Dietary Behaviors and Incident COVID-19 in the UK Biobank

Abstract

Background: Nutritional status influences immunity but its specific association with susceptibility to COVID-19 remains unclear. We examined the association of specific dietary data and incident COVID-19 in the UK Biobank (UKB). Methods: We considered UKB participants in England with self-reported baseline (2006–2010) data and linked them to Public Health England COVID-19 test results—performed on samples from combined nose/throat swabs, using real time polymerase chain reaction (RT-PCR)—between March and November 2020. Baseline diet factors included breastfed as baby and specific consumption of coffee, tea, oily fish, processed meat, red meat, fruit, and vegetables. Individual COVID-19 exposure was estimated using the UK’s average monthly positive case rate per specific geo-populations. Logistic regression estimated the odds of COVID-19 positivity by diet status adjusting for baseline socio-demographic factors, medical history, and other lifestyle factors. Another model was further adjusted for COVID-19 exposure. Results: Eligible UKB participants (n = 37,988) were 40 to 70 years of age at baseline; 17% tested positive for COVID-19 by SAR-CoV-2 PCR. After multivariable adjustment, the odds (95% CI) of COVID-19 positivity was 0.90 (0.83, 0.96) when consuming 2–3 cups of coffee/day (vs. <1 cup/day), 0.88 (0.80, 0.98) when consuming vegetables in the third quartile of servings/day (vs. lowest quartile), 1.14 (1.01, 1.29) when consuming fourth quartile servings of processed meats (vs. lowest quartile), and 0.91 (0.85, 0.98) when having been breastfed (vs. not breastfed). Associations were attenuated when further adjusted for COVID-19 exposure, but patterns of associations remained. Conclusions: In the UK Biobank, consumption of coffee, vegetables, and being breastfed as a baby were favorably associated with incident COVID-19; intake of processed meat was adversely associated. Although these findings warrant independent confirmation, adherence to certain dietary behaviors may be an additional tool to existing COVID-19 protection guidelines to limit the spread of this virus.

Nutritional risk factors for SARS-CoV-2 infection: a prospective study within the NutriNet-Santé cohort

“…Fruit and vegetables indeed provide a mix of these highly relevant compounds for the immune function (as discussed above), and also other bioactive compounds such as polyphenols [ 43 ]. Our findings regarding the consumption of vegetables are consistent with those of the recently published prospective study in the UK-Biobank [ 5 ]. A retrospective study in pregnant women also suggested a moderate effect of fruit and vegetable intake in the prevention of URTI [ 13 ].…”

“…Nevertheless, the outcome assessment in this study was based on self-reported questionnaires collecting SARS-CoV-2 diagnostic tests, and not seroprevalence. On the other hand, a study in the UK-Biobank reported a protective association for higher intakes of coffee and vegetables and higher odds of infection associated with higher intakes of processed meat [ 5 ]. However, this study was conducted only among participants who sought COVID-19 testing, and based on a non-detailed dietary assessment, using a simplified 17-item questionnaire.…”

“…To our knowledge, two prospective studies have examined the prospective link between dietary intakes and the risk of SARS-CoV-2 infection: a Spanish study using a self-reported COVID-19 questionnaire without objective serology data, suggesting a potential protective association with a higher adherence to the Mediterranean diet [ 4 ]. Another study in the UK, used a simplified 17-item food questionnaire, in individuals who voluntarily sought testing by real-time polymerase chain reaction tests (RT-PCR), and suggested a protective association for higher intakes of coffee and vegetables, and higher odds of infection associated with higher intakes of processed meat [ 5 ]. Some studies have explored how intakes (mostly through interventions involving vitamins and minerals such as vitamins A, C, and D or zinc) relate to other respiratory tract infections, including the common cold or pneumonia.…”

COVID‐19 and digestive health: Implications for prevention, care and the use of COVID‐19 vaccines in vulnerable patients

“…In the UK Biobank, the risk of COVID‐19 positivity was lower when consuming vegetables and higher when consuming processed meats. 15 …”

Components of the Mediterranean Diet and Risk of COVID-19

“…Initially micronutrients were mainly analyzed, particularly vitamins (20,21). Afterwards, the antioxidant, antiinflammatory, and antiviral activities of some nutrients and foods have been evaluated (6,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). Less evidence is available for the effect of complete dietary patterns on COVID-19 (4,32,(34)(35)(36)(37)(38), and most published reports on dietary patterns are related to the changes in diet caused by the pandemic or the lockdown.…”