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A population-based case-control study in six countries was recently conducted to investigate the association between dietary patterns and COVID-19

Quick takes:

  • Prior studies suggest a connection between comorbidities and the severity of COVID-19
  • The aetiology of non-communicable diseases like obesity, type 2 diabetes, CVD, and hypertension, each of which considered a risk factor associated with COVID-19 severity, is largely driven by poor nutrition and unfavourable lifestyle choices
  • In six countries, following plant-based or pescatarian diets were associated with lower odds of moderate to severe COVID-19 severity
  • Those consuming low-carbs high protein diets were more susceptible to COVID-19 severity
  • Plant-based or pescatarian dietary patterns may be considered for protection against severe COVID-19 and duration of symptoms

To read the article: https://nutrition.bmj.com/content/early/2021/05/18/bmjnph-2021-000272

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Research continues to investigate the causality of the association of serum vitamin D with the risk and severity of COVID-19 infection. A Mendelian Randomised study was recently conducted to address causality using genetic variants that are associated with serum vitamin D as instrumental variables to represent long-term usual exposure.  Findings suggest that genetically predicted long-term vitamin D nutritional status does not causally affect susceptibility to and severity of COVID-19 infections, including severe respiratory infection and hospitalisation.  However, results do not exclude the possibility that therapeutic doses of vitamin D may be effective in preventing or treating COVID-19 infection, warranting the need for future larger randomised controlled studies to investigate potential therapeutic effects of vitamin D supplementation in the prevention and treatment of COVID-19.

 

For access to the full article, click the link below

https://nutrition.bmj.com/content/early/2021/05/04/bmjnph-2021-000255?utm_source=alert&utm_medium=email&utm_campaign=nph&utm_content=latest&utm_term=19052021

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Quick Takes

  • Ultra-processed foods have been known to be associated with risk of CVD, cancer, and the obesity epidemic.
  • The fast-food, beverage, and food industries have made progress in reducing the unhealthy ingredients but continue to advertise the unhealthy.
  • Increasing the national and local community investment in health literacy with an emphasis on nutrition could be very cost-effective from the public perspective but have a negative impact on the economy and compete with many other priorities.

To read the article Ultra-Processed Foods and Incident Cardiovascular Disease

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The search continues for the origins of the virus that causes COVID-19—and the pathway that it took to leap from animals to humans, wreaking havoc across the globe, infecting more than 129 million people, and killing more than 2.8 million.

Last week, the World Health Organisation released a report from a team of international researchers that travelled to China to investigate four possible scenarios in which the SARS-CoV-2 virus might have caused the initial outbreak. In the days since, however, world governments have expressed concern that the investigators lacked access to complete data, while scientists say that the report has shed little light on how the virus got jumpstarted.

That’s unsurprising given that it typically takes years to trace a virus back to its roots—if it’s possible at all, says Angela Rasmussen, a virologist at the Centre for Global Health Science and Security at Georgetown University Medical Centre. But in this case, she says, “I think we do have enough evidence to say that some are more likely than others.”

 

To read the article click here We still don’t know the origins of the coronavirus. Here are 4 scenarios.

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Personalised Nutrition

As individuals seek increasingly individualised nutrition and lifestyle guidance, numerous apps and nutrition programmes have emerged. However, complex individual variations in dietary behaviours, genotypes, gene expression and composition of the microbiome are increasingly recognised. Advances in digital tools and artificial intelligence can help individuals more easily track nutrient intakes and identify nutritional gaps. However, the influence of these nutrients on health outcomes can vary widely among individuals depending upon life stage, genetics and microbial composition. For example, folate may elicit favourable epigenetic effects on brain development during a critical developmental time window of pregnancy. Genes affecting vitamin B12 metabolism may lead to cardiometabolic traits that play an essential role in the context of obesity. Finally, an individual's gut microbial composition can determine their response to dietary fibre interventions during weight loss. These recent advances in understanding can lead to a more complete and integrated approach to promoting optimal health through personalised nutrition, in clinical practice settings and for individuals in their daily lives. The purpose of this review is to summarise presentations made during the DSM Science and Technology Award Symposium at the 13th European Nutrition Conference, which focused on personalised nutrition and novel technologies for health in the modern world.

