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Many Americans are living with chronic diseases, like obesity, that put them at high risk of complications if they do contract COVID-19. In Ohio, 34% of the population have obesity and a similar percent have overweight. Healthcare organisations have responded by increasing care for those with chronic diseases (reducing hospital admissions by 28% and emergency room visits by 79% for some conditions) as well as delivering meals.
Obesity can cause constant minor inflammation within the body, which prevents the immune system from functioning as well. A paper from researchers at the University of Michigan details how macrophages, a type of white blood cell that usually helps fight pathogens, may actually worsen influenza infection in people with obesity and then applies these conclusions to COVID-19. The researchers also discuss other reasons why people with obesity may experience severe disease.
The ‘Eat Right India’ movement has been scaled up through an Eat Right Challenge under the Food Safety and Standards Authority of India to provide a competition between cities and districts. Participating areas will receive funds to create programmes regarding food safety, food security, sustainability and nutrition in addition to some mandatory trainings and programmes. The timing of this initiative is great because the pandemic has highlighted the need for a healthy diet to boost immunity and the fragility of the food system.
UNICEF has released report cards for EU and OECD countries to evaluate healthy childhoods in higher-income countries. They reveal countries must take major steps to improve mental health, academic achievement, and obesity rates. Previous gains in pre-school enrolment and employment or school attendance in teenagers may be at risk due to COVID-19. Child poverty is also expected to rise. To mitigate the pandemic’s impact on children, governments must reduce and alleviate poverty, provide mental health services for children, increase access to childcare, encourage vaccination, and provide adequate COVID-19 relief.
A report titled “A shock to the food system: Lessons learned from the COVID-19” by Deloitte highlights the reach of the food system (it comprises 10% of global GDP) and the weak points in the system. To strengthen food supply chains, actors must be focussed on the relationship between health and food, provide electronic platforms for food purchase and distribution, protect small-scale farmers, and fight rising food insecurity across the world. Additionally, sustainability, food safety, and transparency must be emphasised going forward.
As SARS-CoV-2 invades the cells that produce insulin, GLP-1 class medications (a type of drug that regulates blood sugar levels) may promote better outcomes. Data is still preliminary, but promising. People with obesity or diabetes may be at higher risk if they do develop a COVID-19 infection.
This article uses photographs taken by Brenda Ann Kenneally to show how poverty and food insecurity are intertwined and how they have been exacerbated by COVID-19. She reflects upon how almost all forms of American food aid are intended to be short-term solutions, which do not fix the wider determinants that contribute to hunger. Additionally, food insecurity now tends to result in the consumption of unhealthy foods, which contributes to obesity and diabetes.
Despite COVID-19, Australian trade in food and beverages has increased. Free trade helps to prevent fluctuations in food prices and guarantee minimum amounts of food, so trade agreements should be secured and strengthened. Australia has been listed as one of the most food-secure countries overall and problems in distribution are more likely than inadequate food production.
The European and International Congress on Obesity (ECOICO) this year focusses on the relationship between COVID-19 and obesity. One paper released concurrently with a presentation at the Congress explained that adipose (fatty) tissue can cause chronic inflammation. This inflammation promotes the excessive release of cytokine molecules which in turn may cause organ damage. Additionally, the renin-angiotensin-aldosterone system, which includes ACE2 receptors that the virus uses to enter cells and replicate, may be too active in people with obesity, therefore possibly causing them to contract COVID-19 at higher rates than others. As vaccines may also be less effective in those living with obesity due to immune dysfunction, more must be done to assist those living with obesity.
The COVID-19 has increased the perceived importance of a healthy diet, especially among younger consumers and parents. People reported that their diets were not as nutritious during the lockdown, but many are considering making changes (although fewer than last year). The main reason why people do not eat a healthy diet is cost, followed by enjoyment of current choices, routine, and lack of familiarity respectively. COVID-19 has also emphasised the importance of the food supply chain and the many negative effects of obesity.
A report by the UN Environment Programme gives 16 recommendations for nations to use more sustainable practices in the agricultural sector, which will reduce greenhouse gas emission and improve food security. Reducing food waste is an excellent strategy for accomplishing these goals, especially as food systems account for 37% of all greenhouse gas emissions, in addition to shifting towards more plant-based diets. Measures must go beyond just sustainability, however, as food must also be made more affordable.
