Advance with MUSC Health

Back to Basics During COVID 19

Joseph Gerald (Jerry) Reves, M.D.
August 31, 2020

As we settle into the new world of COVID-19 coexistence it is time to remind our readers of the two strategies fundamental to healthy aging. They are diet and exercise. We make decisions every day about these two factors that are proven to impact our health and longevity, not to mention our quality of life. Because our decisions regarding these two everyday activities are so significant, it is important to revisit them.

How does COVID-19 Impact Diet and Exercise?

The COVID-19 pandemic has had a direct and indirect impact on these two health strategies. Some food supplies have been adversely impacted by the disease with fewer fresh products of good quality available. Certainly trips to the grocery store have become more challenging with the various restrictions on movement and, in some cases, on the number of shoppers in grocery stores. Supply chains have been stressed and some commodities and foods limited. However, on the whole it is remarkable how abundant the supply of fresh fruits, vegetables, and juices has remained.

Exercise options have certainly been reduced by COVID-19. Gyms and pools have been closed; personal training is now done virtually; golfing and other “group/social” activities are discouraged. Excuses for not exercising are easier to make – in fact, COVID has become a very good reason not to do many of our regular exercises. However, as before COVID, making excuses is inexcusable for daily exercise since there are many, many exercises that can be done alone and at home that have been proven to be healthful and helpful.

Eating and Drinking

Seniors have factors that lead to poor diet. These include diminished taste and smell, dental problems, poor appetite, and depression. In the diet category we should focus on eating plenty of fresh fruits and vegetables. These provide the nutrients and vitamins we need. Preparation should be minimal and certainly not involve frying. We should be choosing foods that are low in added sugar, saturated fats, and sodium. The added sugar adds calories without any benefit and predisposes to type 2 diabetes and other health hazards.  The saturated fats elevate blood lipids that lead to vascular disease which in turn can cause heart disease and or stroke. Sodium contributes to fluid retention which is a problem in kidney disease and heart failure. Fluid retention can also lead to high blood pressure that in turn causes heart disease and stroke. Figure 1 illustrates smart choices when eating: shift away from processed food that tend to be high calorie, high fat, high salt to servings of fruit, fresh vegetables, and whole grains.

5 food choices paired with a more nutrient-dense choice 
Figure 1. Source: National Institute on Aging

Just as with eating, drinking offers us good and bad, tempting choices. Water is what the body needs and it is universally available in our country. If water is unappealing try adding ice or natural, unsweetened flavors like lemon to liven it up. Stay clear of any sugar-added drinks that provide the prototype of empty calories, meaning calories with no nutrient-dense value. Figure 2 illustrates several drinking tips for better health. 

Food and drink packaging now have labels that inform us of what we would consume in each product. One almost universal statistic is the number of calories in a serving. Pay attention to this knowing that in a given day a woman needs from 1,600 to 2,200 calories a day depending on the level of activity (not active to very active) and men need from 2,000 to 2,800 calories a day. Minimize saturated fats in the diet and look for essential vitamins like C, D, B6, and B12 as well as the mineral calcium. If your food and drink do not have the recommended daily vitamins, take a multi-vitamin pill that does get you to your quota.

Beverage choices paired with less calorie-dense choice 
Figure 2. Source: National Institute on Aging


Abandon all excuses, and just get it. Exercise has proven to be an effective way to improve health in seniors. It reduces many of the health problems of aging including diabetes, certain cancers (colon and breast,) osteoporosis, heart disease, obesity, type 2 diabetes, and fall-related injuries. The recommendation is to exercise for at least 30 minutes every day. The exercise regimen can be as simple as a brisk 30-minute daily walk or anything beyond that. Try to increase and sustain the increase in baseline heart rate for the entire 30 minutes or more. It is important to remember that, in addition to walking or some other aerobic exercise, it is crucial to be certain that the exercise accomplishes building endurance, muscle strengthening, balance, and flexibility. Adding weights to a routine for arms and squats for legs are good examples of how to improve muscle strengthening. Balance exercises such as standing on one foot or walking a straight line with one foot in front of the other help with fall prevention. Before and after any exercise it is recommended that stretching be done to improve and preserve flexibility. With exercise it is a good idea to start slowly but add to build endurance. Likewise, it is important not to start with too ambitious a program, but rather build a doable one over time.

The National Institute of Aging (NIA) has a video out now entitled “Staying Physically Active During the Pandemic” given by Dr. Marie Bernard, deputy director of NIA. The video is 16 minutes of not well produced, but interesting tips from Dr. Bernard’s home (because of the pandemic) with some ideas on how to keep exercising during the pandemic that include sample exercises.

The Bottom Line

The COVID-19 pandemic is a fact of life. In addition to social distancing, mask wearing, avoiding crowds, and hand washing we must remember that this, like any other time, is one when we must pay scrupulous attention to diet and exercise, the two factors we know lead us to a healthier aging experience. 

MUSC Health has earned a "High-Performing Hospital" designation in geriatrics from U.S. News & World Report for 2018-2019