format is unique because it involves the entire supply chain, says Karen Howard, the CEO and executive director of Organic & Natural Health Association.²⁸

How to Participate in a Nourish Mint Event

Companies that are interested in presenting at a Nourish Mint event can apply by sending pitch materials to events@organicandnatural.org, on or before June 2, 2020. For members of Organic & Natural Health Association, the cost to present to prospective buyers is $300 and for non-members, it’s $500. Only 20 companies will be chosen to present at the June 18 and 25 sessions.²⁹ Among the industry expert audience, who are called "mintors," will be:³⁰

Heather Granato, VP of content, Informa	Alan Lewis, VP government affairs, Natural Grocers
Andrew Halpner, VP science and technical services, Atrium Innovations	Greg Horn, co-founder of Nutritional Capital Network; director at William Hood and Co.
Debra Short, executive director, SENPA	Kantha Shelke, principle of Corvus Blue
Anthony Zolezzi, chairman and co-founder UxHealth	Corinne Shindelar, president emeritus, founder and former CEO INFRA

Independent retailers who are members in good standing of SENPA, INFRA, Positively Natural and MAHO and Organic & Natural Health Association members may attend for free. Non-members may attend for $150 per session, and tickets can be acquired from the Organic & Natural Health Association.³¹

During the Pandemic Consider Growing Your Own Food

Growing your own vegetables and fruits is one of the best ways to ensure ready access to fresh, nutrient-dense and chemical-free food. It especially makes sense during this pandemic with its economic and food disruptions.

It is not true that you need a large space to grow a meaningful amount of food, though it is a popular misconception. In reality, "The Backyard Homestead" suggests you can grow enough organic food to feed a family of four on only a quarter-acre of land, all year round.³²

In addition to supplying yourself with nutrient-dense, chemical-free food, a garden provides other important benefits. It gives you valuable and enjoyable physical exercise while exposing you to the UV rays so many people miss, especially during the COVID-19 shutdowns.

Gardening is also a natural antidepressant and anxiety reducer. According to a meta-analysis in Preventive Medicine Reports:³³

"To our knowledge, this meta-analysis is the first to provide a quantitative synthesis of the evidence that gardening is beneficial for human health. Overall, the results suggest that participating in gardening activities has a significant positive impact on health.

Indeed, the positive association with gardening was observed for a wide range of health outcomes, such as reductions in depression and anxiety symptoms, stress, mood disturbance, and BMI, as well as increases in quality of life, sense of community, physical activity levels, and cognitive function."

The COVID-19 pandemic has created unemployment, poverty, food insecurity and a likely economic depression. The Nourish Mint is a ray of hope and a new way forward for farmers and natural product businesses during these troubling times.

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As the number of people who have died from COVID-19 rises, more widespread testing reveals the infection may have moved farther and faster than was anticipated. The Centers for Disease Control and Prevention recently released five planning scenarios¹ "designed to help inform decisions by modelers and public health officials who utilize mathematical modeling."

Each of the scenarios is based on numerical values and epidemiological characteristics of the viral infection, reflective of data gathered before April 29, 2020. The CDC is clear these are estimates and not predictions:²

• There was no known pre-existing immunity before 2019 so all people in the U.S. were assumed to be susceptible
• Between 20% and 50% of all people believed to be infected were asymptomatic; they were deemed likely to be infectious
• The "best estimate" is 0.4% of people who show symptoms will die; for people over 65 it's 1.3% and for those 49 and under it's 0.05%

Although there was nearly immediate pushback,³ estimates from The Centre for Evidence-Based Medicine at the University of Oxford were similar.⁴ There were two numbers used to define the percentage of deaths. The case fatality rate was chosen to represent the number of deaths divided by the number of confirmed cases; it was limited by the number of people tested.

Based on the possibility that up to 50% of those infected were asymptomatic, this created an abnormally high percentage. The infection fatality rate was used to represent the number of deaths divided by the number of people infected with SARS-CoV-2. That number was far lower since it included all people who are infected and not just those whose status was confirmed with a test.

