Not everyone exposed to COVID virus gets virus into functioning cells of lungs, heart, kidneys, muscle, fat and pancreas. Some have natural, innate full protection. Those with poor acid-base balance are poorly protected. Liable to get intracellular infection and suffer severe illness. Exercise and physical fitness restore normal acid-base balance.
 
Exercise and physical fitness also strengthen immune function. Even when immune function is weak.

Many in the US have already been infected by SARS-CoV-2. At least one-third. Of the others, probably half haven’t yet been dangerously exposed.¹

They will be. Sooner or later, everyone will be exposed. Of those not yet infected, probably half were dangerously exposed and just didn’t get infected. They were able to resist infection.

Not because they had been vaccinated against Coronavirus infection. Vaccination doesn’t prevent infection. It just prevents severe illness.

Even without symptoms of illness, people who have been infected are contagious. They expose others in close contact with them to Coronavirus infection. Any of those others who have not been vaccinated are liable to severe illness.

Not everyone exposed to SARS-CoV-2 infection gets infected. Not even when living in the same household as someone with a positive diagnosis.

Rates of transmission have been studied in 101 households in Tennessee and Wisconsin. In each household with someone newly infected, others in the household were examined and tested repeatedly for secondarily becoming infected. During 7 days of follow-up, 54% of other members became secondarily infected. 36% were symptomatic and 18% were Infected without symptoms. ²

Rates of secondary infection depended on risk factors known from other clinical studies. As shown in the figure of rates in relation to age, older household members had greater rates of secondary infection than younger members.

Other risk factors such as high blood pressure, lung disease, cardiovascular disease, diabetes, obesity, and chronic inflammatory dysfunction also increase the risk of secondary infection. Studies in other clinical trials show that about half of all people everywhere have co-morbid medical conditions that increase the likelihood of becoming infected with Coronavirus.

Apparently, many people of all ages everywhere have a natural, innate resistance to Coronavirus infection. Including all the virus variants that keep appearing. What is it that protects them?

Protection by Exercise has been studied during the COVID pandemic. Kaiser Permanente in California recorded week-by-week physical activity at outpatient health clinic visits from March 2018 to March 2020. ³

During the past 10 years, patients have been asked about their exercise. Their responses are included as vital signs in their health records. Along with body temperature, blood pressure, and pulse rate. About one-third report at least 150 minutes of moderate exercise every week. Of the others, almost one-third don’t do any exercise and the rest do less than 150 minutes.

As shown in the Figure, most of the groups with COVID infection were inconsistently active. Only 0.4% consistently exercised at least 150 minutes a week.

From January to October 2020, the clinic population of 4.7 million had about equal numbers of outpatients in each exercise group. About 2% of the total population was diagnosed with COVID-19. Those who were continuously eligible under study criteria were evaluated for risks of COVID in relation to their physical activity.

Risks of infection with COVID were much greater in those who had not been consistently active. About 3% for those who exercised less than 150 minutes a week. Less than 0.5% for those who exercised consistently at least 150 minutes a week.

Risks for severe COVID infection were much greater in those who had not been consistently active. The Figure indicates about a 20-fold increase in incidence of severe illness compared to those who had been exercising at least 150 minutes a week. Severe illness required hospitalization for 0.4% of those who had been consistently inactive. In contrast, severe illness affected only 0.02% of those who had been consistently active.

Results from other clinical studies have been similar. In addition, subjects who were older, female, belonging to minority racial or ethnic groups, were obese or had chronic health conditions were more likely to be inactive. Severity of COVID illness has always been less in subjects who consistently exercised.

Consistently, frequency and intensity of exercise are the most remarkable features discriminating between subjects at high and low risk of COVID-19 infection and severity of illness.

Energy for Action

Anything that’s alive needs energy for chemical reactions, growth, and motion. Human muscles convert chemical energy into movement with about 50% efficiency. Energy is lost in heat and CO2. Remarkably efficient considering normal body temperature is less than 100^o F. A cylinder in a car engine burns fuel at 2,800^o F. The result is about 10% fuel efficiency.

The breakdown of food releases energy. That energy is captured in smaller chemical forms and carried to places where energy is needed. Or places where it can be stored as carbohydrate or fat.

Protein Structure and Function

The chemical machines guiding action consist mostly of proteins bonded together. Called enzymes. Each enzyme acts on specific substances to break chemical bonds, rearrange them or make new bonds. More than 20,000 enzymes in a typical human cell.

The structure of proteins is more complex than a simple string of molecules. Strings are folded into 3-dimensional shapes. The folded proteins must be stable for enzymes to function correctly.

Protein folding depends on temperature and chemicals surrounding the structure. It also depends on acid-base conditions. More acidic solutions have more hydrogen positive molecules than basic solutions with more negatively charged molecules. The measure of how acidic or how basic is called pH. Which means “potential of hydrogen.” It’s a measure of how much free hydrogen carrying a positive charge is in solution.

Optimal function depends on proteins that are fully folded. Extremes of higher or lower acid-base conditions disable normal protein function.

The range of pH goes from 0 to 14. Completely acid at 0, neutral at 7 and completely alkaline at 14.

Virus Structure and Function

A virus is a core of proteins containing genetic material surrounded by a protein capsule. It can’t capture or produce energy, move or grow. It’s not alive. It can survive and multiply only by entering living cells and capturing essential materials.

Optimal function of proteins in virus particles occurs in more acidic solutions at lower pH than optimal function of proteins in host protective enzymes.

