Maybe youre popping vitamins and upping your intake of key nutrients in the hope of strengthening your bodys defenses against COVID-19 and the flu.

But is this a sound strategy?

We consulted Dr. Nora Zabel Tossounian, an internist at Hackensack Meridian Health Primary Care and Womens Health in Lodi.

She cautions against too many megadoses of vitamins or overeating a certain type of food just because it may supply a specific nutrient.

There are some good medical studies that support it and there are some that dont, she says of foods and supplements touted as immune boosters. The main thing that it boils down to is healthy lifestyle habits and the importance of good, balanced nutrition and exercise and sleep. Cant beat that.

A vitamin-based defense and clean eating may possibly help mitigate health risks on some level, but theyre not a substitute for wearing a mask, social distancing, avoiding crowds and washing your hands.

While some supplements may be advisable, Zabel Tossounian says we should start with our plates. Make that a moderately clean plate.

I always tell my patients to try to get the nutrients as much as possible from food thats minimally processed, she says.

Ditch juices in favor of whole fruit (in moderation), she says, and try to cut down on processed, refined and bleached carbohydrates.

That doesnt mean buying something just because it says natural or organic on the label.

Many people try to say, Well, these potato chips ... they say theyre natural, she says. Thats a processed carb.

Baking, a favorite pandemic pastime, can make us more vulnerable to reward eating. As we eat more carbs, our bodies produce more insulin to keep up with the sugar. Cookies can seem like a good quick fix for stress, but if we're trying to avoid inflammation, insulin spikes are not our friend. Steve Hockstein for The Star-Ledger

Zabel Tossounian points out that carbs in excess are problematic because they cause belly fat and weight gain and increase insulin levels.

What does that have to do with immunity?

Insulin is known to be a pro-inflammatory marker, she says. It can make it more challenging for our immune system to fight off infections.

Of course, starting in March, when grocery stores began to feel the strain of the pandemic, a whole lot of people were panic-buying chips, cookies and other treats. Even if the irony is a time-honored one, we were using unhealthy behavior to try to soothe our fears about the health crisis.

A lot of us during these stressful times tend to overeat or emotionally eat, Zabel Tossounian says. Mindful eating is so important. Sometimes we do make the wrong choice intentionally because we need to have that satisfaction.

If opting for oat milk, nut milk or other milk alternatives, look for products fortified with vitamin D. But this may not be enough to reach an optimal vitamin D level.Thomas Urbain | AFP via Getty Images

Want to enlist vitamin D in strengthening your bodys defenses?

Sources of vitamin D in your diet could include milk, cheese and yogurt. Zabel Tossounian tells her patients to stick with varieties that have reduced fat. Those who are lactose intolerant or vegan can opt for nut milks or milk alternatives like soy, almond, hemp and coconut. Oat milk has become one of the most popular, but check the labels.

Sometimes they may not fortify with vitamin D, Zabel Tossounian says. And even if they are fortified, the amount can be less than optimal.

The majority of patients in our practice tend to be vitamin D-deficient, she says. Many take supplements. (You can always ask your doctor to check your vitamin D level.)

Avocado on toast or not may have become a trendy food associated with the finances of millennials, but it is also a source of fiber, protein, healthy fat and vitamin C.Anna-Rose Gassot | AFP via Getty Images

Some studies in COVID patients have shown that (zinc) does help with the mechanism of the immune system fighting off this virus, Zabel Tossounian says. We also use it to a certain extent in certain hospitalized patients.

Natural sources of zinc include mushrooms, beans, chickpeas and nuts.

Most fruits and vegetables do have a fair amount of zinc, she says. Zinc is very important.

She tells patients who would prefer a supplement that they can try 50 milligrams of zinc a day.

Vitamin C is most traditionally associated with a perceived defense against ailments like the common cold.

Many patients during this time will down glasses of orange juice or take megadoses of vitamin C, Zabel Tossounian says. First of all, orange juice contains a lot of carbs.

People wanting to limit carbs should stay away or stick to one serving, she says. Those who are worried about acid reflux can avoid orange juice altogether in favor of a 500-milligram daily supplement. The catch: only do this if you can drink at least 64 ounces of water per day.

The reason for that is long-term, higher doses of vitamin C in some patients can increase the risk of kidney stones, Zabel Tossounian says. Another option is to only take a vitamin C supplement during the fall and winter months.

Salmon: a good source of protein and healthy fats.Eric Piermont | AFP via Getty Images

Zabel Tossounian says that in order to avoid lopsided diets that are too heavy on the carbs, for instance, she counsels patients to make one third of their plate low-fat protein, one third vegetables and one third minimally processed starch.

Salmon is a good go-to protein and supplies necessary healthy fats, she says. Another option is baked or boiled (not deep-fried) chicken as long as the skin is removed.

Vegans and vegetarians can opt for beans, bean-based pastas and avocado for protein (and healthy fats). They can also choose plant-based meat substitutes, though Zabel Tossounian says to watch the fat content on your favorite plant-based burgers. Either limit how many times theyre in the rotation or cut down on fats and oils elsewhere in your meal.

She tells patients to limit red meat ideally lean cuts to no more than twice per week.

About those processed carbs. A lot of patients have been coming to Zabel Tossounian with weight gain in the pandemic what some have been calling the COVID 19.

In the beginning of the pandemic, aisles that normally stocked flour and sugar were half (or all) empty since many people started baking.

They loved it and they did with their families, she said. As we know, food, in all cultures, is a way of connecting with your loved ones. The kitchen became the most important room in the entire home.

Has your kitchen become a production line for cakes and cookies in the pandemic?Sarah Rice | The Star-Ledger

Why not focus on food when you can plan your day around the meal youre going to have at night? Of course, that makes it easier to overeat or stray from good eating, especially if theres a sense of reward involved.

A lot of it comes from entitlement, Zabel Tossounian says. Had a bad day at work or had a difficult Zoom meeting? You know, Im entitled to that Snickers bar. It gives temporary satisfaction. All of us do it, were human.

She suggests eating clean 80 to 90% of the time and leaving a bit of room for indulgence.

More vitamin D and C may not mean much without vitamin sleep and exercise.

Moving for at least 30 minutes five days a week can help us feel better.

Why? Its not just the lack of guilt for not exercising were talking about here. The happy hormones, or endorphins, released during a workout can help to ease stress, anxiety and depression.

This 24 Hour Fitness gym in Springfield reopened in September. If you can't get to a gym or don't feel comfortable going, there are many free options for online workouts. Patti Sapone | NJ Advance Media

Another benefit of exercise is that when you start thinking about how many pushups you may need to cancel out a candy bar, you may think twice and temper emotional eating, Zabe
l Tossounian says.

Even if your gym has gone out of business, there are ways to stay fit in the winter. Zabel Tossounian often recommends that patients check out free resources like the YMCA 360 website, which has on-demand fitness videos, or workouts on the Nike Training Club app.

Some local gyms are still offering online classes and virtual memberships to a wide range of workout programs are available online.

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Amy Kuperinsky may be reached at akuperinsky@njadvancemedia.com and followed at @AmyKup on Twitter.

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