The Centre acknowledges that estimating fatality rates in the early stages of infection is subject to uncertainty. However, it's important to note that the infection fatality rate in the 3,711 passengers on the Diamond Princess cruise ship — the ship quarantined in Yokohama for 27 days at the start of the pandemic⁵ — was 1.3%.⁶

Quercetin Boosts Cellular Response to Viruses

Even one death is too many. As I've written in the past, quercetin is a natural antihistamine and anti-inflammatory that lowers your risk for viral illnesses. In a recent paper, researchers identified one mechanism through which quercetin may work to control viral replication and promote health.⁷

Casein kinase II (CK2) is an enzyme with a diverse set of functions in the body. It is fundamental to controlling homeostasis at the cellular level. Yet, much of its functioning and mechanisms of action are still unknown.⁸ The enzyme is also involved in the survival and metastatic spread of cancer cells.

There is evidence that it down-regulates the ability a cell has to generate type 1 interferon when attacked by a virus. It does this by inhibiting retinoic acid-inducible gene I (RIG-I),⁹ which has protein sensors that signal genetic expression of type 1 interferon by identifying the replication of RNA viruses, such as SARS-CoV-2.

Researchers found that quercetin could inhibit the expression of CK2, which slowed the replication of RNA viruses in the lab and in mice.¹⁰ They pointed out that the effectiveness of supplemental quercetin may be hindered by the low solubility of the compound, which affects absorption.

By using "enzymatically modified isoquercitrin (EMIQ)" they discovered they could develop plasma levels 20 times higher than the same intake of unmodified quercetin. The authors concluded quercetin or EMIQ "should be included" in aiding the control of viral infections.

In research on the Ebola virus (EBOV) that triggered epidemics between 2013 and 2016, scientists found that the virus also suppressed type 1 interferon. They discovered that quercetin could suppress the effect on type 1 interferon and that it restored the body's ability to protect itself:¹¹

"Overall, quercetin is the first identified inhibitor of the EBOV VP24 anti-IFN function, representing a molecule interacting with a viral binding site that is very promising for further drug development aiming to block EBOV infection at the early steps."

What Are Interferons?

Interferons (IFNs) are a subset of cytokines discovered in 1957.¹² These cells are often the initial defense against viruses. There are two types and three forms of interferon. Within type 1 interferon, there are alpha and beta. Type II interferon has the gamma form.¹³

The different types are based on the function of the cytokine. Type I interferons help cells resist viruses. Type II aids in responding to infections and cancer growth. Initially, researchers hoped it could be used to treat diseases, including cancer. But it had serious side effects.

After further development, several forms were released to treat genital warts, multiple sclerosis and hepatitis B and C with varying results. The name "interferon" came from the ability of Type 1 to interfere with the virus's ability to duplicate. A cell secretes interferons when a foreign substance, like a virus, is detected.

However, the interferon does not function by attacking the virus. Instead, it tells the infected cell and the cells that surround the infected cell to make proteins that stop viral replication. Quercetin functions to stop CK2 from interfering with the action of type 1 interferon so cells are signaled to stop viral replication.

Quercetin Works With Zinc to Stem Viral Replication

Quercetin also functions as a zinc ionophore. This is a substance that helps transport zinc through the cellular plasma membrane¹⁴ and raises the level of zinc inside the cells. It's another mechanism through which quercetin may help lower the viral load and reduce the severity of viral infections.

Zinc has proven antiviral properties and can reduce the length of the average cold by 33%.¹⁵ Recently, scientists pointed out there were indications that maintaining normal zinc levels may help reduce the severity of COVID-19.¹⁶

In the lab, zinc has demonstrated the ability to inhibit replication of the SARS-CoV-2 virus, which researchers believe is the underlying therapeutic effect in the use of hydroxychloroquine.