Innate Physical and Chemical Protection

Surface skin and inside membranes keep almost everything from getting inside. Cells are arranged side by side, over and under one another. Each fastened tightly to those next to it. Injury can rip them apart. Physical force, and toxic chemicals can cause injury and some places leak enough to let things inside.

Just getting inside skin and membranes is enough for poisons and toxic chemicals to cause harm. Results of those injuries have to be taken care of.

Also, getting inside is enough for infection by bacteria, fungi, parasites and worms. They start growing and spreading. They’re alive and have to be caught and killed.

Viruses that get inside into blood and tissue juice, still can’t grow and spread. Infection is not established. They need essential materials from inside cells. Floating in fluid outside cells, they can be captured and destroyed.

Cell membranes are strong and protective. Proteins join cells together. Very few chemicals just diffuse through. Proteins control movement of chemicals in and out of the cell.

Blood, tissue and most cells are slightly alkaline. Even slight change to acid has dramatic effects. Cell protection and normal cell function depend on alkaline pH. Acidic pH causes protein structure to unfold and lose normal function. ⁴

Virus infection of tissue cells depends on fusing with the cell membrane. Optimal pH for protein in a virus envelope is more acidic than protein in the host cell membrane. Alkalinity provides protection from attachment, penetration and entry of virus into cells. Once inside, the virus takes over cellular proteins that enable virus multiplication, growth and eventual destruction of the host cell.

Natural resistance to virus infection depends on maintaining a protective acid-base balance. Slightly alkaline. Host cellular protective proteins with optimal pH higher than optimal pH for invading virus particles.

Innate Immune Protection

Cells and tissue fluid contain protein receptors that recognize patterns and structures that can cause injury. Some receptors are attached to special immune cells and some are inside normal functioning cells.

These receptors bind to anything that is not natural to the tissue. Especially dangerous foreign molecular structures. They begin the process of destroying them and activating other local immune cells.

They also signal systemic activity to bring in additional protection. Some things are captured and cleared with little local effect. More damaging substances bring out full inflammatory responses.

Cellular action that creates additional inflammatory cells and substances requires energy. That energy comes from metabolism that doesn’t require oxygen. Sugar is broken down into smaller molecules releasing energy. What’s left is lactic acid. Some of the lactic acid combines with bicarbonate and some washes away in the circulation. Either way, inflammation changes the acid-base balance in tissue and blood. More acid and less bicarbonate.

Protection from COVID Infection

The virus causing COVID circulates through droplets in the air spread by coughing or sneezing. It enters through mouth, nose or eyes and spreads to the back of the throat. From there, it can reach the lungs. Also, it can be swallowed down to the stomach.

Virus particles stay on the surface until breathed out or washed away. Kept out by physical and chemical barriers of the upper airway.

Protection of Nose and Throat

Captured by cilia, virus particles are bathed in secretions. Normal acid-base balance of saliva and nasal secretions varies from pH 6 to 8. ⁵

COVID infection of nose and throat occurs when tissue fluids become acid. Acidic pH causes cell protein structure to unfold and lose normal protective function. Virus particles fuse with protein on the cell membrane, enter the cell and take over essential protein structures. Infection is completed.

Hydration affects acid-base balance of saliva and nasal secretions. Even mild dehydration reduces rates of flow and produces acid secretions. Increased rates of flow produce secretions that are less acid and more alkaline. ⁶

Drinking 6 to 8 glasses of fluid a day is commonly recommended for good health. Especially with strenuous physical activity in hot or humid weather. Even more at high altitude.

Chronic, mild dehydration is a risk factor for COVID infection of nose and throat. Especially when associated with co-morbid conditions that increase risk for severe illness from COVID. Certainly, fluid intake should be at least 6 glasses a day if pH of saliva is less than 6.0. Increasing intake of fluid could well produce secretions of saliva that are less acid and reduce risk of COVID infection. ⁷

Rates of flow also depend on general acid-base balance in circulating blood and local tissue fluid. Any acid-base shift that reduces pH in tissue fluid reduces pH of saliva and nasal secretions.

Protection of Lungs

COVID virus moves down the airway from mouth, nose and throat to the lungs. Virus particles released from cells in the nose and throat are released into the air in droplets.

Air inhaled into the lungs fills small spaces called “alveoli.” From there, CO2 moves from blood into the air that’s exhaled. Along with droplets carrying virus particles. Most droplets carried in are carried on out. But some droplets with virus join with fluid lining the air spaces.

Dissolved in tissue fluid, CO2 is a weak acid. Released into air, it leaves behind a more basic solution. Alkaline fluid with pH greater than 6.0 effectively excludes entry of virus particles.

The acid-base balance of airway lining fluid can be measured. Droplets of fluid are caught up in exhaled air. Collected and condensed, the pH has been measured. ⁸

Samples of Airway Lining Fluid were collected from 404 healthy young adults living around the University of Virginia. Individuals were excluded if they had any acute or chronic condition of any system. Median pH was 8.0. Fewer than 10% of these normal subjects had pH less than 7.4. No effect of age or sex.

Release of CO2 from fluid lining air spaces in the lungs decreases acidity and increases alkalinity. Lower levels of bicarbonate and lesser loss of CO2 increase the acidity of the fluid. Increased amounts of other acids stay in the fluid and decrease the pH.

