Single and Combinative Impacts of Healthy Eating Behavior and Physical Activity on COVID-19-like Symptoms among Outpatients: A Multi-Hospital and Health Center Survey
Minh H Nguyen, Thu T M Pham, Dinh N Vu, Binh N Do, Hoang C Nguyen, Thai H Duong, Khue M Pham, Linh V Pham, Thao T P Nguyen, Cuong Q Tran, Quyen H Nguyen, Thanh M Hoang, Khanh V Tran, Trang T Duong, Shwu-Huey Yang, Chyi-Huey Bai, Tuyen Van Duong
Nutrients, doi:10.3390/nu13093258
Background: Healthy eating and physical activity are effective non-pharmacological approaches to boost immune function and contain the pandemic. We aimed to explore the associations and interactions between physical activity and healthy eating behavior with COVID-19-like Symptoms (Slike-CV19S). Methods: A cross-sectional study was conducted on 3947 outpatients, from 14 February to 2 March 2020, at nine health facilities in Vietnam. Data collection included sociodemographic characteristics, healthy eating behavior (using the healthy eating score (HES) questionnaire), physical activity (using the short form international physical activity questionnaire), and Slike-CV19S. The associations and interactions were tested using logistic regression models. Results: Frequent
Supplementary Materials: The following are available online at https://www.mdpi.com/article/ 10.3390/nu13093258/s1; Table S1 : Confounders associated with suspected COVID-19 symptoms among outpatients (n = 3947), Table S2 : Spearman's correlation (rho) among potential confounders (n = 3947), Table S3 : Associations of underlying diseases with healthy eating behavior and physical activity among outpatients (n = 3947). Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.
Conflicts of Interest: The authors declare no conflict of interest.
References
Ammar, Brach, Trabelsi, Chtourou, Boukhris et al., Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey, Nutrients,
doi:10.3390/nu12061583Ardestani, Onvani, Esmailzadeh, Feizi, Azadbakht, Adherence to Dietary Approaches to Stop Hypertension (DASH) Dietary Pattern in Relation to Chronic Obstructive Pulmonary Disease (COPD): A Case-Control Study, J. Am. Coll. Nutr,
doi:10.1080/07315724.2017.1326858Arvaniti, Priftis, Papadimitriou, Papadopoulos, Roma et al., Adherence to the Mediterranean type of diet is associated with lower prevalence of asthma symptoms, among 10-12 years old children: The PANACEA study, Pediatr. Allergy Immunol,
doi:10.1111/j.1399-3038.2010.01113.xBarach, Fisher, Adams, Burstein, Brophy et al., Disruption of healthcare: Will the COVID pandemic worsen non-COVID outcomes and disease outbreaks?, Prog. Pediatr. Cardiol,
doi:10.1016/j.ppedcard.2020.101254Bartsch, Ferguson, Mckinnell, O'shea, Wedlock et al., The Potential Health Care Costs and Resource Use Associated with COVID-19 in the United States, Health Aff,
doi:10.1377/hlthaff.2020.00426Butler, Barrientos, The impact of nutrition on COVID-19 susceptibility and long-term consequences, Brain Behav. Immun,
doi:10.1016/j.bbi.2020.04.040Calder, Carr, Gombart, Eggersdorfer, Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections, Nutrients,
doi:10.3390/nu12041181Caprara, Mediterranean-Type Dietary Pattern and Physical Activity: The Winning Combination to Counteract the Rising Burden of Non-Communicable Diseases (NCDs), Nutrients,
doi:10.3390/nu13020429Charlson, Pompei, Ales, Mackenzie, A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation, J. Chronic Dis,
doi:10.1016/0021-9681(87)90171-8Chew, Lee, Tan, Jing, Goh et al., A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak, Brain Behav. Immun,
doi:10.1016/j.bbi.2020.04.049Craig, Marshall, Sjöström, Bauman, Booth et al., International physical activity questionnaire: 12-country reliability and validity, Med. Sci. Sports Exerc
Davison, Kehaya, Jones, Nutritional and Physical Activity Interventions to Improve Immunity, Am. J. Lifestyle Med,
doi:10.1177/1559827614557773De Luis, Armentia, Aller, Asensio, Sedano et al., Dietary intake in patients with asthma: A case control study, Nutrition,
doi:10.1016/j.nut.2004.06.027Decoster, Gallucci, Iselin, Best practices for using median splits, artificial categorization, and their continuous alternatives, J. Exp. Psychopathol,
doi:10.5127/jep.008310Diet, Nutrition and the Prevention of Chronic Diseases
