Inverse Association Between the Mediterranean Diet and COVID-19 Risk in Lebanon: A Case-Control Study

Abstract

Background: Since 2019, the world is confronting the COVID-19 public health crisis that deeply impacted all aspects of life, from the health sector to economy. Despite the advancement of research targeting pandemic containment measures, more strategies are still needed to alleviate the burden caused by this novel disease. In particular, optimal nutrition was proposed as a possible mitigating factor in the context of COVID-19. Indeed, the light is shed on balanced diets, such as the Mediterranean diet, which present the finest nutritional quality to support the immune system and other physiologic functions. In contrast, less varied diets that lack the needed nutrients and favor inflammation have been correlated with adverse health effects, including a hindered immune response, such as the western diet.Methods: This observational case control study aimed at exploring the possible associations between the different dietary patterns present among a sample of the Lebanese population and the COVID-19 occurrence and outcomes. An online survey collected information about the sociodemographic characteristics, health status, lifestyle, and dietary habits through the Mediterranean diet questionnaire and a semi-quantitative fod frequency questionnaire, and the COVID-19 infection and its burden. The sample consisted of 399 respondents divided into the case and control groups (37.6 and 62.4%, respectively) on the basis of the presence or absence of a COVID-19 infection history.Results: The participants in the case and control groups had average adherence to the Mediterranean diet and their dietary intake was closer to the western diet. However, the cases had a lower mean of the MedDiet score (p = 0.009). Food groups consumption analysis showed that this significant difference within the overall similar dietary patterns was due to a higher consumption of poultry and a trend toward decreased consumption of olive oil and increased read meat and alcohol intake among the cases. Additionally, gender influenced the levels of different foods' consumption. Nonetheless, the dietary intake did not impact the COVID-19 burden.Conclusion: It is recommended to adopt healthy food choices within the different dietary patterns for a better protection against COVID-19. These findings should be validated in larger-scale studies.

Mediterranean Diet a Potential Strategy against SARS-CoV-2 Infection: A Narrative Review

“…An observational case control study explored the possible associations among different dietary patterns and COVID-19 events and outcomes. The results showed that the cases had a lower mean of the MedDiet score (p = 0.009) than controls did, demonstrating an inverse association between the MetDiet and COVID-19 risk [37].…”

Comparative Study Regarding the Adherence to the Mediterranean Diet Among Older Adults Living in Lebanon and Syria

“…In Lebanon, few studies were found to assess the compliance with the MedDiet ( 17 – 19 ). Poor adherence to MedDiet has been found among the Lebanese adult University students ( 20 ) and the adult population during the COVID-19 outbreak and the economic crisis ( 21 ).…”

Dietary Recommendations for Post-COVID-19 Syndrome

“…As for fat intake, a daily intake of 1.5–3 g/day of omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) should be advised to improve inflammation. Interestingly, it has been shown that omega-3 fatty acids might inhibit the viral replication of enveloped viruses—such as COVID-19—possibly reducing the risk of new infections [ 76 ]. Moreover, the consumption of extra-virgin olive oil should be increased to provide adequate intake of monounsaturated fatty acids, tocopherols, and polyphenols, which have demonstrated anti-inflammatory and antioxidant properties [ 77 ].…”

“…Indeed, several studies confirmed the anti-inflammatory and immunomodulatory effects of a Mediterranean diet on several diseases associated with chronic low-grade inflammation [ 108 ]. Interestingly, observational studies highlighted an association between adherence to the Mediterranean diet and better outcomes in patients with COVID-19 (mortality, recovery rate) as well as risk of COVID-19 infection in different populations [ 76 , 109 , 110 , 111 , 112 ] Therefore, it is recommended to consume more plant-based foods (fruit, vegetables, wholegrain, and legumes), high-quality animal proteins (fish, lean meat, poultry, eggs, and low-fat cheese), and extra-virgin olive oil as the principal source of fat [ 113 ].…”