Less than 10 percent of the total quantity of carbon dioxide carried in the blood is eliminated during passage through the lungs. Slowing the flow of air out of the air spaces decreases the amount of CO2 removed. Increased concentration of CO2 in the air slows innate action to maintain and repair cells lining the air spaces.

The combination of decreased bicarbonate, increased organic acids and decreased elimination of CO2 quickly lowers the pH. Virus particles become able to fuse with cell membranes and pass into the interior. Infection is complete.

Heart Rate Response to Injury and Infection

The innate immune system includes increasing heart rate. Protein receptors that recognize danger react and send out signals for an inflammatory response. Including signals that stimulate the brain to increase heart rate. Short-term acute or long-term chronic. Complete recovery from acute injury or infection returns all systems to normal. ^{9  10}

As a result, infection by COVID virus causes an increase in resting heart rate. Before the host has any symptoms of infection. Even before virus can be detected using a nasal swab. An alert triggered by increased heart rate forms an opportunity to isolate the newly infected host from transmitting virus to others. ¹¹

Chronic Inflammation

Injury or infection anywhere that persists keeps resting heart rate higher than normal. Sympathetic nerves from the spinal cord act to increase heart rate. The vagus nerve, running through the neck and chest acts to slow the heart. ¹²

Stimulation of the vagus nerve also acts to increase secretion of saliva. Increasing not only the amount of fluid secreted but also the amount of enzymes involved in digestion. Also, the amount of immune enzymes involved in defense of salivary cells.

The defense enzymes are mostly basic proteins which increase the pH of saliva. The normal pH of saliva is about 7.0 which is neutral. At peak flow, optimum pH is close to 8.0. Much higher than optimum pH for envelope proteins of COVID viruses.  

The effect of chronic inflammation anywhere enough to increase resting heart rate is to increase acidity of saliva. Decrease in pH of saliva below 6.0 increases the risk of COVID infection in the nose and throat.

Chronic inflammation also affects acid-base transport everywhere. Local action of immune cells without oxygen increases acidity of local tissues. Local tissue acidity decreases bicarbonate and increases organic acids in circulating blood. Acid-base transport in the kidneys adjusts the pH of circulating blood by excreting acid urine. Decrease in pH of urine below 6.0 increases the risk of COVID infection in the lungs.

Exercise Training for Preventing and Controlling COVID-19 Infection

Many clinical studies have shown that moderate intensity aerobic training strengthens the immune system. It’s safe and it works! Even one 10-minute session activates neural, endocrine, cellular, and humoral defense against infection. ^{13  14  15}

Endurance training most often used is walking, running, cycling or swimming. Intensity that increases heart rate to about 70% between resting rate and maximal heart rate. Duration between 20 and 60 minutes. Frequency 3 to 5 sessions a week. That’s a total of moderate exercise for about 150 minutes in each week.

Intensity and duration for protection of most healthy people is an average heart rate between 120 and 160 bpm for at least 20 minutes. About the most that anyone can do comfortably 3 to 5 sessions a week. Able to talk but only a few words in short sentences between breaths.

So far, the best proven protective effect of regular exercise has been a lesser number of sick days. Fewer than half as many sick days in adults with exercise training over a period of 8 to 15 weeks.

The best laboratory indicator of exercise protection has been low plasma level of c-reactive protein. Levels in normal healthy adults are <3 mg/L and safest levels are <1 mg/L. CRP is produced by the liver in response to early indicators of infection and inflammation. Its level rises rapidly to a peak in about 48 hours after onset of disease. Its concentration decreases when inflammation lessens and healing begins. ¹⁶

COVID-19 infection causes average levels of 20 to 50 mg/L. Patients with severe COVID-19 requiring hospitalization had levels more than 2-fold higher than those with mild disease. Patients who died from COVID-19 had about 10-fold higher levels of CRP than the recovered patients.

High levels of CRP in healthy adults have been measured before and after moderate exercise training. A clinical study of about 200 parents and 400 adults in their families was done in USA and Europe. About 25% of them had levels of CRP greater than 3 mg/L. Those with high levels of CRP also tended to have abnormal clinical features and other abnormal laboratory values. Many similar to individuals with hypertension, obesity, diabetes and abnormal blood lipid levels. ¹⁷

An exercise training program on cycle ergometers was conducted 3 times a week for 20 weeks. Increase in heart rate during exercise started at 55% of maximum possible during the first week and increased to 75% for the average during the last week. Maximum energy capacity increased about 18%.

Reductions in CRP only occurred in individuals with levels at baseline greater than 3 mg/L. There were no consistent associations with changes in other clinical features or laboratory values.

High levels of CRP certainly indicate high risk for severe COVID-19 illness. Whether already infected or exposed to infection. Also, moderate exercise training reduces levels of CRP in patients with comorbid conditions.

Especially evident in patients with common conditions like hypertension, lung disease, diabetes and obesity. The target of exercise training always is reducing severity of comorbid conditions.

Physical fitness also affects levels of CRP and indicators of acid-base balance. Results of exercise tests were compared with blood levels measured for 2,714 healthy young adults in the US National Health and Nutrition Examination Survey (1999-2004). Lower levels of physical fitness were associated with higher levels of acid in the blood. Also, associated with higher levels of CRP. Low levels of physical fitness had chronic inflammation along with an excess of acid in tissue and blood. ^{18  19  20}

Apparently, physical activity including less than 15 to 30 minutes a day of moderate exercise causes the same risk to health and life as smoking tobacco.

