J Nutr Health Aging. 2020;24(9):1011-1018 © Serdi and Springer-Verlag International SAS, part of Springer Nature
RELATION OF DIETARY FACTORS WITH INFECTION AND MORTALITY RATES OF COVID-19 ACROSS THE WORLD D.M. ABDULAH1, A.B. HASSAN2 1. Community Health Unit, College of Nursing, University of Duhok, Iraq; 2. Basic Sciences Department, College of Nursing, University of Duhok, Iraq. Corresponding author: Deldar Morad Abdulah, Community Health Unit, College of Nursing, University of Duhok, Iraq, Email: deldarmorad@gmail.com, Phone: +9647507443319, ORCID: https://orcid.org/0000-0002-8986-5793
Abstract: Objective: Poor dietary habits are considered to be the second-leading risk factors for mortality and disability-adjusted life-years (DALYs) in the world. Dietary patterns are different based on cultural, environmental, technological, and economic factors. Nutritional deficiencies of energy, protein, and specific micronutrients have been shown to contribute to depressed immune function and increased susceptibility to infections. We aimed to explore the relation of dietary factors with global infection and mortality rates of COVID-19 in this study. Design: In the current ecological study, the countries that had national dietary data from the Global Dietary Databases of the United Nations and coronavirus disease statistics from the World Health Organization (WHO) were included. The countries that had coronavirus disease statistics from the WHO were consecutively checked for the recent data of the dietary factors. Setting: World. Participants: 158 countries across the world. Measurements: infection and mortality rates of COVID-19; dietary factors. Results: The median crude infection and mortality rates by COVID-19 were 87.78 (IQR: 468.03) and 0.0015 (IQR: 0.0059), respectively. The two highest percentage of the crude infection rate were between 0 and 500 (75.9%) and 500-1000 (8.9%) per one million persons. The regression analysis showed that the crude infection rate has been increased by raising consuming fruits (Beta: 0.237; P=0.006) and calcium (Beta: 0.286; P=0.007) and was decreased with rising consuming beans and legumes (Beta: -0.145; P=0.038). The analysis showed that the crude mortality rate was increased by raising consuming sugar-sweetened beverages (Beta: 0.340; P<0.001). Whereas, the crude mortality rate by COVID-19 has been decreased by increasing fruits consuming (Beta: -0.226; P=0.047) and beans and legumes (Beta: -0.176; P=0.046). Conclusion: The present study showed the higher intake of fruits and sugar-sweetened beverages had a positive effect on infection and mortally rates by COVID19, respectively. In contrast, the higher intake of beans and legumes had a negative effect on both increasing infection and mortality rates. Key words: Dietary Factors, acute respiratory infections, macronutrients, proteins, fruits. Abbreviations: DALYs: disability-adjusted life-years; IFN: Interferon; IQR: Interquartile Range; RNA: RiboNucleic Acid; SPSS: statistical package for social sciences; SSBs: sugar-sweetened beverages; WHO: World Health Organization.
Introduction Poor dietary habits are considered to be the second-leading risk factors for mortality and disability-adjusted life-years (DALYs) in the world. The poor dietary habits are responsible for 10.3 million deaths and 229.1 million DALYs in 2016 (1). For example, the following dietary habits are among the leading risk factors for early death and disability in European countries. The habits are low intakes of whole grains, fruit and vegetables, and nuts and seeds, and high intakes of alcohol and sodium. The western dietary habits are consuming diet processed, high in red and processed meat, diets with high in sugar-sweetened beverages, and low in milk. These kinds of dietary habits are regarded to be a rising health concern. Dietary patterns are different based on cultural, environmental, technological, and economic factors. However, the Dietary patterns are becoming similar due to increasing living standards and growing globalization of the food sector (2, 3). Mertens et al. (4) explored the dietary intakes in four different European counters using individual-level dietary
Received May 8, 2020 Accepted for publication May 26, 2020
intake in adults in nationally- representative surveys of Denmark, France, Czech Republic, and Italy. They reported a higher intake of fruits and vegetables and lower intakes of sweetened beverages and alcohol in Italy. While individuals in Denmark and the Czech Republic had a higher intake of vegetables. A comparison of population subgroups within countries shows that there is a difference in the dietary preferences, beliefs, and practices for particular consumer groups. For example, highly-educated persons and women have a higher intake of fish, nuts, and seeds along with lower intake of red and processed meats (5). The individual-level reported dietary data of the countries could be used as a useful tool to make a connection between health and environment with foods as their common denominator (1). A recent review study reported that the detailed assessment of patients for the dietary and nutritional risks along with medical, lifestyle, and environmental factors with suitable risk management strategies make the sensible way to deal with the COVID-19 (6). The diet and nutrition have a variance impact on the immune system competence. In addition, they determine the risk and severity of the 1011
Published online July 4, 2020, http://10.1007/s12603-020-1434-0