When we think of our immune system – not something most of us think much about – it is when it is failing us in some way, either unable to fend off infection, or even worse, attacking our own body. Most of us have some idea that stress and fatigue affect our immune system negatively, but does that translate into any change in how we take care of ourselves and each other? With the recent intense focus on the COVID-19 outbreak, this has become an issue that is possibly timelier than ever.
While we still know relatively little about how this virus affects human bodies, we can surmise from other infectious agents that it afflicts those with impaired immune systems more readily than those who are doing what they can to maintain and even augment their immunity. A leading theory regarding the coronavirus SARS-2, the virus that leads to the syndrome called COVID-19, is that it is, in itself, a fairly innocuous virus, but it possesses some sort of property that causes the immune system of certain people to overreact wildly. This would explain why the virus seems to affect almost every organ system in the body, likely even the brain, though the brain is often shielded from our own immune system.
Why do some people’s immune systems go haywire when exposed to this virus and others barely notice? We have not figured this out yet, but it seems that certain people are more likely to get ill; namely, those who are already ill, especially with what we can call Metabolic Syndrome, a catch-all term to describe what I like to call “Industrial Disease,” in other words, the syndrome that we all get to some extent as a result of living in our industrial society and eating our standard industrial diet. It consists of such common conditions as having an excess of adipose (fat) cells, commonly referred to as obesity. Actually, though, this term is a poor one, as it really does not describe the true issue, which is an inflammatory state that weakens the immune system and damages the vital organs, in particular, the liver. We used to think that fat cells are inactive, but we now find that they are very active, but mostly in harmful ways, sending out chemical signals that lead to this inflammation.
There are other signs of having Metabolic Syndrome, such as Type 2 diabetes, hypertension, lipid abnormalities, sleep apnea, gout, fatty liver, Alzheimer’s, dementia and so on. It is hard to find an adult in this country who has none of these, though there are many who have them and do not yet know.
Let us take one of the most common, which I would call adiposity (rather than obesity, as weight has little to do with the condition). We used to think that we knew what causes this: eating too much and moving too little; in other words, gluttony and sloth, two of the Mortal Sins. Scientists refer to it as “calories in, calories out.” Now, we are finding that this is not the case. Rates of this condition have increased over the past five or six decades around the world, but research has shown that the average American is no less active today than in the 1950s. So, sloth is out as a cause.
Diet is certainly a major – in fact, the most important – cause, but it is not as simple as eating too much. It seems that the problem is really the poor quality of the things we eat and drink, rather than the quantity, though they affect each other (consuming sugar, for example, makes us much hungrier). So, we can scratch gluttony off the list as well.
There are other causative factors and the biggest of these non-diet factors are sleep and stress; further, these two factors are closely linked. When we get too little sleep, our stress level the next day is elevated, leading to inflammation and disruption of the immune system. Weight gain may also occur, but is just a side effect of these other disturbances. Conversely, when we are stressed in the daytime, we sleep much more poorly because of elevated adrenaline as well as inflammation (again), which has been strongly linked to sleep apnea (in fact, more so than obesity).
So, what can we do to reduce these problems of inflammation and disrupting our immune system? We need to look at all of the above: namely, diet, sleep and stress. But, rather than take a piecemeal approach, what I think we all need to do is to reassess our hurried lives and try to slow down. If we can do so, we can improve all three of the major factors: if we are less hurried, we can cook ourselves a healthy meal, we can sleep and we can relax. This virus has afforded some of us an opportunity to do exactly that. We need to work fewer hours, if we can possibly afford to. This will likely mean cutting back on certain expenses, but that may reduce stress for us as well. If we all work less and consume less, there may be less pressure from society to go back to the work-consume-work cycle in which many of us are trapped.
Research has shown that the happiest societies are not the richest ones, and that individual happiness is not correlated with income or status, but rather with social connections, especially family bonds and the time to develop and enjoy these.
For those reading this who are working flat out to just keep a roof over their heads, this may not apply. But for the rest, we need to re-examine our lives, what we are all working toward and the price we are paying as individuals, as families and as a society. If we do so, we may find it is a price not worth paying. QCBN
By David A. Wolkoff, M.D.
David A. Wolkoff, M.D., is the medical director at West Yavapai Guidance Clinic.