Carmen Piernas and Jordi Merino argue that suboptimal diet and poor metabolic health aggravated the covid-19 pandemic and require greater attention to increase population resilience and reduce health inequalities
The covid-19 pandemic emerged at a time when many countries were already grappling with unprecedented levels of obesity and cardiometabolic disease.1 Underlying poor metabolic health, unhealthy diets, and increased health inequalities compounded the pandemic’s economic, public health, and social burdens.
The initial policy responses reasonably aimed at containing the spread of the virus through restricting movement (lockdowns). However, in the context of suboptimal diets and poor metabolic health, these measures unintentionally imposed additional challenges on people’s lifestyles, with observed trends towards overeating, unhealthy snacking, and increased alcohol consumption across many countries.2 In addition, the pandemic restrictions amplified food insecurity, which further compromised dietary quality, especially among people already living in difficult conditions.3
Even though effective vaccines and treatment advances have significantly reduced covid-19 severity and death rates, a compromised health system during the pandemic has delayed adequate medical care, increasing morbidity and mortality among those with underlying, preventable, and treatable medical conditions.4 We argue that suboptimal nutrition, obesity, and cardiometabolic diseases aggravated the burden of covid-19 and propose preventive strategies that can help mitigate future pandemics.
Early in the pandemic, numerous observational studies reported a high prevalence of obesity and related morbidities among patients admitted to hospital with covid-19.5 Subsequent evidence has confirmed that obesity and impaired metabolic health are strong independent predictors of covid-19 severity (box 1). A systematic review of studies across the world reported with high certainty that a body mass index (BMI) ≥40 is an independent prognostic risk factor for covid-19 severity and mortality.6 Body fat distribution, specifically a higher proportion of adipose tissue around the visceral area, has also been …