Impact of obesity on COVID-19 and its dietary prevention and control measures

Since the global pandemic of COVID-19, a huge challenge has been brought to human health and life. Here, we review the literature and present a comprehensive analysis to identify the relationship between obesity and CDVID-19. Obesity can cause chronic inflammation, respiratory impairment, vitamin D and other micronutrient deficiencies, and dysbiosis in humans, thereby affecting susceptibility and disease severity of COVID-19, as well as the body's response to the vaccine. The COVID-19 outbreak causes psychological stress, sleep disturbance, increased sedentary behavior, and increased intake of fast foods and overprocessed foods, which will increase the risk of developing obesity. Over 50% of the world's population is currently overweight or obese, and the number of COVID-l9 cases has rapidly increased to over 470 million. According to the theory of public health prevention and control, we propose that a comprehensive program with rational dietary action as the core is the optimal strategy for and controlling preventing and controlling obesity and COVID-19.

Mitigating poverty and undernutrition through social protection: a simulation analysis of the COVID-19 pandemic in Bangladesh and Myanmar

The COVID-19 pandemic resulted in severe income losses, but little is known about its impacts on diets and nutritional adequacy, or the effectiveness of social protection interventions in mitigating dietary and nutritional impacts. We first assess the likely impacts of COVID-19 shocks in Bangladesh and Myanmar on poverty and food and nutrient consumption gaps. We then analyze the estimated mitigating effects of five hypothetical social protection interventions of a typical monetary value: (1) cash transfers;(2) in-kind transfers of common rice;(3) in-kind transfers of fortified rice enriched with multiple essential micronutrients;(4) vouchers for a diversified basket of rice and non-staple foods;and (5) food vouchers with fortified rice instead of common rice. The simulation results suggest modest effectiveness of the cash transfers for mitigating poverty increases and little effectiveness of all five transfers for preventing increasing food and nutrient consumption gaps among the poorest 40%. Rice fortification is, however, effective at closing key micronutrient consumption gaps and could be a suitable policy instrument for averting 'hidden hunger' during economic crises.

Influence of perioperative oral nutritional supplementation on short-term efficacy of laparoscopic sleeve gastrectomy for obesity patients: a prospective study

Objective: To investigate the effect of perioperative oral nutritional supplementation on the short-term curative effect of obese patients after laparoscopic sleeve gastrectomy (LSG). Methods: A prospective research method was adopted. The clinical data of 218 obese patients who underwent LSG in Ningxia Medical University General Hospital from January 2018 to December 2021 were selected. The patients who received oral nutritional supplement therapy during the perioperative period were set as the experimental group, and those who received conventional treatment were set as the control group. Observation indicators: (1) Grouping of enrolled patients. (2) Postoperative and follow-up situation. (3) Nutrition-related indicators. (4) Diet compliance. (5) Status of weight loss-related indicators. Follow-up visits were conducted by telephone, We Chat and outpatient visits. The patients were followed up once 30 days after discharge, including albumin (Alb), hemoglobin (Hb), dietary compliance and weight loss-related indicators. The follow-up time will end in February 2022. The measurement data with normal distribution were expressed as x+or-s, and the comparison between groups was performed by independent sample t test. The measurement data is represented by M (range), and the comparison between groups is performed by Mann?Whitney U test. Enumeration data were expressed as absolute numbers or percentages, and the X2 test was used for comparison between groups. Repeated measures data were analyzed by repeated measures analysis of variance. The rank sum test was used to compare the rank data. Results (1) Grouping of the enrolled patients. Screened 218 eligible patients;42 males and 176 females;age (32+or-9) years;body mass index (BMI) (39+or-7) kg/m2. Among the 218 patients, there were 109 cases in the test group and 109 cases in the control group. Gender (male, female), age, BMI, preoperative Alb, and preoperative Hb of patients in the test group were 17 and 92 cases, (33+or-9) years old, (39+or-7) kg/m2, (40.6+or-4.8) g /L, (141.7+or-13.9) g/L;the above indicators in the control group were 25 and 84 cases, (31+or-8) years old, (39+or-8) kg/m2, (40.9+or-4.2) g/L, (142.9+or-9.7) g/L;there was no significant difference in the above (X2=1.89, t=-1.52, 0.51, 0.40, 0.71, P > 0.05). (2) Postoperative and follow-up situation. The first hospitalization time and first hospitalization expenses of the patients in the experimental group were (9.1+or-2.9) d and (3.6+or-0.5) ten thousand yuan respectively;the above indicators of the patients in the control group were (4.9+or-1.0) ten thousand yuan respectively;There were statistically significant differences in the above indicators between the two groups (t=5.58, 12.38, P < 0.05). Among the 218 patients, 119 were followed up, including 62 in the experimental group and 57 in the control group. The 119 patients were followed up for 31.0 (25.0-38.0) days. Among the 218 patients, 14 cases had postoperative complications and led to rehospitalization, including 2 cases in the experimental group, 1 case of nausea and vomiting and 1 case of intestinal obstruction;12 cases in the control group, 10 cases of nausea and vomiting, gastric fistula 2 cases;there was a statistically significant difference between the two groups in hospital readmission (X2=7.63, P < 0.05). The time interval between re-admission and first discharge of 14 patients was (22.0+or-6.7) days. (3) Nutrition-related indicators. The Alb and Hb levels of 62 patients in the experimental group who were followed up before operation, before the first discharge, and 1 month after operation were (40.4+or-5.5) g/L, (35.9+or-3.8) g/L, (45.4+or-2.9) g/L, respectively and (140.8+or-13.9) g/L, (130.5+or-16.9) g/L, (147.8+or-17.2) g/L;the above indicators of 57 patients in the control group were (41.2+or-3.9) g/L, (34.2 +or-3.9) g/L, (42.7+or-5.3) g/L and (143.0+or-9.7) g/L, (122.9+or-12.8) g/L, (139.0+or-11.4) g/L;There was a statistically significant difference between the Alb and Hb groups from preoperative to postoperative 1 mont

