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0 0.5 1 1.5 2+ Severe case 78% Improvement Relative Risk Symptomatic case 15% Case 20% Perez-Araluce et al. Diet for COVID-19 Prophylaxis Is a healthy diet beneficial for COVID-19? Retrospective 4,403 patients in Spain (March - December 2020) Lower severe cases (p=0.15) and fewer symptomatic cases (p=0.31), not stat. sig. Perez-Araluce et al., Frontiers in Nutrition, doi:10.3389/fnut.2021.805533 Favors healthy diet Favors control

Components of the Mediterranean Diet and Risk of COVID-19

Perez-Araluce et al., Frontiers in Nutrition, doi:10.3389/fnut.2021.805533
Perez-Araluce et al., Components of the Mediterranean Diet and Risk of COVID-19, Frontiers in Nutrition, doi:10.3389/fnut.2021.805533
Jan 2022   Source   PDF  
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Retrospective 5,194 participants in Spain with 382 COVID-19 cases, showing lower risk of COVID-19 with high adherence to a Mediterranean diet, with statistical significance only when excluding healthcare professionals.
risk of severe case, 77.9% lower, RR 0.22, p = 0.15, higher quality diet 1 of 1,103 (0.1%), lower quality diet 10 of 3,300 (0.3%), NNT 471, odds ratio converted to relative risk, high vs. low adherence.
risk of symptomatic case, 15.1% lower, RR 0.85, p = 0.31, higher quality diet 52 of 1,103 (4.7%), lower quality diet 214 of 3,300 (6.5%), odds ratio converted to relative risk, high vs. low adherence.
risk of case, 19.7% lower, RR 0.80, p = 0.14, higher quality diet 58 of 1,103 (5.3%), lower quality diet 248 of 3,300 (7.5%), odds ratio converted to relative risk, high vs. low adherence.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Perez-Araluce et al., 24 Jan 2022, retrospective, Spain, peer-reviewed, survey, 4 authors, study period March 2020 - December 2020.
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Components of the Mediterranean Diet and Risk of COVID-19
Rafael Perez-Araluce, Miguel Ángel Martínez-González, Alfredo Gea, Silvia Carlos
Frontiers in Nutrition, doi:10.3389/fnut.2021.805533
Adherence to the traditional Mediterranean diet has been customarily assessed with the Mediterranean diet score (MDS or Trichopolou Index), with values of 0 or 1 assigned to each of the nine elements, and with the use of the sex-specific median as the cutoff. The value of persons whose consumption of the six beneficial items (ratio of monounsaturated to saturated fatty acids, vegetables, legumes, fruits and nuts, cereal, and fish) is at or above the median and is assigned a value of 1. Otherwise they receive 0 points. For detrimental elements (meats and dairy products) persons whose consumption is below the median are assigned a value of 1. An additional ninth point is assigned to moderate ethanol intake. We assessed the effect of each of the nine components of the MDS (replacing the fats ratio with olive oil, the main source of monounsaturated fats in the Mediterranean diet) on the risk of COVID-19 infection, symptomatic and severe COVID-19. From March to December 2020, 9,699 participants of the "Seguimiento Universidad de Navarra" (SUN) cohort answered a COVID-19 questionnaire. After excluding doctors and nurses, 5,194 participants were included in the main statistical analyses. Among them, we observed 382 cases of COVID-19 based on symptoms and clinical diagnosis; 167 of them with test confirmation. For the two COVID-19 definitions used, we found a significant decrease in risk for a higher adherence to the Mediterranean diet (OR = 0.64, 95% CI: 0.42-0.98, p for trend = 0.040; and OR = 0.44, 95% CI: 0.22-0.88, p for trend = 0.020, for test-diagnosed cases). A protective effect was also found for symptomatic COVID-19 (OR = 0.64, 95% CI: 0.41-1.00, p for trend = 0.050). Among the different individual food groups, only the consumption of whole dairy products showed a harmful direct association. The Mediterranean diet as a whole seems more important than each of its components in preventing the infection and symptoms of COVID-19.
ETHICS STATEMENT The studies involving human participants were reviewed and approved by the Research Ethics Committee of the University of Navarra. The patients/participants provided their written informed consent to participate in this study. AUTHOR CONTRIBUTIONS RP-A, MM-G, and SC participated in the design of the study. RP-A was involved in the data analysis, supervised by SC and MM-G. SC and RP-A participated in writing the original manuscript. Finally, the manuscript was reviewed by MM-G and AG. All authors contributed to the article and approved the submitted version. FUNDING The SUN Project has received funding from the Spanish Government-Instituto de Salud Carlos III, and the European Regional Development Fund (FEDER) (RD 06/0045, CIBER-OBN, Grants PI10/02658, PI10/02293, PI13/00615, PI14/01668, PI14/01798, PI14/01764, PI17/01795, and G03/140), the Navarra Regional Government (27/2011, 45/2011, 122/2014), the Government Delegation for the National Drug Plan (2020/ 021), and the University of Navarra. Conflict of Interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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