Impact of ultra-processed food intake on the risk of COVID-19: a prospective cohort study
Lihui Zhou, Huiping Li, Shunming Zhang, Hongxi Yang, Yue Ma, Yaogang Wang
European Journal of Nutrition, doi:10.1007/s00394-022-02982-0
Purpose Nutrition plays a key role in supporting the human immune system and reducing the risk of infections. However, there is limited evidence exploring the relationship between diet and the risk of COVID-19. This study aimed to assess the associations between consumption of ultra-processed foods (UPF) and COVID-19 risk. Methods In total, 41,012 participants from the UK Biobank study with at least 2 of up to 5 times 24-h dietary assessments were included in this study. Dietary intakes were collected using an online 24-h dietary recall questionnaire and food items were categorized according to their degree of processing by the NOVA classification. COVID-19 infection was defined as individuals tested COVID-19 positive or dead of COVID-19. Association between average UPF consumption (% daily gram intake) and COVID-19 infection was assessed by multivariable logistic regression adjusted for potential confounders. Results Compared to participants in the lowest quartile of UPF proportion (% daily gram intake) in the diet, participants in the 2nd, 3rd, and highest quartiles were associated with a higher risk of COVID-19 with the odds ratio (OR) value of 1.03 (95% CI: 0.94-1.13), 1.24 (95% CI: 1.13-1.36), and 1.22 (95% CI: 1.12-1.34), respectively (P for trend < 0.001), after adjusting for potential confounders. The results were robust in a series of sensitivity analyses. No interaction effect was identified between the UPF proportions and age groups, education level, body mass index, and comorbidity status. BMI mediated 13.2% of this association. Conclusion Higher consumption of UPF was associated with an increased risk of COVID-19 infection. Further studies are needed to better understand the underlying mechanisms in such association.
Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1007/ s00394-022-02982-0. Author contributions LZ and HL designed the study and drafted the statistical analysis plan. LZ compiled the data, did the statistical analysis, interpreted the data, and drafted the manuscript. HL and SZ interpreted the data, and critically revised the manuscript. HY critically revised the manuscript. YM compiled the data. YW conceived the study, critically revised the manuscript, and acquired the data and funding. All authors gave final approval and agree to be accountable for all aspects of the work ensuring integrity and accuracy. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. Funding This study was funded by the National Natural Science Foundation of China (No. 71910107004, 91746205). The funding sources had no role in the design, execution, analyses, and interpretation of the data or decision to submit the results of this study.
Declarations Conflict of interest The authors declare that there is no conflicts of interest.
Ethical approval The ethical approvals of UK Biobank were obtained from the North West Multi-Centre Research Ethics Committee, as a Research Tissue Bank (RTB) approval. This study was approved under the UK Biobank application number 45676. Consent to participate Informed consent was obtained from all individual..
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