Adherence to the Mediterranean Diet Association with Serum Inflammatory Factors Stress Oxidative and Appetite in COVID-19 Patients
Mohajeri et al.
, Adherence to the Mediterranean Diet Association with Serum Inflammatory Factors Stress Oxidative and Appetite..
, Medicina, doi:10.3390/medicina59020227
Retrospective 600 COVID-19 patients in Iran with moderate/severe CT scans, showing lower prevalence of dyspnea, fever, taste/smell abnormalities, and cough with high adherence to the Mediterranean diet in unadjusted results.
This study is excluded in the after exclusion results of meta
unadjusted results with no group details.
risk of progression, 25.4% lower, RR 0.75, p < 0.001, higher quality diet 62 of 105 (59.0%), lower quality diet 392 of 495 (79.2%), NNT 5.0, dyspnea.
risk of progression, 51.1% lower, RR 0.49, p < 0.001, higher quality diet 50 of 105 (47.6%), lower quality diet 482 of 495 (97.4%), NNT 2.0, fever.
risk of progression, 70.3% lower, RR 0.30, p < 0.001, higher quality diet 23 of 105 (21.9%), lower quality diet 365 of 495 (73.7%), NNT 1.9, taste/smell.
risk of progression, 9.7% higher, RR 1.10, p = 0.03, higher quality diet 98 of 105 (93.3%), lower quality diet 421 of 495 (85.1%), fatigue.
risk of progression, 52.9% lower, RR 0.47, p < 0.001, higher quality diet 38 of 105 (36.2%), lower quality diet 380 of 495 (76.8%), NNT 2.5, cough.
risk of progression, 25.9% lower, RR 0.74, p = 0.007, higher quality diet 44 of 105 (41.9%), lower quality diet 280 of 495 (56.6%), NNT 6.8, diarrhea.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Mohajeri et al., 26 Jan 2023, retrospective, Iran, peer-reviewed, survey, 3 authors.
email@example.com (corresponding author), firstname.lastname@example.org.
Adherence to the Mediterranean Diet Association with Serum
Inflammatory Factors Stress Oxidative and Appetite in
Mahsa Mohajeri 1, *, Reza Mohajery 2
Citation: Mohajeri, M.; Mohajery, R.;
Cicero, A.F.G. Adherence to the
Mediterranean Diet Association with
Serum Inflammatory Factors Stress
Oxidative and Appetite in COVID-19
Patients. Medicina 2023, 59, 227.
Academic Editors: Yusra Habib Khan,
and Arrigo F. G. Cicero 3,4, *
Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil 56189-85991, Iran
Energy Management Research Center, University of Mohaghegh Ardabili, Ardabil 56199-11367, Iran
Medicine and Surgery Sciences Department, Alma Mater Studiorum University of Bologna,
40126 Bologna, Italy
IRCCS AOU S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy
Correspondence: email@example.com (M.M.); firstname.lastname@example.org (A.F.G.C.);
Tel.: +98-9143592794 (M.M.); +39-512142224 (A.F.G.C.)
Abstract: Background and Objectives: The Mediterranean diet’s bioactive components are suggested
to strengthen the immune system and to exert anti-inflammatory actions. This study investigated
the association between adherence to the Mediterranean diet with serum inflammatory factors, total
antioxidant capacity, appetite, and symptoms of COVID-19 patients. Materials and Methods: This crosssectional study was conducted among 600 Iranian COVID-19 patients selected by a simple random
method. The ten-item Mediterranean diet adherence questionnaire was used to assess diet adherence.
At the beginning of the study, 5 cc of blood was taken from all patients for measurement of serum
interleukin 1β) IL-1β), tumor necrosis factor (TNF-α), malondialdehyde (MDA), high sensitivity Creactive protein (hs-CRP) and total antioxidant capacity (TAC). A human ELISA kit with serial number
950.090.096 produced by the Diaclone Company was used to test this cytokine using the sandwich
ELISA method. Results: One hundred and five patients presented a high adherence and 495 patients
presented a low adherence to the Mediterranean diet. The incidence of fever, cough, diarrhea, taste
changes, and pneumonia severity index were significantly lower in patients who adhered to the
Mediterranean diet more than other patients. Serum levels of tumor necrosis factor (5.7 ± 2.1 vs.
6.9 ± 2.8 p = 0.02), interleukin 1 beta (3.2 ± 0.02 vs. 4.9 ± 0.01 p = 0.02), high-sensitivity C-reactive
protein (17.08 ± 4.2 vs. 19.8 ± 2.5 p = 0.03), and malondialdehyde (5.7 ± 0.2 vs. 6.2 ± 0.3 p = 0.02)
were significantly lower in patients who adhered more to the Mediterranean diet than other patients.
Conclusion: The Mediterranean diet can improve the symptoms and elevated serum inflammatory
factors in COVID-19 patients, so clinical trial studies are suggested to confirm this effect.
Tauqeer Hussain Mallhi,
Tahir Mehmood Khan and
Keywords: mediterranean diet; inflammatory factors; stress oxidative; appetite; COVID-19
Received: 25 December 2022
Revised: 18 January 2023
Accepted: 22 January 2023
Published: 26 January 2023
Copyright: © 2023 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
Please send us corrections, updates, or comments. Vaccines and
treatments are complementary. All practical, effective, and safe means should
be used based on risk/benefit analysis. No treatment, vaccine, or intervention
is 100% available and effective for all current and future variants. We do not
provide medical advice. Before taking any medication, consult a qualified
physician who can provide personalized advice and details of risks and
benefits based on your medical history and situation. FLCCC
provide treatment protocols.