covid-19 (19)

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Background

Coronavirus disease 2019 (COVID-19) has led to unprecedented changes in the way we live, particularly for people at higher risk of severe illness from COVID-19. People with pre-existing health conditions have been markedly impacted and, in some instances, left unsupported due to reduced provision of routine healthcare services. People living with obesity (PLWO) are identified as at higher risk of severe illness from COVID-19 infection. Currently, there is a paucity of evidence about the impact of the first COVID-19 lockdown on PLWO, including those accessing weight management and bariatric surgery services (WMS).

Methods

543 adults (16–80 years) with obesity (BMI ≥ 30 kg/m2) were recruited between 14th May and 9th July 2020 through social media advertisements, professional and patient obesity organisations and WMS. Participants completed an online survey regarding the impact of the first COVID-19 lockdown upon, mental health, well-being, health-related behaviours, risk mitigating behaviours, access to WMS and weight stigma.

Findings

During the first COVID-19 lockdown, the majority of PLWO reported deterioration of their mental health and health-related behaviours such as diet, physical activity (PA) and sleep. With 55% reporting an unhealthier diet, 61% reduced PA and 80% worsening of their sleep. Higher depression and lower wellbeing scores were found to associate with the greatest adverse impact upon health-related behaviours. PLWO who were attending WMS prior to the first lockdown reported a greater deterioration of their diet, with nearly 50% reporting worsening of their diet and PA worsening compared to PLWO who were not attending WMS. Most participants took two or more risk mitigating actions (73%). PLWO attending WMS reported reduced access (44%) with insufficient information (49%) from their clinical service providers. The majority of participants reported no change in perceived weight stigma.

Interpretation

This study shows the detrimental impact of the first COVID-19 lockdown on PLWO in relation to health-related behaviours, mental health and access to WMS. Our findings show that PLWO with poor mental health and those attending WMS were most adversely impacted and highlights the need for greater mental health support and continued provision of support from WMS for PLWO during future lockdowns.

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COVID-19 has boosted interest in functional foods that deliver wellbeing benefits like immunity and stress management. But while the pandemic may have accelerated this trend, functional foods are no flash in the pan, experts insisted at FoodNavigator’s Positive Nutrition Digital Summit yesterday.

To read the article click Functional food is no COVID fad: ‘Consumers have fundamentally changed their attitudes to health and wellness’

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The assessment is based on 377 documents covering 62 countries from Africa, Asia, Europe, Oceania and the Americas.

The analysis reveals that the dimension of food security that has been most affected is accessibility. Both financial (affordability) and physical access to food have been disrupted, in particular in urban areas and in low and middle-income countries (LMICs). As a result, proximity and convenience have been affected with a degradation in food choice and diversity.

In contrast, there is no clear evidence that the availability of food has been affected beyond some initial disruptions and there is not enough information to provide robust conclusions about the effects of the pandemic on the utilization of food (safety or quality).

Finally, the impact of COVID-19 on the nutritional status of people is still poorly documented but expected to be substantial in the long run.

To download the publication, go here: Impacts of COVID-19 on people’s food security: Foundations for a more resilient food system

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Solving the obesity crisis

Obesity is on the rise; current initiatives and policies aimed at fighting obesity have been insufficient to reverse the trend. The success of tackling the obesity pandemic depends on governments, businesses and civil society working together to fix inadequacies in our food and health systems, focusing on better nutrition and diets for all.

This year, on World Obesity Day, it has never been more important to recognise that improving nutrition and addressing poor diets needs to be at the forefront of collective efforts to tackle obesity. The COVID-19 pandemic is interlinked with the slower, yet no less devastating pandemic of food and nutrition insecurity, obesity, diabetes and other diet-related conditions. The top predictors of severe COVID-19 complications, other than age, are diet-related risks such as obesity, diabetes, hypertension and cardiovascular disease. In fact, a recent global analysis suggests that being obese doubles the risk of hospital treatment and increases the risk of dying from Covid by nearly 50 percent.

To read more click here: Solving the obesity crisis

And here: COVID-19 and Obesity: The 2021 Atlas

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The COVID-19 pandemic is affecting food and nutrition security through economic and social systems shocks, food system disruptions and gaps in coverage of essential health and nutrition services. Food systems in low- and middle-income countries must adapt and strengthen food and nutrition security in the wake of COVID-19.

Food insecurity, deteriorations in diet quality, micronutrient deficiencies and other forms of malnutrition stem from fundamental, complex and dynamic changes in our food system9. Despite varying burdens and differential mitigation responses to SARS-CoV-2 across the globe, the impacts on national, regional and local food systems have consistently resulted in job losses, income shortfalls and food shortages.