Duong, Aringazina, Kayupova, Nurjanah, None
Duong, Nguyen, Pham, Nguyen, Giap et al., Validation of the Short-Form Health Literacy Questionnaire (HLS-SF12) and Its Determinants among People Living in Rural Areas in Vietnam, Int. J. Environ. Res. Public Health,
doi:10.3390/ijerph16183346Dyer, COVID-19: Variants are spreading in countries with low vaccination rates, BMJ,
doi:10.1136/bmj.n1359Ekelund, Sepp, Brage, Becker, Jakes et al., Criterion-related validity of the last 7-day, short form of the International Physical Activity Questionnaire in Swedish adults, Public Health Nutr,
doi:10.1079/PHN2005840Fletcher, Landolfo, Niebauer, Ozemek, Arena et al., Promoting Physical Activity and Exercise: JACC Health Promotion Series, J. Am. Coll. Cardiol,
doi:10.1016/j.jacc.2018.08.2141Fondell, Lagerros, Sundberg, Lekander, Bälter et al., Physical activity, stress, and self-reported upper respiratory tract infection, Med. Sci. Sports Exerc,
doi:10.1249/MSS.0b013e3181edf108Górnicka, Drywie Ń, Zielinska, Hamułka, Dietary and lifestyle changes during COVID-19 and the subsequent lockdowns among Polish adults: A Cross-sectional online survey PLifeCOVID-19 study, Nutrients,
doi:10.3390/nu12082324Harrison, Lin, Wang, Mechanisms of SARS-CoV-2 Transmission and Pathogenesis, Trends Immunol
Haspel, Anafi, Brown, Cermakian, Depner et al., Perfect timing: Circadian rhythms, sleep, and immunity-An NIH workshop summary, JCI Insight,
doi:10.1172/jci.insight.131487Hosseini, Berthon, Wark, Wood, Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis, Nutrients,
doi:10.3390/nu9040341Huang, Weinstein, Yu, Männistö, Albanes, Relationship Between Serum Alpha-Tocopherol and Overall and Cause-Specific Mortality, Circ. Res,
doi:10.1161/CIRCRESAHA.119.314944Iddir, Brito, Dingeo, Fernandez Del Campo, Samouda et al., Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis, Nutrients,
doi:10.3390/nu12061562Ipaq Group, Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ)-Short and Long Forms
Jin, Wang, Li, Zheng, Ye et al., Economic burden of COVID-19, China, January-March, 2020: A cost-of-illness study, Bull. World Health Organ,
doi:10.2471/BLT.20.267112Kaluza, Harris, Linden, Wolk, Long-term consumption of fruits and vegetables and risk of chronic obstructive pulmonary disease: A prospective cohort study of women, Int. J. Epidemiol,
doi:10.1093/ije/dyy178Kaluza, Larsson, Orsini, Linden, Wolk, Fruit and vegetable consumption and risk of COPD: A prospective cohort study of men, Thorax,
doi:10.1136/thoraxjnl-2015-207851Kostka, Berthouze, Lacour, Bonnefoy, The symptomatology of upper respiratory tract infections and exercise in elderly people, Med. Sci. Sports Exerc,
doi:10.1097/00005768-200001000-00008Laddu, Lavie, Phillips, Arena, Physical activity for immunity protection: Inoculating populations with healthy living medicine in preparation for the next pandemic, Prog. Cardiovasc. Dis,
doi:10.1016/j.pcad.2020.04.006Lee, Macfarlane, Lam, Stewart, Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): A systematic review, Int. J. Behav. Nutr. Phys. Act,
doi:10.1186/1479-5868-8-115Lemoine, Brigham, Woo, Hanson, Mccormack et al., Omega-3 fatty acid intake and prevalent respiratory symptoms among U.S. adults with COPD, BMC Pulm. Med,
doi:10.1186/s12890-019-0852-4Mahase, COVID-19: What new variants are emerging and how are they being investigated?, BMJ,
doi:10.1136/bmj.n158Matthews, Ockene, Freedson, Rosal, Merriam et al., Moderate to vigorous physical activity and risk of upper-respiratory tract infection, Med. Sci. Sports Exerc,
doi:10.1097/00005768-200208000-00003Mattioli, Sciomer, Moscucci, Maiello, Cugusi et al., Cardiovascular prevention in women: A narrative review from the Italian Society of Cardiology working groups on 'Cardiovascular Prevention, Hypertension and peripheral circulation' and on 'Women Disease, J. Cardiovasc. Med,
doi:10.2459/JCM.0000000000000831Mccullough, Feskanich, Stampfer, Giovannucci, Rimm et al., Diet quality and major chronic disease risk in men and women: Moving toward improved dietary guidance, Am. J. Clin. Nutr,
doi:10.1093/ajcn/76.6.1261Mckie, Would Herd Immunity Stop the Spread of Coronavirus
