Doctor’s Note: How to stay healthy during lockdown

A doctor explains the four pillars of health and how you can adhere to them during the coronavirus pandemic.

Personal trainer Antonietta Orsini carries out an exercise class for her neighbours from her balcony while Italians cannot leave their homes due to the coronavirus disease (COVID-19) outbreak, in Rome
Personal trainer Antonietta Orsini carries out an exercise class for neighbours from her balcony while Italians cannot leave their homes due to COVID-19 in Rome, March 18, 2020 [Remo Casilli/Reuters]

With our usual routines going out window and the thought of staying in your pyjamas all day becoming ever more tempting, it is more important than ever to stay healthy during the lockdown.

This may require you to think a little outside of the box, but you should certainly try to maintain the four pillars of health.


Grocery store delivery slots have become as precious as gold dust in many places, and every journey to the supermarket feels as if you are walking through a petri dish, so it can be difficult to access fresh fruit and vegetables, hampering most of our healthy-eating diets.

The good news, however, is that we can still achieve our five-a-day by eating frozen, dried or tinned fruit and vegetables. 

According to the NHS, 80 grammes (2.8 ounces) of fresh, canned or frozen fruit and vegetables count as one portion of your five-a-day, as do 30g (1.06oz) of dried fruit.

If you like your fruit and vegetables in liquid form, 150ml (5.07 fluid ounces) of fruit juice or fruit smoothie or 80g of beans and pulses are also one of your one a day. Juice and smoothies can only count towards just the one, however, irrespective of how many glasses of juice or cans of beans you have.

For example, if you drink two glasses of fruit juice and a smoothie a day, it only counts for one portion, not three. This is because when fruit is blended or juiced, it releases its sugars and therefore it is not considered healthy to have more than one small glass a day.

It is important to consider the sugar quantities in these foods, so try to choose tinned fruit in natural juice or water rather than in syrup.

Furthermore, some fruit juices contain significant amounts of sugar, so take a look at the nutrition label or, better yet, opt for vegetable juices where possible.

Another common complaint from people in lockdown is that in being home all day, it is easy to find yourself snacking constantly.

For some, snacking keeps their hunger levels balanced and prevents ravenous overeating at mealtime. But for many, it is just a habit of boredom and self-comfort.

I would recommend setting meal times, like you would have if you were at work, to ensure you are eating healthy, regular meals.

I would also recommend that you eat “mindfully”. Shovelling food down your mouth in front of your TV, without really taking the time to notice and appreciate each mouthful is not good for you.

Research suggests that eating mindfully may improve digestion, appetite regulation, and most importantly enjoyment.

It is not bad to snack if you are hungry, but try to prepare healthier snacks that are easily available. These should include high-protein, healthy fats and fibre snacks like nuts, guacamole, edamame and crudites which will help maintain a stable blood sugar level and keep you fuller for longer.


It is tempting to stay up late if you do not have to be up early for work, but maintaining a routine is imperative for stabilising your inbuilt body clock (the circadian rhythm ) and providing a good quality of sleep.

I would recommend you continue to go to bed when you normally would and keep your alarm set to wake you up at the same time each morning.

You should become a creature of habit, repeating the same bedtime routine every night to help regulate your circadian rhythm and give your brain the cue it needs to know when it is time to unwind and go to sleep.

Evidence supports the need for adults to sleep for seven to eight hours each night and we know that people who regularly sleep for fewer hours than this are at higher risk of serious health problems such as heart disease, diabetes and stroke.

As well as these physical problems, a poor night’s sleep can also play havoc with you emotionally, making everything feel harder to cope with.

If you are struggling to sleep there are lots of ways to improve your sleep through “sleep hygiene” methods.

This can include avoiding white light before bedtime. You may think you find watching TV or using your computer or phone before bed is a good way to relax, but it can be detrimental because of the bright light emitted which acts as an environmental cue to your body that it is daytime, hindering your biological urge to fall asleep.

If you have the option of “night mode” on your phone or tablet, this may help, but ensure that you do not watch anything too stimulating, and avoid watching anything while in bed. Allow your bed to simply be used as a haven for sleep.

Other sleep hygiene methods can include relaxation techniques. This may take the form of a warm bath, for example. It is not just an old wives’ tale that a bath before bed will send you to sleep. 

Self-care in this form can be a big part of relaxation; pampering yourself in the evening with soothing oils or body lotion can make starting a bedtime routine an enjoyable process.

You could also try lavender-scented candles while enjoying your warm bath, or a diffuser in your bedroom to de-stress, creating the perfect ambience to drift off into a peaceful slumber.

As well as the relaxation factor this provides, research has shown that if you take a warm bath one to two hours before bed, the rise in temperature, followed by the drop in temperature when you then enter a colder room after taking a bath induces sleep.

Additional relaxation techniques found to aid sleep can be practices like yoga, mindfulness and meditation. 

Controlling stress

Stress is a common cause of poor sleep and, during this uncertain time, even the most positive of us can suffer from anxiety, while those already suffering from mental health conditions could tip over even further.

It is important to alleviate some of this stress by talking. It is hard when you cannot meet up with your usual support network but technology is on our side, so diarise some dedicated time to video conferencing and speaking to those you are comfortable opening up to, be that friends, family, your GP or a therapist. 

Some people reach for alcohol or drugs to self-medicate in times like this, and while you may feel like they alleviate your symptoms in the short term, the next day you are likely to wake up feeling much worse, so this is not a stress control method I would advise. 

The feeling of being cooped up is also stressful, so if you have a garden or balcony, use it to soak up some vitamin D.

There are numerous studies that show the benefits of nature for good mental health. There have been lab studies assessing the effect of nature images and sounds on psychology and stress. There have also been fieldwork studies comparing the psychological benefits when comparing participants who walked in nature versus urban environments. We are also aware of the psychological wellbeing of those that live in proximity to green spaces.

This time in your garden is a good time to practise your breathing and relaxation techniques, although they can be done anywhere. 

Calming breathing techniques only take a few minutes and have been found to have profound effects on psycho-physiological interactions, leading to improved anxiety levels. 

If you feel lost when it comes to meditation and breathing, there are many apps and online resources that can guide you through these techniques.

Physical activity

Many of us use exercise to manage stress, but it is also important to exercise for physical health.

There is an overwhelming body of evidence linking exercise to improved mortality and morbidity. Physical activity can reduce your risk of heart disease, stroke, type 2 diabetes and cancer by as much as 50 percent, and reduce your risk of early death by up to 30 percent.

Just because the gym is closed, it does not mean you cannot exercise. In the United Kingdom, for example, the guidelines are that you can still go out for one hour every day to exercise, providing you stay more than two metres (six feet) away from others.

So, if you can, I would certainly recommend using any outdoor time allowance you have to go for a run, walk or cycle and to get your heart rate pumping. 

If you cannot go outside, most of your favourite fitness gurus will be doing online exercise programmes that you can follow from the comfort of your own living room.

The UK’s National Health Service (NHS) recommends that you should aim for at least 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity a week.

In addition to cardiovascular activities, it is important to also work on strengthening exercises at least twice a week.

Source: Al Jazeera