Measuring Your Good Health

Good health improves natural protection from infection. Including infection by Coronovirus-2 and variants. The strength of health-supporting protection can be evaluated by physical and laboratory tests.

Vaccines that are available provide very little protection against Coronavirus infection. They do reduce the severity of illness. At least for several months. But they do not protect against illness of all variants that continue to appear. Variants that will continue to appear as long as some people are poorly protected.

Also, protection against severity reduces but does not completely protect against transmitting infection to others.

Many people have natural features and strength of good health that reduce risk from infection. As well as risk of severe illness. Many others are in great danger of infection and illness. Almost everybody can improve their health enough to decrease risk of infection and severe illness.

Results of laboratory tests combined with personal information can be used to determine natural features and strength of good health protecting against infection and illness.

We will assess individual features of health to make recommendations for increasing personal safety from infection and illness.

References

1. Adams ML, Katz DL, Grandpre J. Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States. Emerging Infectious Diseases. 2020;26(8):1831-1833. doi:10.3201/eid2608.200679 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7392427/pdf/20-0679.pdf

2. Grijalva CG, Rolfes MA, Zhu Y, et al. Transmission of SARS-COV-2 Infections in Households — Tennessee and Wisconsin, April–September 2020. MMWR Morb Mortal Wkly Rep 2020;69:1631–1634. doi:10.15585/mmwr.mm6944e1
https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6944e1-H.pdf

3. Sallis R, Young DR, Tartof SY, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. British Journal of Sports Medicine 2021;55:1099-1105
 https://bjsm.bmj.com/content/bjsports/55/19/1099.full.pdf

4.  Zhou T, Tsybovsky Y, Kwong PD. A pH-dependent switch mediates conformational masking of SARS-CoV-2 spike. bioRxiv. 2020, Jul 4.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337388.1/

5. Baghizadeh Fini M. (2020). Oral saliva and COVID-19. Oral oncology, 108, 104821. doi:10.1016/j.oraloncology.2020.104821

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250788/pdf/main.pdf

6. Stookey JD, Allu PKR, et al. Hypotheses about sub-optimal hydration in the weeks before coronavirus disease (COVID-19) as a risk factor for dying from COVID-19. Med Hypotheses. 2020;144:110237. doi:10.1016/j.mehy.2020.110237

https://www.sciencedirect.com/science/article/pii/S0306987720319460

7. Farshidfar N, Hamedani S. Hyposalivation as a potential risk for SARS-CoV-2 infection: Inhibitory role of saliva. Oral Dis. 2021;27 Suppl 3:750-751. doi:10.1111/odi.13375

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267261/pdf/ODI-9999-na.pdf

8.  Paget-Brown AO, Ngamtrakulpanit L, Smith A, et al. Normative data for pH of exhaled breath condensate. Chest. 2006;129(2):426-430. doi:10.1378/chest.129.2.426

https://www.researchgate.net/publication/7297871_Normative_Data_for_pH_of_Exhaled_Breath_Condensate

9. Whelton SP, Narla V, Blaha MJ, et al. Association between resting heart rate and inflammatory biomarkers (high-sensitivity C-reactive protein, interleukin-6, and fibrinogen) (from the Multi-Ethnic Study of Atherosclerosis). Am J Cardiol. 2014;113(4):644-649. doi:10.1016/j.amjcard.2013.11.009

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280910/pdf/nihms651029.pdf

10. Sajadieh A, Nielsen OW, Rasmussen V, et al. Increased heart rate and reduced heart-rate variability are associated with subclinical inflammation in middle-aged and elderly subjects with no apparent heart disease. Eur Heart J. 2004;25(5):363-370. doi:10.1016/j.ehj.2003.12.003

https://academic.oup.com/eurheartj/article/25/5/363/485118

11. Hirten RP, Danieletto M, Tomalin L, et al. Use of Physiological Data From a Wearable Device to Identify SARS-CoV-2 Infection and Symptoms and Predict COVID-19 Diagnosis: Observational Study. J Med Internet Res. 2021 Feb 22;23(2):e26107. doi:10.2196/26107

https://www.jmir.org/2021/2/e26107/PDF

12. Farwell WR, Taylor EN. Serum anion gap, bicarbonate and biomarkers of inflammation in healthy individuals in a national survey. CMAJ. 2010;182(2):137-141. doi:10.1503/cmaj.090329

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817320/pdf/1820137.pdf

13. Scudiero O, Lombardo B, Brancaccio M, et al. Exercise, Immune System, Nutrition, Respiratory and Cardiovascular Diseases during COVID-19: A Complex Combination. Int J Environ Res Public Health. 2021;18(3):904. Published 2021 Jan 21. doi:10.3390/ijerph18030904

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7908487/pdf/ijerph-18-00904.pdf

14. Hilde Grindvik Nielsen (May 15th 2013). Exercise and Immunity, Current Issues in Sports and Exercise Medicine, Michael Hamlin, Nick Draper and Yaso Kathiravel, IntechOpen, DOI: 10.5772/54681. Available from:

https://www.intechopen.com/chapters/44616

15. Stewart LK, Flynn MG, Campbell WW, Talbert E, et al. The influence of exercise training on inflammatory cytokines and C-reactive protein. Med Sci Sports Exerc. 2007;39(10):1714-1719. doi:10.1249/mss.0b013e31811ece1c

https://www.researchgate.net/publication/5936431_The_Influence_of_Exercise_Training_on_Inflammatory_Cytokines_and_C-Reactive_Protein

