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Tue, May 26 10:21am · How Obesity Affects COVID-19

Healthy food preparation

As researchers continue to learn about COVID-19, they are increasing their understanding of who is being most affected by the novel coronavirus. One unsettling revelation has been that obesity is a common factor in a significant number of cases in the U.S. and around the world.

While the implications of the obesity epidemic embedded within the pandemic of COVID-19 indeed are troubling, UCLA professor of internal medicine and director of the UCLA Center for Human Nutrition Dr. Zhaoping Li views the situation as a potential wake-up call for people to reset their eating habits.

“COVID-19 has disrupted our daily patterns,” Dr. Li says. “This is the time to reevaluate how we nourish our bodies, how that plays into our overall wellness and informs our community response.”

Obesity — defined as weight that is higher than what is considered as a healthy weight for a given height —is a global epidemic. Two-thirds of Americans are overweight or obese; by 2030, it is expected that nearly half of all adults will be obese and one-in-four will be severely obese.

Dr. Li, who also is chief of the UCLA Division of Clinical Nutrition, talks about the impact of obesity on COVID-19 and offers practical steps we can take now to better nourish our bodies and improve our health.

What is the relationship between diet, obesity and immune function?

Diet and obesity affect immune function in complex ways. Generally, those who regularly consume high-fat, high-sugar and high-salt processed foods are more likely to develop illnesses. On the flipside, eating a well-balanced diet helps your body’s ability to fight infections, viruses and other chronic conditions.

People who are obese often have respiratory problems that can include difficulty breathing, impaired blood oxygenation and low lung volume and muscle strength. They also are predisposed to diabetes, high blood pressure, pneumonia, pulmonary hypertension and cardiac stress, all of which are risk factors that can lead to poor outcomes for individuals who are diagnosed with COVID-19.

Why is it important for you to highlight the link between obesity and COVID-19?

We, as physician-researchers, are watching the data points very closely. A preliminary report published by Nature, a respected research journal, found that among 4,103 patients with COVID-19 in New York City, having a BMI greater than 40 — sometimes categorized as “extreme” or “severe” obesity — was the second-strongest independent predictor of hospitalization, after old age. The researchers also found that among 383 patients with COVID-19 in Shenzhen, China, those with obesity were more likely to require mechanical ventilation than those with diabetes or cardiovascular disease.

As the prevalence of obesity increases in the U.S., so, too, do the number of people who suffer from malnutrition. People who eat unhealthy meals consume fewer nutrients and over the long-term develop impaired immune function, which makes it difficult for them to fight off an illness like COVID-19.

What do you tell your patients?

I try to remind my patients that we are settling into a reality in which this virus will be with us for a long time. If you feel like you don’t have regular eating patterns, try placing structure around how and when you eat. This can include planning for meals ahead of time or writing down what you have eaten after a meal is consumed.

How can we all live a healthier lifestyle?

Focus on overall wellness. Eat colorful fruits and vegetables, cut down on refined starches, avoid foods with hidden fats, get adequate sleep and design a personal exercise program that you can stick with. If you need help, talk to your primary care physician; he or she can provide you with information about resources that are available to you.

What essential advice would you give to someone who has decided to make a change?

It is vital for everyone to do whatever they can now to strengthen their immune health. It looks like there will be a significant period of time before a vaccine is developed, and strengthening the immune system will help us all safely reenter a “new normal” as stay-at-home guidelines are loosened. Now is the time to think about addressing obesity as part of our societal response to COVID-19.

Thu, May 14 4:25pm · Canned Versus Frozen Fruits and Vegetables: What's Better for You?

The COVID-19 pandemic has necessitated that we find new ways to live our lives as public health measures shape the daily choices that we make. One of the arenas where we see this play out is at our local grocery store.

As people limit their potential exposure to COVID-19 by reducing the number of trips they make to the store, many are buying more non-perishable food items such as flour, rice and pastas. At the same time, nutrition experts urge people to include fruits and vegetables — essential for overall nutrition and to support a healthy immune system — in their daily diets.

But fresh fruits and vegetables have a limited shelf life, and that can discourage some people from purchasing them. While stocking up on fresh fruits and vegetables may not be a viable option for many people, canned or frozen are.

