Is diet partly responsible for differences in COVID-19 death rates between and within countries?

Abstract

Reported COVID-19 deaths in Germany are relatively low as compared to many European countries. Among the several explanations proposed, an early and large testing of the population was put forward. Most current debates on COVID-19 focus on the differences among countries, but little attention has been given to regional differences and diet. The low-death rate European countries (e.g. Austria, Baltic States, Czech Republic, Finland, Norway, Poland, Slovakia) have used different quarantine and/or confinement times and methods and none have performed as many early tests as Germany. Among other factors that may be significant are the dietary habits. It seems that some foods largely used in these countries may reduce angiotensin-converting enzyme activity or are anti-oxidants. Among the many possible areas of research, it might be important to understand diet and angiotensin-converting enzyme-2 (ACE2) levels in populations with different COVID-19 death rates since dietary interventions may be of great benefit.

Allium Flavonols: Health Benefits, Molecular Targets, and Bioavailability

“…We emphasize that the dietary co-administration of the antioxidant-rich foods along with clinical treatments may ameliorate chronic illnesses mediated by heightened free radicals in the body. It has particularly been observed that people with chronic illnesses are more vulnerable to clinical complications and deaths by novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) infections [3][4][5]. The on-going coronavirus disease (CoVID-19) pandemic has forced people across the globe to rethink their nutritional habits, switching to antioxidant-rich foods to avoid chronic illness with stronger immunity [6,7].…”

Food science and COVID-19

“…Recent studies have attempted to explain the highly variable COVID-19 case fatality ratios between countries with at least partially differing dietary habits [ 38 , 39 ]. For example, an examination of the correlation between average consumption of fermented vegetables and COVID-19 mortality across Europe, using information from the European Food Safety Authority Comprehensive European Food Consumption Database found that the national mortality risk for COVID-19 decreased by 35.4% for each g/day increase in the average intake of fermented vegetables such as sauerkraut [ 39 ].…”

Sulforaphane: from death rate heterogeneity in countries to candidate for prevention of severe COVID-19

“…Although many factors are involved in COVID-19 mortality, [5][6][7][8][9][10][11] a recent hypothesis has proposed that differences between countries may partly be explained by diet: the diet of low-death rate countries often includes certain vegetables that are potent anti-oxidants. 12 Two studies have examined the association between the COVID-19 mortality rate in EU countries and diet. Fermented vegetables, head cabbage and cucumber have been associated with lower death rates.…”