16. Martins RA, Veríssimo MT, et al. Effects of aerobic and strength-based training on metabolic health indicators in older adults. Lipids Health Dis. 2010;9:76. Published 2010 Jul 22. doi:10.1186/1476-511X-9-76

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2912308/pdf/1476-511X-9-76.pdf

17. Lakka TA, Lakka HM, Rankinen T, et al. Effect of exercise training on plasma levels of C-reactive protein in healthy adults: the HERITAGE Family Study. Eur Heart J. 2005;26(19):2018-2025. doi:10.1093/eurheartj/ehi394

https://academic.oup.com/eurheartj/article/26/19/2018/532081

18. Abramowitz MK, Hostetter TH, Melamed ML. Lower serum bicarbonate and a higher anion gap are associated with lower cardiorespiratory fitness in young adults. Kidney Int. 2012;81(10):1033-1042. doi:10.1038/ki.2011.479

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340439/pdf/nihms346734.pdf

19.  Aeschbacher S, Schoen T, Dörig L, et al. Heart rate, heart rate variability and inflammatory biomarkers among young and healthy adults. Ann Med. 2017;49(1):32-41. doi:10.1080/07853890.2016.1226512

https://www.tandfonline.com/doi/pdf/10.1080/07853890.2016.1226512?needAccess=true

20. Farwell WR, Taylor EN. Serum anion gap, bicarbonate and biomarkers of inflammation in healthy individuals in a national survey. CMAJ. 2010;182(2):137-141. doi:10.1503/cmaj.090329

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2817320/pdf/1820137.pdf

Good health skills are learned. Practice, little by little, brings Recovery from Type 2 Diabetes. Let’s get started.Diabetes Action Plan For 2020.

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To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

History Of Reversal, Remission And Recovery From Overeating

Reversal of diabetes depends on consuming less sugar and fat than is used, stored or excreted. Weight loss is the most obvious physical sign of reversal. A large increase in physical activity may decrease amount of overeating without change in body weight but it seldom creates reversal of diabetes.

Remission is success in reducing levels of sugar in blood without surgery or diabetes medication below measurements diagnostic of type 2 diabetes. It does not mean levels of sugar are in the normal range. Most of all, it does not mean levels of insulin in blood are in the normal range. Consequently, some people with normal levels of sugar and fat have high levels of insulin in their blood.

Success reaching remission does not mean successful return to normal health. Remission does not remove the danger of insulin and other humoral substances causing hypertension, renal disease and abnormal cholesterol metabolism.

Prolonged remission is 5 years or more of normal blood sugar levels without using diabetes medication.

Recovery from type 2 diabetes means restoring levels of sugar, fat and insulin to normal in the blood. It also indicates reducing dangers of chronic illness and disability.

Remission without full recovery to normal still carries increased risk of heart disease, stroke, cancer, mental illness and dementia.

What’s the Problem? Why is Recovery so Hard? History of recovery from type 2 diabetes and recovery from obesity has been very negative.

Long-term Remission in ordinary adults with type 2 diabetes occurs very seldom. Most clinical studies of reversal and remission have enrolled special patients who are well motivated to improve their health. Unfortunately, most patients with type 2 diabetes do not even try to improve their health. Also, clinical studies of remission seldom report full recovery to normal levels of sugar, fat and insulin in blood.

A study in California about 10 years ago, followed the health of more than 100,000 men and women with type 2 diabetes. All were treated in high quality healthcare clinics and received standard care. After 7 years of follow-up, their laboratory values were studied.

Complete remission was defined as consecutive values for HbA1c under 5.7% over a period of at least 12 months without diabetes medications. The incidence of any remission was 1.5% and the incidence of complete remission was less than 0.01%

Long-term Reversal and Remission in the Look AHEAD Study (Action for Health in Diabetes) occurred only in patients who lost more than -10% body weight. This study recruited 5,145 obese men and women with type 2 diabetes. Those in the intervention group were prescribed food intake of 1,200 to 1,800 kcal/day (depending on body weight) and exercise that was gradually increased up to 175 min/week.

Patterns of weight loss and reduction of HbA1c were assessed at baseline, again after 1 year of intensive treatment and finally after 4 years of treatment. All participants had their greatest weight loss and greatest reductions in HbA1c measured 1 year after beginning treatment. Larger weight losses were associated with greater reductions in HbA1c.

As shown in the Figures, those who lost more than -10% of body weight were most successful in maintaining reversal of HbA1c. This happened in about 18% of the intensively treated group.

Complete remission was defined as HbA1c under 6.5%. Complete remission for 4 years occurred in 3.5% of those intensively treated.

Patterns of early weight loss >-10% show greatest likelihood of long-term remission. Weight loss >-10% in the first 12 months makes it twice as likely complete remission will last at least 5 years.

Successful weight loss maintenance has been analyzed in the National Weight Control Registry. Those most successful follow several health practices. They monitor and limit what they eat, weigh themselves frequently and exercise regularly at least 400 minutes a week. The most common exercise was walking briskly every day for about an hour.

Amount of energy spent on exercise by men was about 3,000 kcal/week or about 500 kcal/day. Women spent about 2,500 kcal/week or about 400 kcal/day.

