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HEALTHCARE JOURNAL OF BATON ROUGE I  JUL / AUG 2020 23 For weekly eNews updates and to read the journal online, visit HealthcareJournalBR.com across the state delivering cooking lessons and demonstrations on topics such as food dollar management, making healthy meals from dollar store purchases and fresh produce preparation. Video titles include: • Cook Once, Eat Twice! : How to cook once and eat twice to maximize time and buying power. • Dollar Store Meals : How to make healthful, low-cost meals with ingredients that can be purchased at “dollar stores” • Cook With Produce From The Farmer’s Mar- ket : How to prepare healthy meals using fresh produce Additional videos are currently in development and will provide education about creating healthy, well-rounded meals with commodity items and fresh produce. “Building a healthy meal will aid the every- day consumer over time to change behavior, which leads to healthy decisions about food,” said Dr. Gina Eubanks, LSU AgCenter associate vice president for food and consumer sciences. “Research supports that healthy eating helps to reduce chronic disease such as diabetes, high blood pressure, high cholesterol, and cardiovas- cular disease.” The Build A Healthy Meal videos are available via the LSU AgCenter website, YouTube chan- nel, and social media platforms, including Face- book, Pinterest, and Instagram. Louisiana Health- care Connections is also sharing the videos via its Facebook page and promoting them as a resource for physicians working to address hun- ger and food insecurity at the point of care. The project brings together LSU AgCenter and Louisiana Healthcare Connections with the shared goal of increasing nutritional education and healthy food access among Medicaid-enrolled and resource-limited populations in the state. Both organizations have identified food insecu- rity, defined by the U.S. Department of Agricul- ture (USDA) as “a lack of access to enough food for an active, healthy life,” as a key factor that negatively affects the health of Louisiana families. In its December 2018 “U.S. Hunger Atlas,” Hun- ger Free America found that nearly 25 percent of all children in Louisiana lived in households that could not always afford food from 2015-2017, and with 847,556 food insecure individuals, the state ranked as the third most food insecure in the nation. “Food insecurity affects thousands of families across our state, and because so many in Louisi- ana are struggling with losses of income due to COVID-19, it is a particularly critical issue right now,” said John Kight, senior vice president of population health for Louisiana Healthcare Con- nections. “We are pleased to work with the LSU AgCenter to provide these families with budget- friendly nutritional information to help them over- come barriers that may negatively impact their health.” To view the videos, visit www.LSUAgCenter.com/ topics/food_health/food/build-a-healthy-meal. Top 5 FAQs: Pennington Biomedical: Obesity and COVID-19 In these five FAQs, the experts at Penning- ton Biomedical Research explain why obesity affects COVID-19—and how. Providers of these responses are Steven Heymsfield, MD, FTOS, for- mer executive director of the Center; Eric Ravus- sin, PhD, Boyd Professor and associate executive director of clinical science; and Peter Katzmarzyk, PhD, FACSM, FTOS, associate executive director for Population and Public Health Sciences. 1. Why are those with obesity more at risk for a severe case of COVID-19? Inflammation that often accompanies obesity can cause the body to rev up the immune sys- tem response to any infection such as COVID-19. Under normal circumstances, inflammation indi- cates that the immune system is fighting off infec- tion by sending blood cells and other messen- gers to the injury. Once those cells show up to the injured tissue, you’ll notice swelling and you may see a reddish or “inflamed” color. Once the wound heals, the immune system backs off, swell- ing goes down and color returns to normal. In people with obesity, the immune system may see fat that surrounds organs in the abdomen, or visceral fat, as a threat like a potential injury. So the immune system is working overtime, sending out blood cells and other chemicals every day, all day long, to attack those visceral fat cells. This leads to chronic inflammation. In the case of COVID-19, the immune system goes into even higher overdrive in a way that can cause a “cytokine storm” reaction. Cyto- kine molecules are part of healthy immune sys- tem response, except when the number of mol- ecules soars. Then immune cells may build so quickly that they crowd and break through the walls of an inflamed lung, as just one result. That’s when fluids will build up in the lung, making it hard to breathe and triggering the need for ven- tilator support. Roughly 40 percent of U.S. adults have obesity, which helps explain the severity of COVID-19’s impact on our healthcare system. 2. Is inflammation the only reason COVID- 19 is more dangerous to people with obesity? No. It gets worse. Impaired immune systems make an individual more susceptible to viral infec- tions in general. One study shows that adults with obesity had twice the incidence of flu or flu-like illnesses despite being vaccinated. Obesity is also often accompanied by other conditions that are risk factors for COVID-19 com- plications, such as type 2 diabetes, cardiovascu- lar disease, and pulmonary disease like obstruc- tive sleep apnea. 3. What BMI is most at risk? Those with severe or class III obesity which is defined as a BMI of 40 or higher. A person who is 5’9” and weighs 271 pounds has a BMI of 40. A person with severe obesity who requires hos- pitalization presents a greater challenge. He or she may need a special, bariatric hospital bed. Even hospitals with bariatric surgery units have a limited number of these beds. Other hospitals may not have any. People with obesity and COVID-19 are more likely to need a ventilator. But intubations may be more difficult and require personnel with special- ized training. Hospitals have been able to reduce mortality rates for some patients who need venti- lators by placing the patients on their stomachs. This option may not be available for people with class III obesity because they, like pregnant women, may not do well in that position. Obtaining an imaging diagnosis may also be more complicated because many imaging machines have weight limits.