Food industry must share blame for obesity pandemic and severity of COVID-19 disease

The editorial ‘Obesity and COVID-19: the role of the food industry’, written by researchers from the Queen Mary University of London, argues that multiple mechanisms could explain the relationship between obesity and COVID-19. It also proposes that the food industry shares the blame for not only the obesity pandemic, but the severity of the novel coronavirus.

The authors are calling on Government to impose a ruling on the food industry to remove unnecessary and high levels of sugar, saturated fat and salt added to food and drinks and only promote healthy foods. The hope is that will improve the UK’s diet and bring greater benefits for those who are more socially deprived.

In the UK, individuals who were overweight or obese made up 78 percent of the confirmed COVID-19 infections and 62 percent of the COVID-19 deaths in hospitals. Linking UK COVID-19 data to that of a population cohort (428,225 participants, 340 confirmed COVID-19 hospital cases) and to electronic health records (17,425,445 participants, 5,683 COVID-19 deaths) have shown a dose-response relationship between excess weight and severity of COVID-19. In other words, the more severe the obesity, the more likely the individual is to be hospitalised for COVID-19 and/or die from it.^1,2

Following adjustments for factors such as age, sex, ethnicity and social deprivation, the risk of critical illness from COVID-19 rose by 44 percent for those who are overweight and nearly doubled for those with obesity. The risk of dying from this strain of coronavirus also increased with the severity of obesity.

“Unlike most other risk factors identified for COVID-19 such as age, sex and ethnicity – obesity is a modifiable risk factor,” said Graham MacGregor, co-author of the study and Professor of Cardiovascular Medicine at Barts and The London Hospital. “This is why Governments worldwide must seize the opportunity to help people to eat more healthily and enforce measures to restrict the promotion, marketing, and advertising of unhealthy foods and ensure their reformulation to contain far less salt, sugar, and saturated fat. This would reduce mortality from this vicious virus and many other chronic diseases.”

According to the researchers, smaller studies from Asia-Pacific Region, Europe and the US have confirmed these findings.

Several mechanisms could clarify the relationship between obesity and COVID-19, this is because obesity can:

• Result in larger quantities of ACE2 in the body – the enzyme exploited by the virus for cell entry
• Diminish the immune response
• Reduce lung function.

The authors highlight that the obesity pandemic is not the fault of the individual consumer, but rather the result of living in a society where it is difficult not to over-consume.

Monique Tan, co-author of the study and PhD Researcher at Queen Mary University of London, added: “Obesity is the major cause of type 2 diabetes which, in itself, is another potentially modifiable risk factor for more severe COVID-19. However, long planned and awaited governmental measures to address this have been put on hold due to the COVID-19 outbreak, at a time when they have never been more necessary. We urge the UK government to implement Action on Sugar’s evidence-based plan (presented to the Prime Minister two weeks ago).”³

References:

1. Ho FK, Celis-Morales CA, Gray SR, et al. Modifiable and non-modifiable risk factors for COVID-19: results from UK Biobank. medRxiv 2020 doi: 10.1101/2020.04.28.20083295 [published Online First: 02.05.2020]
2. The OpenSAFELY Collaborative, Williamson E, Walker AJ, et al. OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. medRxiv 2020 doi: 10.1101/2020.05.06.20092999 [published Online First: 07.05.2020]
3. Action on Sugar and Action on Salt. Obesity: Treat and Prevent. An evidence-based action plan to reduce death from Covid-19. 2020 [Available from: http://www.actiononsugar.org/media/actiononsugar/Action-on-Sugar_Action-on-Salt_Treat-and-Prevent-Report-29th-May-2020..pdf accessed 05.06.2020.