The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19

Frel, Daan L. de; Atsma, Douwe E.; Pijl, Hanno; Seidell, Jacob C.; Leenen, Pieter J.M.; Dik, Willem A.; Rossum, Elisabeth F.C. van

doi:10.3389/fnut.2020.597600

Cited by 77 publications

(76 citation statements)

References 102 publications

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“…An important lesson learned from the coronavirus pandemic is the importance of a healthy lifestyle to positively influence the course of COVID-19 disease. A non-processed nutrient-rich diet [ 173 , 174 , 175 ], limited excessive or overly energy-rich food, sufficient and intensive exercise [ 176 ], sufficient sleep [ 177 ] and avoiding chronic psycho-emotional stress [ 178 ] are all efficient health-promoting measures in the prevention of obesity [ 179 ]. We also advocate an integrated multidisciplinary approach in the fight against COVID-19.…”

Section: Conclusion and Implications For Further Researchmentioning

confidence: 99%

Obesity as a Risk Factor for Severe COVID-19 and Complications: A Review

Demeulemeester¹,

Punder²,

Heijningen³

et al. 2021

Cells

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Emerging data suggest that obesity is a major risk factor for the progression of major complications such as acute respiratory distress syndrome (ARDS), cytokine storm and coagulopathy in COVID-19. Understanding the mechanisms underlying the link between obesity and disease severity as a result of SARS-CoV-2 infection is crucial for the development of new therapeutic interventions and preventive measures in this high-risk group. We propose that multiple features of obesity contribute to the prevalence of severe COVID-19 and complications. First, viral entry can be facilitated by the upregulation of viral entry receptors, like angiotensin-converting enzyme 2 (ACE2), among others. Second, obesity-induced chronic inflammation and disruptions of insulin and leptin signaling can result in impaired viral clearance and a disproportionate or hyper-inflammatory response, which together with elevated ferritin levels can be a direct cause for ARDS and cytokine storm. Third, the negative consequences of obesity on blood coagulation can contribute to the progression of thrombus formation and hemorrhage. In this review we first summarize clinical findings on the relationship between obesity and COVID-19 disease severity and then further discuss potential mechanisms that could explain the risk for major complications in patients suffering from obesity.

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Section: Conclusion and Implications For Further Researchmentioning

confidence: 99%

Obesity as a Risk Factor for Severe COVID-19 and Complications: A Review

Demeulemeester¹,

Punder²,

Heijningen³

et al. 2021

Cells

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“…The immune system plays a key role in an individual's susceptibility and response to infectious diseases, including COVID-19 [3,4]. A major modifiable factor affecting immune function is dietary behavior that influences nutritional status [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Dietary Behaviors and Incident COVID-19 in the UK Biobank

Rydland

Achenbach

et al. 2021

Nutrients

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Background: Nutritional status influences immunity but its specific association with susceptibility to COVID-19 remains unclear. We examined the association of specific dietary data and incident COVID-19 in the UK Biobank (UKB). Methods: We considered UKB participants in England with self-reported baseline (2006–2010) data and linked them to Public Health England COVID-19 test results—performed on samples from combined nose/throat swabs, using real time polymerase chain reaction (RT-PCR)—between March and November 2020. Baseline diet factors included breastfed as baby and specific consumption of coffee, tea, oily fish, processed meat, red meat, fruit, and vegetables. Individual COVID-19 exposure was estimated using the UK’s average monthly positive case rate per specific geo-populations. Logistic regression estimated the odds of COVID-19 positivity by diet status adjusting for baseline socio-demographic factors, medical history, and other lifestyle factors. Another model was further adjusted for COVID-19 exposure. Results: Eligible UKB participants (n = 37,988) were 40 to 70 years of age at baseline; 17% tested positive for COVID-19 by SAR-CoV-2 PCR. After multivariable adjustment, the odds (95% CI) of COVID-19 positivity was 0.90 (0.83, 0.96) when consuming 2–3 cups of coffee/day (vs. <1 cup/day), 0.88 (0.80, 0.98) when consuming vegetables in the third quartile of servings/day (vs. lowest quartile), 1.14 (1.01, 1.29) when consuming fourth quartile servings of processed meats (vs. lowest quartile), and 0.91 (0.85, 0.98) when having been breastfed (vs. not breastfed). Associations were attenuated when further adjusted for COVID-19 exposure, but patterns of associations remained. Conclusions: In the UK Biobank, consumption of coffee, vegetables, and being breastfed as a baby were favorably associated with incident COVID-19; intake of processed meat was adversely associated. Although these findings warrant independent confirmation, adherence to certain dietary behaviors may be an additional tool to existing COVID-19 protection guidelines to limit the spread of this virus.

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“…The association holds for both obesity and obesity-associated metabolic health – hypertension, diabetes, dyslipidemia, and systemic inflammation ( 13 ). Similarly, obesity and excess adipose tissue have also been associated with higher risk of SARS-CoV-2 infection ( 10 , 14 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

Poor Metabolic Health Increases COVID-19-Related Mortality in the UK Biobank Sample

Morys

2021

Front. Endocrinol.

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Previous studies link obesity and components of metabolic health, such as hypertension or inflammation, to increased hospitalizations and mortality of patients with COVID-19. Here, in two overlapping samples of over 1,000 individuals from the UK Biobank we investigate whether metabolic health as measured by waist circumference, dyslipidemia, hypertension, type 2 diabetes, and systemic inflammation is related to increased COVID-19 infection and mortality rate. Using logistic regression and controlling for confounding variables such as socioeconomic status, age, sex or ethnicity, we find that individuals with worse metabolic health (measured on average eleven years prior to 2020) have an increased risk for COVID-19-related death (adjusted odds ratio: 1.75). We also find that specific factors contributing to increased mortality are increased serum glucose levels, systolic blood pressure and waist circumference.

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The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19

Cited by 77 publications

References 102 publications

Obesity as a Risk Factor for Severe COVID-19 and Complications: A Review

Obesity as a Risk Factor for Severe COVID-19 and Complications: A Review

Dietary Behaviors and Incident COVID-19 in the UK Biobank

Poor Metabolic Health Increases COVID-19-Related Mortality in the UK Biobank Sample

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