Obesity increases the risk of severe illness from health problems, such as heart disease, diabetes, high blood pressure and certain cancers (according to the Centers for Disease Control and Prevention, more than 2% of U.S. adults are obese). It was already known that obesity can worsen the outcomes from COVID-19, increasing the risk of hospitalizations and death.
According to Dr. Donald Hensrud, director of the Mayo Clinic Healthy Living Program, “One of the most prevalent conditions in this country and around the world is increased weight and obesity… Approximately 70% of Americans are either overweight or have obesity. This is not easy to reverse. There are hundreds of things that influence what we eat, our physical activity and our weight.”
Dr. Hensrud adds, “During COVID-19, we’ve taken previous challenges to managing weight to another level. During the pandemic, fitness centers have been shut down, our activity may be decreasing, or we may be working from home and not moving as much,…”In addition, our diet has changed. We may be eating more comfort food or eating what happens to be around the house rather than getting something that is healthier.”
The core elements for a healthy diet pattern include plenty of nutrient-dense foods that have little added sugars, saturated fat and sodium, such as:
- Vegetables of all types, including dark green; red and orange; beans, peas and lentils; and starchy.
- Fruits, especially whole fruit.
- Grains, at least half of which are whole grain.
- Dairy, including fat-free or low-fat milk, yogurt, and cheese, as well as lactose-free versions, and fortified soy beverages and yogurt, as alternatives.
- Protein, including lean meats, poultry, and eggs; seafood; beans, peas and lentils; and nuts, seeds and soy products.
- Oils, including vegetable oils and oils in food, such as seafood and nuts.
Focus on making small changes and following a diet that is both sustainable and healthy. Following the U.S. Dietary Guidelines, 2020-2025 can help to establish a pattern of eating that is practical, enjoyable, sustainable and can help manage weight.
A recent study presented at the American Heart Association’s virtual Scientific Sessions, sought to shed new light “on the intersection of a global pandemic and the national epidemic of obesity,” said lead author Nicholas Hendren. The research was published simultaneously in the AHA journal Circulation.
Our perception of people hospitalized with COVID-19 has been one of elderly adults … and this study changes that conversation,” said Sadiya Khan, a preventive cardiologist at Northwestern University in Chicago who studies obesity’s effect on heart disease. “Young adults might feel like they’re immune, but this shows if you’re young, obesity is an important risk factor.”
Khan noted that the findings underscore the importance of preventing obese people from contracting the coronavirus, no matter how young.
A large meta-analysis conducted across 75 international studies examined the association of excess weight across the COVID-19 spectrum — from infection to death.
According to Barry Popkin, Ph.D., of the University of North Carolina at Chapel Hill, if you contract the novel coronavirus, “You have more than doubled the likelihood of going into the hospital if you’re obese and 50% more likelihood of dying.”
Popkin note that, “The meta-analysis looked at all stages, from risk of getting COVID, to the risk of hospitalization, going into an intensive care unit, being put on a ventilator, and, finally, dying. What surprised me the most was that obese adults had an additional 113% risk, over normal-weight [and overweight] adults, of going into the hospital. That’s more than double the likelihood, if you’re obese, that you will be hospitalized if you test positive for COVID. Then we found that an additional 74% went into the intensive care unit if they had COVID. But even more scary was that people who were obese had an additional [48%] risk [of death] over the other.”
The pandemic has heightened the already negative effects on individuals’ diets as well as activity patterns. Activity patterns in the US and across the world are down. At the same time the purchase pattern has focused more on shelf-ready, ready-to-eat or ready-to-heat kind of food and sugary beverages. A suggestive likelihood is that important weight gains will be the result during this complex period.
Physicians need to alert people who have gained weight, even if they’re not obese or overweight. Because it’s all a steep slope. Once you start eating differently, it’s very difficult to change that.
Encouragement to eat healthier would certainly be important because it’s going to be diet changes that really address obesity and overweight.
As we celebrate National Nutrition month consider the important role that dietitians may play as the nutrition professional best suited to provide practical and potentially life-saving advice.
In some aspects we are moving in a positive direction with regards to the coronavirus through following appropriate science-based measures to help prevent COVID-19 from affecting us and, in the longer term, through being vaccinated. However, it is important not to lose sight of the potentially negative aspects in terms of morbidity and mortality, particularly for those affected by obesity.
Resource & references
An online resource to help providers, patients is available through the Obesity Society. Go to obesity.org.
Mayo Clinic Healthy Living Program/Mayo Clinic; American Heart Association News;
Access the article, “Large Meta-analysis Digs into Obesity’s COVID-19 Risks” at:
U.S. Dietary Guidelines, 2020-2025: health.gov.
Mark Mahoney has been a Registered Dietitian/Nutritionist for over 35 years. He can be reached at firstname.lastname@example.org.
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