Body composition with complete recovery from type 2 diabetes includes:
•% Body fat (BF) of 25% for men and 35% for women
•Maximum waist circumference of 35 in for men and 32 in for women
•% Muscle mass (MM) of 35% for men and 30% for women

Indicators for successful recovery from type 2 diabetes include:
•Weight reduction >-10% in the first 12 months
•Exercise of moderate intensity about 60 minutes every day
•Body composition (%BF|%MM) 25|35 for men and 35|30 for women

Action Plan For Recovery From Type 2 Diabetes

Awareness about benefits of good health and costs of type 2 diabetes is important. If you’re not sure about costs and benefits, check our website at www.diabetesriskalert.com.

Motivation for reversal, remission and recovery can be expressed, measured and checked. The first step is to write down what you want, why you want it, what you intend to do to make it happen and when you’ll do it. Until you think it through and write it down, it’s not going to happen.

Priority in your life for Recovery from type 2 diabetes is what can be measured right now. It must be the first, second or third on your list.

Think through your situation now and figure out both the opportunities and the barriers working for or against your ambition. Most important is to think about the rewards and pleasure good health will bring you. Write that down.

Checking strength of your motivation to get started is assessing your progress in a week or two. If you just say you’ll do something when you’re ready, probably nothing will happen. If I’m wrong, I’ll be really pleased when you call me in a year and tell me how you achieved complete recovery without following a written action plan.

Notes and Records are basic to this action plan. Type or write everything into a file or a notebook. Type text into a note-keeping app like Google Keep or write notes in the pages of a journal.

Information to Record:
•Measurements: Basal HR, FBG, Body Wt, max WC, Insulin injected, Minutes of exercise/week, Hours of sleep, 6-min Walk Test, Strength tests
•Objectives and descriptors: Exercise, Food and drink, Sleep patterns, Stress management, Relaxation, Recreation and Entertainment
•Action plan: for daily routine and deliberate efforts to improve
•Results: Day-by-day and Week-by-week
•Summary: Week-by-week Analysis with Revisions according to Results

Exercise is essential. It is the resource to:
•Provide satisfaction and pleasure

•Increase energy storage potential in muscle, liver and fat tissue

•Build and maintain muscle mass and strength during weight reduction

Neurocognitive function is the basis for automatic responses that initiate plans and practices. Almost every action, reaction, mental response and emotion is governed by memory of lifelong experiences. Conscious plans, actions and responses govern only a small proportion of behavior.

Nonconscious automatic function can be reprogrammed. It happens little by little, day by day with conscious actions in specific situations. Highly desired results and positive outcomes adjust and retrain automatic responses.

Retraining requires months of repetition using conscious effort to transform desired actions and reactions into nonconscious automatic practice.

Gene expression is the metabolic and mechanical output of cellular function. It’s what’s inherited and what’s been learned. It’s even what parents and grandparents inherited and learned to do.

Cellular function is shaped further by prenatal environment, childhood development, adult actions and lifelong experience. Every automatic function that is gradually reprogrammed alters gene expression.

Improvements in good health practice alter gene expression. What we learn to practice automatically is passed to our children by gene expression as well as by example and instruction.

Getting Started
Type or write your Objective
• Make it Consistent with SMART criteria
(Specific, Measurable, Achievable, Relevant, Time-defined)

•Give it a High Priority
(In top 3 of personal concerns and desires)
•Find a Critical Measurement that indicates progress

Type or write one thing you will do several times next week. Choose something that you like to do and will advance you towards your objective.

Check each week whether you did what you predicted. Make it harder for the following week if you did it. Make it easier if you didn’t.

Make an investment
Pay someone to coach you, sign up for a class, join a health club, buy some equipment.

Regular routine review and revision
•Find out what you can do for sure
•Find out what you can reasonably expect to achieve

Set an automatic reminder at a convenient time each week to review, analyze and revise. For example, set a specific time each day for exercise.

Check at this time next week to see if you have adopted any of this Action Plan for 2020.

Summary

Short term positive results are essential to support strong motivation.

Exercise improves metabolism, strength and mental health.

Weight reduction is the best indicator of progress towards recovery.

Body Composition determines capacity for improvement.

Plan something NOW that you can check for progress in a week.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

Let us help you reverse diabetes and enjoy the rewards of good health!

To learn more about programs Herd Healthcare offers, our website is:
www.herdhealthcare.com

New Year’s Resolutions For 2020

A public opinion survey in Washington, DC shows that about a third of those asked made New Year’s Resolutions for 2020. About half of them made just one resolution and the others made several.

More than half making resolutions intend to improve their health. By some combination of eating better, losing weight and exercising more. Others intend to quit smoking, reduce alcohol and sleep better. Resolutions not related to health involved finances, social relations, skills, hobbies and sports.

Those not making New Year’s Resolutions either said they just don’t care, resolutions don’t work for them or they’re too busy.

Among those who made resolutions for 2019, about half said they succeeded. Those who failed said they simply lost motivation, were too busy or didn’t get the help they needed.

That means fewer than 10% every year make resolutions and succeed in improving their health. Most of us don’t even resolve to try!

Resolve To Enjoy The Rewards Of Good Health

Exercise improves enjoyment of life. The physical effects of exercise are well known. Studies have proven exercise brings improvements in strength, endurance and levels of performance. Exercise helps reduce weight, improve body composition, prevent chronic illness and prolong life. All worthwhile, but not why we exercise. The reason for regular exercise is it makes us feel good.

Exercise also prevents depression. Even small amounts of exercise improves mental health. As little as 15 minutes of running every day or 1 hour of brisk walking greatly decreases risk of depression.

