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COVID-19 epidemic caused by an influenza-like virus strain (SARS-CoV-2) invaded the world. The World Health Organization (WHO) announced this infection outbreak as a global pandemic on 11 March 2020. From one day to another the number of new cases is growing and also the number of deaths. This infection emerged earlier in Wuhan City and rapidly spread throughout China and around the world since December 2019. Another silent pandemic disease spreading mainly in industrialized countries is obesity. The best example is US were about 34% of the Americans are obese.In actual context, it can be said there is a coalition of 2 pandemics. In Romania, obesity and overweight prevalence assessed by Predatorr study is at a high level: 34,7% overweight and 31,9% obesity. Systemic inflammation in obesity is the central mechanism leading to lung function decline. There are two main questions a) is obese more sensible to viral infection or b) potentially more contagious? The answer is positive to both. Recent WOF official position stated that obesity is a risk factor for developing severe forms of COVID-19. Donna Ryan’s message, as president of World Obesity Federation WOF, US emphasized at the beginning of April the risk for severe complications for persons with obesity who contracted the infection with SARS-CoV-2. Nutritional support in COVID-19 should prefer oral feeding, whenever is possible. A special attention should be dedicated to a healthy microbiome and intestinal immunity. Energy intake should be 25-30 kcal/body weight, with 1.2-2 g/kg proteins. Enteral nutrition will be recommended in severe cases. Evidence is supporting the recommendation that for people at risk of developing COVID-19 to consider for few weeks a dosage of 10000 UI/day of vitD3, than a maintainance dose of 5000 UI/day. The target must be to stabilize a level of 40-60 ng/ml for 25(OH) D concentration. Pulmonary rehabilitation, smoking cessation, included in a healthy lifestyle will be further steps after patients recovery from this infection.Facing this pandemic coalition, our messages should be stronger in stimulating prevention of obesity. Since more than a half of Romanian population is already overweight or obese, healthy lifestyle should become a daily prescription, not just a luxury recommendation. Daily, right messages from doctors acting like role models, in a partnership between general practitioner and other specialties like diabetologists, pneumologists, cardiologists, nutritionists will be efficient weapons against this cruel coalition: Obesity and COVID 19.

Background: Type 2 diabetes mellitus (T2DM) is associated with increased mortality and morbidity, including cardiovascular diseases and obstructive sleep apnea (OSA). The aim of this study was to assess the associations between cardiovascular risk, chronic diabetes complications and the risk of OSA in adult patients with T2DM. Methods: The study included 529 patients with T2DM in whom moderate-to-severe OSA risk was assessed using the STOP-Bang questionnaire, dividing the subjects into two groups: group 1: STOP-Bang score <5, and group 2: STOP-Bang score ≥5, respectively. In all the subjects, cardiovascular risk was assessed using the UKPDS risk engine. Statistical analysis was performed using SPSS 26.0, the results being statistically significant if p value was <0.05. Results: 59% of the subjects scored ≥5 on the STOP-Bang questionnaire. We recorded statistically significant differences between the two groups regarding diabetes duration, HbA1c, HOMA-IR, albuminuria, as well as cardiovascular risk at 10 years for both coronary heart disease (CHD) and stroke (p < 0.05). Furthermore, through logistic regression, adjusting for confounding factors, we demonstrated that the STOP-Bang score ≥ 5 is a risk factor for 10-year fatal and nonfatal CHD risk. Conclusions: It is extremely important to screen and diagnose OSA in patients with T2DM, in order to improve the primary and secondary prevention of cardiovascular events in these patients.

Since chronic obstructive pulmonary disease COPD and obesity became global public health challenges, the nutritional status evaluation is more important. How malnutrition and obesity will impact COPD prognosis and treatment is relevant and we considered need a separate approach. The new adiposity based chronic disease concept explains the role played by adiposity, and important studies, like European Community Health Survey ECRHS are highlighting the correlation between adiposity and lung function decline. On the other side, malnutrition decreases effort capacity and impairs the strength of respiratory muscles. Foods, nutrients and dietary patterns are influencing COPD prognosis and Mediterranean Diet, integrated in a healthy lifestyle should be part of COPD management. The important benefic role played by fibers, whole grains, combined with anti-inflammatory and antioxidant effects of fruits and vegetables, together with poly-unsaturated fatty acids PUFA, fish, vitamins and minerals, is detailed below, in contrast with the detrimental role of Western Diet. A multidisciplinary approach in COPD should be considered, integrating lifestyle interventions as important tools in COPD management.

Background and Aims-To evaluate the impact of nutritional intervention on vitamins and minerals from intake food and anthropometric parameters at overweight and obese patients.Material and methods-To a sample of 40 overweight and obese patients we evaluated the nutritional content of food intake (kilocalories, macro and micronutrients). We also measured anthropometric parameters like weight, body mass index, body fat, percent of body fat, abdominal circumference and arterial tension.Results-After the nutritional intervention, overweight and obese patients had significantly lower level of intake carbohydrates (P=.018), lipids (P=.002), B1 vitamin (P<.001), B3 vitamin (P=.02) and E vitamin (P=.016). There is a significantly increased level of proteins (P<.001). Regarding the minerals, we found that the intake levels of following‗s decreased: sodium (P<.001), magnesium (P=.006), zinc (P=.035), copper (P=.002), manganese (P<.001). Phosphorus is the only mineral of which the intake level increased significantly (P<.001). All the anthropometric parameters decreased significantly: weight (P<.001), body mass index (P<.001), body fat (P<.001), percent of body fat (P<.001), abdominal circumference (P<0.001), systolic arterial tension (P<.001), diastolic arterial tension (P=.002).Conclusions-All the patients had imbalanced intake of vitamins and minerals both before and after intervention. There is a significant improved on anthropometric measures after nutritional intervention. We need to promote healthy lifestyle changes to prevent the risks associated with obesity.Keywords: overweight; obese; intake food; vitamins; minerals; anthropometric measures. . Obesity is a major risk factor for type 2 diabetes, cardiovascular diseases (mainly stroke and heart disease), cancer (endometrial, breast, colon), pulmonary diseases, osteoporosis, periodontal diseases. It has numerous consequences on lipid, glucose and protein metabolism with hiperglicemia and insulin resistance, hiperlipidemia and hiperuricemia. Obesity apears as a consequence of imbalance between energy intake (by food) and consumed energy (mainly by phisical activities). Sedentary life and unhealthy meals, riched in energy-dense foods ( high-fat, high sugar, high-salt, micronutrient poor ) are the main problem of the contemporany world.Except the vitamin D, that is synthesized in the human body, in the cutaneous tissue, in response to sunlight exposure [2], all the other vitamins are provided by food intake. There are two types of vitamins-one's that are soluble in fat, like vitamins A, D, E. and K and other's that are soluble in water-like vitamins B1, B2, B3, B5, B6, B12, folic acid. Excess of fat-soluble vitamins can not be eliminated so this vitamins will be stored in human body if the intake level is high and it can lead to simptoms and diseases. The water soluble vitamins are eliminated through kidney or liver and the risk of intoxication is lower and the simptoms occurs rarely.Minerals represent only 4-5 % of body weight but they are very important by p...