Messina, Polito, Monda, Cipolloni, Di Nunno et al., Functional Role of Dietary Intervention to Improve the Outcome of COVID-19: A Hypothesis of Work, Int. J. Mol. Sci,
doi:10.3390/ijms21093104Morais, Aquino, Da Silva-Maia, Vale, Maciel et al., Nutritional status, diet and viral respiratory infections: Perspectives for severe acute respiratory syndrome coronavirus 2, Br. J. Nutr,
doi:10.1017/S0007114520003311Nasi, Patrizi, Pizzi, Landolfo, Boriani et al., The role of physical activity in individuals with cardiovascular risk factors: An opinion paper from Italian Society of Cardiology-Emilia Romagna-Marche and SIC-Sport, J. Cardiovasc. Med,
doi:10.2459/JCM.0000000000000855Nguyen, Do, Pham, Kim, Dam et al., Fear of COVID-19 Scale-Associations of Its Scores with Health Literacy and Health-Related Behaviors among Medical Students, Int. J. Environ. Res. Public Health,
doi:10.3390/ijerph17114164Nguyen, Le, Nguyen, Pham, Do et al., Health Literacy and Preventive Behaviors Modify the Association between Pre-Existing Health Conditions and Suspected COVID-19 Symptoms: A Multi-Institutional Survey, Int. J. Environ. Res. Public Health,
doi:10.3390/ijerph17228598Nguyen, Nguyen, Do, Tran, Nguyen et al., People with Suspected COVID-19 Symptoms Were More Likely Depressed and Had Lower Health-Related Quality of Life: The Potential Benefit of Health Literacy, J. Clin. Med,
doi:10.3390/jcm9040965Nguyen, Pham, Pham, Phan, Tran et al., Associations of Underlying Health Conditions with Anxiety and Depression Among Outpatients: Modification Effects of Suspected COVID-19 Symptoms, Health-Related and Preventive Behaviors, Int. J. Public Health,
doi:10.3389/ijph.2021.634904Nicola, Alsafi, Sohrabi, Kerwan, Al-Jabir et al., The socio-economic implications of the coronavirus pandemic (COVID-19): A review, Int. J. Surg,
doi:10.1016/j.ijsu.2020.04.018Pape, Ryttergaard, Rotevatn, Nielsen, Torp-Pedersen et al., Leisure-Time Physical Activity and the Risk of Suspected Bacterial Infections, Med. Sci. Sports Exerc,
doi:10.1249/MSS.0000000000000953Pham, Bui, Nguyen, Nguyen, Tran et al., The prevalence of depression and associated risk factors among medical students: An untold story in Vietnam, PLoS ONE,
doi:10.1371/journal.pone.0221432Pham, Pham, Phan, Tran, Nguyen et al., Healthy Dietary Intake Behavior Potentially Modifies the Negative Effect of COVID-19 Lockdown on Depression: A Hospital and Health Center Survey, Front. Nutr,
doi:10.3389/fnut.2020.581043Pham, Pham, Truong, Nguyen, Oo et al., Development and Validation of a New Short-Form Health Literacy Instrument (HLS-SF12) for the General Public in Six Asian Countries, Health Lit. Res. Pract,
doi:10.3928/24748307-20190225-01Phelan, Katz, Gostin, The Novel Coronavirus Originating in Wuhan, China: Challenges for Global Health Governance, JAMA,
doi:10.1001/jama.2020.1097Rahman, Islam, Bishwas, Moonajilin, Gozal, Physical inactivity and sedentary behaviors in the Bangladeshi population during the COVID-19 pandemic: An online cross-sectional survey, Heliyon,
doi:10.1016/j.heliyon.2020.e05392Riera, Bagattini, Pacheco, Pachito, Roitberg et al., Delays and Disruptions in Cancer Health Care Due to COVID-19 Pandemic: Systematic Review, JCO Glob. Oncol,
doi:10.1200/GO.20.00639Rosato, Temple, La, Vecchia, Castellan et al., Mediterranean diet and cardiovascular disease: A systematic review and meta-analysis of observational studies, Eur. J. Nutr,
doi:10.1007/s00394-017-1582-0Schröder, Marrugat, Vila, Covas, Elosua, Adherence to the traditional mediterranean diet is inversely associated with body mass index and obesity in a spanish population, J. Nutr,
doi:10.1093/jn/134.12.3355Schwingshackl, Bogensberger, Hoffmann, Diet Quality as Assessed by the Healthy Eating Index, Alternate Healthy Eating Index, Dietary Approaches to Stop Hypertension Score, and Health Outcomes: An Updated Systematic Review and Meta-Analysis of Cohort Studies, J. Acad. Nutr. Diet,
doi:10.1016/j.jand.2017.08.024Schwingshackl, Hoffmann, Mediterranean dietary pattern, inflammation and endothelial function: A systematic review and meta-analysis of intervention trials, Nutr. Metab. Cardiovasc. Dis,
doi:10.1016/j.numecd.2014.03.003Scoditti, Massaro, Garbarino, Toraldo, Role of Diet in Chronic Obstructive Pulmonary Disease Prevention and Treatment, Nutrients,