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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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Health care providers (HCPs) globally, including dietitians, are encountering genetic testing for personalized nutrition (ie, nutrigenomics) in their clinical practice. Although considerable basic research examining diet–gene interactions exists in the literature, comparatively less knowledge is available regarding the use of nutrigenomics in clinical practice to alter dietary outcomes. Despite this, patients are bringing direct-to-consumer nutrigenomics reports to HCPs for interpretation, and more HCPs are now offering nutrigenomics tests to their patients. However, HCPs currently lack clinical guidance documents in nutrigenomics and several steps are needed before full clinical practice guidelines are developed.

As a first step in these efforts, our objective was to develop a care map to provide HCPs with a tool for considering nutrigenomics in clinical practice based on the current state of knowledge. An Expert Advisory Panel consisting of 6 nutrigenomics researchers, 3 of whom are also registered dietitians (RDs), developed a care map draft while consulting nutrigenomics literature and incorporating the 3 key pillars of personalized nutrition. To optimize generalizability, the draft was reviewed by 12 HCPs with representation from 6 continents (Africa, Asia, Australia, Europe, North America, and South America) who have experience using nutrigenomics in their clinical practice. The Expert Advisory Panel revised the care map based on HCP feedback and all members of the Expert Advisory Panel approved the final version. A 4-step care map was developed, with sections related to HCP training in nutrigenomics (Step 1), patient screening, assessment and informed consent (Step 2), providing nutrigenomics in clinical practice (Step 3), and patient follow-up (Step 4). Continuing education was incorporated throughout the care map. A nutrigenomics care map was successfully developed and should be used as a starting point to guide clinical practice. This care map is generalizable to dietetics practice globally.

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Prioritizing Nutrition Security in the US

sliced carrots and green bell pepper on brown wooden chopping board The prevalence of nutrition-sensitive conditions such as obesity and type 2 diabetes has increased substantially in the US during the past 30 years. These conditions, combined with other diet-related ones such as cardiovascular diseases and certain cancers, are associated with the majority of morbidity, mortality, and health care spending nationally. Simultaneously, income inequality has increased, with accompanying self-reported food insecurity disproportionately affecting individuals with lower incomes. Food insecurity has been defined as the state of being without reliable access to a sufficient quantity of affordable, nutritious food, and in 2019 was estimated to affect 10.5% of US households.1 Food insecurity and poor nutrition are closely linked: individuals who report being most food insecure also have higher risks of developing obesity, diabetes, hypertension, coronary disease, stroke, cancer, and associated conditions, even after adjusting for other risks such as age, sex, employment, marital status, race/ethnicity, smoking, insurance status, family size, education, and income.2

For decades, US policies to address hunger and food insecurity have focused largely on providing sufficient calories or quantities of food. However, effectively addressing the current diet-related challenges in the US will require a shift beyond these concepts to the broader concept of nutrition security. Addressing nutrition security, which can be defined as having consistent access, availability, and affordability of foods and beverages that promote well-being and prevent (and if needed, treat) disease, may be the next needed approach to inform clinical care and public policy.

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300#FoodTrustReport.

What's damaging consumer trust? 
Anthony Warner - known as The Angry Chef - says: "there's too much information [about food choices]. It's all very confusing."

In this episode of 
#EITFoodFight, he and Liesbet Vranken explore:

➡️ Food marketing and health claims like 'detox'
➡️ The role of social media influencers
➡️ Where consumers can get trustworthy information.

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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 COVID-19 pandemic has upended the lives of families around the world. Across virtually every key measure of childhood, progress has gone backward in the 12 months since the pandemic was declared, leaving children confronting a devastating and distorted new normal.

The past year has seen an increase in children who have been left hungry, isolated, abused and anxious. The education of hundreds of millions of children has been disrupted. Access to protection services and health services – including routine vaccinations – has been severely impacted. The pandemic is also affecting young people’s mental health and pushing their families into poverty. Such social and economic disruptions can increase the likelihood of child marriage.

