The effects of consuming a Mediterranean style diet on associated COVID-19 severity biomarkers in obese/overweight adults: A systematic review

Abstract

Background COVID-19 severity is strongly associated with high Body Mass Index (BMI) (≥25kg/m2) amongst adults and elevated inflammatory markers have enabled prediction of disease progression. The composition of a Mediterranean diet provides favourable outcomes on weight reduction and inflammatory markers. Aim This systematic review aimed to investigate the effects of consuming a Mediterranean diet on BMI and inflammatory markers of obese/overweight adults (≥18 years) at risk of developing severe COVID-19 outcomes. Methods PubMed Central, Cochrane Library and MEDLINE databases were searched to identify randomised controlled trials published between January 2010 to August 2021 evaluating the impact of Mediterranean diet on BMI and inflammatory markers in overweight/obese adults. The review followed the PRISMA checklist, used Cochrane Collaboration search strategies, and is PROSPERO registered (CRD42021277070). Two authors independently screened and evaluated studies for methodological quality. Papers were extracted and included based eligibility, despite risk of bias scores. Results Of 65 extracted records, six studies met the eligibility criteria and were included. Reductions in BMI, TNF-α, IL-6 and hs-CRP were reported amongst most findings, the majority of which were significant. Conclusion The main findings indicate a hypocaloric, fibre dense Mediterranean diet is a short-term (<4 months) mitigation strategy to significantly reduce BMI and inflammatory markers amongst overweight/obese adults at risk of developing severe COVID-19 outcomes. Further research is now needed to examine the role of Mediterranean diet in COVID-19 prevalence, severity, morbidity and mortality.

Scientific evidence supporting the newly developed one-health labeling tool “Med-Index”: an umbrella systematic review on health benefits of mediterranean diet principles and adherence in a planeterranean perspective

“…MedDiet also showed a correlation with inflammation in Dos Reis Padilha’s report [ 75 ], but only in cross-sectional studies. Instead, decreases in BMI, TNF-α, IL-6, and CRP, most of them significant, were reported in the reports by Moore [ 19 ] on the population with overweight or obesity. Analysis of randomized, prospective studies by Genel [ 57 ] showed that a low-inflammatory diet such as MedDiet is associated with greater weight loss, greater decreases in inflammatory biomarkers, greater improvement in measures of pain, and greater improvement in measures of physical function than the usual diet.…”

“…The Mediterranean diet appeared to be more strongly protective for Alzheimer's Disease than for all-cause dementia. A small improvement in cognitive function in response to a Mediterranean style diet was found No Moore E et al [ 19 ] 2022 6 RCT PubMed Cochrane Library MEDLINE Body Mass Index TNF-α Interleukin-6 NR The main findings indicate a hypocaloric, fiber dense MedDiet to be a short-term (< 4 months) mitigation strategy to significantly reduce BMI and inflammatory markers amongst overweight/obese adults. Results demonstrate that TNF-α, have been significantly reduced over a 3–4-month MedDiet intervention for overweight/obese adults.…”

“…Regarding the effect of MedDiet on inflammatory status, we collected one report on Platelet-Activating Factor (PAF) [ 73 ], three on TNF-alpha [ 19 , 74 , 75 ], seven reports on interleukin-6 (IL-6) [ 19 , 41 , 49 , 57 , 74 , 75 , 90 ], and seven on C-reactive protein (CRP) [ 38 , 41 , 49 , 52 , 74 , 84 , 90 ], showing all beneficial results of Mediterranean diet pattern.…”

Relevance of Mediterranean diet as a nutritional strategy in diminishing COVID-19 risk: A systematic review

“…Another relevant finding was that the adoption of a Traditional Mediterranean Diet contributed towards to the improvement of patients with recurring colds and frequent inflammatory complications, with significantly reduced episodes and symptoms [27]. A previous systematic review found that Mediterranean diet was reported to lower inflammatory biomarker levels in obese/overweight adults [28]. Similarly, a precedent meta-analysis reported Mediterranean diet adherence effectively reduce SARS-CoV-2 infection by 78% (95% CI 69%–88%), although the authors recommended cautious interpretation due to the paucity of the included studies [29].…”

“…Participants were divided into tertile groups based on their MDS. inflammatory biomarker levels in obese/overweight adults [28]. Similarly, a precedent meta-analysis reported Mediterranean diet adherence effectively reduce SARS-CoV-2 infection by 78% (95% CI 69%-88%), although the authors recommended cautious interpretation due to the paucity of the included studies [29].…”