Adherence to Healthy Eating Index-2015 and severity of disease in hospitalised military patients with COVID-19: a cross sectional study
Karim Parastouei, S Shokooee Jud, M Sepandi, S Abbaszadeh, M Samadi, G H Meftahi, Dr M Taghdir
BMJ Military Health, doi:10.1136/military-2022-002173
Introduction Proper nutrition can play an important role in preventing and improving disease progression in patients with COVID-19. The Healthy Eating Index-2015 (HEI-2015) is one of the most common measures used to assess overall nutritional quality. This research aimed to identify the relationship between the HEI-2015 score and disease severity in hospitalised military patients with COVID-19. Methods This cross-sectional study was conducted in 295 hospitalised military patients (retired military and military reserve) with COVID-19. A validated food frequency questionnaire was used to assess food intake. To evaluate the quality of the diet, the HEI-2015 score was calculated. A multiple logistic regression analysis was performed to measure the association between HEI-2015 scores and disease severity (intensive care unit (ICU) admission and length of hospital stay greater than 4 days) in hospitalised military patients with COVID-19.
Results The mean HEI-2015 score was significantly higher in non-ICU patients than in ICU patients (58.39±15.02 vs 53.54±15.65, p=0.01). After adjusting for possible confounding factors including age, sex, comorbidities, calorie intake, body mass index and physical activity, adherence to HEI-2015 inversely related to ICU admission (OR 0.98; 95% CI 0.95 to 1.00) and length of hospital stay of more than 4 days (OR 0.99; 95% CI 0.97 to 1.00) in hospitalised military patients with COVID-19, although statistically not significant. Conclusions According to the results of the study, adherence to HEI-2015 inversely related to both ICU admission and length of hospital stay in hospitalised military patients with COVID-19, although it was not statistically significant.
WHAT IS ALREADY KNOWN ON THIS TOPIC ⇒ To our knowledge, this is the first study to examine the relationship between the Healthy Eating Index-2015 (HEI-2015) score and severity of illness in hospitalised military patients with COVID-19. WHAT THIS STUDY ADDS ⇒ The mean HEI-2015 score was significantly higher in non-intensive care unit (ICU) military patients than in ICU patients. ⇒ Adherence to HEI-2015 inversely related to ICU admission and length of hospital stay of more than 4 days in hospitalised military patients with COVID-19, although it was not statistically significant. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY ⇒ It appears that a diet rich in fresh fruits and vegetables, whole grains, protein foods, dairy products and healthy fats could be effective in reducing the severity of COVID-19 disease.
Original research otherwise determined by BMJ. You may download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
ORCID iDs M Sepandi http://orcid.org/0000-0001-6441-5887 M Taghdir http://orcid.org/0000-0003-2853-0196
Alamdari, Moghaddam, Amini, Application of methylene blue -vitamin C-N-acetyl cysteine for treatment of critically ill COVID-19 patients, report of a phase-I clinical trial, Eur J Pharmacol, doi:10.1016/j.ejphar.2020.173494
Asher, Tintle, Myers, Blood omega-3 fatty acids and death from COVID-19: a pilot study, Prostaglandins Leukot Essent Fatty Acids, doi:10.1016/j.plefa.2021.102250
Batiha, Alqarni, Awad, Algammal, Dairy-derived and egg white proteins in enhancing immune system against COVID-19, Front Nutr, doi:10.3389/fnut.2021.629440
Calder, Carr, Gombart, Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections, Nutrients, doi:10.3390/nu12041181
Dai, Gu, Su, Inhibition of curcumin on influenza A virus infection and influenzal pneumonia via oxidative stress, TLR2/4, p38/JNK MAPK and NF-κB pathways, Int Immunopharmacol, doi:10.1016/j.intimp.2017.11.009
De Faria Coelho-Ravagnani, Corgosinho, Sanches, Dietary recommendations during the COVID-19 pandemic, Nutr Rev, doi:10.1093/nutrit/nuaa067
García-Montero, Fraile-Martínez, Gómez-Lahoz, Nutritional components in western diet versus Mediterranean diet at the gut microbiota-immune system interplay. Implications for health and disease, Nutrients, doi:10.3390/nu13020699
Iddir, Brito, Dingeo, Strengthening the immune system and reducing inflammation and oxidative stress through diet and nutrition: considerations during the COVID-19 crisis, Nutrients, doi:10.3390/nu12061562
Kelishadi, Rabiee, Khosravi, Assessment of physical activity in adolescents of Isfahan, Shahrekord University Of med Sci J
Mirmiran, Esfahani, Mehrabi, Reliability and relative validity of an FFQ for nutrients in the Tehran lipid and glucose study, Public Health Nutr, doi:10.1017/S1368980009991698
Moscatelli, Sessa, Valenzano, COVID-19: role of nutrition and supplementation, Nutrients, doi:10.3390/nu13030976
Nikpouraghdam, Farahani, Alishiri, Epidemiological characteristics of coronavirus disease 2019 (COVID-19) patients in Iran: a single center study, J Clin Virol, doi:10.1016/j.jcv.2020.104378
Perez-Araluce, Martinez-Gonzalez, Ci, Mediterranean diet and the risk of COVID-19 in the 'Seguimiento Universidad de Navarra' cohort, Clin Nutr, doi:10.1016/j.clnu.2021.04.001
Saini, Nile, Park, Carotenoids from fruits and vegetables: chemistry, analysis, occurrence, bioavailability and biological activities, Food Res Int, doi:10.1016/j.foodres.2015.07.047
Sepandi, Taghdir, Alimohamadi, Factors associated with mortality in COVID-19 patients: a systematic review and meta-analysis, Iran J Public Health, doi:10.18502/ijph.v49i7.3574
Sheikhi, Yousefian, Tehranipoor, Estimation of the basic reproduction number of alpha and delta variants of COVID-19 pandemic in Iran, PLoS One, doi:10.1371/journal.pone.0265489
Zadeh, Boffetta, Hosseinzadeh, Dietary patterns and risk of gestational diabetes mellitus: a systematic review and meta-analysis of cohort studies, Clin Nutr ESPEN, doi:10.1016/j.clnesp.2020.02.009
Zhu, Ji, Pang, Clinical characteristics of 3062 COVID-19 patients: a metaanalysis, J Med Virol, doi:10.1002/jmv.25884