Greene Michael W, Roberts Alexis P, Frugé Andrew D
Department of Nutrition, Auburn University, Auburn, AL, United States.
Boshell Diabetes and Metabolic Disease Research Program, Auburn University, Auburn, AL, United States.
Front Nutr. 2021 Mar 5;8:591964. doi: 10.3389/fnut.2021.591964. eCollection 2021.
In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) emerged in Wuhan, China, sparking the Coronavirus disease 2019 (COVID-19) pandemic. The high prevalence of nutrition-related COVID-19 risk factors including obesity, type 2 diabetes, and hypertension, suggests that healthy dietary approaches may mitigate COVID-19 related outcomes and possibly SARS-CoV-2 infection. Based on the fundamental role of nutrition in immune function and the well-documented association between Mediterranean diet consumption and risk reduction for chronic diseases that are comorbidities in COVID-19 patients, we hypothesized that there would be a relationship between Mediterranean diet adherence and COVID-19 cases and related deaths. In this perspective, we examined the association between regional adherence to a Mediterranean diet and COVID-19 cases and deaths using an ecological study design. We observed that Mediterranean diet adherence was negatively associated with both COVID-19 cases and related deaths across 17 regions in Spain and that the relationship remained when adjusted for factors of well-being. We also observed a negative association between Mediterranean diet adherence and COVID-19 related deaths across 23 countries when adjusted for factors of well-being and physical inactivity. The anti-inflammatory properties of the Mediterranean diet - likely due to the polyphenol content of the diet - may be a biological basis to explain our findings. However, there are confounding factors unrelated to dietary factors driving COVID-19 cases and related deaths across the regions in Spain and the 23 countries examined in our analysis. Our findings will need to be confirmed and further explored in cohort studies.
2019年12月，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在中国武汉出现，引发了2019冠状病毒病（COVID-19）大流行。包括肥胖、2型糖尿病和高血压在内的与营养相关的COVID-19风险因素普遍存在，这表明健康的饮食方式可能减轻与COVID-19相关的后果，并可能降低感染SARS-CoV-2的风险。基于营养在免疫功能中的基本作用以及地中海饮食消费与COVID-19患者合并症慢性病风险降低之间的充分记录的关联，我们假设地中海饮食依从性与COVID-19病例及相关死亡之间存在关联。从这个角度出发，我们使用生态研究设计检查了地区地中海饮食依从性与COVID-19病例及死亡之间的关联。我们观察到，西班牙17个地区的地中海饮食依从性与COVID-19病例及相关死亡均呈负相关，并且在对幸福感因素进行调整后这种关系依然存在。在对幸福感和身体活动不足因素进行调整后，我们还观察到23个国家的地中海饮食依从性与COVID-19相关死亡之间存在负相关。地中海饮食的抗炎特性——可能归因于饮食中的多酚含量——可能是解释我们研究结果的生物学基础。然而，在我们分析的西班牙各地区和23个国家中，存在与饮食因素无关的混杂因素驱动着COVID-19病例及相关死亡。我们的研究结果需要在队列研究中得到证实并进一步探索。
