Diet Quality and Risk and Severity of COVID-19

This quote is from Dr Mark Hyman - the doctor behind "food as medicine" - in his recent weekly newsletter:

"A recent study published in the British Medical Journal found that those who ate a healthier diet (including more fruits and veggies) had a lower risk of COVID-19 and severe cases of COVID-19. Unfortunately, the pandemic has worsened the habits of most, especially Americans. According to a recent nationwide survey, 100 million Americans are eating 4,000+ more calories per week. Incorporating a variety of colorful plant foods into your diet and limiting the amount of ultra-processed foods you eat is one of the best things you can do for your health right now".

The reference is taken from The British Medical Journal : Gut "Diet quality and risk and severity of COVID-19: a prospective cohort study" Chan et al. I have provided the abstract and of course referenced the entire paper for you.

Again for me, and I may be playing devils' advocate here, it is looking at SEVERE Covid-19 infections - ie the ones that end up in hospital requiring respiratory support. It makes sense to me that a combination of an unhealthy diet consisting of high processed convenience food and lacking in fresh fruit and vegetables is linked to socioeconomic deprivation will result in poorer outcomes.

However organic meat, fish, fruit and vegetables are expensive and especially now so in the UK since the Pandemic and Brexit.

We need to mindful of that when we tell people they need to improve their diet for their health.

My partner recently met someone who did not own a home who had managed to procure various small spaces in people's gardens all around her city in order to grow salad and vegetables. I just wish there were more council run schemes to this affect. Local public spaces for people without gardens to grow fruit and vegetables and get them in touch with the air, the sunshine and the earth.

My second point I wanted to make was that the many people who have had "mild" to "moderate" Covid-19 have been left disabled at up to 18 months later. Listening to all your stories I would say that most of you were healthy, relatively young, exercising and eating a well balanced diet. I would just LOVE for researchers to get to the bottom of why SARS-CoV-2 is affecting us so much.....

Abstract Objective Poor metabolic health and unhealthy lifestyle factors have been associated with risk and severity of COVID-19, but data for diet are lacking. We aimed to investigate the association of diet quality with risk and severity of COVID-19 and its interaction with socioeconomic deprivation.

Design We used data from 592 571 participants of the smartphone-based COVID-19 Symptom Study. Diet information was collected for the prepandemic period using a short food frequency questionnaire, and diet quality was assessed using a healthful Plant-Based Diet Score, which emphasises healthy plant foods such as fruits or vegetables. Multivariable Cox models were fitted to calculate HRs and 95% CIs for COVID-19 risk and severity defined using a validated symptom-based algorithm or hospitalisation with oxygen support, respectively.

Results Over 3 886 274 person-months of follow-up, 31 815 COVID-19 cases were documented. Compared with individuals in the lowest quartile of the diet score, high diet quality was associated with lower risk of COVID-19 (HR 0.91; 95% CI 0.88 to 0.94) and severe COVID-19 (HR 0.59; 95% CI 0.47 to 0.74). The joint association of low diet quality and increased deprivation on COVID-19 risk was higher than the sum of the risk associated with each factor alone (Pinteraction=0.005). The corresponding absolute excess rate per 10 000 person/months for lowest vs highest quartile of diet score was 22.5 (95% CI 18.8 to 26.3) among persons living in areas with low deprivation and 40.8 (95% CI 31.7 to 49.8) among persons living in areas with high deprivation. Conclusions A diet characterised by healthy plant-based foods was associated with lower risk and severity of COVID-19. This association may be particularly evident among individuals living in areas with higher socioeconomic deprivation.


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