Diet quality and risk and severity of COVID-19: a prospective cohort study

Abstract

ObjectivePoor metabolic health and certain lifestyle factors have been associated with risk and severity of coronavirus disease 2019 (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 intersection with socioeconomic deprivation.DesignWe used data from 592,571 participants of the smartphone-based COVID Symptom Study. Diet quality was assessed using a healthful plant-based diet score, which emphasizes healthy plant foods such as fruits or vegetables. Multivariable Cox models were fitted to calculate hazard ratios (HR) and 95% confidence intervals (95% CI) for COVID-19 risk and severity defined using a validated symptom-based algorithm or hospitalization with oxygen support, respectively.ResultsOver 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, 0.88-0.94) and severe COVID-19 (HR, 0.59; 95% CI, 0.47-0.74). 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 for lowest vs highest quartile of diet score was 22.5 (95% CI, 18.8-26.3) and 40.8 (95% CI, 31.7-49.8; 10,000 person-months) among persons living in areas with low and high deprivation, respectively.ConclusionsA dietary pattern characterized by healthy plant-based foods was associated with lower risk and severity of COVID-19. These association may be particularly evident among individuals living in areas with higher socioeconomic deprivation.

The gut microbiome, health and personalised nutrition

“…Recently, COVID‐19 has brought the importance of microbiome health to the forefront because of the links we found between diet quality and COVID‐19 infection severity in the ZOE Covid study 18 due to its crucial role in supporting the immune system. The immune system depends on our gut microbiome to identify pathogens and ensure that inflammatory responses are both timely and appropriate.…”

Shoring Up Vaccine Efficacy

“…The smartphone-based COVID Symptom Study, including 592,571 participants of whom 31,815 developed COVID-19, found that dietary patterns that were highest in fruits, vegetables, and plant-based foods in general were associated with a 41% lower risk of severe COVID-19 and a 9% reduction of COVID-19 infection of any severity, compared with diets lowest in these foods. 6 Similarly, a 2021 case-control study of healthcare workers in six countries revealed that those following largely plant-based diets had 73% lower odds of developing moderate-to-severe COVID-19, compared with those following other diets. Participants following lowcarbohydrate, high-protein diets did worse, with a nearly 4 times greater odds of moderate-tosevere COVID-19 than those following plant-based diets.…”

Pandemic Times for Fitness Professionals and Health and Well-Being Coaches

“…Moreover, the risk of dying from COVID-19 was less in those following this diet emphasizing fresh fruits, vegetables, fish, and olive oil. A very interesting, related study collected data using cell phones and discovered that a high-quality diet (i.e., lots of fruits and veggies) lowered the risk of COVID infection and risk of severe disease (8). What was overwhelming about this study is that they sampled more than 500,000 participants making for a very powerful analysis of data.…”