Zinc may also up-regulate interferon production and the antiviral activity of the protein. Experts think it may reduce the risk of a secondary bacterial infection, especially against Streptococcus pneumoniae. Interestingly, zinc deficiency is common in older adults and in those who are obese, have diabetes or atherosclerosis.

Likely not by coincidence, these are some of the same populations who have a higher risk of severe disease from SARS-CoV-2.¹⁷ The research team who looked at past studies on zinc suggest that it has a protective effect against COVID-19 by lowering inflammation, helping clear mucus, preventing ventilator-induced damage and supporting immunity.¹⁸

In addition to the impact quercetin has on the immune system, researchers have also found it helps to ameliorate obesity, Type 2 diabetes, circulatory dysfunction, chronic inflammation and seasonal allergies.¹⁹ It has also been found to help lower blood pressure in patients with Stage 1 high blood pressure.²⁰

Researchers have found that quercetin can trigger tumor regression and it can activate the mitochondrial pathway of apoptosis.²¹ This is programmed cell death, without which cells can grow uninterrupted and develop into cancerous growths.

Hydroxychloroquine: Poor Outcome With Added Risk

Two recent trials with the antimalarial drug hydroxychloroquine have yielded disappointing results. The first 75 patients at 16 Chinese treatment centers who were positive for COVID-19 were given hydroxychloroquine.²²

The researchers found the primary endpoint of a reduction in the viral load, and secondary endpoints of improvement and reduction in clinical symptoms, were not significantly better than in the control group.

The group receiving hydroxychloroquine had a negative conversion of 85.4% compared to the control group of 81.3%. In addition, the group receiving hydroxychloroquine had a greater number of adverse events compared to the control group. The most common was diarrhea. The authors concluded:²³

"The administration of HCQ did not result in a higher negative conversion rate but more alleviation of clinical symptoms than SOC [standard of care] alone in patients hospitalized with COVID-19 without receiving antiviral treatment, possibly through anti-inflammatory effects. Adverse events were significantly increased in HCQ recipients but no apparently increase of serious adverse events."

In a second study published in the Lancet,²⁴ researchers used a multinational registry of patients who were given hydroxychloroquine or chloroquine, with or without a macrolide antibiotic for treatment. This class of antibiotic includes azithromycin, which has been used in other study groups.

There were 671 hospitals over six continents that supplied data of patients who were hospitalized between December 20, 2019, and April 14, 2020. During the study period there were 96,032 patients who met the criteria; 14,888 were in the treatment group and 81,144 were in the control group.

After controlling for confounding factors, the mortality rates were compared, and the researchers were unable to find a benefit from the antimalarial drugs when they were used alone or with a macrolide. What they did find was that using the:²⁵

"… drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19."

A third observational study, published in The New England Journal of Medicine, found using hydroxychloroquine did not improve patient outcomes with COVID-19.²⁶ In addition the FDA has cautioned against the use of hydroxychloroquine or chloroquine as an outpatient related to the dangerous heart arrhythmia side effects from the drugs.²⁷

What is important to note in each of these studies is the absence of zinc in the intervention groups. We now know that chloroquine and hydroxychloroquine are zinc ionophores,²⁸ which means the main ingredient required to prevent the viral infection may not have been given.

While it is difficult to make an assumption of the efficacy of treatment of COVID-19 with hydroxychloroquine, since zinc was not given in each of these studies, it is also important to consider the secondary side effects associated with the drug, namely ventricular arrhythmias.

Dose Recommendations for Zinc and Quercetin

During the COVID-19 pandemic and future infectious disease seasons, supplementing with quercetin and zinc may be a good idea for many. It can help boost your immune system's innate ability to ward off infectious illness. As for dosage, here are some basic recommendations:

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From burrito bowls to high-protein pumpkin soup, here are seven healthy lunches that will help you put your body into fat-burning mode, all approved by dietitian Melissa Meier. 