The effect of functional exercise along with online nutritional education on inflammatory biomarkers in children with autism spectrum disorder during COVID-19 pandemic: a randomized clinical trial

Background and Objectives: Autism spectrum disorder (ASD) is a neuro-developmental disorder which is mostly caused by deficits in social interactions. Lack of physical activity and poor nutritional habits are common problems in these patients which may be exaggerated by the Covid-19 pandemic. The study aims to assess the effect of functional training along with online nutrition education on inflammatory biomarkers in children with ASD. Subjects and Methods: In this randomized controlled clinical trial, 80 children with ASD (age=9.73+or-1.29 years, weight=49.94+or-2.08 kg, height=146.08+or-40 cm, body mass index=24.71 +or-1.48 kg/m2) were randomly divided into four groups of training, education, training+ education, and control. The interventions lasted for 8 weeks. The inflammatory biomarkers including white blood cell (WBC) count, C-reactive protein (CRP) level, neutrophil count, eosinophil count, and basophil count were assessed (using blood samples collected from antecubital vein) before and after the interventions. Results: There was no significant difference between the groups before the interventions (P>0.05). After the intervention, the results showed a significant decrease in WBC (P<0.001), CRP (P=0.001), neutrophils (sig.=0.009), and eosinophil (P=0.003) in all groups. Basophil count decreased in all groups (P=0.01) except in the education group. Conclusion: Functional training and online nutrition education are beneficial interventions for management of inflammatory biomarkers in children with ASD which can be used during the Covid-19 pandemic.

Gut distress and intervention via communications of SARS-CoV-2 with mucosal exposome.

Acute coronavirus disease 2019 (COVID-19) has been associated with prevalent gastrointestinal distress, characterized by fecal shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA or persistent antigen presence in the gut. Using a meta-analysis, the present review addressed gastrointestinal symptoms, such as nausea, vomiting, abdominal pain, and diarrhea. Despite limited data on the gut-lung axis, viral transmission to the gut and its influence on gut mucosa and microbial community were found to be associated by means of various biochemical mechanisms. Notably, the prolonged presence of viral antigens and disrupted mucosal immunity may increase gut microbial and inflammatory risks, leading to acute pathological outcomes or post-acute COVID-19 symptoms. Patients with COVID-19 exhibit lower bacterial diversity and a higher relative abundance of opportunistic pathogens in their gut microbiota than healthy controls. Considering the dysbiotic changes during infection, remodeling or supplementation with beneficial microbial communities may counteract adverse outcomes in the gut and other organs in patients with COVID-19. Moreover, nutritional status, such as vitamin D deficiency, has been associated with disease severity in patients with COVID-19 via the regulation of the gut microbial community and host immunity. The nutritional and microbiological interventions improve the gut exposome including the host immunity, gut microbiota, and nutritional status, contributing to defense against acute or post-acute COVID-19 in the gut-lung axis.