doi:10.3390/nu11061357Shams-White, Chui, Deuster, Mckeown, Must, Investigating Items to Improve the Validity of the Five-Item Healthy Eating Score Compared with the 2015 Healthy Eating Index in a Military Population, Nutrients,
doi:10.3390/nu11020251Steck, Shivappa, Tabung, Harmon, Wirth et al., The dietary inflammatory index: A new tool for assessing diet quality based on inflammatory potential, Digest
Tabak, Feskens, Heederik, Kromhout, Menotti et al., Fruit and fish consumption: A possible explanation for population differences in COPD mortality (The Seven Countries Study), Eur. J. Clin. Nutr
Tabak, Wijga, De Meer, Janssen, Brunekreef et al., Diet and asthma in Dutch school children (ISAAC-2), Thorax,
doi:10.1136/thx.2005.043034Tran, Do, Pham, Nguyen, Xuong et al., Validity of the International Physical Activity Questionnaire-Short Form for Application in Asian Countries: A Study in Vietnam, Eval. Health Prof,
doi:10.1177/0163278718819708Tran, Lee, Au, Nguyen, Hoang, Reliability and validity of the International Physical Activity Questionnaire-Short Form for older adults in Vietnam, Health Promot. J. Aust,
doi:10.1071/HE13012Van Duong, Chiu, Lin, Chen, Wong et al., E-healthy diet literacy scale and its relationship with behaviors and health outcomes in Taiwan, Health Promot. Int,
doi:10.1093/heapro/daaa033Van Hoa, Giang, Vu, Van Tuyen, Khue, Factors Associated with Health Literacy among the Elderly People in Vietnam, BioMed Res. Int,
doi:10.1155/2020/3490635Walda, Tabak, Smit, Räsänen, Fidanza et al., Diet and 20-year chronic obstructive pulmonary disease mortality in middle-aged men from three European countries, Eur. J. Clin. Nutr,
doi:10.1038/sj.ejcn.1601370Wallace, Bailey, Blumberg, Burton-Freeman, Chen et al., Fruits, vegetables, and health: A comprehensive narrative, umbrella review of the science and recommendations for enhanced public policy to improve intake, Crit. Rev. Food Sci. Nutr,
doi:10.1080/10408398.2019.1632258Zhou, Liu, He, Yue, Gong et al., Smoking, leisure-time exercise and frequency of self-reported common cold among the general population in northeastern China: A cross-sectional study, BMC Public Health,
doi:10.1186/s12889-018-5203-5Zhu, Du, Xu, Anti-inflammatory effects of phytochemicals from fruits, vegetables, and food legumes: A review, Crit. Rev. Food Sci. Nutr,
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'abstract': '<jats:p>Background: Healthy eating and physical activity are effective non-pharmacological '
'approaches to boost immune function and contain the pandemic. We aimed to explore the '
'associations and interactions between physical activity and healthy eating behavior with '
'COVID-19-like symptoms (Slike-CV19S). Methods: A cross-sectional study was conducted on 3947 '
'outpatients, from 14 February to 2 March 2020, at nine health facilities in Vietnam. Data '
'collection included sociodemographic characteristics, healthy eating behavior (using the '
'healthy eating score (HES) questionnaire), physical activity (using the short form '
'international physical activity questionnaire), and Slike-CV19S. The associations and '
'interactions were tested using logistic regression models. Results: Frequent intake of fruits '
'(OR = 0.84; p = 0.016), vegetables (OR = 0.72; p = 0.036), and fish (OR = 0.43; p < 0.001) '
'were associated with a lower Slike-CV19S likelihood, as compared with infrequent intake. '
'Patients with higher HES levels (OR = 0.84; p = 0.033 for medium HES; OR = 0.77; p = 0.006 '
'for high HES) or being physically active (OR = 0.69; p < 0.001) had a lower Slike-CV19S '
'likelihood, as compared to those with low HES or physical inactivity, respectively. Patients '
'with medium HES who were physically active (OR = 0.69; p = 0.005), or with high HES and '
'physically active (OR = 0.58; p < 0.001), had a lower Slike-CV19S likelihood, as compared '
'to those with low HES and physical inactivity. Conclusions: Healthy eating behavior and '
'physical activity showed single and combinative impacts on protecting people from '
'Slike-CV19S. Strategic approaches are encouraged to improve healthy behaviors, which may '
'further contribute to containing the pandemic.</jats:p>',
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