Your resiliency report card

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| By Dr. Ronald Hoffman

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Your resiliency report card

Resiliency has taken on profound relevance these days as COVID-19 continues to loom. “Co-morbidities” have become a buzzword for the immune system Achilles’ heels that render people exposed to the virus more likely to have stormy courses or die.

It’s been proposed that we have “twin epidemics”, or, alternatively, a “pandemic within a pandemic”. That means that the same vulnerabilities which place us at higher risk of premature death from heart disease, stroke, cancer, and other chronic degenerative diseases also render us more susceptible to the Coronavirus.

So, here’s a short questionnaire that assesses your resilience based on acknowledged risk factors. Give yourself a score of 0 for “YES” or “TRUE”, 1 for “NO” or “FALSE”, i.e. a zero score if the statement applies to you; give yourself a one if it doesn’t. Get your pen out and tally your score.

Keep in mind the self-test is predicated on your having had a few simple blood tests that can be readily obtained via your physician, as well as knowledge of your blood pressure.

Metabolic Fitness (the following are from a 2019 NHANES study that assessed criteria for optimal health status):

1) Is your blood pressure frequently greater than 120/80?
2) Are you currently taking blood pressure medication?
3) Is your HDL cholesterol less than 40 (men) or less than 50 (women)?
4) Are your fasting triglycerides greater than 150?
5) Are you currently taking cholesterol-lowering medication?
6) Is your hemoglobin A1c 5.7 or greater?
7) Is your fasting blood sugar greater than 100?
8) Are you currently taking medication for diabetes?
9) Is your waist circumference greater than 40 inches (men) or 35 inches (women)?

If you answered yes to one or more of these questions, you’re not an outlier; the NHANES study concluded that a mere 12% of the adult Americans met all these stringent criteria!

So, here are some additional categories that round out your resiliency portfolio:

Emotional Health:

10) Are you generally more pessimistic than optimistic?
11) Do you cope poorly with adversity?
12) Do you have trouble adapting to changed circumstances?
13) Do you often “sweat the small stuff”?
14) Do you feel your life is out of control?
15) Are you frequently angry or impatient?
16) Do you suffer from loneliness and/or social isolation?
17) Do you lack a sense of an overall life purpose or goal?

Frailty:

18) Do you have trouble getting up unassisted from a seated position?
19) Have you experienced frequent falls?
20) Do you have trouble managing daily tasks (bathing, grooming, dressing, food preparation, etc.) without help?
21) Do you suffer from memory problems that interfere with your ability to manage your affairs and necessitate help from caregivers or family members?

Sleep:

22) Do you regularly get less than 7 hours of relatively uninterrupted sleep per night?
23) Aside from intentional naps, do you find yourself falling asleep frequently during the daytime?
24) Do you wake up unrefreshed?
25) Do you have frequent bouts of insomnia?
26) Do you suffer from sleep apnea?
27) Do you have trouble staying alert while driving?

Hydration:

28) Do you drink less than half your weight (lbs) in ounces (eight ounces = 1 medium glass) of water or non-sugary beverages per day? E.g. if you weigh 160 pounds like me, you should consume 80 ounces = 10 glasses.
29) Do you consciously restrict your fluid intake to curtail your bathroom trips?
30) Do you frequently resist the impulse to drink even when thirsty?

Nutrition:

31) Do you consume less than two six-ounce portions of fish per week (not including shellfish or “fish sticks”)?
32) Do you consume less than five servings of fresh or frozen vegetables or fruits daily?
33) Do you consume processed meats (hot dogs, luncheon meats, bacon) more than twice weekly?
34) Do you drink sugary soda or sweetened fruit beverages more than occasionally (once a week)?
35) Do you frequent fast-food eateries (more than twice weekly)?
36) Are you a “yo-yo dieter”—having lost and regained more than 20 pounds in the last 5 years?
37) Do you frequently eat ultra-processed foods: e.g. chips, salty snacks, sugary desserts, etc.?
38) Are the majority of your meals via take-out or at restaurants?
39) Are you a late-night snacker?

Supplements:

40) You take no multivitamin
41) You take no supplemental vitamin D
42) Your vitamin 25-OH vitamin D levels have been tested, and they’re lower than 30 ng/ml
43) You take no supplemental zinc
44) You take no supplemental selenium
45) You take no supplemental omega 3 fish oil with EPA/DHA
46) You take no supplemental vitamin C
46) You take no immune-supportive herbal supplements

Exercise:

47) You do no exercise beyond “getting around”
48) You walk, but perform no regular aerobic or strength-training regimen comprising at least 30 minutes, 5 times per week
49) You’ve never undertaken HIIT (high-intensity interval training)

Stress Reduction:

50) You have no regular meditation or relaxation practice

How to score: Add up your points. A “perfect” score is 50—pretty well-nigh unattainable. But if your score is 45-49, you’re well on your way to optimal resiliency. A score of 40-44 is pretty good, too, but if you score poorly in one realm, there’s room for improvement. A score of 39 or less reveals gaps in your resiliency portfolio; you have your work cut out for you shore up your vulnerabilities.

On the other hand, if you score in the teens or twenties, you’re high risk for complications or death if you contract COVID-19. You can and should take additional precautions even when lockdowns are rescinded.

But, more importantly, even if you’re not exposed to the virus, these same risk factors will put you in jeopardy of the degenerative medical conditions that prematurely claim the lives of millions of Americans every year. And many of them are modifiable with simple lifestyle changes. Take a look at the categories where you fell short, and create a plan to improve your performance in those areas. A search of my Intelligent Medicine website can lead you toward helpful articles for most of these concerns!

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