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Dietitian Susie Burrell spoke with Professor Grant Brinkworth, a senior research scientist from CSIRO, about the negative side effects of the Keto diet on weight loss. And apparently, the popular diet could lead to long term weight gain - not loss. 

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Get toned, feel sexy and boost your confidence with these saucy — and effective — online workouts.

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Our resident doctor answers the age old question - do you really need to let it ‘breathe’ down there? 

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Love meal prepping, but wish it were easier? A slow cooker is the kitchen appliance you need.

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Could your kids power the electrical grid, if you could only figure out how to tap that energy? Someday, all the hours spent cooped up at home will be a memory, not a daily reality. But if your children are bouncing off the walls with schools and day care still closed and summer coming, here are five active ideas to safely channel their energy. Pandemic or not, preschoolers benefit from active play throughout the day, and children ages 6 to 17 should rack up at least 60 minutes of activity daily, according to the Centers for Disease Control and Prevention. And since regular activity boosts health and lifts mood, everyone stands to benefit.

Pick a card

Annelieke Rietsema, an employee health coach and fitness specialist at Newton-Wellesley Hospital, suggests this simple strategy. Take a pack of playing cards and assign different exercises to each suit. For example, hearts could be jumping jacks or bear crawl; diamonds could be burpees or somersaults (if you have room); spades could be mountain climbers or cat-cow; clubs could be knee pushups or squats. Now shuffle or mix up the cards (face down), then start going through the deck. Kids do the number of each exercise on cards numbered 2 to 9. They do 10 of an exercise if a card is an ace, jack, queen, or king. So, a jack of hearts in the spades suit could equal 10 mountain climbers. For an exercise without discrete repetitive movements, like the bear crawl, try assigning a number of seconds based on the card selected (a five of hearts equals five seconds of bear crawl).

Children can do the shuffling and assign exercise choices, even picking simpler or harder exercises depending on age or ability.

Top of the hour

Five-minute or 10-minute energy burns at the top of each hour may help keep the peace. Have kids set a timer and choose easy exercises: running in place, jumping jacks, skipping rope, practicing sit-ups and squats. Children can compete with each other or with friends — from one week to the next, is it getting easier to do certain exercises? Can you do more than you could before?

Creature moves

Challenge younger children to think up and enact the moves of animals and other creatures: waddle like a duck, small hops like a bunny, giant hops like a kangaroo, slither like a snake, jump high like a frog, crawl-walk like a bear, inch forward like a turtle, waggle-dance like a honeybee, flap arms like a bird, crawl sideways like a crab, and so on. Set up indoor races for the quieter moves (crab, duck, snake) and occasional outdoor races for louder critters, to see who reaches the finish line in the least and most time. Extra points for unusual choices.

Personal best

Record how long a child can hop or balance on one foot or the number of push-ups, sit-ups, jumping jacks, or other exercises a child can do in a row. Practice three times a week and track the results once weekly.

Teens and some younger children may enjoy setting goals and logging progress in virtual races. The Healthy Kids Virtual Running Series for children in pre-K to grade 8 has a state-by-state locator to find local races. Many charities are encouraging people of all ages to raise money while walking, running, biking — or even dancing — in virtual events.

Yoga and fitness classes online

Two engaging options are Cosmic Kids, which combines yoga and storytelling into a calming, enjoyable workout for many children, and Go Noodle, which has high-energy video or app games to get kids moving and silly costumes to amuse them. Or you can find free online options, or sample classes available through local gyms, recreation centers, or YMCAs. Be sure to screen fitness videos aimed at children, to check if they are appropriate for your child.

Whatever you choose to help children burn energy, do give a thought to your neighbors. Quieter exercises are best if you live above someone, and mixing in safe outdoor time is good for everyone, parents included. If there’s enough room to move freely while maintaining safe distances, a game of tag or soccer, a bike ride, or just a run, skip, or kangaroo-hop to the end of each block could be fun.

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