COVID-19: Reducing the risk via diet and lifestyle / 中西医结合学报

This review shows that relatively simple changes to diet and lifestyle can significantly, and rapidly, reduce the risks associated with coronavirus disease 2019 (COVID-19) in terms of infection risk, severity of disease, and even disease-related mortality. A wide range of interventions including regular exercise, adequate sleep, plant-based diets, maintenance of healthy weight, dietary supplementation, and time in nature have each been shown to have beneficial effects for supporting more positive health outcomes with COVID-19, in addition to promoting better overall health. This paper brings together literature from these areas and presents the argument that non-pharmaceutical approaches should not be overlooked in our response to COVID-19. It is noted that, in several cases, interventions discussed result in risk reductions equivalent to, or even greater than, those associated with currently available vaccines. Where the balance of evidence suggests benefits, and the risk is minimal to none, it is suggested that communicating the power of individual actions to the public becomes morally imperative. Further, many lives could be saved, and many harms from the vaccine mandates avoided, if we were willing to embrace this lifestyle-centred approach in our efforts to deal with COVID-19.

Mercado y riesgo: escenarios de transmisión del VIH entre hombres que tienen sexo con otros hombres: Medellín, 1993-2006 / Market and risk: stages of HIV transmission among men with homosexual behaviors: Medellín, 1993-2006

Introducción: Las diferentes respuestas de los individuos a las medidas de prevención para VIH se han relacionado con patrones colectivos de significación que se imponen al comportamiento y que influyen en el éxito de las intervenciones. Objetivo: Mejorar la comprensión de las condiciones colectivas en que los hombres que tienen sexo con hombres (HSH) enfrentan sus riesgos de infección para VIH. Metodología: Estudio cualitativo basado en el interaccionismo simbólico, realizado en Medellín entre 1993 y 2006. Se identificaron y visitaron los sitios donde se reúnen los HSH. Se realizaron grupos focales con informantes claves y 100 entrevistas, de las cuales 39 a HSH. Resultados: Se identificaron y estudiaron siete escenarios donde los HSH enfrentan el riesgo de VIH. En la región, la homosexualidad sigue siendo objeto de sanción social y los HSH deben crear escenarios especiales, donde el ejercicio de la sexualidad les sea menos difícil. Estas condiciones han sido aprovechadas por el mercado que percibe a los HSH como un segmento de consumidores con capacidad de pago, y ha generado una oferta en expansión de escenarios donde la población de HSH realiza varias de sus necesidades sociales, afectivas y sexuales pero se expone también a condiciones de riesgo. Los escenarios se construyen como sistemas normativos generados por el mercado, cuya estructura se impone a los comportamientos individuales restringiendo con frecuencia su capacidad para protegerse de los riesgos de infección. Conclusión: Los hallazgos ilustran la complejidad de las decisiones subjetivas involucradas con la protección personal y la gestión de los riesgos, y ponen en entredicho el paradigma del consumidor racional. Por el contrario, la confluencia de la vulnerabilidad estructural y la vulnerabilidad individual, en un contexto de exclusión social, conforman una compleja red de determinantes que debe ser asumida en su complejidad e integralidad por las políticas sanitarias.

Background: People's different responses to HIV prevention programs have been related to collective patterns of significance that are imposed to their behaviors, and affect the success of health interventions. Objective: To understand the social conditions by which men who have sex with men (MSM) face their risks. Methodology: A qualitative study based on the symbolic interactionism was carried out in Medellín between 1993 and 2006. The places where MSM meet were identified and visited. Focus groups with key informants and 100 in-depth interviews were conducted, of which 39 of them were conducted with MSM. Results: The study identified and studied seven scenarios where MSM face the risk of HIV. In the region, homosexuality continues to be object of social stigma and MSM must create for themselves special stages, where sexual activity can be less difficult. These conditions have been exploited by the market, which perceives MSM as consumers with payment capacity, and it has generated an expansive offer of stages where MSM act out several of their fundamental needs but, at the same time, are also exposed to different risks. The scenarios are built as normative systems generated by the market whose structure is imposed to the individual behaviors, frequently restricting their capacity to be protected from the risk of infection. Conclusion: The findings illustrate the complexity of the subjective decisions involved with the personal protection and the management of the risks; and they question the paradigm of the rational consumer. On the contrary, the conjunction of the structural vulnerability and the individual vulnerability, in a context of social exclusion, conform an intricate net that should be assumed in its complexity and integrity by health policies.