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Background and AimsAdherence to the Mediterranean diet (MD) has been associated with a decreased risk of developing a variety of chronic diseases that are comorbidities in COVID-19 patients. However, its association to the severity and symptoms of COVID-19 are still unknown. This study aimed to examine the association between adherence to the MD pattern and COVID-19 severity and symptoms in Iranian hospitalized patients.MethodsIn this cross-sectional study, 250 COVID-19 patients aged 18 to 65 were examined. We employed a food frequency questionnaire (FFQ) to obtain data on dietary intake of participants in the year prior to their COVID-19 diagnosis. COVID-19 severity was determined using the National Institutes of Health's Coronavirus Disease 2019 report. Additionally, symptoms associated with COVID-19, inflammatory markers, and other variables were evaluated. The scoring method proposed by Trichopoulou et al. was used to assess adherence to the MD.ResultsThe participants' mean age was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients who adhered more closely to the MD had lower serum C-reactive protein levels (7.80 vs. 37.36 mg/l) and erythrocyte sedimentation rate (14.08 vs. 42.65 mm/h). Those with the highest MD score were 77% less likely to have severe COVID-19 after controlling for confounding variables. The MD score was also found to be inversely associated with COVID-19 symptoms, including dyspnea, cough, fever, chills, weakness, myalgia, nausea and vomiting, and sore throat.ConclusionHigher adherence to the MD was associated with a decreased likelihood of COVID-19 severity and symptoms, as well as a shorter duration of hospitalization and convalescence, and inflammatory biomarkers.

Background: Hypertension (HTN) is a ubiquitous risk factor for numerous non-communicable diseases, including cardiovascular disease and stroke. There are currently no wholly effective pharmacological therapies for subjects with HTN. However, salt substitutes have emerged as a potential therapy for the treatment of HTN. The aim of the present study was to assess the effect of salt substitutes on reducing systolic blood pressure (SBP) and diastolic BP (DBP), following a meta-analysis of randomized controlled trials. Methods: Studies were found via systematic searches of the Pubmed/Medline, Scopus, Ovid, Google Scholar and Cochrane library. Ten studies, comprised of 11 trials and 1119 participants, were included in the meta-analysis. Results: Pooled weighted mean differences showed significant reductions of SBP (WMD − 8.87 mmHg; 95% CI − 11.19, − 6.55, p < 0.001) and DBP (WMD − 4.04 mmHg; 95% CI − 5.70, − 2.39) with no statistically significant heterogeneity between the 11 included comparisons of SBPs and DBPs. The stratified analysis of trials based on the mean age of participants showed a significant reduction in the mean difference of SBP in both adults (< 65 years old) and elderly (≥65 years old). However, the DBP-lowering effect of salt substitutes was only observed in adult patients (WMD − 4.22 mmHg; 95% CI − 7.85, − 0.58), but not in the elderly subjects. Conclusions: These findings suggest that salt-substitution strategies could be used for lowering SBP and DBP in patients with stage 2 HTN; providing a nutritional platform for the treatment, amelioration, and prevention of HTN.

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Background and AimsMagnesium is an anti-inflammatory mineral that plays a role in the innate immune system, and the relaxation of bronchial smooth muscle warrants additional attention in COVID-19. This study examined the association between magnesium intake and COVID-19 severity and related symptoms in hospitalized patients.MethodsA cross-sectional study was done enrolling 250 COVID-19 patients aged 18 to 65 years. A validated 168-item online food frequency questionnaire (FFQ) was used to assess dietary magnesium intake. COVID-19 Treatment Guidelines were used to determine COVID-19 severity, and symptoms were evaluated using a standard questionnaire. Crude and adjusted analyses were performed (Model 1: age, sex, and energy intake; Model 2: Model 1 + physical activity, supplements, corticosteroids, and antiviral drugs; Model 3: Model 2 + body mass index).ResultsThe mean age of participants was 44.1 ± 12.1 years, and 46% of them had severe COVID-19. Patients at the highest tertile of dietary magnesium intake had lower serum levels of inflammatory biomarkers, including CRP (11.8 ± 2.2 vs. 29.5 ± 2.1 mg/L, p &lt; 0.001) and ESR (15.8 ± 2.4 vs. 34.7 ± 2.4 mm/hr, p &lt; 0.001), than those at the lowest tertile. After controlling for potential confounders, we observed that a higher dietary magnesium intake was associated with a lower odds of severe COVID-19 (OR: 0.32; 95% CI: 0.15–0.70). Also, we found a significant inverse association between dietary magnesium intake and odds of COVID-19 symptoms.ConclusionWe found that higher intake of dietary magnesium was inversely associated with COVID-19 severity and symptoms.

