In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) emerged in Wuhan, China, sparking the Coronavirus disease 2019 (COVID-19) pandemic. The high prevalence of nutrition-related COVID-19 risk factors including obesity, type 2 diabetes, and hypertension, suggests that healthy dietary approaches may mitigate COVID-19 related outcomes and possibly SARS-CoV-2 infection. Based on the fundamental role of nutrition in immune function and the well-documented association between Mediterranean diet consumption and risk reduction for chronic diseases that are comorbidities in COVID-19 patients, we hypothesized that there would be a relationship between Mediterranean diet adherence and COVID-19 cases and related deaths. In this perspective, we examined the association between regional adherence to a Mediterranean diet and COVID-19 cases and deaths using an ecological study design. We observed that Mediterranean diet adherence was negatively associated with both COVID-19 cases and related deaths across 17 regions in Spain and that the relationship remained when adjusted for factors of well-being. We also observed a negative association between Mediterranean diet adherence and COVID-19 related deaths across 23 countries when adjusted for factors of well-being and physical inactivity. The anti-inflammatory properties of the Mediterranean diet - likely due to the polyphenol content of the diet - may be a biological basis to explain our findings. However, there are confounding factors unrelated to dietary factors driving COVID-19 cases and related deaths across the regions in Spain and the 23 countries examined in our analysis. Our findings will need to be confirmed and further explored in cohort studies.

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Communicating the value of Extension programming to stakeholders remains a challenge for many Extension professionals. Program evaluation is a tool that can help communicate the value of Extension; however, many evaluation methods fail to articulate a story of aggregated impact. A public value instrument was recently developed to help communicate the impact of Extension. Communicating Extension’s impact has become more critical, yet more difficult, to do during the COVID-19 pandemic. This research note shares the results of a program evaluation using the Extension public value instrument to determine the impact of Georgia Cooperative Extension’s programs during the shelter-in-place orders due to COVID-19. Respondents (n = 572) indicated high levels of self-reported knowledge gain, wellness, intent to change behavior, and perceived economic value. The results demonstrated respondents’ overall satisfaction and valuation of Family and Consumer Sciences programs during COVID-19. The Extension public value instrument enabled evaluation data collection for Extension professionals to communicate the value of their program impact despite major disruptions to traditional program formats.