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. 2023 Feb 9;15(4):884.
doi: 10.3390/nu15040884.

Diet-Related Inflammation Is Associated with Worse COVID-19 Outcomes in the UK Biobank Cohort

Longgang Zhao  1   2 , Michael D Wirth  1   2   3   4 , Fanny Petermann-Rocha  5   6 , Solange Parra-Soto  5   7 , John C Mathers  8 , Jill P Pell  9 , Frederick K Ho  9 , Carlos A Celis-Morales  5   10 , James R Hébert  1   2   4
Affiliations

Diet-Related Inflammation Is Associated with Worse COVID-19 Outcomes in the UK Biobank Cohort

Longgang Zhao et al. Nutrients. .

Abstract

Diet, the most important modulator of inflammatory and immune responses, may affect COVID-19 incidence and disease severity. Data from 196,154 members of the UK biobank had at least one 24 h dietary recall. COVID-19 outcomes were based on PCR testing, hospital admissions, and death certificates. Adjusted Poisson regression analyses were performed to estimate the risk ratios (RR) and their 95% confidence intervals (CI) for dietary inflammatory index (DII)/energy-adjusted DII (E-DII) scores. Models were adjusted for sociodemographic factors, comorbidities, smoking status, physical activity, and sleep duration. Between January 2020 and March 2021, there were 11,288 incident COVID-19 cases, 1270 COVID-19-related hospitalizations, and 315 COVID-19-related deaths. The fully adjusted model showed that participants in the highest (vs. lowest) DII/E-DII quintile were at 10-17% increased risk of COVID-19 (DII: RR Q5 vs. Q1 = 1.10, 95% CI 1.04-1.17, Ptrend < 0.001; E-DII: RR Q5 vs. Q1 = 1.17, 95% CI 1.10-1.24, Ptrend < 0.001) and ≈40% higher risk was observed for disease severity (DII: RR Q5 vs. Q1 = 1.40, 95% CI 1.18-1.67, Ptrend < 0.001; E-DII: RR Q5 vs. Q1 = 1.39, 95% CI 1.16-1.66, Ptrend < 0.001). There was a 43% increased risk of COVID-19-related death in the highest DII quintile (RR Q5 vs. Q1 = 1.43, 95% CI 1.01-2.01, Ptrend = 0.04). About one-quarter of the observed positive associations between DII and COVID-19-related outcomes were mediated by body mass index (25.8% for incidence, 21.6% for severity, and 19.8% for death). Diet-associated inflammation increased the risk of COVID-19 infection, severe disease, and death.

Keywords: COVID-19; DII; cohort; inflammation; nutrition.

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Conflict of interest statement

No author discloses a conflict. However, James R. Hébert wishes to disclose that he owns a controlling interest in Connecting Health Innovations LLC (CHI), a company that has licensed the right to his invention of the dietary inflammatory index (DII®) from the University of South Carolina in order to develop computer and smartphone applications for patient counseling and dietary intervention in clinical settings. CHI owns the exclusive right to the E-DIITM. Michael Wirth has a business interest in CHI. The subject matter of this paper will not have any direct bearing on that work, nor has that activity exerted any influence on this project.

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