Native American reservations face high levels of poverty and food insecurity, which is represented in high COVID-19 mortality rates (Native Americans in New Mexico die at 23 times the rate white Americans do). Indigenous communities experienced major delays in receiving government aid under the CARES act. The Partnership with Native Americans Organization helped fill these gaps by delivering essential products, agricultural inputs, and traditional recipes.
According to an online poll of 3,000 people, the usage of “weight”, “unhealthy weight,” “body mass index,” and “overweight” are much preferred over “super obese”, “chubby”, “fat” and “extra-large” based on the emotional responses these words conjure. This may help healthcare professionals avoid stigmatising language, making doctors’ offices more inclusive and thereby increasing access to care.
To combat high childhood obesity rates and deaths from COVID-19, various states in Mexico have implemented several anti-obesity measures. These include front-of-pack labelling and prohibiting minors from buying processed foods. Industry leaders believe that these measures are unenforceable, will hurt small business owners, and violate trade agreements. Nutritionist Aida Fayad states that bans are unlikely to be effective and recommends mor nutrition education.
Marcus Rashford, the football player who convinced the UK government to extend the school meal scheme into the summer months, has now joined a task force with some major food producers and retailers. They hope to expand school meals, the holiday food programme, and Healthy Start vouchers to all students whose parents receive Universal Credit Payments, as well as to increase the value of the vouchers. Rashford hopes to implement long-term change to alleviate child food poverty.
COVID-19 has presented a dilemma for those living with overweight and obesity- they are encouraged to exercise often and take care of their mental health, but being high risk necessitates greater precautionary measures which may prevent these activities. Additionally, some public health messaging has been stigmatising. Obesity may worsen COVID-19 infection through restricted lung function, comorbidities, increased blot clotting, high amounts of adipose tissue, and higher levels of ACE2 receptors.
COVID-19 patients with metabolic syndrome- a combination of diabetes, hypertension, high triglycerides, low good cholesterol, and obesity- are at higher risk of death. A study of 287 predominantly African American patients in Louisiana found that patients with metabolic syndrome were 3.4 times likelier to die of the disease. They were also more likely to require mechanical ventilation. Obesity alone led to an increased risk of admission to intensive care and ventilation. However, experts report that many people are unaware of metabolic syndrome and blame the prevalence for its prevalence of fast-food chains, especially among predominantly Black neighbourhoods.\
Surveys of university students indicate that they are sleeping about 3.5 additional hours per week due to the COVID-19 lockdown. As most Australian teenagers only get 6.5-7.5 hours of sleep on average, and inadequate sleep is linked to a variety of physical and mental health conditions such as obesity, this is considered to be a positive finding. Other researchers in the United States are currently conducting a study to measure sleep, mental health, and productivity during the pandemic.
While obesity rates are high in certain parts of Nairobi, Kenya, relatively few patients out of 1,355 surveyed reported having a discussion with their physician regarding their weight. The study indicated that cultural norms and beauty standards may prevent physicians from discussing weight and dissuade patients from following advice given.
A UK study on hospitalised patients with COVID-19 found that it is exceedingly rare for children to have severe illness and reported only 6 deaths. Children who developed Multisystem Inflammatory Syndrome in Children (MIS-C) were five times more likely to need intensive care. Children with obesity or from BIPOC groups are at higher risk, which corresponds to the same findings in adults.
Recent research indicates that people who survive COVID-19 may have long-term cardiac complications, which would increase the already high burden of NCDS and must be addressed. The article also discusses obesity as a global problem and risk factor for severe disease from COVID-19 as well as some promising and successful interventions from different countries
Children and teenagers are rarely given access to bariatric surgery, even though it is an effective and relatively safe obesity treatment, especially as lifestyle changes tend to be unsustainable long-term. In the US, expenses, misconceptions about the procedure on behalf of both patients and doctors, and stigma surrounding all aspects of obesity form major barriers to accessing bariatric surgery. Surgery can improve the physical, mental, and emotional effects of obesity. The article also uses anecdotes from two teenagers that had positive experiences with bariatric surgery.