To read the article, click here: Food systems, diets and nutrition in the wake of COVID-19

 

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Evidence is emerging that vitamin D – and possibly vitamins K and A – might help combat COVID-19. A new study from the University of Bristol published in the journal of the German Chemical Society Angewandte Chemie has shown how they – and other antiviral drugs – might work. The research indicates that these dietary supplements and compounds could bind to the viral spike protein and so might reduce SARS-CoV-2 infectivity. In contrast, cholesterol may increase infectivity, which could explain why having high cholesterol is considered a risk factor for serious disease.

 

To read the article, click here: How vitamins, steroids and potential antivirals might affect SARS-CoV-2

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An England-wide survey of over 5,000 adults found that 80% of people aged over 18 have made the decision to change their lifestyle in 2021.

The survey showed 8 in 10 adults aged over 18 have decided to modify their lifestyle in 2021, with 7 in 10 adults saying that they are motivated to make healthier lifestyle changes due to coronavirus (COVID-19).

To read the post : Seven in 10 adults are motivated to get healthier in 2021 due to COVID-19

 

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"The COVID-19 pandemic has led to a dramatic loss of human life worldwide and presents an unprecedented challenge to public health, food systems and the world of work. The economic and social disruption caused by the pandemic is devastating: tens of millions of people are at risk of falling into extreme poverty, while the number of undernourished people, currently estimated at nearly 690 million, could increase by up to 132 million by the end of the year."

Please follow the link for the article: Impact of COVID-19 on people's livelihoods, their health and our food systems

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Never has the role of chief medical officer (CMO) been under such scrutiny. In a rare interview, England’s CMO Professor Chris Whitty speaks to The BMJ’s editor in chief, Fiona Godlee, about the pandemic and what it’s like to be a physician in Whitehall

This interview was conducted on 28 October and has been edited for length and clarity.

Chris Whitty as the chief medical advisor to the UK government and has played a pivotal role in shaping the country's response to Covid-19 and in this conversation he gives an important insight into managing the risks and how the pandemic will impact us over the winter.


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8060374068?profile=RESIZE_710x Food Standards Scotland’s updated Situation Report – The Scottish Diet: It Needs to Change 2020 highlights the ongoing challenge for people in Scotland to have a healthier diet, including new exploration of the out of home environment, such as food bought ‘on the go’, and from deliveries and takeaways.

It is important to note that this data was captured prior to the COVID-19 pandemic, and therefore provides a baseline for further investigation on its impact on diet in Scotland.

The report shows that:

  • There continues to be a lack of progress towards the Scottish dietary goals and improving obesity and diet related poor health
  • Two out of three people in Scotland remain either overweight or obese, with a higher proportion of people living with obesity in the most deprived areas compared to the least deprived
  • We continue to buy a lot of discretionary foods and drinks, such as confectionery, cakes, biscuits, pastries, savoury snacks and sugary drinks from shops and supermarkets, and these tend to be heavily promoted
  • The food and drink we purchase from the out of home environment tend to be less healthy, with fried chicken and burger meals and sides among the top takeaway meals and dishes
  • People in Scotland support the food environment providing healthier food to make it easier to choose a healthier diet.

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7928384875?profile=RESIZE_180x180The International Commission for Micro Specifications for Foods (ICMSF) opinion on SARS-CoV-2 & its relationship to food safety: "ICMSF believes that it is highly unlikely that the ingestion of SARS-CoV-2 will result in illness; there is no documented evidence that food is a significant source and/or vehicle for transmission of SARS-CoV-2. It is vital that one differentiates a hazard from a risk, i.e. the mere presence of an infectious agent on food does not necessarily mean that an infection will occur."

“There are no foods that should be considered a risk or warrant consideration as a vector for SARS-CoV-2.” 

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USDA’s Economic Research Service (ERS) has published its annual International Food Security Assessment, which shows that the worldwide coronavirus pandemic has made food security worse.

The annual report determines how much access people in 76 low and middle-income countries have to food. The answer to that question requires tracking incomes, food prices, and other economic factors including agriculture production and market conditions.

“In the 76 low- and middle-income countries examined in the report, the number of people considered food insecure in 2020 was estimated at almost 761 million people or 19.8 percent of the total population. The shock to GDP from COVID-19 is projected to increase the number of food-insecure people by 83.5 million people in 2020 to 844.5 million and increase the share of the population that is food insecure to 22 percent.”

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Bar chart illustrating which foods were most difficult to buy in shops, supermarkets, and online grocery services. Dry goods is the highest, followed by tinned food.