BackgroundCOVID-19 is a highly transmissible viral infection with high morbidity. Few studies have been done about dietary intakes in patients with COVID-19. This study aimed to evaluate the association between major dietary patterns before COVID-19 diagnosis in recovered patients and the risk of disease severity and symptoms after the disease begins.MethodsOverall, 250 recovered cases with both genders completed study questionnaires providing data on demographic characteristics, self-reported web-based 168-item food frequency questionnaire (FFQ), and COVID-19 outcomes in Shahid Beheshti Hospital, Kashan. PCR was used to determine a positive diagnosis of COVID-19. We used multivariable logistic regression models to assess the association between major dietary patterns and study outcomes. All statistical analyses were done by SPSS version 16.ResultsWe identified three major dietary patterns—unhealthy, traditional, and healthy dietary patterns. Serum levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were significantly higher in patients with unhealthy and traditional dietary patterns and lower in those with healthy dietary patterns. There was a significant direct relationship between unhealthy and traditional patterns with risk of severe COVID-19 and hospitalization duration and a significant direct association between an unhealthy pattern and the odds ratio (OR) of convalescence duration. A significant inverse relationship was found between healthy pattern and risk of severe COVID-19 and OR of convalescence duration. We found a significant direct association between unhealthy pattern and OR of cough, fever, chilling, weakness, myalgia, nausea and vomiting, and sore throat and between traditional pattern and OR of cough, fever, and chilling. In contrast, a significant inverse association was seen between healthy pattern and OR of dyspnea, weakness, and sore throat.ConclusionThis study showed that high adherence to an healthy pattern was associated with lower CRP and ESR levels and lower risk of severe COVID-19, hospitalization, and convalescence duration in patients who recovered from COVID-19. More adherence to unhealthy or traditional dietary patterns was associated with higher CRP and ESR levels and a higher risk of severe COVID-19 and hospitalization duration. A direct association was found between unhealthy and traditional patterns and the risk of some COVID-19 symptoms, while an inverse association was found for a healthy dietary pattern.

Background and aimsFruits and vegetables are rich in fiber and a good source of anti-inflammatory and immune-boosting vitamins, minerals, and antioxidants. We investigated the association between fruits, vegetables, and fiber intake and severity of COVID-19 and related symptoms in hospitalized patients.MethodsA total of 250 COVID-19 hospitalized patients aged 18 to 65 years were recruited for this cross-sectional study in Kashan, Iran, between June and September of 2021. Dietary intakes were assessed using an online validated 168-item food frequency questionnaire (FFQ). COVID-19 severity and symptoms were evaluated using the National Institutes of Health (NIH) COVID-19 Treatment Guidelines. Moreover, we examined COVID-19 symptoms, inflammatory biomarkers, and additional factors.ResultsThe mean age of participants was 44.2 ± 12.1 years, and 46% had severe COVID-19. Patients with higher consumption of fruits (OR: 0.28; 95% CI: 0.14-0.58, P-trend &lt;0.001), vegetables (OR: 0.33; 95% CI: 0.16-0.69, P-trend &lt;0.001), and dietary fiber (OR: 0.25; 95% CI: 0.12-0.53, P-trend &lt;0.001) had lower odds of having severe COVID-19. In addition, they had shorter hospitalization and convalescence periods, lower serum C-reactive protein (CRP), and a reduced risk of developing COVID-19 symptoms such as sore throat, nausea and vomiting, dyspnea, myalgia, cough, weakness, fever, and chills.ConclusionHigher consumption of fruits, vegetables, and fiber was inversely linked with COVID-19 severity, clinical symptoms, hospitalization and convalescence duration, and CRP concentrations. The results should be interpreted with caution in light of the limitations, and prospective cohort studies are required to further evaluate these findings.