Both canned and frozen fruits and vegetables typically are processed within hours of being harvested, which helps preserve their nutrients. But while canned and frozen foods may start out equally nutritious, how they are processed can affect their final nutrient content.

Dr. Vijaya Surampudi, an assistant professor of medicine at the UCLA Center for Human Nutrition, helps to make the right choices between canned and frozen varieties.

Canned Foods

Canning food is a practice that dates back to the 18th century. According to Dr. Surampudi, canning requires a lot more processing, and is likely to have less nutritional value than frozen foods. The process of canning is different for different types of food, but typically it involves three major steps that keep the food safe to eat for long periods of time.

  • Processing. Fruits or vegetables are peeled, sliced, chopped, pitted, boned, shelled or cooked.
  • Sealing. The processed food is sealed in its can.

  • Heating. The can is heated to kill harmful bacteria and prevent spoilage.

“Avoid canned varieties with added sugars or sodium,” Dr. Surampudi says. “Many contain high amounts of sodium to hide the change in taste that comes with age and the heating process.”

Frozen Foods

Freezing food is a process that has been practiced for nearly 100 years and is a great option to incorporate into daily diet.

Similar to canned foods, the process differs based on the type of food, but typically involves two major steps.

  • Blanching. Fruits or vegetables are blanched, or quickly cooked for a few minutes, in hot water.   
  • Freezing. Immediately after blanching, the food is flash frozen and stored in airtight packaging.

Blanching allows for the food to retain its nutritional value, kills bacteria and stops it from spoiling.

“While we might lose some key nutrients during the blanching process, the nutritional density of frozen fruits and vegetables is almost comparable to eating them freshly harvested,” Dr. Surampudi says.

So, which is better?

It is important that people eat a balanced diet that includes a variety of fruits and vegetables to ensure they are building a healthy immune system. Whether fruits and vegetables are canned, frozen or fresh, making the effort to consume more colorful foods pays off big time for overall wellness.

That said, Dr. Surampudi recommends frozen foods over canned. “As nutritionists, we advocate, ideally, for our patients to eat fresh foods, but frozen foods are a good option when it is not possible to go to the store regularly. Take some frozen veggies and add them to your pasta, rice or other dishes — or some frozen fruit to your morning oatmeal or in a smoothie — and enjoy,” Dr. Surampudi says.

Wed, Apr 29 12:40pm · Eating Your Way Toward a Healthy Immune System

The COVID-19 pandemic has provoked anxiety and fear throughout the country and prompted many people to explore the best approaches to protecting their health.  While there is no magic bullet to prevent one from falling ill, proper nutrition is one way to help you stay healthy and strong.

No matter what kind of shape you are in, malnutrition makes you susceptible to illness. Eating a healthy diet helps to support a healthy immune system to fight off bacteria, viruses and many other illnesses.

Dr. Vijaya Surampudi, an assistant professor of medicine at the UCLA Center for Human Nutrition, shares some tips for how best to feed the body.

“An ounce of prevention produces a pound of cure,” says Dr. Surampudi. “How you feed your body on a daily basis pays off in a lifetime.”

Nourish your body.

Wisely choosing the foods you eat will help to support your body’s defense mechanisms. Focus on:

  • Increasing your intake of vegetables
  • Not drinking sugar-sweetened beverages
  • Limiting the amount of red meats eaten
  • Including healthy spices like cinnamon, oregano, turmeric and more  
  • Eating whole grains
  • Incorporating healthy fats like avocado and olive oil

Focus on micronutrients.

  • Vitamin A helps regulate the immune system and protects against infections by keeping skin and tissues in the mouth, stomach, intestines and respiratory system healthy. Get this vitamin from such foods as sweet potatoes, carrots, broccoli, spinach, red bell peppers, apricots, eggs or foods labeled “vitamin A fortified” such as milk or some cereals.

  • Vitamin C supports the immune system by stimulating the formation of antibodies. Reach for citrus fruits such as oranges, grapefruit and tangerines, or papaya, strawberries, red bell pepper or tomato juice.

  • Zinc supports the immune system and may help wounds heal. Zinc can be found in lean meats, poultry, seafood, milk, whole grain products, beans, seeds and nuts.