      3 key ways the pandemic impacted access to food 

  1. There was a lack of clarity about how much food people needed to buy.
  2. The pandemic made more people unable to afford food.
  3. Foodservice and hospitality businesses and their suppliers are going to feel the effects of lockdown for years.

EFRA's key recommendations to fix the problem 

1.Ensuring people can afford enough healthy food is the responsibility of multiple Government departments. To bring that work together, the Government should appoint a Minister for Food Security who is empowered to draw together policy across departments on food supply, nutrition and welfare.

2.The Government should work with producers, processors and wholesalers servicing the hospitality and foodservice sector to monitor the health of food and drink suppliers as supply chains restart.

3.The Department for Environment, Food and Rural Affairs (DEFRA) should continue to provide £5 million in annual funding to FareShare to redistribute surplus food from farms and across the supply chain to frontline food aid providers for a further two years. This would help those who struggle to afford food as the effects of the pandemic continue, and reduce food waste from farms.

4.Food supply to supermarkets continued because we were able to keep food coming into the country. Future crises could stop this flow and cause more serious problems. The Government has to update its food resilience plans, taking into account how consumer behaviour can disrupt food supply and whether our efficient "just-in-time" supply chains are as resilient as they need to be.

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ICU Nutritional Management – Insights from the frontline

By Dr Timothy Eden, RD with contributions from Shane McAuliffe, RD and edited by Professor Sumantra Ray, RNutr

 Insights from the frontline as NNEdPro Global Innovation Panel (GIP) member Dr Tim Eden RD shares his own experience of the challenges faced in the nutritional management of COVID-19 patients in ICU: https://twitter.com/TimothyEdenRD/status/1245634083012505602 

With a high rate of COVID-19 patients in the overweight/obese category as well as those with Type-2 Diabetes, this can present a significant challenge when estimating and fulfilling these individualised nutritional requirements. Looking specifically at obese patients, there has historically been an attitude of underfeeding in intensive care, but this cohort is equally at risk of becoming malnourished (rapid, significant and unplanned weight loss) when nutritional requirements are not met for prolonged periods, and this can be a predictor of poorer clinical course and outcomes (1). The following narrative is not intended to replace clinical guidelines but is designed to highlight some key aspects relevant to nutritional assessment in ICU when treating patients with COVID-19.

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  Shane McAuliffe and James Bradfield, writing on behalf of the NNEdPro Nutrition and Covid-19 Taskforce, based in Cambridge, help us to separate    fact from fiction. 

 Given the considerable interest in the role of nutrition throughout the Covid-19 pandemic, we recently we wrote a piece in the Cambridge         Independent about how to eat well and support your health during such uncertain times. It seems as though the discussion around what to do, and   what not to do has been never-ending, with reports emerging almost daily suggesting new ways to improve health and potentially   combat susceptibility to infection or its consequences. 

  While this push for knowledge has fuelled important scientific research and discussion, it has also inevitably led to debate about what is fact, what is    fiction and what makes up the grey areas between them. In reality, Covid-19 is a new disease and so our understanding of its interactions, including    those with nutrition, are continually evolving.             

                                                                                           
New evidence that can inform policy and practice is being generated, including in our flagship journal BMJ Nutrition, Prevention & Health. In it, we have established a dedicated Covid-19 special collection to help gather emerging research on the relationship between the virus and nutrition, in order to add to what we currently know. In this article, we will outline what this collection has uncovered about the relationship between nutrition and Covid-19 so far.

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With the ongoing Covid-19 pandemic, there has been a lot of discussion in both print media and online about whether a healthy diet can ‘boost’ the immune system. While unfortunately, there is no evidence for a dietary panacea, there are still a number of diet and lifestyle choices that you can make to help support your health and the health of your family. This is reflected by the World Health Organization (WHO) emphasising in March 2020 that good diet and lifestyle measures all play a role in maintenance of good health and particularly for those without underlying disease conditions this ought to support a healthy immune system.


The points below are a few broad guidelines that are simple to follow and will stand you in good stead over the coming weeks and months. It is also important to note that these should be done alongside current government guidelines to only leave the house for food, health reasons or work (where essential), staying two metres (6ft) away from other people at all times when outside the home and handwashing as per official advice. As more of us are spending more time at home than usual, it provides a good opportunity to dedicate some extra time to cooking and eating well. While this may evoke images of Masterchef-worthy dishes, genius is often contained within simplicity.


Whether cooking for the family or just for one, simple ingredients used in combination can be combined to make a healthy, nutritious meal while also providing the satisfaction in learning a new recipe, trying out new cuisine or bringing one of your all-time favourites back to the table. Here are some top tips to make cooking easier and more accessible.