Other benefits of exercise include better thinking, better sleep, more energy and less fatigue. Moderate intensity exercise training improves insulin sensitivity, quality of life, and depression status in T2DM patients.

A single bout of exercise increases insulin sensitivity for 2 to 3 days. The effects of a 12 week aerobic exercise training were studied in 13 men and women with T2DM. Their average age was 48 years.

All participated in a 12 week program. They were supervised in aerobic exercise of moderate intensity for 30 minutes three times each week. Effects on insulin sensitivity, quality of life, and depression status were studied over time during exercise training,

Insulin sensitivity increased gradually every 4 weeks and the levels of glucose decreased during oral glucose tolerance testing. As the duration of exercise training increased, quality of life and depression status improved significantly.

Weight reduction also increases enjoyment of life and improves mental health. Amount of improvement generally follows amount of weight reduction. Overweight and obesity affect Quality of Life. Success in reducing body weight improves physical health, emotional well-being, and psychosocial functioning. The relation between benefits and amount of weight reduction was studied in 161 men and women in the US.

Participants were recruited from a primary care clinic or a subspecialty endocrinology clinic. They were treated in regular meetings for 12 months with a registered dietitian who gave them individualized diets and exercise recommendations.

During the 12 month program, participants lost 17.6% of their weight. A total of 25 participants (15.5%) lost 10% of their weight, 39 (24.2%) lost 15%, 38 (23.6%) lost 20%, and 59 (36.6%) lost 20% or more.

All participants completed 31-item questionnaires in 5 areas: Physical Function (11 items), Self-Esteem (7 items), Sexual Function (4 items), Public Function (5 items), and Work Function (4 items). As shown in the Figure, changes in Quality of Life functions were strongly related to reductions in body weight.

Intermittent Metabolic Switching And Mental Health

Metabolic switching with exercise and prolonged overnight hours without eating greatly enhances mood and mental health. The switch occurs when skeletal muscle and other organs use up their stores of sugar and begin using stores of fat.

In early times of evolution, food was available during the day for only short periods of time. Sugar stored in skeletal muscles and liver was quickly available for 6 or 8 hours. When metabolism switched back to using fat, metabolic and hormonal factors triggered cellular mechanisms for growth and repair.

Feelings of well-being and mild euphoria also are increased by switching metabolism from sugar to fat. In addition, metabolic switching brings improvement in cognition, anxiety and mental health.

In modern times, food is consumed all day long, supplying sugar in excess of energy requirements for metabolism and physical work. In type 2 diabetes, levels of sugar in the blood never fall enough to switch back and forth between sugar and fat.

Damage to brain health results from a chronic oversupply of sugar. The result is increased risk of neurological disorders including neuralgia and dementia.

Summary

Exercise improves enjoyment of life and prevents depression.

Weight reduction also increases enjoyment of life and improves mental health.

Metabolic switching with exercise and prolonged overnight hours without eating greatly enhances mood and mental health.

Feelings of well-being and mild euphoria also are increased by daily switching metabolism from sugar to fat.

Resolve in 2020 to enjoy the rewards of good health.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

You’ll be amazed how good you feel!

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Visit our website: www.herdhealthcare.com, or call us at 713-669-0271 to get started on an action plan for good health.

How Things Work

Everything in your life up to now is stored in your brain. Natural Intelligence has sorted out what presented, what happened and how you liked it. After a few thousand times, similar events were connected into automatic responses. By now, you don’t have to think about much any more of what goes on every day. That’s Automatic Intelligence at work.

 
Airplanes are built the same way. Except Automatic Intelligence is programmed all at once and built right in the same for every unit.

And What To Do About It

You can take control any time you want. Human Intelligence has the marvelous capacity to adjust what you do. You duck if you have to and take another path when you need to. You can control just about anything because you know from experience how everything works.

Airplanes have Artificial Intelligence to take care of special situations. If that’s not enough, pilots take care of very unusual situations according to Manuals of Operation.

Unfortunately, we’ve learned what happens when the pilot can’t find the right page in the Manual of Operations. Can’t just fly a big airplane now. Nobody knows everything about what to do.

Human Intelligence

Special feature of Human Intelligence is that it can be revised. We don’t have to shut it down or issue a Car Recall. You don’t have to ground a whole fleet of planes. It’s special for one brain and unique for past experience and future expectations.

Here’s how revision works. Executive function sends down a command. That’s executed and the results evaluated. Repeat situation with another command, also evaluated.

The new response is not established yet. Takes more that one or two trials. Revision can relapse if the original response gets another chance. Executive function has to take care and keep repeating the new command before it finally is adopted.

Eventually, automatic subconscious cognition is revised according to repeated successful trials. All this under direction from conscious executive function.

Conscious cognition is aware of automatic intelligence. You know what your first response will be with something new. Your gut reaction tells you that you’re not going to like it. But you do it anyway. Your executive function overrules Automatic Intelligence.

Executive function gradually revises Automatic Intelligence. As you think of benefits and accomplishments, your subconscious cognition records it as pleasure. The outcome depends on pleasure/pain of each event. Pleasure must come from satisfaction implementing executive action.

Practical Application

Decision for action comes first.

The most obvious indication for action is Overweight/Obese. A rough guide is 2 to 2.5 lb/inch of standing height. Anyone 5 ft tall should weigh no more than 125 lb and anyone over 6 ft tall should weigh no more than 200 lb plus 6 lb/inch over 200.
 
A more reliable indicator is maximum waist circumference at the level of the umbilicus. For men, the maximum girth should be no more than 37 inches and women should have no more than 32 inches.

