Mediterranean diet and the risk of COVID-19 in the 'Seguimiento Universidad de Navarra' cohort.
Clin Nutr. 2022 Dec; 41(12):3061-3068.CN

Abstract

BACKGROUND & AIMS

A potential protection against COVID-19 by a high-quality dietary pattern is to be expected given the biological plausibility supporting the beneficial effects of an adequate dietary intake on the immune system. However, knowledge on the relationship between long-term maintained healthy dietary patterns, such as the Mediterranean diet, and the risk of SARS-CoV-2 infection is still sparse. We longitudinally assessed this association in a well-known Mediterranean cohort.

METHODS

We assessed 9,677 participants from the SUN Project, a prospective cohort of middle-aged university graduates in Spain. We inquired about a positive result in a COVID-19 diagnostic test during the months of February to December 2020. After excluding health professionals (HP), 5,194 participants were included in the statistical analyses (mean age: 52.6, SD: 12.4; 55.2% women). Food habits were assessed at baseline using a previously validated semiquantitative 136-item food frequency questionnaire. Adherence to the Mediterranean diet (cumulative average of 2 repeated measurements 10 years apart) was assessed using the 0-to-9 Mediterranean Diet Score (MDS). We used multivariable logistic regression models to estimate odds ratios and 95% confidence intervals for incident COVID-19 according to the MDS.

RESULTS

Among 5,194 non-HP participants, 122 reported to have received a positive COVID-19 diagnostic test. Participants with intermediate adherence to the Mediterranean diet (3 < MDS ≤ 6) had a significantly lower odds of developing COVID-19 (multivariable-adjusted OR = 0.50, 95% CI: 0.34-0.73), and those with the highest adherence (MDS > 6) exhibited the lowest risk (multivariable-adjusted OR = 0.36, 95% CI: 0.16-0.84, p for trend < 0.001) as compared with participants with MDS ≤ 3. This inverse association remained robust within subgroups and in sensitivity analyses. Notwithstanding, no significant associations were observed for health professionals (p for interaction = 0.06).

CONCLUSION

In conclusion, better adherence to the Mediterranean diet may be associated with a lower risk of COVID-19. Our results are applicable only to persons who are not health professionals.

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Authors+Show Affiliations

Perez-Araluce R

University of Navarra, Department of Preventive Medicine and Public Health, Irunlarrea 1, 31008 Pamplona, Navarra, Spain.

Martinez-Gonzalez MA

University of Navarra, Department of Preventive Medicine and Public Health, Irunlarrea 1, 31008 Pamplona, Navarra, Spain; CIBER Fisiopatología de La Obesidad y Nutrición, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain; IdiSNA, Navarra Institute for Health Research, Irunlarrea 3, 31008 Pamplona, Navarra, Spain; Department of Nutrition, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115, USA.

Fernández-Lázaro CI

University of Navarra, Department of Preventive Medicine and Public Health, Irunlarrea 1, 31008 Pamplona, Navarra, Spain; IdiSNA, Navarra Institute for Health Research, Irunlarrea 3, 31008 Pamplona, Navarra, Spain; IQVIA, Madrid, Spain.

Bes-Rastrollo M

Gea A

Carlos S

MeSH

Middle AgedFemaleHumansMaleDiet, MediterraneanCOVID-19Prospective StudiesFollow-Up StudiesIncidenceSurveys and QuestionnairesSARS-CoV-2Spain

Pub Type(s)

Journal Article

Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33934925

Citation

Perez-Araluce, R, et al. "Mediterranean Diet and the Risk of COVID-19 in the 'Seguimiento Universidad De Navarra' Cohort." Clinical Nutrition (Edinburgh, Scotland), vol. 41, no. 12, 2022, pp. 3061-3068.

Perez-Araluce R, Martinez-Gonzalez MA, Fernández-Lázaro CI, et al. Mediterranean diet and the risk of COVID-19 in the 'Seguimiento Universidad de Navarra' cohort. Clin Nutr. 2022;41(12):3061-3068.

Perez-Araluce, R., Martinez-Gonzalez, M. A., Fernández-Lázaro, C. I., Bes-Rastrollo, M., Gea, A., & Carlos, S. (2022). Mediterranean diet and the risk of COVID-19 in the 'Seguimiento Universidad de Navarra' cohort. Clinical Nutrition (Edinburgh, Scotland), 41(12), 3061-3068. https://doi.org/10.1016/j.clnu.2021.04.001

Perez-Araluce R, et al. Mediterranean Diet and the Risk of COVID-19 in the 'Seguimiento Universidad De Navarra' Cohort. Clin Nutr. 2022;41(12):3061-3068. PubMed PMID: 33934925.

* Article titles in AMA citation format should be in sentence-case

TY - JOUR T1 - Mediterranean diet and the risk of COVID-19 in the 'Seguimiento Universidad de Navarra' cohort. AU - Perez-Araluce,R, AU - Martinez-Gonzalez,M A, AU - Fernández-Lázaro,C I, AU - Bes-Rastrollo,M, AU - Gea,A, AU - Carlos,S, Y1 - 2021/04/15/ PY - 2021/03/03/received PY - 2021/03/29/revised PY - 2021/04/01/accepted PY - 2021/5/4/pubmed PY - 2022/12/7/medline PY - 2021/5/3/entrez KW - COVID-19 KW - Health professionals KW - Mediterranean diet SP - 3061 EP - 3068 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 41 IS - 12 N2 - BACKGROUND & AIMS: A potential protection against COVID-19 by a high-quality dietary pattern is to be expected given the biological plausibility supporting the beneficial effects of an adequate dietary intake on the immune system. However, knowledge on the relationship between long-term maintained healthy dietary patterns, such as the Mediterranean diet, and the risk of SARS-CoV-2 infection is still sparse. We longitudinally assessed this association in a well-known Mediterranean cohort. METHODS: We assessed 9,677 participants from the SUN Project, a prospective cohort of middle-aged university graduates in Spain. We inquired about a positive result in a COVID-19 diagnostic test during the months of February to December 2020. After excluding health professionals (HP), 5,194 participants were included in the statistical analyses (mean age: 52.6, SD: 12.4; 55.2% women). Food habits were assessed at baseline using a previously validated semiquantitative 136-item food frequency questionnaire. Adherence to the Mediterranean diet (cumulative average of 2 repeated measurements 10 years apart) was assessed using the 0-to-9 Mediterranean Diet Score (MDS). We used multivariable logistic regression models to estimate odds ratios and 95% confidence intervals for incident COVID-19 according to the MDS. RESULTS: Among 5,194 non-HP participants, 122 reported to have received a positive COVID-19 diagnostic test. Participants with intermediate adherence to the Mediterranean diet (3 < MDS ≤ 6) had a significantly lower odds of developing COVID-19 (multivariable-adjusted OR = 0.50, 95% CI: 0.34-0.73), and those with the highest adherence (MDS > 6) exhibited the lowest risk (multivariable-adjusted OR = 0.36, 95% CI: 0.16-0.84, p for trend < 0.001) as compared with participants with MDS ≤ 3. This inverse association remained robust within subgroups and in sensitivity analyses. Notwithstanding, no significant associations were observed for health professionals (p for interaction = 0.06). CONCLUSION: In conclusion, better adherence to the Mediterranean diet may be associated with a lower risk of COVID-19. Our results are applicable only to persons who are not health professionals. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/33934925/full_citation DB - PRIME DP - Unbound Medicine ER -

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Mediterranean diet and the risk of COVID-19 in the 'Seguimiento Universidad de Navarra' cohort.Clin Nutr. 2022 Dec; 41(12):3061-3068.CN