Create consistency.

One of the ways you can develop a rhythm of eating healthy is by “coloring your plate.” The more colorful your plate, the greater variety of nutrition you are getting.

Blue:

  • Promotes healthy aging.
  • Lowers the risk of some cancers.
  • Improves urinary tract health, memory function and heart health.
  • Reach for blueberries, blackberries, elderberries and more.

Orange:

  • Maintains heart, vision and immune system health.
  • Reach for pumpkin, sweet potato, carrots, winter squash, cantaloupe, apricots and more.

Red:

  • Promotes memory function and urinary tract health.
  • Maintains a healthy heart.
  • Lowers risks of some cancers.
  • Reach for tomatoes, pink grapefruit, red peppers, watermelon and more.

Green:  

  • Lowers risk of some cancers and heart disease, maintains vision health and protects against birth defects in pregnant women.
  • Keeps blood cells, bones and teeth strong.
  • Reach for collard greens, kale, spinach, broccoli, brussels sprouts, lettuces and artichokes.

Avoid supplements.

If you are eating a balanced diet, there is no need for supplements. Supplements are not packaged the same way as food, so we do not know what else is needed for adequate absorption and utilization by the body.

Building immunity is multilayered.

Every part of your body, including your immune system, functions better when protected from environmental assaults and is improved by healthy living strategies, such as:

  • Not smoking
  • Eating a diet abundant with fruits and veggies
  • Exercising regularly
  • Getting adequate sleep
  • Taking steps to avoid infection such as washing your hands
  • Maintaining a healthy weight

Wed, Apr 15 4:32pm · COVID-19 Survivor Urges Community to Donate Convalescent Plasma as Potential Treatment

In a nationwide effort to study convalescent plasma as a potential treatment for COVID-19, UCLA is encouraging members of the community who have recovered from coronavirus to donate blood plasma as part of a clinical trial. One of the many COVID-19 survivors, 51-year-old Michelle Simonne, dutifully answered the call and is sharing her experience with others to support COVID-19 patients.

In December 2019, weeks before the COVID-19 outbreak was confirmed in the United States, Simonne became seriously ill with what she believed was pneumonia. Sick for multiple weeks, her symptoms were consistent with the novel coronavirus. After a successful recovery, her neighbor who works at UCLA suggested she have her blood tested for the disease-fighting antibodies. She was surprised when the results showed that her immune system had developed antibodies to fight and protect her from the virus.

“This was such a gift to be able to do something about this,” said Simonne “My antibodies and my plasma could actually help someone fight the infection or stop it in its tracks.”

Convalescent plasma is a liquid component collected from the blood of people who have recovered from COVID-19. There is currently no treatment for COVID-19 but small studies suggest that antibodies may help people recover. This type of treatment is not new; convalescent plasma was used to help those who suffered from the Spanish Flu, SARS, MERS, H1N1 and other viruses.

“Patients [around the world] have been able to be taken of mechanical ventilation and have even been discharged after being treated with convalescent blood,” said Dr. Alyssa Ziman, medical director of transfusion medicine in the UCLA Department of Pathology and Laboratory Medicine.

More than 850 patients have signed up to donate their convalescent plasma. Those who have tested positive for COVID-19  and meet blood donation requirements are encouraged to register and take the survey on the UCLA COVID-19 Convalescent Plasma Donation website to see whether they are eligible. Antibody testing is not currently being offered as part of this study.

In addition to potentially saving lives, the clinical trial will help researchers better understand antibody response to COVID-19, test development for neutralizing antibodies, and the relationship between the amount and type of antibody in convalescent plasma units and patients’ response to plasma treatment.

“It’s just a small way that I can help on the frontlines without actually being there,” added Simonne.

UCLA is one of more than 50 institutions across the country participating in the National COVID-19 Convalescent Plasma Project.

Wed, Apr 15 8:08am · Hope in Unity and Kindness: Stress-relief Station Offers a Safe Space for Frontline Providers

There was a collective sense of calm as pediatric nurses, physicians, housekeeping and other critical staff entered the new stress-relief space on the Chase Child Life Terrace of UCLA Mattel Children’s Hospital. While members of the music-therapy team played soft harmonies in the background, staff were able, if but for a few moments, to hit pause and process the difficult experiences of these past weeks in unity.

