1. In this study, higher quality diet was associated with lower risk of COVID-19.
2. Amongst participants living in areas of high socioeconomic deprivation, the association between poor diet quality and COVID-19 risk was more evident.
Evidence Rating Level: 2 (Good)
Patients with metabolic diseases such as obesity and Type 2 diabetes have been found to have increased risk for COVID-19 incidence and outcomes. Diet plays a critical role in these metabolic diseases but how quality of diet impact risk and severity of COVID-19 has not been well-characterized.
This prospective observational study followed 592,571 participants from the United Kingdom (UK) and United States (US) between March 24, 2020 and December 2, 2020 as a part of the smartphone-based COVID-19 Symptom study. Patients with symptoms of COVID or a positive COVID test prior to start of study and patients who were younger than 18 years old, pregnant, and who only logged 1 daily assessment during follow-up were excluded. Assessment of dietary patterns prior to observational period was done using questionnaires and the Plant-Based Diet Index (hPDI), with higher scores correlating with more intake of fruits, vegetables, and whole grains.
In this study, 31,815 participants developed COVID-19 during the study period. Patients in the highest quartile of diet score had 9% lower risk of developing COVID-19 and 41% lower risk of developing severe COVID-19 compared to patients in the lowest quartile of the diet score. Strikingly, the inverse association between diet quality and COVID-19 risk was more evident in participants living in areas of high socioeconomic deprivation. However, this study was limited in that the assessment of diet quality was only in the pre-observation period, which did not account for potential impact of the pandemic on food access. Nonetheless, this study was significant in suggesting that policies that work to ensure food security in groups disparately effected by COVID-19 is critical.
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