You’ll first see change in belt length.

But your belt resting on the top of your pelvic bones on each side is lower than the level of Maximum Waist Circumference. It can be different by 4 or even 5 inches.

Measure your girth at the umbilicus with a piece of string about 4 feet long. Tie knots at both ends where the ends cross over around your waist. Then measure the distance between knots. That’s Maximum Waist Circumference.

Implementation is your action to assess health practice as a baseline for improvement. First, you must test your Executive Function. You can say what you’d like to do but you really don’t know what you will do.

Keeping records is the first test of your Executive Function. Keep Day-by-Day records of Body Weight or Fasting Blood Sugar or Pedometer steps or time spent exercising without stopping. You must determine the ability to exercise this executive function at least briefly at least 5 days a week.

Submit Telehealth Reports from your mobile unit last thing at night or first thing the next morning. Then review results at the end of each week.

If keeping the Health Journal at least 5 days in the week was easy, measure and record more of your health practice:
• measure and record several things each day.
• add descriptions or photographs of one or more meals on one or more days.

If unsuccessful reporting at least 5 days of health practice records:
• maybe you just forgot. Install alarm reminders on your smartphone.
• make it easier. Submit records with name and date, nothing more.
• consider unanticipated barriers that can be fixed.
• try shifting priorities for executive actions.
• ask someone to remind you.

Note that this is an important step. If you don’t think about your health practice every day, thinking about it once a week won’t be enough to accomplish what you’re trying to do.

Enjoy Your Accomplishments

Real time walking for 30 minutes. Consciously review the experience of your walk in the context of pleasure in how you are progressing towards hiking in Big Bend National Park with your grandchildren.

Review with pleasure how walking gets easier and easier as you gradually increase time and distance of your walk.

Note improved mental capacity along with better performance and greater productivity. Fewer days of illness and incapacity.

Sleep better as your health improves.

Save money with less medication, fewer physician visits and less loss of time.

Enjoy every meal and think positive. Think about the pleasure coming as you
balance your metabolism and reduce your weight. People will keep telling you how good you look!

What you hold in your mind is what your subconscious cognition interprets as pain or pleasure from your good health practice.

If you dwell on thoughts of eating more until you’re completely full, your subconscious interprets the outcome as pain. If you take satisfaction in healthy eating, your brain interprets pleasure.

We are pleased to share our blog articles with you, and we are always interested to hear from our readers. Our website address is: www.herdhealthcare.com

Contact us and we’ll help you make it happen!

January, 2019

Janus, the Roman god of doorways, has two faces. He looks back at December when we celebrated and ahead to February when we’ll fix everything up again.

Every January, about half the people all over the country, make New Year’s Resolutions. So far reports from New York tell us most popular for 2019 is “Exercise More” followed closely by “Eat Healthier” and “Lose Weight.” Lots of people are resolving to do all three.

Half the people polled said they didn’t make any resolutions last year. Another third said they’re still keeping some or all of their resolutions. The others said they just didn’t succeed in keeping any of them.

The record for success sticking to Resolutions is not good. By the end of 2 years, 20% report they have faithfully kept their resolutions. For those who fail, it happens fairly quickly. Follow-up polls by YouGov in 2018 showed that 50% of those who failed, did so within 3 months.

Intentional Weight Loss

People do keep trying! Every year in this country, about half the adults 40 to 60 years of age try to lose weight. The Figure shows that 44% of men and 60% of women in that age group attempted to lose weight.

More than two-thirds of adults in this country carry unhealthy weight, more than about 2.5 lb per inch of standing height. More than one-third are obese, weighing more than 3.5 lb per inch. Apparently, men and women who are obese are the ones most likely to attempt losing weight.

The Figure shows that 67% of all who are obese attempted to lose weight compared to 49% of those overweight. Within each category, more women than men tried to lose weight. In any year, 71% of obese women tried to lose weight compared to 62% of obese men.

It Is Possible To Lose Weight

It really is possible to lose weight. The National Health and Nutrition Examination Survey in the U.S. reported results from 2500 men and women who tried to lose weight. Results showed 41% lost more than -5% of their weight and 21% lost more than -10%. 

Those who were successful reported:

1. eating less fat
2. exercising more
3. joining commercial weight loss programs

They did not have any greater success using liquid diets, nonprescription diet pills or popular diets.

Unfortunately, many people who lost weight initially, gained back about 10 lb in body weight following their success in weight loss. Most of the weight was gained back in the first 6 months after their program ended.

How To Make Resolve A Reality

Almost any program will work for somebody. But there is no program that works for everybody. For each individual, we just have to create the program that works best.

So Let’s Get Started!

You’re the one who knows what will work for you. Tell me what you know for sure you can do and I will help you get started. Send an email to jakaherd@gmail.com.

My end is secured for Protected Health Information (PHI). I’ll send you instructions how we can connect using Google Hangouts. Then we’ll have security with end-to-end encryption for PHI.

Perspective

If we keep doing something we know we can do, we’ll get better at it. If we keep trying a little harder, we’ll get really good at it.

Anything new we try to do, eventually we’ll figure it out and it’ll become easy.

Remember, it took your whole life to get where you are. That’s what your brain expects and it makes you feel it’s going to be hard to change.

To get where you want to be, we’ll teach your brain some new tricks.                                                                                                                                                                                                                                        

Who cares?

You care . . . . . and I care.

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