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The COVID‐19 pandemic has brought forth multiple voices advising particular dietary strategies to combat the disease. Although many do so with the best of intentions, some may have personal biases or financial conflicts of interest. Here we summarise the evidence surrounding the role of some of the key micronutrients in infectious disease with a focus on respiratory conditions.

Vitamins A, C, D, E, B2, B6, B12 & B9 and minerals Fe, Se, Zn, Mg & Cu are highlighted.

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A 10-point summary on diet, nutrition and the role of micronutrients

E Fallon, S McAuliffe & S Ray on behalf of the NNEdPro Global Centre for Nutrition and Health (Design by M Abrantes; Reviewed by E Beck, L Buckner, J Bradfield, D Crocombe, M McGirr & K Martin) 26th March 2020. Correspondence to: info@nnedpro.org.uk

In the wake of the current and unprecedented COVID-19 pandemic, on 20th March 2020, the Director-General of the World Health Organization (WHO) emphasised the importance of appropriate diet and lifestyle measures including adequate nutrition to protect the immune system. This is of course not a substitute for adherence, first and foremost, to key public health and medical advice on prevention. However, as vast sections of society spend more time at home, it provides an opportunity to focus on strengthening the four lifestyle pillars of sleep, mind, exercise and diet. To elaborate on diet and nutrition, particularly given the variable quality of online information, we have put together a 10-point summary as general guidance: 

1 The Coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2) is highly transmissible and can be potentially lethal. Hence any strategies that can prevent or mitigate respiratory infection risk and strengthen overall immunity are critical at this time. 

2 Poor nutrition, due to either insufficient dietary intake of key nutrients or a poor overall diet quality, can compromise immune function and increase overall infection risk. 

3 Micronutrients, commonly known as vitamins and minerals, are required in small quantities but are critical for health and pivotal in strengthening the immune system. 

4 Multiple micronutrients are essential for good immune function, particularly vitamins A, C, D, E, B2 (riboflavin), B6 (pyridoxine), B12 (cobalamin) and B9 (folic acid) and minerals iron, selenium, zinc, magnesium and copper (Calder, Carr, Gombart & Eggersdorfer, 2020) and these are found in a variety of foods that form part of a balanced diet in line with national guidelines. 

5 There are a variety of foods rich in vitamins and minerals (see below), in particular fruit and vegetables, which can be fresh, tinned or frozen:

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6 In the United Kingdom, as an example, several micronutrient deficiencies are prevalent as the Government’s National Diet and Nutrition Survey (2019) demonstrates widespread inadequacy in the intakes and/or status of vitamin D, vitamin A (retinol), folate and selenium across the UK population and in specific age groups. This is likely to be mirrored more widely across multiple countries. 

7 Certain individuals are at greater risk of micronutrient deficiency; this includes women of childbearing age, particularly pregnant and lactating women, infants and toddlers, children, adolescents (particularly females), older adults (Maggini, Pierre & Calder, 2018), obese individuals, and the critically ill, plus individuals with inflammatory bowel disease (Kilby, Mathias, Boisvenue, Heisler & Jones, 2019) and other chronic inflammatory and malabsorptive conditions. 

8 In many high risk groups, a balanced diet alone may not be sufficient to meet these requirements and deficiencies can contribute to impaired immune function. This can be due to a variety of factors affecting intakes, absorption and also due to increased utilisation of micronutrients during times of infection. In such cases, the immune system can be supported by micronutrient supplementation particularly to help correct deficiencies.

9 As a key example from the UK, Vitamin D supplementation is recommended at 10 micrograms a day, as per guidelines. The average diet provides less than half of this amount. In fact, Public Health England (PHE) is now recommending that people consider taking a Vitamin D supplement of 10ug throughout the spring and summer as lockdown continues and access to sunlight may be limited. This is of particular concern in individuals in the high-risk category, which includes people who are housebound, living in a care home and those with darker skin. 

10 Overall, whilst COVID-19 is causing inevitable distress to one and all, aside from the impact of the viral illness itself, prevention through social distancing and staying at home can affect both mood and feelings. This may cause depression, anxiety, loneliness and irritability. During these testing times, it is important to remember that eating well, staying hydrated, thinking positively, sleeping adequately and staying active will contribute to both physical and mental wellbeing. Some examples of useful UK resources include:

(i) NHS ‘stay at home’ exercises – https://www.nhs.uk/live-well/exercise/gym-free-exercises/

(ii) Doing things for others – www.actionforhappiness.org

(iii) A mental health community pack – https://www.maldon.gov.uk/healthandwellbeing 

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