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

Merino, Jordi LU ; Joshi, Amit D. ; Nguyen, Long H. ; Leeming, Emily R. ; Mazidi, Mohsen ; Drew, David A. ; Gibson, Rachel ; Graham, Mark S. ; Lo, Chun Han and Capdevila, Joan , et al. (2021) In Gut 70(11). p.2096-2104
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... (More)

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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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
COVID-19, diet, dietary factors, infectious disease
in
Gut
volume
70
issue
11
pages
9 pages
publisher
BMJ Publishing Group
external identifiers
  • scopus:85116036036
  • pmid:34489306
ISSN
1468-3288
DOI
10.1136/gutjnl-2021-325353
language
English
LU publication?
yes
additional info
Publisher Copyright: © Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
id
3dd6aca5-7d1e-476e-9204-c040fbc027e1
date added to LUP
2022-05-11 00:33:01
date last changed
2022-08-12 05:36:17
@article{3dd6aca5-7d1e-476e-9204-c040fbc027e1,
  abstract     = {{<p>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.</p>}},
  author       = {{Merino, Jordi and Joshi, Amit D. and Nguyen, Long H. and Leeming, Emily R. and Mazidi, Mohsen and Drew, David A. and Gibson, Rachel and Graham, Mark S. and Lo, Chun Han and Capdevila, Joan and Murray, Benjamin and Hu, Christina and Selvachandran, Somesh and Hammers, Alexander and Bhupathiraju, Shilpa N. and Sharma, Shreela V. and Sudre, Carole and Astley, Christina M. and Chavarro, Jorge E. and Kwon, Sohee and Ma, Wenjie and Menni, Cristina and Willett, Walter C. and Ourselin, Sebastien and Steves, Claire J. and Wolf, Jonathan and Franks, Paul W. and Spector, Timothy D. and Berry, Sarah and Chan, Andrew T.}},
  issn         = {{1468-3288}},
  keywords     = {{COVID-19; diet; dietary factors; infectious disease}},
  language     = {{eng}},
  month        = {{11}},
  number       = {{11}},
  pages        = {{2096--2104}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Gut}},
  title        = {{Diet quality and risk and severity of COVID-19 : a prospective cohort study}},
  url          = {{http://dx.doi.org/10.1136/gutjnl-2021-325353}},
  doi          = {{10.1136/gutjnl-2021-325353}},
  volume       = {{70}},
  year         = {{2021}},
}