Even as remarkable, life-saving progress is made in distributing COVID-19 vaccines, the latest available data from UNICEF reveal the devastation already wrought on the world’s children:

To read the article: How the COVID-19 pandemic has scarred the world’s children

 

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Food in a Pandemic report published

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The Food in a Pandemic report, commissioned by the FSA and produced by Demos as part of Renew Normal: The People’s Commission on Life after Covid, looks to understand how a new food environment created during the pandemic has impacted the public’s behaviours and preferences. The research included: a nationally representative survey of 10,069 UK adults, a nationally representative online deliberative method called Polis with 1,006 UK respondents, a series of four deliberative workshops, and an open access survey of 911 adults.

Key findings on the public’s experience during the pandemic 

Food insecurity 

The report shows that people have stepped in to help prevent new forms of food insecurity caused by people self-isolating by offering informal forms of support such as shopping for others   

Findings also show there is a public appetite for the government to take action to help feed those without the means to feed themselves. People also tend to be more supportive of preventative actions for food insecurity, such as ensuring well-paid jobs are available to all. Just under two thirds (63%) agreed in the Polis that ‘it is the government’s responsibility to make sure no-one goes hungry’. 

UK food supply 

It’s reported a significant proportion of the population have bought food more locally or grown more food during the pandemic, reflecting a wider move towards individual self-sufficiency. Many of those who have made this move expect it to continue after the pandemic. 

78% of those surveyed supported the UK keeping its current food quality standards, even if food is more expensive and less competitive in the global market. A similar proportion (82%) also supported maintaining the UK’s current animal welfare standards, when presented with the same trade-off against prices and competitiveness. 

Diet and eating habits 

There has been a complex shift in people’s diets during Covid-19, with more home cooking. Although a third (32%) of respondents in the poll reported eating more healthy main meals, a third (33%) ate more unhealthy snacks. 

Some of the restrictions and public health advice, such as stay at home, might have encouraged more healthy eating. Those who have cooked more or eaten healthier main meals tend to expect this change to continue. However, this is likely to be somewhat dependent on the other changes, such as continued flexible working.  

Read full report.

 

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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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A case control study, which has been peer reviewed and published in the New England Journal of Medicine, compared 596 618 people who were newly vaccinated in Israel and matched them to unvaccinated controls.1 Two doses of the mRNA vaccine reduced symptomatic cases by 94%, hospitalisation by 87%, and severe covid-19 by 92%, according to the data from the Clalit Institute for Research which is Israel’s biggest healthcare provider. Read the full article here.

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NEW BRUNSWICK, N.J., February 27, 2021 – Johnson & Johnson (NYSE: JNJ) (the Company) today announced that the U.S. Food and Drug Administration (FDA) has issued Emergency Use Authorization (EUA) for its single-dose COVID-19 vaccine, developed by the Janssen Pharmaceutical Companies of Johnson & Johnson, to prevent COVID-19 in individuals 18 years of age and older. Read the full article here.

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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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8634658853?profile=RESIZE_710xTable seeks to facilitate informed discussions about how the food system can become sustainable, resilient, just, and ultimately “good”. We impartially set out the evidence, assumptions, and values that people bring to food system debates. 

Scientific knowledge is necessary for understanding the issues and complexities around healthy and sustainable food. But science alone cannot tell us how to act or what a good and ethical food system is. Making decisions about the food system involves value judgements about what is important and these depend on people’s preferences and visions for the future.

Therefore, we aim to engage with a wide range of stakeholders and perspectives to bring out value-based reflections and to clarify the arguments, assumptions and evidence around issues of concern. 

Table is rooted in academia. We are a collaboration between the University of Oxford, the Swedish University of Agricultural Sciences (SLU) and Wageningen University and Research (WUR). Table is the successor to the Food Climate Research Network, based at the University of Oxford, which for 15 years conducted, synthesised, and communicated research on food sustainability. You can find previous FCRN explainers and FCRN reports on our website.

 

Podcasts

Read more about the podcast and listen to the Trailer episode with Tara GarnettEpisode 1 with Ken Giller on the Food Security Conundrum, and Episode 2: with Rob Bailey on Global Food Trade.

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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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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).

This article 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. Read the full article here.

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