Aged brain and neuroimmune responses to COVID-19: post-acute sequelae and modulatory effects of behavioral and nutritional interventions.

Advanced age is one of the significant risk determinants for coronavirus disease 2019 (COVID-19)-related mortality and for long COVID complications. The contributing factors may include the age-related dynamical remodeling of the immune system, known as immunosenescence and chronic low-grade systemic inflammation. Both of these factors may induce an inflammatory milieu in the aged brain and drive the changes in the microenvironment of neurons and microglia, which are characterized by a general condition of chronic inflammation, so-called neuroinflammation. Emerging evidence reveals that the immune privilege in the aging brain may be compromised. Resident brain cells, such as astrocytes, neurons, oligodendrocytes and microglia, but also infiltrating immune cells, such as monocytes, T cells and macrophages participate in the complex intercellular networks and multiple reciprocal interactions. Especially changes in microglia playing a regulatory role in inflammation, contribute to disturbing of the brain homeostasis and to impairments of the neuroimmune responses. Neuroinflammation may trigger structural damage, diminish regeneration, induce neuronal cell death, modulate synaptic remodeling and in this manner negatively interfere with the brain functions.In this review article, we give insights into neuroimmune interactions in the aged brain and highlight the impact of COVID-19 on the functional systems already modulated by immunosenescence and neuroinflammation. We discuss the potential ways of these interactions with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and review proposed neuroimmune mechanisms and biological factors that may contribute to the development of persisting long COVID conditions. We summarize the potential mechanisms responsible for long COVID, including inflammation, autoimmunity, direct virus-mediated cytotoxicity, hypercoagulation, mitochondrial failure, dysbiosis, and the reactivation of other persisting viruses, such as the Cytomegalovirus (CMV). Finally, we discuss the effects of various interventional options that can decrease the propagation of biological, physiological, and psychosocial stressors that are responsible for neuroimmune activation and which may inhibit the triggering of unbalanced inflammatory responses. We highlight the modulatory effects of bioactive nutritional compounds along with the multimodal benefits of behavioral interventions and moderate exercise, which can be applied as postinfectious interventions in order to improve brain health.

Nutritional Support During Long COVID: A Systematic Scoping Review.

Introduction: Long COVID is a term that encompasses a range of signs, symptoms, and sequalae that continue or develop after an acute COVID-19 infection. The lack of early recognition of the condition contributed to delays in identifying factors that may contribute toward its development and prevention. The aim of this study was to scope the available literature to identify potential nutritional interventions to support people with symptoms associated with long COVID. Methods: This study was designed as a systematic scoping review of the literature (registration PROSPERO CRD42022306051). Studies with participants aged 18 years or older, with long COVID and who underwent a nutritional intervention were included in the review. Results: A total of 285 citations were initially identified, with five papers eligible for inclusion: two were pilot studies of nutritional supplements in the community, and three were nutritional interventions as part of inpatient or outpatient multidisciplinary rehabilitation programs. There were two broad categories of interventions: those that focused on compositions of nutrients (including micronutrients such as vitamin and mineral supplements) and those that were incorporated as part of multidisciplinary rehabilitation programs. Nutrients included in more than one study were multiple B group vitamins, vitamin C, vitamin D, and acetyl-l-carnitine. Discussion: Two studies trialed nutritional supplements for long COVID in community samples. Although these initial reports were positive, they are based on poorly designed studies and therefore cannot provide conclusive evidence. Nutritional rehabilitation was an important aspect of recovery from severe inflammation, malnutrition, and sarcopenia in hospital rehabilitation programs. Current gaps in the literature include a potential role for anti-inflammatory nutrients such as the omega 3 fatty acids, which are currently undergoing clinical trials, glutathione-boosting treatments such as N-acetylcysteine, alpha-lipoic acid, or liposomal glutathione in long COVID, and a possible adjunctive role for anti-inflammatory dietary interventions. This review provides preliminary evidence that nutritional interventions may be an important part of a rehabilitation program for people with severe long COVID symptomatology, including severe inflammation, malnutrition, and sarcopenia. For those in the general population with long COVID symptoms, the role of specific nutrients has not yet been studied well enough to recommend any particular nutrient or dietary intervention as a treatment or adjunctive treatment. Clinical trials of single nutrients are currently being conducted, and future systematic reviews could focus on single nutrient or dietary interventions to identify their nuanced mechanisms of action. Further clinical studies incorporating complex nutritional interventions are also warranted to strengthen the evidence base for using nutrition as a useful adjunctive treatment for people living with long COVID.