“Let’s do this together,” said Irene Johnson, a pediatric chaplain with UCLA Health’s Spiritual Care Department, who helped organize the event.

The strain that the COVID-19 pandemic is placing on staff can generate anxiety and fear among even the toughest health care veterans. To help alleviate some of that stress, the Chase Child Life and Spiritual Care teams created the relief station for staff to enjoy a few quiet moments to breathe fresh air, have their identification badges disinfected and connect with colleagues over snacks and self-care products donated from grateful patients.

“We wanted to create a centering experience for our frontline workers,” Johnson said. “So many of our providers are worried about the virus, and we wanted to remind them that they are safe, and they are protected.”

Frontline workers could take a “labyrinth walk” to help process their thoughts. As they moved along the path, outlined in chalk, they were greeted with words of encouragement such as hope, love and peace written on the floor of the terrace.

“Our terrace typically is reserved for our pediatric patients who are medically fragile,” said Alisha Hollingworth, one of the Child Life Specialists who helped to organize the space. “But we saw an opportunity to open it up to our staff and demonstrate small acts of appreciation. We wanted to let our care partners know we are here for them.”

Once staff completed the walk, they were asked to answer a special question: What gives you hope?

More than a hundred staff participated, writing their answers on post-it notes that are pasted to the windows of the Child Life room. While many shared that their families, friends and patients give them hope, two answers were most often repeated: kindness and my colleagues.

“How beautiful it was to see that our UCLA Health staff have a shared joy and hope for each other,” Johnson said. “We have oneness in the desire for kindness, and that is the fire that keeps all of us going.”

The Chase Child Life Program and Spiritual Care hope to continue the restorative practice once a week for all pediatric staff.

Tue, Apr 7 11:51am · From the Basketball Court to the Hospital Room: Kareem Abdul-Jabbar Donates 900 Safety Goggles to UCLA Health

As UCLA Health rallies the community to step up to support doctors, nurses and staff on the front lines combatting COVID-19, NBA legend and UCLA Health ambassador Kareem Abdul-Jabbar answered the call in a very personal and generous way, donating 900 pairs of safety goggles.

Abdul-Jabbar wanted health care workers to have the same sense of safety that he had wearing eye protection, as he regularly wore goggles as he became the NBA’s all-time leading scorer in his 20-year career.

“I am honored to be able to use whatever resources I can to help UCLA Health continue its courageous and necessary work to protect the health of our community,” said Abdul-Jabbar.

UCLA’s Dr. Eric Esrailian accepted the donation from Abdul-Jabbar. Dr. Esrailian, chief of the Vatche & Tamar Manoukian Division of Digestive Diseases, director of the Melvin & Bren Simon Digestive Diseases Center and Lincy Foundation Chair in Clinical Gastroenterology at the David Geffen School of Medicine at UCLA, has been one of UCLA Health’s leaders in the effort to raise funds for supplies, equipment and innovative research during this COVID-19 crisis. He has created two COVID-19 funds: one to help patients and a second to help first responders.

“On behalf of UCLA Health, I am honored and grateful to accept the generous donation of protective goggles from our friend, the legendary Kareem Abdul-Jabbar,” Dr. Esrailian said.  “We are incredibly grateful for the recent outpouring of financial support and donations of supplies during this unprecedented time. #TeamLA is stronger than ever before thanks to all of you, and we will get through this together.”

Abdul-Jabbar teamed up with his longtime friend and manager Deborah Morales to make the donation and secure much needed, high-quality medical supplies for UCLA Health and other hospitals in Southern California.

To learn more about the UCLA Health COVID-19 funds, please visit: https://www.uclahealth.org/Giving/covid-19-philanthropic-support

Fri, Apr 3 2:57pm · Child Life Specialists Begin Using Telemedicine to Reach Hospitalized Children During COVID-19

Child life programs play
a crucial role to make hospital stays less scary for pediatric patients and their
families, utilizing playtime, medical role play, music therapy and other
approaches to ease their anxieties and promote connectivity. In addition to
making hospital stays less intimidating, research has demonstrated that
playtime is critical for emotional, social, physical and cognitive development
in children.

