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Paradoxically, those who experience food insecurity in the United States and other developed nations are more likely to develop overweight and obesity, as supported by a study from the Pennington Biomedical Research Center. Over an 18-year period, food insecurity has more than doubled, which corresponds to rising obesity rates. This may be attributed to the greater expense of healthy foods as compared to unhealthy, ultra-processed foods and higher rates of anxiety and depression in those experiencing food insecurity. Because COVID-19 has dramatically increased food insecurity, it is extremely important to develop policies ensuring access to nutritious items, promote dietary education, lower eligibility requirements for aid programmes, and fund community food banks.
Obesity may worsen the course of COVID-19 infection through a variety of physiological mechanisms. However, a recent study of 363 COVID-19 patients, some of whom had once undergone bariatric surgery, found significantly lower hospitalisation rates for those who received surgical interventions. However, the sample size of this study is somewhat low, and more research is needed before scientific consensus is reached.
In this article, obesity specialist Dr Cate Varney reviews the most compelling studies linking obesity to severe COVID-19 infection. She also discusses weight stigma, particularly in the medical field, caused by lack of up-to-date obesity education in medical schools. Additionally, Varney speaks on the mechanisms by which obesity may lead to severe COVID-19 disease, including breathing difficulties due to excess adipose (fat) tissue, inflammatory products released by adipose tissue that may create an immune overreaction, and higher expression of the ACE2 receptors SARS-CoV-2 uses to enter cells.
As people with obesity are more likely to experience adverse health outcomes from COVID-19, the obesity epidemic has now become a subject of international discourse. Obesity and overweight are widespread in both developing and developed nations. Obesity is an extremely complex disease with a myriad of causes which is expensive to treat. Preventive measures, including taxes on sugar-sweetened beverages, have been attempted in major metropolitan areas. Investors are pressuring companies to be more transparent and health-conscious, and some product reformulation is being done, but the food industry has pushed back against regulation.
While COVID-19 is an important public health issue, the death toll in Malta is less than half of the yearly deaths attributed to obesity. The article describes other obesity statistics within Malta.
The Regional Overview of Food and Nutrition Security in Latin America and the Caribbean 2020 report, published by the UN, examines the double burden of malnutrition in specific regions which may otherwise be obfuscated by country averages. Most areas with severe malnutrition are rural with high numbers of people of indigenous and African descent. Urban areas have higher rates of obesity. Most areas are observing major increases in food insecurity, which in turn may worsen COVID-19 infection.
COVID-19 has an extremely high mortality rate in Mexico as compared to the rest of the world. This is in part due to the fact that three-quarters of Mexican adults have overweight or obesity, which experts attribute to an excess of ultra-processed foods. Additionally, many Mexicans carry a gene that greatly increases their diabetes risk. Distrust of the medical system is also a factor in the death rate. Government officials have defended their COVID-19 response and plan to start vaccinating the public as soon as possible.
While diabetes has been tied to mortality from COVID-19 in Africa, many fewer deaths have been reported there than have been in Europe and in the US. Elderly Africans are still more susceptible to severe disease than younger residents are, according to an WHO report. However, the incidence of diabetes, another known COVID-19 risk factor, is rising throughout Africa. Many people with diabetes are unaware of their condition.
Young people working with Slow Food Youth Network are taking a stand to promote the availability of nutritious foods by advocating for climate-friendly growing methods. Additionally, some of the group’s projects focus on cultural preservation through the recording of traditional recipes. Many young people have gotten more interested in agriculture as they take over some duties for the older generations due to COVID-19 control measures.
A survey by VLCC has indicated that many urban Indian residents (almost 4/5ths) have deliberately taken steps to improve their immunity to COVID-19 by exercising more or eating more nutritious foods. There is a demand for professional guidance, although the vast majority of survey respondents were not confident in infection control measures currently implemented by some clinics. The organisation has also created TRANSFirM, a combined wellness and weight-management programme.
In this article, several experts in public health argue that consistent access to nutritious foods should be considered a human right. Malnutrition (undernutrition or overnutrition) has been worsened by the COVID-19 pandemic due to reductions in consumer purchasing power and disruptions to food transport, which in turn creates greater susceptibility to COVID-19. Experts are advocating for the development of international guidelines concerning the right to food.
According to Hank Cardello, previous food industry executive and current public health advocate, a Biden presidency will most likely result in much greater regulations on the US food industry. The industry has already undergone massive changes to adapt to COVID-19 regulations and will be able to make this change as well. He anticipates that more strict regulations on food will be put in place (possibly in the form of taxes), rules will be established to mitigate the climate footprint of the food industry, and children’s health will be prioritised. Companies can make pre-emptive changes, such as reducing portion sizes, to demonstrate ethical leadership, and the industry can be pushed in a positive direction by establishing ambitious goals.
Professor Dame Sally Davis, formerly the Chief Medical Officer for England, notes that the UK likely had a more severe COVID-19 outbreak than other countries because of the prevalence of overweight and obesity, overcrowding, and enduring health inequities (particularly in deprived areas). Davis heavily focussed on combating obesity during her time in office.
Pharmaceutical companies have successfully developed safe and effective vaccines against COVID-19. However, it will take time to manufacture enough doses for everyone, and therefore some groups must be prioritised. Several countries intend to vaccinate those living with obesity early due to the correlation between obesity and COVID-19 severity. Doing so would make a statement against the characterisation of obesity as a “moral failing” instead of a disease. Additionally, the US intends to prioritise deprived areas and areas with high minority populations.