COVID-19 mortality rates are especially high in Mexico, which author Nathaniel Parish Flannery attributes to leadership mismanagement and inadequate hospital care as patient mortality rates are much higher at public hospitals than at private ones. While President Lopez Obrador blames the high rates of obesity, diabetes, and other noncommunicable diseases in Mexico for the death rate, Flannery claims that survival rates for patients with these conditions who are placed on mechanical ventilators are similar to those in the US and notes that fewer Mexican patients are connected to a ventilator at all in public hospitals. Flannery also argues that obesity and other underlying conditions can increase disease severity but do not necessarily increase mortality if supportive care is offered.
Major disruptions to the Indian food system during lockdowns caused many to go hungry despite government programmes. Dr Shweta Khandelwal, Head of Nutrition Research and Professor at the Public Health Foundation of India, notes the double burden of malnutrition (high prevalence of undernutrition and obesity) within India, which is costly in terms of healthcare and economic productivity, food security, and land usage. To fix this, more research and education investment is necessary, as is access to technology, community action, integration in policies, and quick action
According to Matty Ennis, the UK obesity strategy focusses on issues that could exacerbate eating disorders without targeting the fundamental causes of obesity like poverty. It was also launched in close proximity to the Eat Out Help Out scheme, which creates confusing messaging. He notes that the plan seems rushed and will not properly account for the time and expense of nutritious home-cooked food. Additionally, those in deprived areas are less able to exercise safely.
The UK obesity strategy is promising for reducing and reversing rising trends in obesity rates because it takes a whole-of-society approach. The British Heart Foundation believes the scheme goes beyond exclusively addressing personal responsibility and hopes that this continues as measures are signed into law.
South Asia and the Pacific Islands are facing the double burden of malnutrition due to high rates of both under- and over-nutrition. COVID-19 has disrupted household income for many, which is particularly concerning as consuming a balanced diet is more expensive in East Asia than anywhere else and wasting rates in the Pacific islands are similarly high. According to the director general of the Food and Agriculture Organisation of the United Nations, individual nations must increase resilience within the food system, mitigate pandemic effects through the COVID-19 Response and Recovery Programme, increase flexibility within the food chain, develop new innovations, encourage farmers to produce healthier foods by providing agricultural inputs, improve distribution of these foods, and provide education on healthy eating. Governments, academics, private companies, the UN, financial institutions, civil society organisations, and farmers must all work together to accomplish these goals.
The COVID-19 pandemic has disrupted both everyday routines and access to care for noncommunicable diseases, therefore increasing the development of noncommunicable diseases. In a virtual discussion titled “Weighing the impact of COVID-19: Nutrition, Overweight, Obesity and NCDs”, various experts noted that the pandemic has led to increased consumption and donation of ultra-processed foods. They recommended that policies be implemented to target the food advertising and encourage healthy lifestyles, parents cook healthy meals with their children, and nutritious food be made more affordable. Additionally, people should get sufficient sleep, exercise often, and manage stress in healthy ways.
People are avoiding hospitals due to fears over contracting COVID-19, which may worsen or prevent screening for noncommunicable diseases, including obesity. The article lists several precautions that hospitals should take, including staggered appointments, separate entrances, provision of hand sanitiser and masks, social distancing, and COVID screening. It is important that the public sees hospitals as safe to aid in prevention and treatment of other illnesses. This article was written by Preetha Reddy, President of NATHEALTH and Vice Chairperson of Apollo Hospitals.
This article highlights the fact that the best way to boost immunity is to eat a healthy and balanced diet, to exercise frequently, and to take care of mental health. The prevalence of malnutrition in all its forms leads to reduced immunity worldwide. Concerned people should undergo a nutrition assessment regularly to monitor body mass index, read nutrition labels, and consume vitamin D supplements as directed by a doctor.
This press release discusses how the food system has been preserved in the Caraga region of the Philippines despite the COVID-19 pandemic. One municipality was able to buy food directly from farmers for aid packages. Farmers were also able to sell their produce directly to consumers through online platforms. High-level policymakers hope that other regions can develop similar programmes.
One presentation at the European and International Congress on Obesity (ECO ICO 2020) will be given by Professor of Surgery at the Faculty of Medicine of the University of Lille François Pattou regarding the link between obesity and severe COVID-19 disease. Pattou published a case study early in the pandemic detailing how patients at higher BMI were more likely to be admitted to intensive care and placed on a ventilator. He will also speak on an ongoing larger study being done across the world on the relationship between obesity and mechanical ventilation specifically.