However, the dramatic, but necessary, changes that have been made to prevent community spread of COVID-19 made Kelli Carroll, director of the Chase Child Life Program at UCLA Mattel Children’s Hospital in Los Angeles, ask, “How can we practice physical distancing and still bring children healing and neurological development through playtime?”

The question sparked
some creative thinking from her child life specialists.

From hosting Zoom calls with patients and families to recording YouTube videos of specialists playing games, remotely conducting musical sing-alongs to explaining why a doctor might look frightening while donning personal protective equipment — the child life team has used innovation and technology to develop their own virtual content for children in the hospital.

When the child life
team learns that a pediatric patient is arriving, specialists quickly set up
the room with a personal iPad, an email address written on the room’s
whiteboard and a special QR code to see their curated content.

“We have adapted to
this new reality, but the mission remains the same: helping to support children
and families navigate hospital life and, to the best of our abilities, make this
feel like a second home,” said Carroll. “Children are still coming into the
hospital, and for a lot of those who are here for follow-up, the new way of
doing things can be overwhelming.”

This new practice has evoked a positive response from patients and families, with numerous requests from patients and families for more videos.

“We are constantly
looking at different ways to keep our hospitalized patients engaged, and we
have had conversations with children’s hospitals across the country to develop
new ideas,” Carroll said. “I never thought that something as simple as unboxing
a new toy could spark joy in a child.”

If you are interested in learning more or supporting the Chase Child Life Program, please visit: https://www.uclahealth.org/mattel/chase-child-life.

To learn more about how UCLA is incorporating telemedicine with child care, click here.

Fri, Mar 13 12:49pm · COVID-19: How to Care for Dry Hands After Washing Them So Much

More people are upping their hand washing game now that the CDC and health officials have emphasized that regular hand washing is imperative to helping curb the spread of COVID-19.

But there’s
one step we all tend to forget after washing our hands or applying hand
sanitizer – that critical layer of hand cream. Ironically, by over-washing our
skin, we can develop dry cracks in the skin, giving bacteria an entry point
into our bodies.

Sara Hogan, MD, a dermatologist at UCLA Medical Center, Santa Monica, shares some best practices on how to treat signs of over-washing like pain, redness, flaking and itching.

Why is handwashing so harsh on our skin?

The outermost layer of our skin is composed
of oils and wax, and it acts as both a shield from the outside and a guard that
maintains natural moisture in the skin. This natural barrier is broken down by
the suds created by soap while washing hands, which does not discriminate
between unwanted oil, germs, debris and natural oils in the skin. Not applying hand
cream can lead to dryness, redness, itching, flaking, discomfort and in severe
cases, cracks in the skin. Those with preexisting dermatologic conditions like
eczema can experience worsening symptoms.

How should we wash our hands
to avoid skin dryness?

Apply
enough mild, fragrance-free soap to remove dirt, but avoid using so much that
it creates a thick lather—this washes away natural oils. Wash with warm, not
hot water, for at least 20 seconds, patting your hands dry with a towel. Once
your hands are dry, apply a moisturizer immediately. Keep small travel sizes of
creams in purse, gym bag, and at your work desk to make sure it is within
reach.

Are there any ingredients people should avoid when their
skin is chapped? 

Products that contain fragrance can be irritating to chapped,
sensitive skin. Creams and ointments are better than lotions. Hand sanitizers
with too much alcohol can be drying to chapped skin. You can try a hand
sanitizer with a moisturizing base, just know that it will not be as effective
in killing viruses. 

Are there common misconceptions about what to look for in
hand creams? 

Use hand ointment or cream instead of a lotion as these are more
effective. Petrolatum (Vaseline) is still the most effective moisturizer out
there. 

Are there other treatments besides hands creams that
people should consider? 

At nighttime before going to bed, apply thick moisturizer and then
cover with cotton gloves to increase absorption. Beauty product junkies can
consider a moisturizing mask for hands. These glove-like masks are applied for
20 minutes, then washed off.  Consider a humidifier at night—raising
the humidity level in a room can help dry skin.