Prior to COVID, I never spent much time thinking about the nature of viral infections. What first struck me was the very early finding in 2020 that obese people did much worse with COVID than appropriate-weight individuals – this was in the news, so everyone knew about it.
I found this interesting because the pro-inflammatory state of obesity is a known promoter of most non-infectious chronic diseases, such as heart disease, cancer, Alzheimer’s disease, depression, and musculoskeletal conditions such as osteoarthritis and tendinosis.1 However, it never occurred to me that the severity of viral infections is greater in obese individuals.
Obesity and Infection Severity
With the above in mind, I began to collect articles about obesity and viral infection severity. For example, note the title of this paper (which is freely downloadable): “Influenza and Obesity: Its Odd Relationship and the Lessons for the COVID-19 Pandemic.”2
The authors tell us that obese people and calorie-deprived, malnourished individuals suffered worse outcomes during the “Spanish” influenza pandemic of 2018. So, for over 100 years before COVID emerged, the scientific community knew that obese people are more likely to die from viral infections. Why is that not common knowledge? Here is a direct quote from the above paper:
The 1957–1960 “Asian” and the 1968 “Hong Kong” influenzas confirmed that obesity and diabetes lead to a higher mortality as well as a more prolonged duration of illness even if the subjects were without other chronic conditions that increase the risk of influenza-related complications. During the 2009 Influenza A virus (IAV) H1N1 pandemic, obesity was also linked to increased risk of severe disease and a risk factor for hospitalization and death.
Understanding the Human Virome
This led me to think more about the relationship between human cells, bacterial cells and viruses. I learned that bacterial cells do not outnumber human cells by 10:1 or more, as I’d previously thought. In fact, the ratio is close to 1:1.
For example, a male weighing 155 pounds at 20-30 years of age has 30 trillion human cells and 39 trillion bacterial cells in the microbiome that weigh about .44 pounds.3 I also learned a bit about the human virome, which I had never really considered before. I was actually shocked to discover that there are 100 times more viruses in our bodies than human cells.4 This means we have about 3 quadrillion viruses in our bodies and about 8% of our genome is represented by viral fragments.4
I would suggest getting reference #3, which is also freely downloadable. Tables and images illustrate the various viruses that occupy space in various body systems. For example, in Figure 1 in that paper, we can clearly see that Coronaviridae are part of the normal human respiratory tract.4 In fact, the only location where coronaviruses have been found in humans is the respiratory tract.3
This means we have a natural symbiotic relationship with some coronaviruses. And not surprisingly, that made me wonder why this latest coronavirus was made out to be such an issue, considering the fact that the real predictor of severity for COVID is obesity and hyperglycemia, which is consistent with previous viral outbreaks.
For perspective, Streptococcus pyogenes, which causes strep throat, is part of the airway epithelium for many people and causes no harm until a symbiotic / homeostatic disruption occurs.
So, we should probably start viewing bacterial infections more accurately as homeostatic disruptions between our human and bacterial cells. The same holds true for viral infections. And the biggest issue is the pro-inflammatory state of obesity and hyperglycemia.
Since there are more bacterial cells and viruses in the body than human cells, this means the human immune system is absolutely adapted to their presence. When I was growing up, we children got sick and mom never did. Why not? She was exposed to increased viral loads from a sick kid for several days – and at one point our ages were 11, 9, 4 and 1, so she was very busy if one of us got sick; and sometimes there was more than one.
In short, the viral load we delivered to our mother was not substantial enough to trigger an immune response, so she did not get sickness symptoms. Everyone has had this experience: not all family members get sick when one gets a cold or flu in the middle of winter.
Moving Beyond the Superficial View of Viral Infection
This should not be interpreted as if I am rejecting that people spread viral infections to each other; that is not what I am saying. What I am saying is that we have been conditioned to embrace a superficial view of viral infections that suggests we are at their mercy and should live in fear. Instead, we should embrace that fact that we need to have a healthy relationship with our 3 quadrillion viruses.
So, I think a better view is that we disrupt our symbiotic relationship with our virome when we suffer from an excess of pro-inflammatory insults that can be acute and/or chronic, which renders the immune system hyperexcitable in one respect and inhibited in another.
A fever or way worse, a cytokine storm, reflects hyperexcitable states. An example of immune inhibition is a reduced capacity to phagocytose virally infected cells. This is an example of the immune dysfunction that exists when one is obese and hyperglycemic,5 so there should be absolutely no confusion as to why these individuals struggled to deal with a novel virus – they have a heightened cytokine response and a reduced phagocytic capacity.
References
Governor Gavin Newsom has retracted the proposed budget cuts to the Medi-Cal acupuncture program for low-income Californians for the 2024-2025 budget year. This decision marks a significant victory for health care providers and advocates who have long championed acupuncture as a vital component of comprehensive medical care.
There’s no doubt that many of your patients visit your practice because they are in pain. And there’s certainly no doubt that curcumin from turmeric (Curcuma longa) can be incredibly effective in stopping that pain, whether due to chronic conditions like arthritis or acute pain from intensive workouts. But your patients may also benefit from curcumin for other reasons.
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Fair and appropriate wages in health care are typically based on economic evaluations. A simple literature review illuminates that acupuncture is missing economic evaluations; which implies you are either underpaid or overpaid. The complexity of services provided by most American acupuncturists, which they are trained and certified to provide, must be reimbursed fairly.