A Synthesis Review of Vitamins Involved in the Fight against Covid-19

Although literature studies on earlier viruses such as the Severe Acute Respiratory Syndrome (SARS), the Middle East Respiratory Syndrome (MERS), and other similar viruses, in terms of treatment of coronavirus suggested the repurposing of some antiviral drugs, some Covid-19 specific treatments, general forms of treatments, the use of convalescent plasma, as well as nutritional interventions in the form of vitamins, it is imperative to interrogate the nutritional status, age, and comorbidities of each infected patient before receiving any form of treatment. In the absence of any conclusive treatment so far, the study encourages the use of all likely interventions that could help arrest the spread of the disease. In addition, the current study has a particular interest in the syntheses and applications of vitamins and their derivatives which have been touted to play a significant role in the fight against Covid-19, namely, vitamins A–E. It must, however, be mentioned that literature is not comprehensive. © 2023 Wiley-VCH GmbH.

Review of dietary intervention studies that utilized online tools for pregnant or postpartum women

Objective: Due to the prolonged social restrictions implemented during the novel COVID-19 pandemic, there is a need to develop effective dietary intervention methods for pregnant/postpartum women without meeting in-person. We conducted a literature review on online dietary intervention studies on pregnant/postpartum women.

COVID-19 GIT affection: an updated review

Background: Although it was initially believed that the coronavirus disease 2019 (COVID-19) only attacked the respiratory system, reports over time demonstrated that this disease could attack the gastrointestinal tract (GIT) as well. The predominant presenting symptoms in patients infected with COVID-19 were gastrointestinal, resulting in gastrointestinal (GI) pathological changes. While clinicians' concerns are mostly related to respiratory system manifestations, GI symptoms should be monitored and managed appropriately. Objectives: This review summarizes the essential information about COVID-19 GIT infection in terms of pathogenesis, major pathological changes, microbiological bases of infection and the possibility of feco-oral transmission, the severity of associated symptoms, the major radiological findings, the impact on GI surgery, the role of therapeutic agents in induction or magnification of GI symptoms, and a pitfall on the nutritional supplementation in COVID-19 patients.

Implementing DASH-aligned Congregate Meals and Self-Measured Blood Pressure in two senior centers: An open label study.

BACKGROUND AND AIMS: Cardiovascular Disease (CVD) poses significant health risks for seniors, especially among low-income and minority communities. Senior centers offer multiple services. We tested whether implementing two evidence-based interventions- DASH-aligned meals provided through an existing congregate meal program, and support for home Self-Measured Blood Pressure (SMBP) monitoring-lowers blood pressure among participants at two senior centers serving low-income, racially diverse communities. METHODS AND RESULTS: Open-label study, enrolling clients aged ≥60, eating ≥4 meals/week at two NYC senior centers. Participants received DASH-aligned congregate meals, and training in nutrition, BP management education, and personal SMBP device. Co-Primary outcomes: a) change in systolic BP measured by independent health professionals, and b) change in percent with "controlled BP" (Eighth Joint National Committee (JNC-8) Guidelines), at Month 1 compared to Baseline. SECONDARY OUTCOMES: Changes in BP at Months 3 and 5/6 (last measure). We enrolled 94 participants; COVID closures interrupted implementation mid-study. Mean systolic BP at Month-1 changed by -4.41 mmHg (n = 61 p = 0.07) compared to Baseline. Participants with controlled BP increased (15.7%) at Month 1. Change in mean BP at Month 1 was significantly correlated with BMI (p = 0.02), age (p = 0.04), and baseline BP (p < 0.001). Mean systolic SMBP changed by -6.9 mmHg (p = 0.004) at Months 5/6. CONCLUSIONS: Implementing an evidence-based multi-component BP-lowering intervention within existing congregate meal programs at senior centers serving minority and low-income communities is feasible, and early findings show promising evidence of effectiveness. This approach to cardiovascular risk reduction should be further tested for widespread adoption and impact. Registered on ClinicalTrials.gov NCT03993808 (June 21st, 2019).

Applicability of three nutritional screening tools in patients with liver cirrhosis under the Global Leadership Initiative on Malnutrition criteria. (Theme Issue: Diagnosis and treatment of liver failure in children.) [Chinese]

Objective: To investigate whether Royal Free Hospital Nutritional Prioritizing Tool (RFH-NPT) is more suitable than Nutritional Risk Screening 2002 (NRS-2002) in nutritional risk screening for patients with liver cirrhosis, as well as the applicability of subjective global assessment (SGA) in the nutritional assessment of patients with liver cirrhosis.

Recommendations on nutritional strategies and metabolic management. (Pautas nacionales para la atenci..n de pacientes adultos con COVID-19.) [Spanish]

The aim of the article was to discuss current guidelines for metabolic management. Current considerations on nutritional therapy (NT) in the ICU for patients with COVID-19 are based on indirect recommendations established in similar populations of critically ill patients;for example, in conditions such as acute respiratory distress syndrome (ARDS), sepsis, or acute kidney injury. From a practical point of view, it is appropriate that the NT strategy in these patients consider: (1) the phase of the disease, (2) the hemodynamic condition and (3) the type of respiratory support indicated for each individual patient. Therefore, patients with severe pneumonia or COVID-19 sepsis should be considered patients with high nutritional risk. On the other hand, it has been shown that an increased BMI is related to a poor prognosis, which supports a possible role of sarcopenic obesity in the survival of critically ill patients with COVID-19. Patients with sepsis due to COVID-19 and septic shock have no contraindication to start an EN, with the exception of vasopressor doses being increased, presenting elements of tissue dysoxia or acute gastrointestinal dysfunction with intolerance to EN.

Can Probiotics and Diet Promote Beneficial Immune Modulation and Purine Control in Coronavirus Infection?

Infection caused by the SARS-CoV-2 coronavirus worldwide has led the World Health Organization to declare a COVID-19 pandemic. Because there is no cure or treatment for this virus, it is emergingly urgent to find effective and validated methods to prevent and treat COVID-19 infection. In this context, alternatives related to nutritional therapy might help to control the infection. This narrative review proposes the importance and role of probiotics and diet as adjunct alternatives among the therapies available for the treatment of this new coronavirus. This review discusses the relationship between intestinal purine metabolism and the use of Lactobacillus gasseri and low-purine diets, particularly in individuals with hyperuricemia, as adjuvant nutritional therapies to improve the immune system and weaken viral replication, assisting in the treatment of COVID-19. These might be promising alternatives, in addition to many others that involve adequate intake of vitamins, minerals and bioactive compounds from food.

Malnutrition and Inadequate Eating Behaviour during Hospital Stay in Geriatrics-An Explorative Analyses of NutritionDay Data in Two Hospitals.

(1) Background: Malnutrition in hospitalized patients is prevalent worldwide, but the severity of the issue is often underestimated by practitioners. The purpose of this study is to investigate the prevalence of malnutrition and inadequate eating behaviour in a geriatric sample. (2) Methods: Two hospitals participated with six wards on nutritionDay in 2017, 2018 and 2019. Nutritional status, food intake, and nutritional interventions were analyzed for all patients ≥ 65 years (n = 156), using the official nutritionDay questionnaires. Malnutrition risk is identified by Malnutrition Universal Screening Tool (MUST), malnutrition by the ESPEN criteria (European Society of Clinical Nutrition and Metabolism). (3) Results: According to MUST (n = 136) 16.9% (n = 23) were at medium risk of malnutrition, 33.8% (n = 46) at high risk of malnutrition, 28.1% (n = 38) were malnourished. Overall, 62.8% (n = 98) showed an inadequate eating behaviour during hospital stay. Moreover, patients with inadequate nutrition had significantly worse self-reported health statuses (p = 0.001; r = -0.276), were less able to walk on nutritionDay (p = 0.002; r = -0.255), had eaten little in the week before admission to hospital (p < 0.001; r = -0.313), and had an increased length of stay (p = 0.036; r = -0.174). (4) Conclusion: To identify malnourished patients is a significant barrier for practitioners seeking to administer specific, tailored interventions. Malnutrition screening protocols must be improved, just as nutrition monitoring in general.